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OCCUPATIONAL HEALTH DISPARITIES

different populations

Activities: NIOSH Research Projects

The research dollars invested in projects related to special populations topics are shown in Figure 1. Based on this graph, other than a large upsurge following the initiation of NORA and a spike in funding following the 1999 NORA solicitation, there has been a steady increase in extramural funding of about 3 to 4 million dollars per year and in intramural funding of 2 to 3 million dollars per year over the pre-NORA funding levels. This increase does not include the 2 to 3 million dollars of funding for extramural projects funded by NIH focusing on occupational exposures under the partnered Environmental Justice and Health Disparities programs.

Intramural Projects

A Participatory Intervention Program for Homecare Workers

This is a 5-year community-based participatory research project that will develop and evaluate a model intervention program for one large population of predominately female low-income, minority and immigrant home care workers (HCWS) in Alameda County, California. The focus of the intervention will be the development of an interactive checklist and accompanying educational materials aimed at improving awareness and knowledge about safety and health risk factors and improving the ability of HCWs, their consumers, social workers, and others to identify simple, available interventions. The target population is multilingual (English, Spanish, and Chinese) and of low literacy level. The project will use a combination of qualitative and quantitative methods to gather information about HCW safety and health needs and available materials and resources to address those needs. NIOSH investigators will construct a prototype of a checklist using information from focus groups, key informant interviews, and observational site visits. Community outreach workers using peer education techniques will field test the efficacy of the intervention materials with other HCWs and consumers. The completed checklist will be evaluated using a randomized experimental design to examine the HCWs’ and their consumers’ improvement in safety and health awareness and ability to identify and change hazards in the work environment utilizing the checklist materials.

Contact: Sherry Baron
Division of Surveillance, Hazard Evaluation, and Field Studies
(513) 458-7159

Occupational and Health Disparities

Numerous large-scale prospective population-based epidemiologic studies have been established to examine a broad array of social, behavioral, physiologic, and genetic determinants of health disparities for several potentially work-related diseases such as cardiovascular disease, mental illness, arthritis, and chronic back conditions. Although these studies are well suited to the examination of population-based health disparities due to the racial, ethnic, gender, and socio-economic diversity of the study populations, occupational information obtained from participants is generally confined to job title. This lack of occupational information limits our ability to examine empirically the role of occupational factors on racial and ethnic disparities in health and impedes our ability to identify modifiable workplace factors that could be targeted for health prevention activities.

To better understand current practices in the measurement and analytic treatment of occupational variables in population-based health research, NIOSH is conducting a systematic review of federally funded population-based cardiovascular epidemiology studies. To identify studies for this review, a search was conducted of the biomedical database CRISP (Computer Retrieval of Information on Scientific Projects). The search criteria were study dates (current or recently completed as of 1/1/2000), health end-points (cardiovascular disease), and study design (population-based epidemiology study). For each study identified for review, we retrieved data dictionaries or comparable information sources from the selected studies to identify current practices used to measure occupation. Study publication lists were obtained and journal articles were selected for review if work-related issues were examined. A manuscript was prepared (in review) for publication that presents a review of the state of the science concerning the measurement and analytic treatment of occupation-related variables in population-based cardiovascular disease studies.

During FY06, we finalized the study manuscript and initiated manuscript peer review. An abstract of this work was presented at the Society of Epidemiologic Research (SER) Conference in June, 2006. Due to the interest of external partners (NIH/OBSSR, NHLBI, CDC SES Measures Work Group) in our review and the review findings, we envision involving these partners in the manuscript review process (post-peer review) and engaging them in ongoing discussions via conference calls about “best practices” for the measure of occupation in population-based studies, as well as barriers and opportunities to their implementation. We hope that involving these partners will encourage the development of new funding initiatives in future years that may focus on convening experts from public health and occupational health to guide the measures of occupation used in population-based studies and/or focus on providing supplemental funding for one or more ongoing population studies to include a module of occupational measures in one or more rounds of future data collection.

Contact: Leslie MacDonald
Division of Surveillance, Hazard Evaluation, and Field Studies
(513) 841-4529

Mortality, Cancer Incidence, and Biomarker Studies

These studies are being conducted to elucidate exposure-outcome relationships, especially dose-response relationships for risk assessment, and to examine relationships between biomarkers (of exposure, susceptibility, and oncogene expression) and cancer outcomes. More than half of all dry-cleaning workers are women, and more than half of these women belong to minority and/or immigrant groups. In “mom-and-pop” family-staffed shops, children may be on site all day. NIOSH has documented the causes of death in a cohort of dry cleaners, including an increased risk of death from cervical cancer and dry cleaning chemical, fire, and ergonomic risks. NIOSH has also shown how those risks might be reduced by upgrading equipment and explored the attitudes of dry-cleaning workers and owners toward the risks. (Other studies are also being done through this project that do not involve priority populations.)

Contact: Avima Ruder
Division of Surveillance, Hazard Evaluation, and Field Studies
(513) 841-4440

Overcoming Barriers to Occupational Safety and Health in Priority Populations

This project is the coordination project for a NORA research program on Overcoming Barriers to Occupational Safety and Health in Priority Populations, including low-income, minority, immigrant and/or older workers. This project will provide the coordination and integration of quantitative and qualitative data collected across four research projects. It will examine the role of multilevel factors in creating barriers to effective safety and health programs including 1) individual-level factors such as language, literacy, previous knowledge and experience regarding occupational safety and health; 2) workplace-level factors including provision of tools and training, management commitment to safety and health, and supervisor and coworker social support; and 3) societal-level factors such as discrimination, policies regarding undocumented immigrants, and the overall economic prospects that allow workers to find alternative employment. The project will also analyze a variety of existing surveillance data sources to better describe the work and health of priority working populations. Finally, the project will improve coordination and dissemination of project outcomes as well as consultation with outside experts, promotion of improved training on research methodology for priority populations among internal NIOSH staff, and dissemination of findings through national workshops and NIOSH and peer-reviewed publications.

Contact: Sherry Baron
Division of Surveillance, Hazard Evaluation, and Field Studies
(513) 458-7159

Health Survey of Minority Farm Operators

This project is interdivisional and involves collaboration with another federal partner. The farm operator survey was conducted through an interagency agreement between NIOSH and the USDA National Agricultural Statistics Service (NASS), and in collaboration with DSR. As this is a surveillance project, no specific hypotheses were proposed; however, the goal of describing the occupational health problems of farm operators was planned. Data were collected in 2000 and FY2006. Planned data collection includes telephone interviews with approximately 25,000 farm operators that will include several questions on hazardous exposures, barriers to using hearing protection, and pesticide-related illness. The 2000 Minority Farm Operator Occupational Health Survey was conducted by USDA/NASS on behalf of NIOSH. A stratified simple random sample of farm operators from 50 U.S. states was selected for telephone interviews via USDA’s Computer Assisted Telephone Instrument (CATI) system. Stratification was based on gender, race, and ethnicity. Hispanic/Latino, minority, and female farm operators were oversampled to increase the corresponding sample size. Because of a low response rate, an additional sample of Latino farm operators from California, Arizona, New Mexico, and Texas were selected for face-to-face interviews to further increase the sample size. Weight was calculated for each stratum from observed sample size and USDA/NASS 1997 Census of Agriculture.

Activities during FY06 have concentrated on data analysis and preparation of the primary paper. Data analyses conducted thus far include calculations of estimated national prevalence of general health conditions, hearing loss, and mental health symptoms by gender, race, and ethnicity. Investigators have been working with Dr. Carles Muntaner from the University of Toronto on analyses and discussion of health disparities. Papers for publication include a general summary of survey results with an emphasis on health disparities and several papers focused on key health issues such as mental health and hearing loss. The primary paper presenting estimated national prevalence of health conditions by racial and ethnic group was completed and submitted for review to the branch, a statistical colleague in DSR, and to our collaborators at the USDA/NASS. The paper is being revised based upon recommendations received and will be submitted for clearance and external review shortly.

In collaboration with NASS, a summary will be written and information may be placed in the NIOSH Chartbook and on the USDA/NASS website. Two faculty members from the University of Texas Center for Health Promotion and Prevention Research are working on applying the process of Intervention Mapping (a theory- and evidence-based method for planning, implementing, and disseminating health promotion interventions) based on results of this study. The consultants selected barriers to the use of hearing protection as a primary example due to the high percentage of self-reported hearing loss by farm operators in this survey (34%). The consultants have the opportunity to analyze questions on barriers to the use of hearing protection included in focus groups held by the National Center for Farmworker Health. Findings will be disseminated to USDA/NASS constituents and through scientific publications. Translations will be done to disseminate information to Spanish-speaking groups who represent the populations surveyed. Data analysis and writing of papers will continue in FY06-FY08. New data collected in FY06 may not be available from NASS for analysis and dissemination until FY07-FY08.

Contact: Toni Alterman
Division of Surveillance, Hazard Evaluation, and Field Studies
(513) 841-4210

National Agricultural Workers Survey (NAWS) Health Surveillance

This project provides ongoing occupational health surveillance of hired farmworkers. As this is a surveillance activity, there are no specific hypotheses. Rather, this is a continuation of efforts to collect descriptive information on the working conditions and health of hired farmworkers, with a shift in focus to psychosocial factors and mental health. The National Agricultural Workers Survey (NAWS) is a national survey of farmworkers in crop agriculture conducted by the Department of Labor (DOL). The NAWS collects data on demographics, legal status, education, family size, wages and working conditions, and participation in the U.S. labor force. In 1999, NIOSH funded an occupational health supplement to the NAWS. Data collection has been reduced in subsequent years. This project is conducted through an interagency agreement with the Employment and Training Administration (ETA) at the Department of Labor. Mental disorders account for approximately 25% of all disabilities in the United States and are a leading cause of premature death. They represent not only an immense psychological, social, and economic burden to society, but also increase the risk of physical illnesses. Based upon previous research and recommendations from a meeting of national and international experts held in 2004, an occupational health supplement was piloted in FY2006. A revised supplement may be added to the National Agricultural Workers Survey (NAWS) for FY07-FY08. This study will be the first to provide prevalence estimates of mental health problems in a nationally representative sample of hired farmworkers, along with descriptive information on work organization and psychosocial factors experienced. Results can be used for monitoring farmworker health and targeting farmworkers most at risk for poor health because of their work. Prevalence data can also be used to measure the impact of interventions or changes in policy. The supplement includes questions on job insecurity, working conditions, structure of work and job stress (demand/control), work-family concerns, mental health, general health, and work limitations. In FY06, items were selected, translated, and tested with hired farmworkers. Revisions were made and piloting of the new questions began in March 2006. Pilot data was provided by DOL in August 2006. External partners with expertise in occupational and social epidemiology, health disparities, Latino culture, and farmworker health and migration include Dr. Joseph Grzywacz, Wake Forest University School of Medicine; Dr. Carles Muntaner, Chair, Department of Psychiatry University of Toronto; and Jorge Nakamoto, cultural anthropologist, Aguirre International. Our partner at the DOL is Daniel Carroll, Senior Policy Advisor in the Education and Training Administration.

Surveillance data from this project will be included in the next NIOSH Worker Health Chartbook. In FY2006, a surveillance document containing national prevalence estimates of health symptoms, working conditions, exposures, field sanitation, use of personal protective equipment, and pesticide training was sent for formal external review. Analyses were conducted on hired farmworker women. A paper was published in FY2006 in the Journal of Agricultural Safety and Health (May 2006), Occupational Health Survey of Farm Workers by Camp Health Aides. The finalized supplement may be administered in FY07-FY08. Once a data set is received, additional papers for publication will be written. In FY07-FY09, DOL will work with NIOSH to prepare a public use data set that will be made available to researchers.

Contact: Toni Alterman
Division of Surveillance, Hazard Evaluation, and Field Studies
(513) 841-4210

Childhood Agricultural Injury Surveillance

In fiscal year 1997, Congress provided funding for NIOSH to implement the Childhood Agricultural Injury Prevention Initiative. The goal of the initiative is to reduce the risk of fatal and nonfatal injuries to children who live on, work on, or visit farms. Since inception of the NIOSH Childhood Agricultural Injury Prevention Initiative, NIOSH has applied a triad approach of surveillance, research, and information dissemination. This project is designed to encompass the nonsurveillance components of the initiative. Activities within this project include (1) assuming a leadership role in federal efforts to prevent childhood agricultural injuries; (2) assisting in the development of a grant/cooperative agreement program to stimulate research and the use of empirical data to reduce agricultural injuries to children; (3) eliciting feedback from stakeholders on progress of the Initiative and strategies or ideas for improving research and prevention efforts; (4) providing technical and programmatic assistance to the National Children's Center for Rural and Agricultural Health and Safety; and (5) serving as a liaison for NIOSH research activities in order to achieve wide dissemination of research results to childhood agricultural safety and health practitioners.

The research component is primarily conducted through an extramural grant program. To date, NIOSH has funded 31 extramural research projects under the initiative, encompassing a range of areas identified as priorities by external constituents and partners. These research areas include examining injury etiology, rigorous evaluations of commonly available childhood educational or training programs to determine effectiveness in influencing safety and health behaviors to prevent agricultural injuries and illnesses among children and adolescents; developing new or enhancing existing control technologies to reduce injury to youth exposed to agricultural production hazards; promoting a better understanding of the magnitude and scope of childhood agricultural injuries and illnesses; evaluating the effectiveness of community-based interventions in reducing childhood agricultural injury and disease; evaluating incentives that encourage adults to protect youth from farm hazards; and identifying the economic and social consequences of youth working on farms.

In the first year of the Initiative, NIOSH funded the National Children’s Center for Rural Agricultural Health and Safety (NCCRAHS). The Center is designed to help translate research into commonly understood concepts or terms for parents and practitioners, and to provide the latest up-to-date information on childhood agricultural injury prevention to stakeholders. Examples include posting the latest NIOSH/USDA surveillance information on the Center’s website,, disseminating promising research findings, and translating research findings into plain and easy to understand language for practitioners and farm families. This has resulted in development of the North American Guidelines for Children’s Agricultural Tasks (a developmental-based guide for work tasks for youth), an action plan for addressing Migrant and Seasonal Adolescent Farmworkers, Creating Safe Play Areas on Farms (to address the majority of youth who are injured on farms while not working), and the promotion of promising research interventions for agricultural youth injury prevention. A public awareness campaign is being developed for youth in agriculture. This Childhood Agricultural Safety Public Awareness campaign is being led by the NCCRAHS with support of the Childhood Agriculture Safety Network (CASN). Three topics selected to be presented in an ongoing public awareness campaign were 1) youth and tractors, 2) ATVs and youth, and 3) safe play areas. The NCCRAHS also seeks to work with internal and external partners and stakeholders to address and implement the recommendations from the 2001 Childhood Agricultural Injury Prevention Summit and the 1996 National Action Plan. The ultimate goal of the project is to facilitate and enhance federal efforts to reduce childhood agricultural injuries.

Contact: John Myers
Division of Safety Research
(304) 285-6005

Childhood Agricultural Injury Prevention

NIOSH has developed a surveillance system that is centered on relationships with the National Agricultural Statistics Service (NASS) and the U.S. Department of Labor (USDOL). NIOSH has to date conducted six farm operator surveys with NASS to estimate injuries to children living, working on, or visiting farms: Childhood Agricultural Injury Surveys (CAIS), covering all farming operations, were conducted for 1998, 2001, and 2004; Minority Farm Operator Childhood Agricultural Injury Surveys (M­CAIS), covering racial and ethnic minority farms, were conducted for 2000 and 2003; and a farm hazard survey covering all farming operations was conducted in FY2006. The 1998 CAIS results were released in FY2001. The preliminary results from the 2001 CAIS were released by NASS in FY2004. A NIOSH brochure highlighting results of the 2001 CAIS was released in FY2005. Complete results will be release in FY2007. For the 2004 CAIS, a brochure highlighting results was released in FY2006. The CAIS will be conducted in years ending in 0 and 5. For the 2000 M-CAIS, four brochures highlighting results were released in FY2004 and two volumes of a statistical abstract were released in FY2006. The final two volumes will be released in FY2007. Data collection for the 2003 M-CAIS occurred in FY2004, with results scheduled for release in FY2007. The M-CAIS will be conducted in the years ending in 4 and 9. A Web-based data retrieval system (Ag-RISQS) for the CAIS and M-CAIS should be available in FY2007. Data from the farm hazard survey, conducted in FY2006, are scheduled for release in FY2008. NIOSH continues collaborating with the USDOL on the National Agricultural Workers Survey (NAWS) youth farm worker injury module to assess farm injuries to workers under 20 years old. NAWS data collected from fiscal years 2001 through 2004 were analyzed in FY2006. NIOSH plans to continue exploring collaborative opportunities with USDOL for future NAWS efforts. NIOSH will also continue reporting childhood agricultural injury data available from other surveillance systems. An analysis of data from the Consumer Products Safety Commission's National Electronic Injury Surveillance System (NEISS) for the years 2000-2003 will be published in FY2007. An analysis of youth farm fatalities in the Bureau of Labor Statistics' Census of Fatal Occupational Injuries (CFOI) surveillance system was accepted for publication in FY2006. As of FY2006, this project has produced 40 publications, with 11 more expected in FY2007. The 40 completed publications include: eight NIOSH brochures directed at farm operators; three NASS fact sheets directed at the news media and general public; seven NIOSH surveillance documents containing results targeted at researchers and other health professionals; and 22 peer-reviewed journal articles or conference papers directed at researchers and health professionals. Surveillance data from this project are being used by extramural researchers to assess issues such as the impact of proposed changes to Child Labor Hazardous Orders, the possible impact of guidelines for assigning work to household youth on farms, and the assessment of farm tractor use by youth on farms. Furthermore, these surveillance data are being reported by nationally recognized youth injury prevention groups as the best measure of childhood agricultural injury burden in the United States. NIOSH will continue to provide increased access to these surveillance data to extramural partners in FY2007.

Contact: David Hard
Division of Safety Research
(304) 285-6068

A Faith - Based Stress Interventions for African Americans

The goals of this project are to: (1) Design a culturally tailored occupational stress intervention for working African Americans in partnership with a local faith-based organization (FBO) and to (2) Test the intervention with members of the target audience to evaluate the extent to which it improves OSH knowledge, impacts behavioral intentions, and increases efficacy in preventing and/or managing work-related stress.

In Phase 1 of the project (FY06), NIOSH is designing a culturally innovative occupational stress intervention for working African Americans in partnership with a local faith-based organization (FBO) in consultation with the University of Cincinnati experts. In Phase 2 (FY07), the FBO will deliver and test the intervention with members of the target audience to evaluate the extent to which the intervention improves OSH knowledge, impacts behavioral intentions and increases efficacy in managing work-related stress. Participants are expected to report pre- to post-intervention gains in OSH knowledge, in behavioral intentions related to use of new knowledge and skills, and perceptions in efficacy to address work-related stress.

This 2-year pilot project brings together NIOSH and University of Cincinnati researchers and members of an FBO to develop and test a culturally tailored occupational stress intervention. Formal expertise in stress management and African American health together with the FBO’s local knowledge of the cultural communication, beliefs, preferences, and understandings of its community will ensure that such a product is successfully developed and tested. Further, the project will generate an effective partnership model for working collaboratively with FBOs, an identification of effective strategies for reaching African American workers, and strengthened FBO capacity to provide OSH or other health interventions to its community.

Contact: Rashaun Roberts
Division of Applied Research and Technology
513-533-8346

Assessing the TB Education Needs for Hispanic Immigrant Workers

This proposal will build upon previous work by the investigators that established the feasibility of the proposed recruitment strategies and qualitative data collection methods with Hispanic immigrant workers. This project will interview Hispanic immigrant workers and their employers to accomplish the following specific goals: 1) To better understand the factors that would motivate the employers of Hispanic immigrant workers to provide TB-related training for their workers. 2) To better understand how to meet the training needs specific to the many small businesses that employ Hispanic immigrant workers. Both goals will be met by interviewing employers of Hispanic immigrant workers (half from small businesses) regarding their willingness to provide TB education for their workers and about their training needs and preferences. 3) To better understand Hispanic Immigrant Workers’ knowledge of and attitude toward TB. Focus groups will be conducted with HIW from a broad range of industries. Participants will discuss their levels of knowledge, health beliefs, attitudes and cultural practices related to TB. The participants will be recruited through the Coalition for the Dignity and Rights of Immigrants, an advocacy group serving the local Hispanic community. 4) To better understand the factors contributing to TB test seeking and treatment adherence among Hispanic immigrant workers. The increasing incidence of multi-drug resistant tuberculosis (MDR-TB) presents a significant public health concern. MDR-TB results when individuals who are infected with tuberculosist begin but do not complete the course of treatment. Preliminary interviews with the Hamilton County TB Control Program indicated that there were significant numbers of HIW in the area who have tested positive on TB skin testing, but who did not return for follow-up tests. Working with the Hamilton County TB Control Program and other agencies/groups serving the local Hispanic community, we hope to identify three cohorts of individuals (1) Hispanic immigrant workers who had an initial positive skin test reaction (PPD+) and did not seek further tests, 2) Hispanic immigrant workers who started treatment for TB (active or latent) but did not complete treatment, and 3) Hispanic immigrant workers who completed treatment TB (active or latent)] to identify factors, which if addressed, could increase treatment follow through. 5) To develop recommendations for the development of TB educational materials for Hispanic immigrant workers and their employers.

The findings from the informational interviews with employers conducted for Specific Goals 1 & 2, the focus groups conducted for Specific Goal 3, and the interviews with individuals who tested positive for TB that were conducted for Specific Goal 4 will be reviewed by a panel comprised of the researchers, other NIOSH subject matter experts, the project consultants, and representatives from our community partners to generate recommendations for the development of the following:

  • TB educational materials targeted at the employers of Hispanic immigrant workers,
  • Strategies to meet the training needs of small businesses that employ Hispanic immigrant workers,
  • Spanish-language TB education materials tailored to meet the needs of Hispanic immigrantworkers.

The actual development and evaluation of the TB education materials for both employers and Hispanic immigrant workers is beyond the scope of the current study. Project timeline: Year 1 – Clearance; Year 2 – Complete clearance and data collection for Specific Goals 1, 2, 3 & 4; Year 3 – Specific Goal 5, dissemination of results.

Contact: Donald Eggerth
Education and Information Division
513-533-8505

Biomechanical and Physiological Study of Firefighter Boots

This project is a laboratory study which will be conducted over a two-and-one-half-year period. Twenty-five female and 25 male career or volunteer firefighters will be recruited and tested for physiological and biomechanical responses while performing several simulated firefighting tasks (e.g., climbing a ladder, carrying a charged hose line, and dragging a 165-lb dummy) in the laboratory. Subjects’ physiological responses will be determined by metabolic and respiratory variables including energy expenditure, minute ventilation, and peak flow. Standard anthropometric measurements will be recorded of the lower extremity and foot for both genders. Subjects’ biomechanical responses in performing simulated fire fighting tasks will be determined by examining their whole-body center-of-mass movements as well as joint loadings (e.g., joint forces and moments). The Human Factors Laboratory of the Protective Technology Branch, Division of Safety Research is considered to be a state-of-the-art motion analysis facility, and the DSR staff involved is uniquely qualified to conduct this research.

This laboratory-based study will provide important outcomes which are expected to impact emergency response and fire department workers, emergency response and firefighter boot manufacturers, and the US national standards setting body responsible for oversight of structural fire fighting policy (NFPA). The long-term goal is to provide much needed biomechanical and physiological data to the NFPA 1971 standards committee so they may revise and update their standards for protective ensembles for structural fire fighting.

Contact: Shiowyi Chiou
Division of Safety Research
304-285-6029

Community Partners for Healthy Farming Intervention Research

The Community Partners for Healthy Farming Intervention Research (CPHF-IR) program provides substantial technical input from multiple NIOSH Divisions to evaluate new or adapted interventions for reduction of farm-related injuries, hazards, and illnesses. These projects are selected from proposals submitted in response to a RFA’s. A total of 13 projects were funded in the prior two series (1996-1999 and 1999-2003). As required in the RFA, each extramural project has a strong evaluation component and has formed partnerships between researchers, local communities, workers, managers, agricultural organizations, agribusinesses, and other stakeholders who provide unique resources and collaborate in every aspect from inception through evaluation and dissemination. NIOSH technical liaisons and advisors provide selected technical expertise and consultation on project development, electronic formatting of educational materials, human subjects compliance, implementation, dissemination and evaluation with individual awardees. In FY2003 a new, third series of 4-year projects (2004-2007) were selected. Funded activities involve nine states (CA, IA, IL, IN, MN, MI, OH, OR, WI). The Certified Safe Farm (CSF) project is utilizing health insurance claims data (not workers’ compensation) of Iowa Farm Bureau members to evaluate the impact of the CSF program, a unique access to data for all industries. Two ergonomic interventions projects are expected to enhance production in nursery operations in Midwest and significantly reduce identified ergonomic risk factors among hand-harvesters of tree-fruit crops in California. The fourth project is evaluating the effectiveness of specially-designed, computer-based safety training in Hispanic vineyard workers with no prior English or computer use expertise. The first three are outgrowths of prior series of CPHF-IR projects and a fourth builds of educational tools previously piloted among Hispanic nursery workers with limited education. This c- TRAIN system replaces the keyboard with a 9-button input device and is expected to enhance training while reducing costs for small operations and be transferable to other industries. In collaboration with partners, researchers have collected baseline data, assessed needs, and piloted selected interventions. In FY2007, the final year of this series, the projects will continue implementing selected interventions, collect post-intervention data, analyze results and begin disseminating findings and products. In 2005 a compendium of 40 formally evaluated training curriculums, promotional programs, and publications as well as outcomes of completed Community Partners projects was published (Ehlers and Palermo). Simple Solutions: Ergonomic Solutions for Farm Workers, NIOSH pub. No. 2001-111, an outgrowth of Community Partners and other NIOSH agricultural initiatives continues in demand with over 80,000 copies disseminated in collaboration with current and prior Community Partners projects. Cooperative agreement funding enhances collaborative learning and resource utilization, between NIOSH and awardees, and intradivisional collaboration of technical advisors. NIOSH promotes collaboration between the CPHF projects, other NIOSH-funded intramural and extramural projects, e.g. Agricultural Centers, and with appropriate stakeholders. NIOSH organized meetings of Community Partners extramural partners at the annual conference of the National Institute for Farm Safety in British Columbia, Canada; maintains a list-serve; updates and distributes tables describing the projects with contact information; provides multimedia expertise via consultations, and maintains a CPHF website with links to the extramural project websites. At the NORA Symposium (2006), the evaluation method for their social marketing project was presented by the extramural principal investigator at a plenary session and a poster over viewing the Community Partners program by the NIOSH liaison. In FY 2007, (1) small purchase order contracts will be used to further the dissemination of Simple Solutions to selected audiences, (2) staff will collaborate to evaluate and disseminate NIOSH documents on noise-induced hearing loss among farmers 15-30 years of age, and (3) summarize information from the NIOSH-funded surveillance activities under the Occupational Health Nurses in Agricultural Communities cooperative agreement program.

Contact: Janet Ehlers
Division of Surveillance, Hazard Evaluations, and Field Studies
513-841-4205

Core OSH Training for New/Young Workers

In FY 2003, NIOSH convened a multidisciplinary working group to select and refine the best of the existing OSH curricula and methods for use as a national foundation curriculum for youth. This curriculum currently consists of six modules: 1) understanding new and young worker risk of workplace injuries; 2) recognizing and finding hazards; 3) controlling workplace hazards by making jobs safer and working safety; 4) your roles in dealing with emergencies at work; 5) know your rights; and 6) taking action: getting the information you need and communicating with your boss and co-workers. All modules contain guidance for teachers as well as a variety of activities that are designed to be used in a participatory, interactive manner within classrooms. The curriculum was evaluated during 2005/6 in 16 schools across 10 states through a partnership with the National Association of State Directors of Career Technical Education (NASDCTE). The evaluation determined the effectiveness of the curriculum in improving health and safety knowledge, skills, and work practices. During 2006/7, the foundation OSH curriculum was modified as appropriate for all 50 states and Puerto Rico. It is now being prepared for dissemination via website and CD-ROM to other states, schools, training programs, junior colleges, or appropriate training venues. This intervention effectiveness study employs quasi-experimental methods. States self-selected to participate and stratification was used to ensure that representative schools participated with varying demographics including urban and rural environments, considerations of ethnic and cultural diversity, and various socioeconomic strata associated with school districts. The curriculum was taught by existing high school teachers within their current career clusters programs. A contracted coordinator arranged for teacher training and served as a support person and quality control evaluator to school districts utilizing the curriculum. Students participated as part of their existing career exploration or vocational programs, thus no special permissions were needed. The research protocol qualified for exempted NIOSH approval because all data collection occurred in existing educational settings according to established school procedures. Assessments included routine tests and quizzes to assess knowledge gain, demonstrations of skills, critical thinking, and problem solving, and scores on other assignments as given by the teachers. Longitudinal follow-up of students' workplace experiences is desirable and the feasibility of doing this through collaborations with teachers and guidance counselors is being explored. A representative sample of teachers was invited to participate in a qualitative process assessment of the program through a focus group.

Contact: Carol Stephenson
Education and Information Division
513-533-8581

Development of Epidemiologic Research Methods

The goal of this project is to develop appropriate methods and computer programs to analyze epidemiologic studies and update cohort master files, and to create incidence and mortality rate files for use in epidemiologic analyses. These methods, programs and rates are used by researchers worldwide in the conduct of etiologic epidemiology research. This methods development project realizes outcomes that indirectly benefit worker health, by providing tools for the evaluation of health hazards. The elucidation of these hazards may lead to changes in the workplace, for example, in reducing worker exposures or in providing incentive for the development of new control technologies.

NIOSH LIFE TABLE COMPUTER PROGRAM. The NIOSH Life Table Analysis System (LTAS) is used by hundreds of researchers within and outside of NIOSH to analyze occupational cohort studies. Half the registered users of LTAS reside outside the U.S. A conversion of LTAS to a Windows-based platform has been nearly completed and will be made available to users within and outside of NIOSH.

RATE FILE DEVELOPMENT. NIOSH maintains a number of mortality rate files stratified by age, race, sex, and calendar time. These files must be continually updated with new mortality and population data. These files include county-, state-, and nationallevel mortality rate files made publicly available through CDC. In addition, special rate files for mortality and cancer incidence must be updated continually. New International Classification of Diseases (ICD) codes must be incorporated when appropriate, such as when new ICD revisions occur, or when old ones are modified (e.g., use of the ICD-10 revision beginning in 1999).

EPIDEMIOLOGIC DATABASE MANAGEMENT SYSTEM (EDMS) AND AUTOMATED UPDATE OF COHORT FILES. EDMS was created to provide a relational database platform for epidemiologic study data. This system allows more-detailed information to be stored with increased accessibility to researchers than has been previously possible. Vital status of cohorts is determined via several national sources. Information from these sources needs to be electronically, rather than manually, applied to cohort files. Furthermore, demographic information such as names, addresses and dates of birth need to be incorporated automatically. Such programs have been developed and are continually being revised as new databases and technologies become available.

In FY06: 1) LTAS.NET: Methods used to develop LTAS.NET were presented at a statistical conference. A user manual was written, and the program algorithms were extensively validated in SAS and beta-tested by internal and external users. 2) Rate files with data through 2003 were updated, and a manuscript was published on ICD-10 rates. Special rate files were created as requested by researchers. 3) EDMS continued as the production system for IWSB mortality and incidence studies and for worker notification, with 17 current studies, including the extensive updates of the Beryllium cohort. Ongoing maintenance included upgrading the data entry system to the current software version, improving the reporting system, and training additional IT staff to use the system.

For FY07: 1) LTAS.NET: A manuscript will be drafted for submission to a journal for publication. A dissemination plan for the rollout of LTAS.NET will be implemented. Training for NIOSH users will be provided. Ongoing support of the program will be provided given changing security environments as the software is rolled out. 2) Rates will continue to be created, adding 2004 data to all rate files. 3) EDMS will continue as the production system for IWSB mortality and incidence studies and for worker notification. Maintenance includes completing the data entry conversion, completing reporting improvements, and creating turnkey programs for importing data.

Contact: Mary Schubauer-Berigan
Division of Surveillance, Hazard Evaluations, and Field Studies
513-841-4251

Emerging Issues in Injury Surveillance

The goals of this project are to explore new or previously under-recognized occupational injury problems, and evaluate new sources of traumatic occupational injury data; to develop and publish new recommendations to prevent occupational injury; and to develop and disseminate these data, including the use of new formats and in association with appropriate partners. This emerging issues project will thus address a variety of topics that will include new (or newly appreciated significant) occupational injury problems; new ways to obtain, process, evaluate and disseminate occupational injury data; and responses to the continual presentation of new recommended safety guidelines or standards. Specific activities include providing expert advice and assistance to developers and end-users of injury surveillance systems and communicating NIOSH data to the public. The project will thus involve a variety of research and service efforts directed at occupational injury surveillance issues. This project has spawned new surveillance and research, including a FY04 NORA research program to fill data gaps on worker injuries and illnesses associated with transportation and a FY05 project to examine the potential of federal workers’ compensation data to guide injury and illness prevention efforts among federal workers. This project has contributed to NIOSH comments to regulatory agencies, principally analyzing and interpreting relevant injury surveillance data. It is anticipated that identification of information or research gaps, and new surveillance projects, as well as better injury prevention recommendations, will be important outcomes of the project. Specific efforts in fiscal year 07 include contributing to the implementation of the NIOSH surveillance program, working with partners seeking to utilize available data to guide prevention efforts focused on young workers including youth working in agriculture, and filling gaps in information on injuries sustained by emergency responders at the World Trade Center terrorism site.

Contact: Dawn Castillo
Division of Safety Research
304-285-5916

Evaluation of Safety Training for Spanish Speaking Roadway Workers

If it is possible for a supervisor that does not speak fluent Spanish to effectively transmit OSH information to Spanish speaking workers using materials, they may serve as a template for additional training efforts with other ESL workers. Specifically, foreman's use of a set of English language safety training materials will be compared to the way in which they attempt to use Spanish language safety training materials. Different patterns of use (or non-use of certain materials) may be associated with differences in employees' gains in workplace safety knowledge, attitudes and skills. This project will first utilize interviews with supervisors regarding their current practices and problems they are experiencing training non-English speaking workers. This will be followed by direct observation of worksite training and a pilot intervention assessing the usefulness of one set of bilingual materials. The study will provide information on how instructors, supervisors, and employers can more effectively meet the learning needs of Spanish speaking workers. Such information is needed so that more effective safety training can be provided for Spanish speaking workers, a workforce population that is rapidly increasing in the U.S. The Laborer's Health and Safety Fund of North America developed bilingual training materials that will be used in this study. Participants will be recruited with the assistance of this union and their associated contractors who are involved in road and bridge construction, thus performing tasks relevant to the training materials of interest. This study involves a formative data gathering phase and a quasi-experimental design phase to evaluate the existing training materials. Brief pre and post-training hands-on demonstrations performed by the participants will be used to collect data regarding participant skill competency after training. Data will also be collected, as needed, through onsite observations of the training, assessment of the safety climate of the overall worksite, targeted interviews, and focus groups. A multivariate analysis method will be used.

Contact: Carol Stephenson
Education and Information Division
513-533-8581

Fatality Assessment and Control Evaluation (FACE) Project

The goals/objectives of this project are to prevent fatal work injuries by identifying work situations at high risk of fatal injury and developing prevention strategies for those who can intervene in the workplace.

NIOSH is voluntarily notified of selected occupational fatalities (currently machine-related, workers under 18 years of age, highway construction work zones, and Hispanic workers) by the Departments of Labor in the states of Maryland, North Carolina, South Carolina, Tennessee, and Virginia, Federal OSHA Area Offices in Ohio and Pennsylvania, and the Allegheny County Coroner’s Office in Pittsburgh, Pennsylvania. NIOSH is notified of work-related deaths of youth under 18 years of age across the nation by the Wage and Hour Division, U.S. Department of Labor. Through on-site fatality investigations, FACE personnel collect agent, host, and environmental information from the pre-event, event, and post-event phases of the fatal incident via a case series design to facilitate descriptive analysis of the incidents. These investigations are not conducted to find fault or place blame, but to better understand the chain of events and contributing factors and develop recommendations for preventing similar deaths. Findings from FACE investigations are frequently combined with surveillance data to describe specific injury problems and develop broad-based prevention recommendations. The results of FACE investigations are disseminated through narrative reports for each fatality, NIOSH Alerts, Workplace Solutions, technical reports, targeted mass mailings, journal articles, MMWRs, and presentations. NIOSH Alerts and Hazard IDs have covered the topics of forklifts, skid steer loaders, telecommunication towers, skylights, moving large hay bales, and wood chippers among others. The results of the FACE program have the unique capability to reach workers at risk and provide timely intervention strategies to targeted areas.

All FACE products are available on the internet. Additionally, NIOSH frequently undertakes targeted dissemination efforts to provide prevention information to specific audiences. For example, in FY04 NIOSH mailed a packet documenting crane-related injury risks and steps that can be taken to prevent worker death and injury to approximately 4,600 crane rental and crane service establishments across the nation.

NIOSH also partners with other federal agencies and private sector groups to communicate prevention information from the FACE program. For example, NIOSH has worked for several years with OSHA and the National Association of Tower Erectors (NATE) to reduce extremely high fatality rates for workers who erect and maintain telecommunication towers. NIOSH data analysis, information from FACE investigations, and recommendations are used by OSHA and NATE as training materials. To address shared concerns about the incidence of young workers being fatally injured while operating forklifts, NIOSH and the Department of Labor’s Wage and Hour Division (WHD) collaborated in December 2002 to send an information packet on forklift safety and young workers to more than 10,000 retail warehouses and storage facilities. NIOSH, WHD, and OSHA all participated in additional outreach efforts in January 2004 to distribute 5,000 copies of this same packet, along with an OSHA bulletin, in a broader mailing that included OSHA alliance partners such as the Industrial Truck Association (ITA).

Contact: Nancy Romano
Division of Safety Research
304-285-5889

Flight Crew Studies

MENSTRUAL CYCLE BIOMONITORING STUDY OF FEMALE FLIGHT ATTENDANTS: This biomonitoring feasibility study enrolled 71 flight attendants and teachers (comparison group). Sleep measures and urinary melatonin monitored circadian disruption, and urinary hormone assays monitored hormonal changes. An analysis plan for salivary cortisol has been developed and laboratory analyses are underway. In FY06, a manuscript describing sleep quality was prepared. In FY07, primary study outcomes will be analyzed.

REPRODUCTIVE HEALTH STUDY OF FLIGHT ATTENDANTS: This study used a telephone questionnaire to collect information on reproductive outcomes and risk factors from flight attendants and teachers (referents). Outcomes of interest include spontaneous abortion, menstrual disorders, and time-to-pregnancy. By the end of FY07, programming for work histories was completed, exposure variables were created and data acquisition was completed. In FY07, analyses of the spontaneous abortion and menstrual cycle data will begin.

EXPOSURE ASSESSMENT FOR REPRODUCTIVE HEALTH STUDIES OF FLIGHT ATTENDANTS: Study objectives are to characterize cosmic radiation and cabin air quality exposures for a variety of aircraft and flight routes, and to compare cosmic radiation exposure dose with predicted dose from an FAA model. Radiation exposure data will be used to develop exposure guidelines and health risk education for flight crew. In FY06, two papers on flight crew radiation exposure measurement were drafted. In FY07, three cosmic radiation and one indoor environmental quality manuscripts will be completed and submitted.

BIO-AEROSOL MONITORING STUDY: This study will establish a baseline of bio-aerosol measurements on a wide-body, twin aisle passenger aircraft. Samples monitoring on a total of 16 flight segments included viable airborne bacteria/fungi, surface viable bacteria/fungi, fungal spore counts, and bulk allergen dust samples. Temperature, relative humidity, and carbon dioxide measurements were also collected. As of FY06, three manuscripts were written and in review. In FY07, one manuscript was published and the carbon dioxide analysis and the bulk allergen dust manuscript will be initiated.

COHORT MORTALITY STUDY OF FORMER PAN AM FLIGHT ATTENDANTS: This study will examine the mortality experience of over 10,000 former Pan Am flight attendants to determine whether they are at increased risk of mortality from breast and other cancers. A cancer incidence study (Breast Cancer Incidence Among Former Pan Am Flight Attendants - CAN 7124) is being conducted concurrently in the same cohort. In FY07, the data analysis will be completed and a draft manuscript will be prepared.

COHORT MORTALITY STUDY OF FORMER PAN AM PILOTS: This study will examine the mortality experience of 6,000 former Pan Am pilots to determine whether they are at increased risk of mortality from cancers thought to be associated with exposure to ionizing radiation. As of FY06, the protocol was peer reviewed and HSRB approval was obtained, editing of the data abstracted/entered from the Pan Am records was initiated, and the data abstracted/entered from several Pan Am records continue to be edited. In FY07, the editing of the data from all records will be completed, and the editing of the merged data will be initiated.

CYTOGENETIC STUDY OF MARKERS OF COSMIC RADIATION EXPOSURE AND EFFECTS AMONG PILOTS: This study will quantify chromosomal aberrations (CA) detected by fluorescence in situ hybridization (FISH) assay as a marker of damage due to ionizing radiation exposure in 83 long-haul pilots and 51 university faculty (referents). In FY06, participants were notified of individual dietary results; questionnaire and laboratory data were merged and edited; pilot flight segment data were edited, and flight plans were obtained for the dose estimation algorithm. In FY07, questionnaire data were analyzed and an abstract and manuscript were prepared; genotyping analysis of DNA repair and other polymorphic genes will be performed; cosmic radiation dose estimates will be completed; and the flight records and additional stored blood samples will be anonymized.

Contact: Barbara Grajewski
Division of Surveillance, Hazard Evaluations, and Field Studies
513-841-4429

Improving the Health and Safety of Minority Workers

This 5- year project will join a team of NIOSH researchers, University of Illinois at Chicago and other external researchers, industry experts and community-based organizations (CBOS). The first phase of the project will involve the conduct of a mixed methods study in the Chicagoland area designed to investigate the relationship between psychosocial stressors at work, stress, and stress-related problems and factors that moderate these relationships among minority and White workers. In subsequent phases of the project, a web-based survey will be administered to Chicago-based companies and CBOs to gauge awareness and the prevalence of psychosocial factors found by the study to be the most salient to minority health and to assess current practices and policies that may be intended to address diverse OSH needs, if any. The web-based survey will also evaluate perceptions of what workplaces and CBOs need (i.e. in terms of information, assessment tools, etc.) to build more responsive OSH practices, programs and policies. The results of the web-based survey and the mixed methods study will inform the development of toolkits for reducing psychosocial risks in diverse workforces. The toolkits will be disseminated to employers and community-based organizations and subsequently evaluated.

Contact: Rashaun Roberts
Division of Applied Research and Technology
513-533-8346

Minority Health and Work Organization: Research to Practice

Although the psychosocial work environment is known to affect physical and mental health, little is known about how this relationship contributes to racial/ethnic health disparities. This project will develop, evaluate and utilize methods to detect workplace risk factors contributing to stress and stress-related problems among minority workers and to gauge the effectiveness of occupational safety and health (OSH) programs and services available through employers and community organizations. The work will be done in three phases. Phase 1 will involve developing, finalizing and evaluating the validity and reliability of a survey instrument designed to detect organization of work risk factors for disease and illness in a multiracial/multiethnic sample of workers. One of the first of its kind, the instrument will be designed to evaluate the potential impact of both race-based and traditional stressors on safety and health. Phase 2 will entail conducting a cross-sectional study in which the aforementioned survey instrument is utilized to detect workplace risk factors to minority health. Additional survey items to evaluate the extent to which workplace OSH programs and policies are used and or perceived as effective by minority workers will be administered as part of the survey. The survey will also assess availability of OSH information and programs through community-based organizations (CBOs). The cross-sectional survey will be telephonically administered to a random sample of workers of diverse racial/ethnic backgrounds. Finally, in Phase 3, a participatory approach to product development will be used to create 2 different sets of informational products (e.g., web links to relevant information for CBOs and work organizations, fact sheets, booklets/pamphlets, guidelines for addressing psychosocial risk) designed to build knowledge about workplace psychosocial risk factors to minority health. Materials will be customized for, and distributed to CBOs and to work organizations employing a diversity of workers. Follow-on email and/or telephone contacts 3-6 months after distribution will assess the utility and impact of the information.

Project work in FY06 is focusing on survey and development of the survey methodology. Work in FY07 expected to focus on cognitively testing the survey instrument, completing the survey pilot, refining the survey and sampling methodologies based on the pilot results and preparing for the formal administration of the survey.

Contact: W Stephen Brightwell
Division of Applied Research and Technology
513-533-8173

NIOSH Information Dissemination Strategy: Spanish

NIOSH is expanding its ability to disseminate occupational safety and health (OSH) information to Spanish-speaking workers and their employers. The purpose of this project is to disseminate Spanish-language OSH communication products and identify audiences and partners that may use these materials. This dissemination strategy is based on a study report commissioned by NIOSH and authored by the National Academies of Science as well as input from all NIOSH divisions and from external partners and audiences.

Information is currently being disseminated through emails, the NIOSH 800-number, and translated NIOSH publications on the Internet. Beginning in FY2007, this project will focus more on developing easy-to-read materials (e.g., brochures with photos and diagrams demonstrating processes such as putting on PPE) that are based on technical NIOSH documents. Presenting material in this format will be more useful to workers who may have difficulty with written language.

Contact: Susan Afanuh
Education and Information Division
513-533-8345

Silica & Noise Exposure Control for Tile Roof Installers

A series of recent NIOSH Health Hazard Evaluations has highlighted a newly recognized hazard that results from the use of concrete tiles in the residential roofing industry. Roofers, who cut tiles, are exposed to high concentrations of respirable dust, quartz, and noise. Because of the intrinsically hazardous nature of work on pitched roofs and the characteristics of the material, traditional engineering control solutions such as local exhaust ventilation or water suppression are not viewed favorably due to potential slipping and tripping hazards. In addition, because of the nature of the tools and the material cut, noise is a hazard.

Utilizing a systems approach to address exposures to silica and noise, a series of laboratory and field studies will be performed in collaboration with the Hazard Evaluations and Technical Assistance Branch, DSHEFS, and in partnership with roofers, roofing contractors, tile manufacturers, trade unions, and OSHA. The goal is to develop practical, effective measures to protect this group of workers from noise and silica exposures. Roofing tile is typically cut without the use of controls for reducing exposures to crystalline silica. Data characterizing these “uncontrolled” exposures have been collected through HHEs. To evaluate control effectiveness, additional data must be gathered, including information about tool and control design and performance, operating parameters, and environmental conditions. For this project, effective controls are those that maintain exposures below the occupational exposure limit (in this case the NIOSH recommended exposure limit or the OSHA permissible exposure limit) or those that reduce exposure by 70 to 95% or better. The suite of silica and dust control options to be investigated in this project include hand-held tools with local exhaust ventilation; the use of wet methods including the application of water while cutting with hand-held and stationary tools; amending the water with a surfactant to improve wetting and investigate the ability of the surfactant (e.g., detergent) to prevent staining said to occur when water is used when cutting these tiles; the addition of a retarder to the water to slow down the curing of the water-concrete dust mixture and preclude staining (Roofers told NIOSH investigators that when cutting concrete roofing tiles water reacts with the concrete tile resulting in stained tiles); and the use of local exhaust ventilation with stationary masonry saws. Several hand-held tools with local exhaust ventilation are commercially available. In addition, at least one tool has been developed by a roofer specifically to address the current exposure issue. This study will assess the effectiveness of commercially available and emerging tool designs in the field in collaboration with the roofing partnership; laboratory evaluations as a screening of these designs will also be performed.

EPHB researchers are conducting a laboratory assessment of a stationary saw using both water suppression and local exhaust ventilation to control dust emissions. In addition, low-cost hood designs for stationary masonry saws will be developed and tested by EPHB engineers. This effort will build on EPHB’s success in developing low-cost ventilation control products (e.g., reducing lead exposures in radiator repair shops.)

Contact: Alberto Garcia
Division of Applied Research and Technology
513-841-4596

State-Based Fatality Surveillance Using FACE Model

State-based FACE is a continuing extramural program of identification and epidemiologic investigation of selected occupational fatalities. The objective of the State-based FACE project is to prevent fatal work-related injuries through an integrated program of surveillance, on-site investigation, and dissemination and prevention activities. The project is implemented through cooperative agreements with State health and labor departments.

State-based FACE identifies cases through active surveillance of all external causes of occupational death occurring within the funded state, and collects general epidemiological data on each case. In-depth field investigations are conducted for selected cases in targeted categories of fatal injuries. These targets are determined according to national and state priorities. Current national targets include: youth less than 18 years of age, Hispanic workers, machine-related deaths, and deaths of highway/street construction zone workers. States select their own targets based on fatal injury patterns and prevention priorities within their states. Emphasis is placed on occupational fatalities in the agricultural and construction industries.

Detailed epidemiologic data are collected on the circumstances of selected fatalities through on-site investigations using a standardized investigation procedure. Agent, victim, and environmental information are evaluated in relation to the pre-event, event, and post-event phases of the incident. The project's ability to couple case identification with surveillance data yields detailed information beyond that normally available for developing prevention strategies. Because the project is state-based, the resulting prevention recommendations will be readily adaptable to state-specific and regional needs and can be rapidly disseminated to the audiences best suited to implement workplace controls.

Since the project start date in FY89, 22 states have actively participated in the project identifying over 18,000 work-related fatalities, and conducting over 1,500 fatality investigations. Recommended interventions have been broadly disseminated at the state level through presentations, journal articles, news media, videos, safety brochures, fact sheets, and training guides. State fatality data and case reports have also significantly contributed to NIOSH documents, journal articles and presentations. Through these dissemination methods, what is learned through the State-based FACE project's surveillance and investigation activity is quickly translated into prevention actions.

Contact: Doloris Higgins
Division of Safety Research
304-285-6276

Tailoring OSH Training for Hispanic Immigrant Workers

This study will collect information from recent (<2 years in U.S.) Hispanic immigrant workers (HIW) regarding occupational safety and health (OSH) training histories, risk perception, risk acceptance and adjustment strategies and use it to tailor OSH training interventions HIW working in construction. Specific Aim 1- Understanding differences in prior OSH knowledge, risk perception, risk acceptance and adjustment strategies. 24 focus groups [5 with HIW, 5 with NHIW and 5 with NHW) with workers from a broad range of industries will be conducted to identify the unique aspects of the HIW experience. The Hispanic participants will be recruited through agencies serving the Cincinnati, OH and Santa Fe, NM Hispanic immigrant communities. Content analyses of the focus group data will be used to guide development of a research questionnaire that will be used to further assess differences in OSH training histories, risk perception, risk acceptance and adjustment strategies between HIW, NRH and ABW. This questionnaire will be validated on a sample of approximately 600 workers (200 HIW, 200 NRHW and 200 ABW) from a broad range of industries. Specific Aim 2 - Develop culturally sensitive OSH training modules. The questionnaire developed in Specific Aim 1 will be administered to approximately 100 HIW employed in the construction industry. The survey responses will be used to tailor an existing OSH training intervention for construction workers. Specific Aim 3 - Evaluate the effectiveness of the culturally tailored OSH training modules. The training intervention developed in Specific Aim 2 will be administered to approximately 200 HIW employed in the construction industry. The workers will be randomly assigned to receive either tailored or untailored safety training. The participants will be assessed both prior to training and afterwards regarding their OSH knowledge, safety attitudes, and self-reported workplace safety behaviors. To overcome literacy and language barriers, much of this assessment will use worksite simulation demonstrations, video clips and individually administered questionnaires. It is expected that HIW receiving the tailored interventions will show greater gains in OSH knowledge and more improved OSH attitudes than those receiving the untailored training. In addition, the HIW who participate in this training will be asked to share the OSH knowledge they received with fellow workers. The participants will be contacted at 1 and 3 months following training and assessed regarding OSH knowledge, safety attitudes, and self-reported OSH behaviors. In addition, they will be interviewed regarding the frequency and quality of any interactions in which they shared OSH information with a fellow worker. It is expected that the HIW who received the tailored training will retain more OSH information, maintain greater attitude changes, have higher levels of self-reported OSH behavior, and report more frequent and more successful instances of serving as a training resource for other HIW than those who received the untailored training. Project timeline: Year 1 -- Clearance and Aim 1; Year 2 – Aims 1 & 2; Year 3 – Aim 2; Year 4 -- Aim 4; Year 5 -- Aim 4 & dissemination of results.

Contact: Donald Eggerth
Education and Information Division
513-533-8505

Understanding and Promoting OSH in Low Income Older Workers

The proposed study involves two complementary research components. In the first component, a study will be conducted of a federally funded employment program for low income older workers called the Senior Community Service Employment Program (SCSEP). SCSEP is funded by the U.S. Department of Labor (DOL) and run by several national non-profit organizations (e.g., Experience Works, AARP, National Council on the Aging, Easter Seals) and state-based agencies. SCSEP participants must be at least 55 years of age and cannot have a household income more than 25% above the poverty level. They are placed in jobs at community and government agencies (e.g., nurse’s aides, librarians, clerical workers) and receive specialized training related to their job. The ultimate goal of SCSEP is for participants to transition to unsubsidized employment that is not supported with federal funds. In the second component, archival data will be analyzed from the Health and Retirement Study (HRS), a nationally representative longitudinal survey of approximately 10,000 older adults that began in 1992 and is currently on-going. The HRS contains a wealth of information concerning each respondent’s work history, current occupation, job characteristics, health status and conditions, and economic assets. Analysis of HRS data will focus on identifying a group of low income older workers that are roughly comparable to SCSEP participants, and then tracking them over a ten year period with regard to their occupation and health. Together, the analysis of HRS and SCSEP data will provide a more complete picture of low income older workers than either data source can alone. In FY06, the project will begin by using a qualitative approach, in terms of focus groups and key informant interviews, that will identify workplace factors associated with successful safety and health outcomes in low income older workers.

Contact: James Grosch
Division of Applied Research and Technology
513-533-8167

Work Organization Predictors of Depression in Women

This is an interdivisional prospective study examining the relationship between non-traditional work organization stressors (e.g., work-family conflicts, harassment, discrimination), traditional work organization stressors (e.g., demands, control), and depression in working women. It is hypothesized that these stressors are related to depression in women. It is also hypothesized that workplace policies which prohibit discriminatory practices, and programs which promote career progression and work-family balance may attenuate the effects of work organization stressors on depression. A contract research firm will collect telephone survey data on non-traditional and traditional work organization stressors and depression from approximately 2000 women and men working in administrative support positions (e.g., accounting, bookkeeping, clerical). Subjects will be drawn from companies expected to vary with regard to work organization stressors (particularly non-traditional) and organizational policies, practices and programs. A Human Resources representative from each company will also provide information about specific HR policies and programs within their companies. Data will be collected on an annual basis for three years.

During the first year, a draft survey was developed which was reviewed by a focus group of administrative support workers and revised per their comments. In FY02, the revised survey was reviewed by a second focus group, and finalized. A Title 42 Fellow was hired to assist with the project and a contract was awarded to a research firm to identify collaborating companies and conduct telephone surveys. In FY03, HSRB clearance was obtained, and an OMB package was sent to OMB for clearance. In FY04, OMB clearance was obtained, and company and participant recruitment was begun. Recruitment continued into FY06, and the first (baseline) wave of data will be delivered to NIOSH at the end of FY06. The second wave of data collection will occur
between August of 2006 and August of 2007.

Contact: Naomi Swanson
Division of Applied Research and Technology
513-533-8165

Workplace Violence Initiative: Research and Implementation

The primary objective of this project is to support and coordinate the conduct of new research in the area of workplace violence prevention. The specific FY07 aims include: (1) Publish manuscripts in peer reviewed journals, based on the data collected from the survey that used the BLS Survey of Occupational Injuries and Illnesses as a sampling frame for a survey of employers regarding policies, procedures, training, and incidence of workplace violence; (2) Analyze data from the enhanced National Crime Victimization Survey (NCVS) as well as the Workplace Risk Supplement to further identify risk factors and characteristics of workplace violence victims; (3) Continue meetings of the Federal Interagency Task Force on Workplace Violence Research and Prevention; (4) Fund extramural research related to analysis of workplace violence interventions.

Workplace violence has been recognized as a significant public health and occupational safety and health issue, but gaps remain in our knowledge of specific risk factors and the effectiveness of particular intervention strategies. This project will utilize the capacity of broad-based survey systems to incorporate supplements and enhancements in order to fill some of the most pressing data knowledge gaps.

The Federal Interagency Task Force on Workplace Violence Research and Prevention will continue to provide a forum for the sharing of information and identification of potential collaborative efforts among the diverse Federal agencies that fund and/or conduct research or prevention activities related to workplace violence.

Information from the stakeholder meetings have been incorporated into conference presentations and stakeholder newsletters. An educational workplace violence prevention DVD was completed and distribution started in June of 2004 and reprinted in 2005 to meet the large demand. Information from this DVD provides businesses with clear strategies that can be adopted regarding prevention activities.

A new project will be developed for the evaluation of an intervention to prevent work-related homicides and assaults in retail establishments. The objective will be to evaluate models for the delivery of a Crime Prevention Through Environmental Design Program (CPTED). By the First quarter, a protocol will be completed including enrollment of partners, development of a management team, identification of contractual resources, and completion of study design and methodology, development of a management team, a project plan and budget. By the second quarter, FY07, the protocol will be submitted to HSRB and OMB for approvals, and support contracts scope of works initiated with contracts. By the fourth quarter, FY07, support contracts will be awarded. By the first quarter, FY08, site visit teams will be selected and trained. Field site visits are targeted to begin in FY08, follow-up site visits in FY09, and data analysis and publications in FY09-FY10).

Contact: Daniel Hartley
Division of Safety Research
304-285-5812

 

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