January 10, 2018 Celeste Monforton, DrPH, MPH 0Comment

A report released on January 9 by the National Academies of Sciences, Engineering, and Medicine calls on federal and state agencies to establish and strengthen the systems for assembling data on work-related injuries, illnesses, and exposure to hazards and then using the information for prevention. The 12-person committee included public health researchers, state officials, as well as FedEx executive Scott Mugno who has been nominated by President Trump to serve as the assistant secretary of labor for OSHA.

The last comprehensive report on the state of occupational injury, illness, and fatality surveillance was published by the National Research Council more than thirty years ago. This new report by the National Academies notes that the OHS surveillance systems in place today “have generally not evolved to address the changing nature of work.” The authors refer to non-standard work arrangements, such as through temp agencies, “on-demand” or the “gig” economy to make their point.

A Smarter National Surveillance System for Occupational Safety and Health in the 21st Century notes four impediments to developing a better OHS surveillance system: privacy, cost, expertise, and the culture and mission of organizations. On this last point, the barriers listed by the authors include:

  • Requirements and culture at the Bureau of Labor Statistics for confidentiality
  • Organization of CDC and a lack of appreciation of the effect workplace exposures have by public health practitioners
  • Emphasis at NIOSH on research and less commitment to surveillance than other parts of CDC
  • Uniqueness of state based worker compensation agencies

The report’s chapter “International Approaches to Occupational Health Surveillance” is particularly interesting. It starts by pointing out the disadvantage of the U.S.’s state-based workers’ compensation laws for surveillance purposes compared to the national workers’ compensation systems in place elsewhere. The authors continue the chapter by offering examples of surveillance programs used outside the U.S., such as the United Kingdom’s RIDDOR and THOR-GP. RIDDOR is a mandatory reporting system of work-related injuries and illnesses. It includes many more reportable incidents than OSHA’s requirement for employers merely to report amputations and overnight hospitalizations. THOR-GP is a voluntary system for physicians, supported by the UK’s Health and Safety Executive, to report a whole host of work-related injuries and illnesses to a research institution at the University of Manchester.

Other international examples provided by the authors include matrices used in Denmark and Finland to assess the extent of worker exposure to physical and chemical hazards. The last national survey in the U.S. to describe the nature and extent of workers’ exposure to such hazards was conducted in 1981-1983.

In a statement issued on Tuesday announcing the Academies’ report, Edward Shortliffe, professor of biomedical informatics and chair of the committee that wrote the report, said:

“Ensuring and improving worker safety and health is a serious commitment, and federal and state agencies along with other stakeholders should diligently act upon it.

We are experiencing rapid changes in the nature of work, and with new risks developing; the nation is in dire need of a smarter surveillance system that tracks occupational injuries, illnesses, and exposures.”

The committee makes 17 recommendations for a smarter U.S. OHS surveillance system. The recommendations include:

  • BLS should place priority on implementing its plan for a household
    survey of nonfatal occupational injury and illnesses;
  • OSHA should develop plans to maximize the effectiveness and utility of OSHA’s new electronic reporting initiative;
  • HHS should designate industry and occupation as core demographic
    variables collected in federal health surveys and other relevant public health surveillance systems;
  • NIOSH should coordinate with OSHA, BLS, and other relevant
    agencies to measure and report, on a regular basis, the economic and health burdens of occupational injury and disease at the national level.

A Smarter National Surveillance System for Occupational Safety and Health in the 21st Century reflects thousands of hours of work. The experts convened to study the problem recognize the value of data to design effective interventions to prevent work-related injuries and illnesses. The committee has done its work. Now its up to those of us who want safer workplaces to urge the Trump Administration to take action on the recommendations.

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