National Occupational Research Agenda

National Institute for Occupational Safety and Health

National

Occupational

Research

Agenda

Update May, 2000

21 Priorities for the 21st Century

APED TR MENT OF HEALTH & HUMAN SERVICES  USA

CENTERS FOR DISEASE CONTROL

AND PREVENTION

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Public Health Service

Centers for Disease Control and Prevention

National Institute for Occupational Safety and Health
NORA Teams

Bold type indicates team leaders

Allergic & Irritant Dermatitis

Boris D. Lushniak (NIOSH) bdt1@cdc.gov

G. Frank Gerberick (The Proctor and Gamble

Company) gf@pg.com

Stephen P. Berardinelli (NIOSH)

David Bernstein (University of Cincinnati)

Raymond E. Biagini (NIOSH)

Mark F. Boeniger (NIOSH)

Richard Fenske (University of Washington)

James S. Johnson (Lawrence Livermore National

Laboratory)

Michael Luster (NIOSH)

Alan N. Moshell (National Institute of Arthritis and

Musculoskeletal and Skin Diseases/NIH)

Albert E. Munson (NIOSH)

James S. Taylor (Cleveland Clinic)

Susan Q. Wilburn (American Nurses Association)

Asthma & Chronic Obstructive Pulmonary

Disease

Kathleen Kreiss (NIOSH) kxk2@cdc.gov

John Balmes (University of California, San

Francisco)

Robert Castellan (NIOSH)

Jeffrey Fedan (NIOSH)

Paul Henneberger (NIOSH)

Gail Weinmann (National Heart, Lung, and Blood

Institute/NIH)

Susan Kennedy (University of British Columbia)

Hillel Koren (Environmental Protection Agency)

Edward Petsonk (NIOSH)

Carol Rao (NIOSH)

Greg Wagner (NIOSH)

David Wegman (University of Massachusetts, Lowell)

David Weissman (NIOSH)

Cancer Research Methods

Paul Schulte (NIOSH) pas4@cdc.gov

Elizabeth M. Ward (NIOSH) emw3@cdc.gov

Steve Bayard (Occupational Safety and Health

Administration)

Mary Ann Butler (NIOSH)

Dave Dankovic (NIOSH)

Ann F. Hubbs (NIOSH)

Carol Jones (Mine Safety & Health Administration)

Myra Karstadt (Environmental Protection Agency)

Gregory L. Kedderis (Chemical Industry Institute of

Toxicology)

Ronald Melnick (National Institute of Environmental

Health Sciences/NIH)

Paul Brandt-Rauf (Columbia University)

Carrie A. Redlich (Yale University)

Nathaniel Rothman (National Cancer Institute/NIH)

Michael Sprinkler (International Chemical Workers)

Mark Toraason (NIOSH)

Ainsley Weston (NIOSH)

Control Technology & Personal Protective

Equipment

Laurence Reed (NIOSH) ler3@cdc.gov

Dale Avery (NIOSH)

Mike Seymour (Occupational Safety and Health

Administration)

Steven Berardineli (NIOSH)

Donald Campbell (NIOSH)

David deVries (American Society of Safety

Engineers)

Richard Duffy (International Association of

Firefighters)

Mike Flynn (University of North Carolina)

Bill Heitbrink (NIOSH)

Bill Kojola (AFL - CIO)

Steve Mallinger (Occupational Safety and Health

Administration)

Ernest Moyer (NIOSH)

Daniel K.Shipp (Industrial Safety Equipment

Association)

Jenny Topmiller (NIOSH)

Fred Kissell (NIOSH)

Emerging Technologies

Aaron Schopper (NIOSH) aws0@cdc.gov

Nicholas Ashford (Massachusetts Institute of

Technology)

George Bockosh (NIOSH)

Kenneth D. Brock (Liberty Mutual Insurance Group)

Tai Chan (General Motors Corporation)

David Conover (NIOSH)

Jack Finklea (National Center for Injury Prevention

and Control/CDC and CPWR)

James Jones (NIOSH)

Raymond Levott (The National Environmental

Education and Training Center)

Maureen Ruskin (Occupational Safety and Health

Administration)

Paul Schlecht (NIOSH)

Randal P. Schumacher (The Jefferson Group)

John Sparks (Environmental Protection Agency)

Jeffrey Welsch (NIOSH)

Exposure Assessment Methods

Mary Lynn Woebkenberg (NIOSH)

mlw2@cdc.gov

Martin T. Abell (NIOSH)

Thomas W. Armstrong (Exxon Biomedical Sciences,

Inc.)

Gayle DeBord (NIOSH)

Dennis W. Groce (NIOSH)

Mike Keane (NIOSH)

Paul Knechtges

David K. Pegram (Department of Energy)

Beth D. Reh (NIOSH)

Bonnie Rogers (University of North Carolina)

Mark Stenzel (Occidental Chemical Corporation)

James Weeks (George Washington University)

Kenneth L. Williams (NIOSH)

David Utterback (NIOSH)

Fertility & Pregnancy Abnormalities

Teresa Schnorr (NIOSH) ths1@cdc.gov

Coleen Boyle (National Center for Environmental

Health/CDC)

Sally Perreault Darney (Environmental Protection

Agency)

George Daston (Procter & Gamble)

Barbara Grajewski (NIOSH)

Ronald Gray (John Hopkins University)

Tina Lawson (NIOSH)

Barbara Mackenzie (NIOSH)

Michele Marcus (Emory University)

Melissa McDiarmid (University of Maryland)

Eisuke Murono (NIOSH)

Steven Schrader (NIOSH)

Mike Shelby (National Institute of Environmental

Health Sciences/NIH)

Health Services Research

Scott D. Deitchman (NIOSH) sed2@cdc.gov

Joan Buchanan (Harvard University)

William Bunn (Navistar International Transportation

Corporation)

Mary A. Cummings (Agency for Health Care Policy

and Research)

James Ellenberger (AFL-CIO)

Janice Gordon (University of Maryland)

Jay Himmelstein (University of Maryland)

Ted Katz (NIOSH)

Kent W. Peterson (Occupational Health Strategies,

Inc.)

Gordon Reeve (Ford Motor Company)

Kathleen Rest (NIOSH)

Linda Rudolph (California Department of Industrial

Relations)

Rosemary Sokas (NIOSH)

Gregory Wagner (NIOSH)

Hearing Loss

John Franks (NIOSH) jrf@cdc.gov

Patricia Brogan (Wayne State University)

David Byrne (NIOSH)

John Casali (Virginia Tech University)

Steven N. Hacker (Solutia, Inc)

Lee Hager (James Anderson & Associates)

Howard Hoffman (National Institute on Deafness

 & Communicative Disorders/NIH)

Dan Johnson (ANSI/ISO Standards)

James E.Lankford (Northern Illinois University)

Carol Merry (NIOSH)

Anthony Miltich (Digital Hearing Systems

Corporation)

Doug Ohlin (U.S. Army Center for Health Promotion

and Preventative Medicine)

Scott Schneider (Laborers International Union)

Mark R. Stephenson (NIOSH)

Ed Thimons (NIOSH)

Randy Tubbs (NIOSH)

Indoor Environment

Mark Mendell (NIOSH) mfmo@cdc.gov

Darryl Alexander (American Federation of Teachers)

William S. Cain (University of California, San Diego)

Bill Fisk (Lawrence Berkeley National Laboratory)

Carolyn Freeman (Occupational Safety and Health

Administration)

John Girman (Environmental Protection Agency)

Cindy Hines (NIOSH)

Paul Jensen (NIOSH)

Kay Kreiss (NIOSH)

Hal Levin (Building Ecology Research Group)

Don Milton (Harvard University)

Mary Prince (NIOSH)

Larry Rexroat (General Services Administration)

Ken Wallingford (NIOSH)

Infectious Diseases

Thomas K. Hodous (NIOSH) thh1@cdc.gov

James August (American Federation of State,

County, and Municipal Employees)

Yvonne Boudreau (NIOSH)

Joel Breman (Fogarty International Center)

Yvette Davis (National Center for HIV, STD and TB

Prevention/CDC)

William G. Denton (Denton International)

Feroza Daroowalla (NIOSH)

(continued inside back cover)
National Occupational Research Agenda

National Institute for Occupational Safety and Health

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Public Health Service

Centers for Disease Control and Prevention

National Institute for Occupational Safety and Health

National

Occupational

Research

Agenda

Update May, 2000

21 Priorities for the 21st Century
Table of Contents

Message from NIOSH ............................................................................................ 1

Liaison Committee Perspective ............................................................................... 2

Background .......................................................................................................... 3

Measuring the Success of NORA ............................................................................ 5

Tracking Research Funding ...................................................................... 5

NIOSH Funding .......................................................................... 5

Intramural Initiatives .................................................................... 8

NORA Research: What Counts? .................................................... 8

Other Federal Funding ................................................................ 9

Sector-Specific Funding ............................................................. 11

NORA Grant Funding ................................................................ 12

Grant Funding Success ............................................................ 16

Shifting the Balance .................................................................. 16

Tracking Partnership Products ................................................................ 17

Requests for Applications .......................................................... 17

Team Products ........................................................................ 17

Tracking the Literature and Recognition of NORA ...................................... 19

Bibliometrics ............................................................................ 19

NORA Effectiveness Survey ....................................................... 19

Other Tracking ......................................................................... 19

Partnership ......................................................................................................... 20

NORA Partnerships ............................................................................... 20

NORA—A Model for Partnership .............................................................. 22

NORA Partnership Award ....................................................................... 23

Guiding NORA Implementation .............................................................................. 24

Liaison Committee ................................................................................ 24

Federal Liaison Committee ..................................................................... 24

Partnership Teams ................................................................................ 27

Team Summaries ................................................................................ 27

Kudos for NORA .................................................................................................. 34

NORA Milestones ................................................................................................ 36

Summary ........................................................................................................... 38

National Occupational Research Agenda
Message from NIOSH

Partnership continues to be the cornerstone of NORA. This is evident in the exciting

NORA-related research partnerships, the continued support from partners on the

Partnership Teams, the Liaison Committee and the Federal Liaison Committee, and the

number of partners participating in the NORA extramural funding process.

The NORA extramural grants program has been hugely successful. The number of new

NORA grants has increased from 11 in FY 1996 to 86 in FY 1999. Thanks to an $11.3

million Congressional appropriation for NORA in FY 2000, the stage is set for this year’s

NORA grant cycle to surpass the FY 1999 level. The FY 2000 NORA appropriation has

also allowed NIOSH to fund three large-scale intramural NORA projects (see page 8).

NIOSH will continue to focus its intramural efforts, often in partnership with external

partners, on large NORA-related research studies that can have a significant impact on

specific areas of research.

I’d like to that all of the NORA partners who have worked diligently to implement NORA

over the past four years. NORA was conceived as an agenda for the entire occupational

safety and health community. It is the remarkable degree of partnership support and

collaboration that has truly made NORA an agenda for the Nation. In fact, the value of

NORA as a model for research planning is being recognized well beyond the occupational

safety and health community as international organizations, government agencies and,

non-profit organizations use NORA as they undertake their own planning activities.

This point is further illustrated in the remarks of Donna Shalala, Ph.D., Secretary, U.S.

Department of Health and Human Services, at the NORA Symposium 1999: Partnership

for Research. “From its [NORA’s] beginnings, NIOSH and its partners have understood

that a prerequisite to making workplaces safer in this new economy is making sure

that no one is left out of the decision making process. That’s really the genius of

NORA. . . . I’ve encouraged all my staff to use NORA as a model for building strong

research partnerships.”

While we report NORA’s 2000 successes in this document, we begin preparations for

the 2001 NORA Symposium, which is not only NORA’s fifth birthday but NIOSH’s 30

anniversary. I hope you will all plan to attend the symposium and continue to help us

make history with NORA.

Linda Rosenstock, M.D., M.P.H.

Director

National Institute for Occupational Safety and Health

NIOSH Vision

Delivering on the Nation’s promise:

safety and health at work for all

people...through research and

prevention.

NORA Vision

No single organization has the

resources necessary to conduct

occupational safety and health

research to adequately serve the

needs of workers in the United

States. These constraints mandate

that the entire occupational safety

and health community engage in

collaboration and coordination of its

resources. The National Institute for

Occupational Safety and Health

(NIOSH) and its public and private

partners developed the National

Occupational Research Agenda

(NORA) to provide a framework to

guide occupational safety and health

research into the next decade—for

NIOSH and the entire occupational

safety and health community.

National Occupational Research Agenda 1
Liaison Committee Perspective

As the reach and impact of NORA continue to grow, so to do the roles and

responsibilities of the Liaison Committee. Page 24 of this NORA Update

contains a summary of the 1999 survey conducted by the committee to

determine the effectiveness and reach of NORA. While the survey revealed

that NORA is well recognized, there is still room for improvement. The

Liaison Committee is committed to further increasing the recognition and

reach of NORA by continuing to work with NIOSH to guide and track NORA’s

progress and pursue new outreach opportunities.

Another new responsibility of the Liaison Committee is administering the

NORA Partnership Award for Worker Safety and Health. The next award will be

given at the NORA Symposium in 2001. We look forward to reviewing the

partnership activities inspired by NORA. Watch for the nomination

guidelines in the NORA News and on the NIOSH web page.

The Liaison Committee has seen the difference NORA has made in the field of

occupational safety and health. We are proud to be part of this effort and

will continue to work with the rest of the NORA partners to ensure that NORA

continues to make a difference in protecting worker safety and health.

Bonnie Rogers, DrPH, COHN-S, FAAN

Chair, NORA Liaison Committee

University of North Carolina, Chapel Hill

Liaison Committee

James August

American Federation of State County

and Municipal Employees

Robin Baker

American Public Health Association

Kari P. Barrett

Chemical Manufacturers Association

Thomas F. Bresnahan

American Society of Safety Engineers

William B. Bunn

Navistar International Transportation Corporation

Tai Chan

General Motors Corporation

William Greaves

American College of Occupational and Environmental Medicine

Tee Guidotti

Association of Occupational and

Environmental Clinics

Gwendolyn Keita

American Psychological Association

Monroe Keyserling

Association of University Programs in Occupational

Health and Safety

Gwendolyn Keita

American Psychological Association

Sandra Lange

National Institute of Environmental Health Sciences

Tom Leamon

Liberty Mutual Insurance Company

Wayne Lednar

Eastman Kodak Company

Pamela Tau Lee

Labor Occupational Health Program at U.C.

Berkeley

Steven P. Levine

American Industrial Hygiene Association

Joseph Main

United Mine Workers of America

Franklin Mirer

United Auto Workers

Carolyn Phillips

Chemical Manufacturers Association

Robert J. Pleasure

Center to Protect Workers’ Rights

Beth Resnick

National Association of County

 and City Health Officials

Gerard Scannell

National Safety Council

Bonnie Rogers (Committee Chair)

American Association of Occupational Health

Nurses

Margaret M. Seminario

AFL-CIO

Michael Silverstein

Dept. of Labor and Industries, Washington State

Frank White

Organization Resources Counselors, Inc.

2 National Occupational Research Agenda
Background - An Agenda for the 21st Century

In April 1996, NIOSH and its partners unveiled the National Occupational Research Agenda

(NORA), a framework to guide occupational safety and health research into the next

decade—not only for NIOSH but for the entire occupational safety and health community.

Approximately 500 organizations and individuals outside NIOSH provided input into the

development of the Agenda. Before NORA no national research agenda existed in the field

of occupational safety and health, and no research agenda in any field had captured such

broad input and consensus. The NORA process resulted in a remarkable consensus

about the top 21 research priorities (see table below).

NORA arose out of the recognition that occupational safety and health research in both

the public and private sectors would benefit from targeting limited resources. The

creators of the Agenda also recognized the need to address changes in the U.S.

workplace, as well as the increasingly diversified workforce. The distribution of jobs in our

economy continues to shift from manufacturing to services. Longer hours, compressed

work weeks, shift work, reduced job security, and part-time and temporary work are

realities of the modern workplace. By the year 2005, the U.S. workforce will grow to an

estimated 147 million, with minorities representing 28 percent of the workforce and with

women representing approximately 48 percent.

 NORA Priority Research Areas

 CATEGORY PRIORITY RESEARCH AREAS

Disease and Injury Allergic and Irritant Dermatitis

Asthma and Chronic Obstructive Pulmonary Disease

Fertility and Pregnancy Abnormalities

Hearing Loss

Infectious Diseases

Low Back Disorders

Musculoskeletal Disorders of the Upper Extremities

Traumatic Injuries

 Work Environment and Emerging Technologies

 Workforce Indoor Environment

Mixed Exposures

Organization of Work

Special Populations at Risk

 Research Tools Cancer Research Methods

 and Approaches Control Technology and Personal Protective Equipment

Exposure Assessment Methods

Health Services Research

Intervention Effectiveness Research

Risk Assessment Methods

Social and Economic Consequences of Workplace

 Illness and Injury

Surveillance Research Methods

National Occupational Research Agenda 3
NORA also addressed the broadly recognized need to focus research in the areas with

the highest likelihood of reducing the still significant toll of workplace illness and injury.

Each day, an average of 9,000 U.S. workers sustain disabling injuries on the job, 17

workers die from an injury sustained at work, and 137 workers die from work-related

diseases. The economic burden of this continuing toll is high. Data from a NIOSH-funded

study reveal $171 billion annually in direct and indirect costs of occupational injuries and

illnesses ($145 billion for injuries and $26 billion for diseases). These costs compare to

$33 billion for AIDS, $67.3 billion for Alzheimer’s Disease, $164.3 billion for circulatory

diseases, and $170.7 billion for cancer (see graph below).

Developing NORA was only the first step in the collaborative effort between NIOSH and its

many partners to guide and promote occupational safety and health research. Even at

the time the Agenda was announced, there was a common commitment to work to

implement the Agenda, namely, to increase activities and resources in the 21 priority

areas. In the first four years of the implementation of NORA, NIOSH and its partners have

demonstrated that NORA is generating funding and research activities in the 21 priority

areas. The 20 partnership teams (the two musculoskeletal priority research areas are

being addressed by one team) have been instrumental in this success.

Prior to NORA, research in occupational safety and health was fragmented, suffering from

a “shotgun” approach to tackling major problems. Through NORA, the Nation is better

positioned to address the toll of workplace injury and death.

Economic Burden of Disease and Injury (Direct and Indirect Costs)

Cancer

$200

150

100

50

0

$ in Billions

Circulatory

Diseases

Diseases

Injuries

Alzheimer

Disease

Occupational AIDS

Diseases &

Injuries

171

33

67

164 170

4 National Occupational Research Agenda
FY1996 FY1997 FY1998 FY1999

$80

70

60

50

40

30

20

10

0

$ in Millions

* FY 2000 numbers are estimates

15.4

Grants

Intramural Research and Cooperative Agreements

28.1

46.9

61.1

FY2000*

72.3

Measuring the Success of NORA

Tracking Research Funding in NORA

Priority Areas

NIOSH Funding

As the only Federal agency with a mandate to conduct and fund occupational safety and

health research, NIOSH made a commitment to redirect some of its resources to the 21

NORA priority areas. Data are available to track both the number of projects and total

economic resources in each priority area.

In FY 1996, at the time the Agenda was unveiled, the NIOSH baseline investment in the

NORA priority areas was $15.4 million (approximately 9 percent of the FY 1996 budget).

Of this, $8.7 million was devoted to intramural research (NIOSH-conducted) and cooperative agreements (NIOSH-funded extramural research in which NIOSH directly participates),

and $6.7 million for research grants (extramural investigator-initiated projects). A

redirection of resources in FY 1997 nearly doubled this investment to $28.1 million. A new

$5 million special Congressional appropriation to NIOSH in FY 1998 for NORA, coupled with

additional reinvestment of baseline monies into NORA priority areas, resulted in $46.9

million of research (about 25 percent of the budget) in NORA priority areas for FY 1998.

NIOSH NORA Investment

In FY 1999, continued Congressional support for NORA as well as ongoing internal

resource allocation resulted in $61.1 million of NIOSH research funds (31 percent of the

budget) directed at NORA priority areas. In FY 2000, an $11.3 million Congressional

appropriation for NORA contributed to the estimated $72.3 million allocated to NORA

priorities (34 percent of the NIOSH budget).

Such an increase is tangible evidence of NIOSH’s commitment to NORA. This shift is

particularly notable given existing Congressional mandates and obligations that limit how

much of the NIOSH budget can be redirected. An ongoing effort has been in place since

NORA’s inception to assure that these shifts are “real” (rather than merely a reporting

artifact) using consistent definitions and an independent evaluation team to assess

projects for NORA-relatedness. National Occupational Research Agenda 5
NIOSH NORA Investment by Priority Research Area, FY 96-99

Disease and Injury

Work Environment and Workforce

Extramural

Intramural

Dollars in Millions

$5.0

4.5

4.0

3.5

3.0

2.5

2.0

1.5

1.0

.5

0

Allergic &

Irritant

Dermatitis

* FY FY FY FY FY

96 97 98 99 00

Asthma &

Chronic

Obstructive

Pulmonary

Disease

FY FY FY FY FY

96 97 98 99 00

Fertility &

Pregnancy

Abnormalities

FY FY FY FY FY

96 97 98 99 00

Hearing

Loss

FY FY FY FY FY

96 97 98 99 00

Infectious

 Diseases

FY FY FY FY FY

96 97 98 99 00

Low

Back

Disorders

FY FY FY FY FY

96 97 98 99 00

Musculoskeletal

Disorders of the

Upper Extremities

FY FY FY FY FY

96 97 98 99 00

Traumatic

Injuries

FY FY FY FY FY

96 97 98 99 00

Emerging

Technologies

Indoor

Environment

Mixed

Exposures

Organization

of Work

Special

Populations

 at Risk

Dollars in Millions

FY FY FY FY FY

96 97 98 99 00

FY FY FY FY FY

96 97 98 99 00

FY FY FY FY FY

96 97 98 99 00

FY FY FY FY FY

96 97 98 99 00

FY FY FY FY FY

96 97 98 99 00

$7.5

5.0

4.5

4.0

3.5

3.0

2.5

2.0

1.5

1.0

.5

0

6 National Occupational Research Agenda
Research Tools and Approaches

*FY 00 numbers are estimates. Dollars in Millions

$11.0

10.0

9.0

8.0

7.0

6.0

5.0

4.0

3.0

2.0

1.0

0

Surveillance

Research

Methods

FY FY FY FY FY

96 97 98 99 00

Social & Economic

Consequences of

Workplace Illness

& Injury

FY FY FY FY FY

96 97 98 99 00

Risk Assessment

Methods

FY FY FY FY FY

96 97 98 99 00

Intervention

Effectiveness

Research

FY FY FY FY FY

96 97 98 99 00

Health

Services

Research

FY FY FY FY FY

96 97 98 99 00

Exposure Assessment

Methods

FY FY FY FY FY

96 97 98 99 00

Control Technology & Personal Protective Equipment

FY FY FY FY FY

96 97 98 99 00

Cancer

Research Methods

FY FY FY FY FY

96 97 98 99 00

National Occupational Research Agenda 7
Intramural Initiatives

Recognizing its unique position to conduct large studies that can have a significant impact

on a particular area of research, in March 1999, NIOSH encouraged its intramural

researchers to join together to compete for new FY 2000 NORA funding with large scale

proposals in selected NORA priority areas. The proposals underwent multiple steps of

internal review, with three areas subsequently chosen for further development –

musculoskeletal disorders, allergic and irritant dermatitis, and asthma and chronic

obstructive pulmonary disease. NIOSH funded three interdisciplinary cross-divisional

priority program areas for a total of about $3 million, following an external peer review

process. The funded projects include an exposure-response and intervention program for

the prevention of work-related musculoskeletal disorders, development of a dermal policy

based on laboratory and field studies, and research for occupational asthma reduction.

This effort generated considerable enthusiasm, both internally and externally. For FY

2001, NIOSH is encouraging similar efforts in six NORA-related areas: work organization

and cardiovascular disease; injury; work organization and depression; control technology;

noise and hearing loss; and health care (a sector relevant to all NORA priority areas).

NORA Research: What Counts?

NIOSH has set a high bar to determine which studies are designated as NORA research.

Efforts to ensure that NIOSH does not “over count” NORA research have resulted in an

actual under representation of research in the 21 priority areas. A Quality Assurance

Committee of senior NIOSH scientists reviews all intramural and extramural research

proposals to determine whether they indeed qualify as NORA research. To track and

report funding of NORA research, NIOSH counts only studies that devote at least 80% of

the research effort to a designated NORA topic. This strict definition provides a valid and

consistent method of tracking NORA progress over time. Some important activities in

occupational safety and health, such as surveillance programs, have research elements

but may not be primarily research. Likewise, some research (e.g., an occupational cancer

epidemiology study) may involve a NORA subject (e.g., cancer research methods), without

the NORA subject being the primary emphasis. In addition, a project that is distributed

equally between two NORA areas such as 50 percent in hearing loss and 50 percent in

control technology would not be counted by this definition in either NORA area. Data are

available, however, to count projects with as little as 20% dedicated to a priority area.

One example of how the high threshold NORA definition excludes important contributions

to NORA research is the Fatality Assessment Control and Evaluation (FACE) Program.

NIOSH and 20 state partners evaluate incidents in which workers have been fatally injured.

This information is used to improve and promote the use of prevention strategies. FACE

contributes importantly to the NORA Traumatic Injuries priority area, but since surveillance

and education are a large component, investments in FACE are not included in the routine

tracking of NORA research spending.

8 National Occupational Research Agenda
Other Federal NIOSH

FY 1996 FY 1998

$250

200

150

100

50

0

$ in Millions

218

199

Federal OS&H Spending FY 1996 and FY 1998

For the purposes of this analysis, the total NIOSH budget is attributed to occupational

safety and health research.

Other Federal Funding

As part of NORA, a survey of federal occupational safety and health research is conducted

biennially. The first survey, covering FY 1996, provided a baseline identifying a total of only

$39 million spent for all occupational safety and health research outside of NIOSH for a

total federal investment of $199 million. The second survey identified the total spending in

occupational safety and health research by federal agencies as $218 million in FY 1998

(NIOSH at $187 million and other federal agencies at $31 million).

The FY 1996 baseline for NORA-related research from non-NIOSH federal sources was

about $15 million, increasing in FY 1998 to $23.4 million.

National Occupational Research Agenda 9

Federal NORA Spending FY 1996 and FY 1998

$70

60

50

40

30

20

10

0

$ in Millions

FY 1996 FY 1998

15

15

47

23

Other Federal NIOSH

70

30
Federal NORA Spending by Priority Area

In FY 1998 as in FY 1996, there was no reported spending by federal partners in the

priority area of Indoor Environment. There are reported decreases in spending by nonNIOSH federal agencies in some priority areas, e.g. Fertility & Pregnancy Abnormalities

and Traumatic Injuries and increased spending is seen in others, e.g. Allergic & Irritant

Dermatitis and Hearing Loss (see graph below). In sum, there has been an increase

overall at the federal level in NORA-related research. However, for non-NIOSH federal

sources, this increase is the result of a redirection of existing resources to NORA, as

opposed to new investments in the priority areas. Federal partners will continue to

perform the survey biennially, with the next survey assessing FY 2000 expenditures.

10 National Occupational Research Agenda

Due to the scale of this graphic the following investments are not visible:

NIOSH FY 1996

Cancer Research Methods: $44,000

Other Federal FY 1998

Control Technology & PPE: $38,000

Intervention Effectiveness Research: $43,000

$8

6

4

2

0

$ in Millions

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

FY

96

FY

98

NORA Priority Areas

* Combines two NORA priority areas, Low Back Disorders and Musculoskeletal Disorders of the Upper Extremities

NIOSH

Other

Federal

Allergic & Irritant Dermatitis

Asthma & Chronic Obstructive Pulmonary Disease

Fertility & Pregnancy Abnormalities

Hearing Loss

Infectious Disease

* Musculoskeletal Disorders

Traumatic Injuries

Emerging Technologies

Indoor Environment

Mixed Exposures

Organization of Work

Special Populations at Risk

Cancer Control Research

Control Technology & Personal Protective Equipment

Exposure Assessment Methods

Health Services Research

Intervention Effectiveness Research

Risk Assessment Methods

Social & Economic Consequences of Workplace Illness

Surveillance Research Methods
NORA Investments by Sector, FY 2000*

Sector-Specific Funding

During the development of NORA, the importance of sector-specific research was

consistently raised. It was finally decided that the most effective way to integrate

consideration of research efforts within specific sectors (such as construction, mining,

agriculture, and health care) was to apply a matrix approach of coordinated research in

some or all of the 21 priority areas, as appropriate for each sector. As such, it is clear

that NORA is having an impact on sector-focused research. In FY 2000, within NIOSH,

nearly $35 million is being allocated to NORA research in agriculture ($8.3 million),

construction ($9.3 million), mining ($12 million), and health care ($5.1 million).

$12

10

8

6

4

2

0

$ in Millions

Grants (Extramural)

Intramural Research and Cooperative Agreements

Agriculture Construction Mining

8.3 9.3

*FY 2000 numbers are estimates

12

Healthcare

5.1

National Occupational Research Agenda 11
12 National Occupational Research Agenda

NORA Grant Funding

NORA has been successful in stimulating new research needed to address the problem of

workplace injuries and illnesses. A major initiative was started in FY 1998 when NIOSH

and three federal partners awarded about $8 million in grants in ten NORA priority

research areas, which was the largest infusion of funding ever by the federal government

for extramural occupational safety and health research. NIOSH built on these partnerships

in FY 1999 and jointly announced two Requests for Applications (RFA) with six other federal

agencies: National Cancer Institute (NCI); National Heart, Lung, and Blood Institute (NHLBI);

National Institute on Aging (NIA); National Institute on Deafness and Other Communication

Disorders (NIDCD); National Institute of Environmental Health Sciences (NIEHS), and the

Environmental Protection Agency (EPA).

A total of about $9 million was awarded to support 33 grants in eight NORA priority areas.

In addition to these RFAs, NIOSH awarded another 53 grants that address NORA priority

areas under the Institute’s general grants Program Announcement (PA). A graph of the

NORA funding of new grants in FY 1999 is shown below, by NORA area (also see listing on

page 14).

FY 1999 NORA Grant Awards

The grant figures presented above represent new grants each year in the NORA priority

areas. A more complete picture of the NORA grants program includes both new and

continuing NORA grants. When both categories are included, the total grant funding for

FY 1998 is $16.8 million and $26.7 million for FY 1999.

$3.0

2.5

2.0

1.5

1.0

.5

0

$ in Millions

Partners Funds

NIOSH Funds

NORA Priority Areas

Asthma & Chronic Obstructive Pulmonary Disease

Fertility & Pregnancy Abnormalities

Hearing Loss

Low Back Disorders

Musculoskeletal Disorders of the Upper Extremities

Traumatic Injuries

Indoor Environment

Mixed Exposures

Organization of Work

Special Populations at Risk

Cancer Control Research

Control Technology & Personal Protective Equipment

Exposure Assessment Methods

Health Services Research

Intervention Effectiveness Research

Risk Assessment Methods

Surveillance Research Methods
In FY 2000, NIOSH and eight NIH partners have solicited applications in all 21 NORA

priority areas under a general PA. The amount of grant funding will depend on the number

of quality applications received. The NIH Institutes included in the announcement are NCI,

NHLBI, NIA, National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute

of Allergy and Infectious Diseases (NIAID), National Institute of Arthritis and

Musculoskeletal and Skin Diseases (NIAMS), NIDCD, and NIEHS.

In addition to the PA, NIOSH and seven co-sponsors announced about $10 million for

research related to Special Populations at Risk and Mixed Exposures. NIOSH is also

targeting about $8 million for additional RFAs which focus on 11 of the NORA priority

areas. NIOSH is inviting applications that will:

• Reduce agriculture-related injuries to children through the development of new and

improved hazard control technologies and the evaluation of educational materials and

training.

• Evaluate the effectiveness of new intervention methods for controlling workplace

hazards.

• Strengthen surveillance methods for work-related injuries and illnesses, particularly

those involving high-risk occupations and industries.

• Provide exploratory research in the NORA priority areas of allergic and irritant

dermatitis, social and economic consequences of workplace injury and illness, health

services research, and pregnancy and fertility abnormalities.

• Study upper-limb and low-back musculoskeletal disorders at varying levels of exposure

to job stressors.

• Develop new data on incidence of needlestick injuries and availability of safer needle

devices among health care workers.

• Foster multidisciplinary research on the adverse pulmonary effects of mixed dusts,

such as welding fume, boiler ash, and diesel exhaust particles.

100

80

60

40

20

0

Number of Funded Grants

FY 1996 FY 1997 FY 1998 FY 1999 FY 2000

Number of Grants Partners

12

10

8

6

4

2

0

Number of

Federal Partners

Grants not

yet awarded

NORA Grants/Partners FY 1996 – FY 2000

National Occupational Research Agenda 13
14 National Occupational Research Agenda

Asthma and Chronic Obstructive

Pulmonary Disease

Chemokine Biomarkers of Diisoyanate

Induced Occupational Asthma – University of

Cincinnati

Occupational Lung Disease in a Flocking

Plant – University of Washington

Iron Calcium and Oxidative Stress in Lung

Injury – New York University

Irritant-Induced Asthma: Epidemiology and

Pathogenesis – Hopital du Sacre-Coeur

Occupational Asthma Associated with

Seafood Processing – University of Michigan

Peak Exposures in Aluminum Smelting –

University of Washington

*A Novel Mouse Model of Isocyanate-Induced

Asthma – Yale University

*Murine Models of Occupational COPD –

University of Cincinnati

Cancer Research Methods

Antibodies to Hemoglobin Adducts in Butadiene Exposed Workers

Biomosaics, Inc.

Control Technology and Personal

Protective Equipment

System for Measuring Workplace Protection

Factors – University of Iowa

Respirator Efficacy for Tuberculosis

Aerosols – Johns Hopkins University

Improving the Work Environment in Livestock

Buildings – Kansas State University

Ergonomic Solutions for Furniture Manufacturers – North Carolina State University

Electronic Safety Devices for Construction

Workers – Technological Systems Research

Design & Education

Ventilation Control to Reduce Airborne

Contaminants – University of Iowa

Statistical Modeling of Respirator Penetration

Data – University of California

CFD Analysis of Mine Face Ventilation

Systems – University of Kentucky

Hearing Protector Allowing Acoustic

Communication – Sensimetrics Corporation

Exposure Assessment Methods

Reconstruction of Doses for Chernobyl

Liquidators – International Agency for

Research on Cancer

Temporal and Impulsive Characteristics of

Hand Tools – University of Connecticut

Tools for Exposure Assessment of Physical Risk

Factors in VDT Work – Harvard University

A Simple Device for Measuring Personal

Exposures to UV – Riverbend Instruments, Inc.

A Model for Predicting CTDs Due to Repetitive

Loading – University of Massachusetts

Airborne Heavy Metal Monitor –

Physical Sciences, Inc.

Methods for Assessing Synthetic Textile Dust

Exposure – University of Massachusetts

Uncertainty Analysis for Characterizing

Plutonium Exposure to Improve Lung Cancer

Risk Estimates – University of Colorado

Pollution Prevention and Worker Toxic

Exposures: A Method – Johns Hopkins

University

Laser Hazard Sensor with Recorder –

Princeton Scientific Instruments, Inc.

An Ergonomics Assessment Methodology for

Work-Worker Systems – North Carolina State

University

Fertility and Pregnancy Abnomalities

Portability of Biochemical Markers of Sperm

Maturity – Yale University

Health Services Research

Developing Community-based Research with

Immigrants – University of Massachusetts

Hearing Loss

Epidemic Occupational Hearing Loss in

Washington State – University of Washington

Hearing Damage Among Newly-Hired

Construction Workers – University of Washington

Indoor Environment

Health Effects of Exposures to VOCs, Ozone

and Stress – University of Medicine & Dentistry

of New Jersey – Robert Wood Johnson

Ultraviolet Lights in HVAC Systems – Effect on

Health and Well Being – McGill University

Intervention Effectiveness Research

Wisconsin Production Agriculture Intervention

Evaluation – University of Wisconsin

WMSD: Evaluating Interventions Among Office

Workers – Institute for Work and Health

Healthy Work Organization: Intervention

Effectiveness – University of Georgia

Reducing Violence Against Nursing Home

Caregivers – University of Cincinnati

Preventing Musculoskeletal Disorders Among

VDT Operators – Emory University

Outcomes of the Revised CA Bloodborne

Pathogens Standard – University of California

Prevention of Upper Extremity Cumulative

Trauma Disorders – University of Maryland

Evaluating Exposures Under OSHA’s 1984 EtO

Standard – Dana-Farber Cancer Institute

Effects of OSHA Guidelines on Violence

Prevention in Mental Health – University of

Maryland

The Impact of OSHA Inspections on Manufacturing Injuries – University of Pittsburgh

Evaluation of Dust Control Technologies in

Construction Tasks – University of Washington

OSH Program Evaluation in Manufacturing and

Small Business – Dana-Farber Cancer Institute

Claims-Based Surveillance to Identify Injury

Precursors – MCP Hahnemann University

Low Back Disorders

Predictors of Low-Back Injury and Disability in

the U.S. Army – Johns Hopkins University

Low Back Pain: A Multicenter Randomized

Trial – Dartmouth Medical School

Mixed Exposures

Diesel Exhaust and Occupational Lung Cancer

Risk – VA Medical Center

Metalworking Fluids and Aerodigestive Cancer

Risk – University of Massachusetts

Role of O3 in Modulating CR Toxicity in the

Lung – New York University

Combined Effect of Radiation and Asbestos in

Producing Pulmonary Fibrosis – University of

Washington

FY 1999 Grant Awards Related to the National Occupational Research Agenda (NORA) Grouped by NORA Priority Area
Musculoskeletal Disorders of the Upper

Extremities

A Model for Occupational Epicondylitis –

University of California

Carpal Tunnel Syndrome Among Construction Workers – University of Iowa

Organization of Work - Sleep Disorders

Work Schedules and Health in Women

Health Professionals – Brandeis University

Practical Circadian Interventions for Night

Shift Work – Rush-Presbyterin-St. Luke’s

Medical Center

The Impact of Total Workload on Maternal

Postpartum Health and Quality of Life –

University of Minnesota

Work Schedules and Workplace Injuries –

National Opinion Research Center

Caffeine and Naps: Practical Shiftwork

Interventions – St. Luke’s Hospital

*Circadian Adaptation to Night Work in

Older People – Brigham & Women’s

Hospital

Risk Assessment Methods

Measurement Error Methods for Underground Miner Studies – University of

Southern California

Dermal Absorption Enhancers Affect

Organotropism – University of Cincinnati

Correcting for Measurement Errors in

Radiation Exposure – New York University

*Carcinogenesis Modeling for Livers and

Liver Tumors of Mice Treated with DCA or

TCA – Battelle Memorial Institute

*Mechanism of Nongenotoxic Occupational

Carcinogens – Medical College of Ohio

*Cytogenetic Models for Assessing Low

Dose Radiation Risk – University of California

Special Populations at Risk/Aging

Workforce

Work Related Risk Factors Associated with

Falls During Pregnancy – University of

Cincinnati

Ergonomic Aspects of Older Workers’

Postural Balance – University of Cincinnati

Injury and Musculo-Skeletal Disorders

Among Aging Workers in an Industrial

Workforce – Yale University

Work Injuries and Illnesses in Older Workers:

Causes, Consequences and Prevention –

University of Massachusetts

Children’s Injuries on Kentucky Beef Cattle

Farms – University of Kentucky

Work and Social Environments: Urban Youth

and CVD Risk – Johns Hopkins University

Surveillance Research Methods

Injury and Illness Surveillance in Migrant

Farmworkers – University of Texas

Laboratory Reporting for Pesticide Illness

Surveillance – Public Health Institute

Surveillance of Serious Work-Related

Trauma – Minnesota Department of Health

*Multi-State Migrant Farmworker Surveillance Study – Northeast Center for

Agricultural & Occupational Health (NEC)

*Development and Validation of a Mail

Survey of Chemical Exposure – New Jersey

Department of Health

*Distributed Occupational Knowledge

System – University of California

Traumatic Injuries

Postural Stability Effects in Low Seam

Mining Tasks – University of Cincinnati

Electrical Arc Injury Parameters and

Prevention – University of Chicago

Homicide During Robbery: A Case Control

Study – University of North Carolina

Slip, Trip and Fall in Construction and

Transportation – University of Maine

Occupational Knee Injury and Disability in the

U.S. Army – University of Massachusetts

Effects of Musculoskeletal and Sensory

Degradation due to Aging on the

Biomechanics of Slips and Falls –

Texas Tech University

National Occupational Research Agenda 15

* Funded by Partner Agencies
16 National Occupational Research Agenda

Grant Funding Success

The success of NORA in attracting research talent to occupational safety and health

continues to outstrip the ability of NIOSH to fund high-rated research proposals. The

NIOSH success rate for grants funding (the percentage of qualified research proposals

that are funded) still lags substantially behind the rate at NIH (23 percent vs. 32 percent in

FY 1999). One consequence of a disparately low success rate is loss of interested

investigators to research fields with a higher probability of funding. NIOSH has worked

hard through NORA to continue to generate enthusiasm among the research community

despite low success rates, and has experienced a dramatic increase in submitted and

approved grants, particularly in NORA priority areas.

NIOSH Grant Funding Success, FY 1990 - FY 1999

Shifting the Balance

Another NORA success has been in shifting the spectrum of occupational safety and

health research to achieve more balance between etiologic research, i.e., problem

identification and characterization, and problem-solving research. Highlighting this trend is

the growth of intervention effectiveness research grants supported by NIOSH, from

$500,000 in FY 1996 to $4.6 million in FY 1999. Current grants for intervention

research address many subjects of high concern among the general public and policy

makers. These include projects that will evaluate:

• Training in lifting techniques to prevent back injuries

• Preventing hearing loss among construction workers

• Preventing silica exposure among construction workers

• A joint strategy by OSHA and the construction industry to prevent fatalities, injuries,

and illness among home builders

• Reducing musculoskeletal disorders and traumatic injuries among dairy and

vegetable produce farmers

• Preventing back and shoulder injuries among nursing home workers

• Ergonomic interventions to reduce musculoskeletal disorders among office workers

These studies provide crucial information to employers, workers, and others on the

effectiveness of specific strategies for the prevention of injury and illness. For example, a

recently published NIOSH-funded study documented great reductions (as much as 93%) in

sharps and needlestick injuries achieved by a highly replicable intervention strategy

integrating administrative, engineering, and behavioral elements.

25

20

15

10

5

0

Success Rate

300

250

200

150

100

50

0

Number of Grant Applications

FY 90 FY 91 FY 92 FY 93 FY 94 FY 95 FY 96 FY 97 FY 98 FY 99

Success Rate

Number of Grants
Tracking Partnership Products

Requests for Applications (RFAs)

Through targeted RFAs, NORA has been successful in directing resources into the priority

research areas. In FY 1998, NIOSH and NIH awarded 50 grants through a NORA RFA

spending a total of about $8 million dollars in ten NORA priority research areas. In FY

1999, through two RFAs, NIOSH and NIH awarded 33 grants in 17 priority research areas

totaling about $9 million. NIOSH also awarded another 53 NORA grants through the

Institute’s general grants Program Announcement. In FY 2000, NIOSH and NIH partners

are targeting $10 million for an RFA on research related to Special Populations and Mixed

Exposures and NIOSH has announced another $8 million available for additional RFAs

focused on 11 NORA priority areas. Moreover, beginning in FY 2000, NIOSH is partnering

with eight NIH institutes to seek proposals in all NORA priority areas on an ongoing basis.

Team Products

In addition to leveraging resources, as mentioned above, partnership teams are an

integral part of implementation. Team products are also being tracked as a measure of

NORA’s success. The teams have been very active and as expected, each is proceeding

somewhat differently. Many teams are writing white papers, documents that use variable

approaches to advance issues in each priority area, such as summarizing the research in

a priority area, defining gaps, and laying out opportunities for collaboration. In some areas,

a well-defined research agenda currently exists (e.g., asthma), so a white paper was

deemed not necessary. The following 16 NORA teams (covering 17 priority areas) have

completed or are currently working on white papers:

• Allergic and Irritant Dermatitis

• Cancer Research Methods

• Emerging Technologies

• Exposure Assessment Methods

• Fertility and Pregnancy Abnormalities

• Health Services Research

• Hearing Loss

• Infectious Diseases

• Indoor Environment

• Intervention Effectiveness Research

• Mixed Exposures

• Musculoskeletal Disorders (includes Upper Extremity and Low Back)

• Organization of Work

• Social and Economic Consequences of Workplace Illness and Injury

• Surveillance Research Methods

• Traumatic Injuries

Partnership Team activity can also be measured through conferences and workshops.

From September 1996 through June 1999, NIOSH and its partners have sponsored 34

major meetings related to NORA as a whole or to specific priority areas (one in 1996, four

in 1997, 10 in 1998, eight in 1999, and 11 scheduled through October 2000). A list of

the NORA meetings follows. In addition to white papers, conferences, and workshops,

teams are also developing surveys, establishing graduate-level training programs,

participating in continuing medical education workshops, and developing other

documents.

National Occupational Research Agenda 17
18 National Occupational Research Agenda

NORA Meetings, September 1996 through November 2000

Comparing and Contrasting Reproductive Toxicity Testing for Males and Females:

November 9-11, 2000

Enhancing Working Conditions and Patient Safety: Best Practices: October 25, 2000

National Occupational Research Injury Symposium 2000: October 17-19, 2000

Future Research for Improving Risk Assessment Methods: August 15-18, 2000

RESNA 2000 (Rehabilitation Engineering and Assistive Technology Society of North

America): July 28, 2000

Occupational Infectious Disease Research Needs – American Occupational Health

Conference: May 18, 2000

Third International Conference on Measuring the Burden of Injury: May 15-16, 2000

Workplace Violence Intervention Research Workshop: April 5-7, 2000

Preventing Hearing Loss in the Construction Trades: A Best Practices Conference:

March 30-31, 2000

Third Annual Applied Ergonomics Conference: March 14-16, 2000

Donald J. Birmingham Occupational Skin Diseases Session at the 11th Annual Meeting

of the American Contact Dermatitis Society Annual Meeting: March 9, 2000

Musculoskeletal Meeting to Set a Research Agenda (Houston, TX - fourth in a series):

March 8, 1999

Best Practices in Hearing Loss Prevention: October 29, 1999

Working Conditions and Quality of Care: October 12-13, 1999

Functional, Economic, and Social Outcomes of Occupational Injuries and Illnesses:

Integrating Social, Economic, and Health Services Research:

June 13-15, 1999

Experimental Contact Dermatitis Research Group Meeting: May 21-22, 1999

NORA Symposium 1999: Partnership for Research: May 14, 1999

Work, Stress, and Health 99: Organization of Work in a Global Economy:

March 11–13, 1999

Developing a National Occupational Research Agenda for Prevention of

Musculoskeletal Disorders: March 8, 1999

Research Workshop on the Risks and Benefits of Exposure to Ultraviolet Radiation and

Tanning: September 16-18, 1998

Hazardous Substances and Male Reproductive Health: May 14-15, 1998

Natural Rubber/Latex Allergy: Recognition, Treatment, and Prevention, Satellite

Downlink Teleconference: May 5, 1998

Occupational Asthma: In and Out of the Workplace: April 30-May 2, 1998

Round Table Discussion on the Organization of Work at the Society for Industrial and

Organizational Psychology Conference: April 24-26, 1998

Three Musculoskeletal Meetings to Set a Research Agenda

 • April 20, 1998 - Seattle, WA

 • April 27, 1998 - Washington, DC

 • March 25, 1998 - Chicago, IL

Control of Workplace Hazards for the 21st Century: March 10-12, 1998

1998 Applied Workshop on Occupational and Environmental Exposure Assessment:

February 23-25, 1998

National Occupational Injury Research Symposium: October 15-17, 1997

First National Occupational Research Agenda Symposium: July 1, 1997

Delaware Valley Latex Allergy Conference: March 31-April 1, 1997

Pneumonitis in the Machining Environment Workshop: January 28-29, 1997

Workplace-Related Skin Diseases and Exposure Assessment Workshop:

September 25-26, 1996
National Occupational Research Agenda 19

Tracking the Literature

and Recognition of NORA

Bibliometrics

Bibliometrics is among the approaches used to evaluate the impact of NORA.

Bibliometrics is a semi-quantitative method to examine publication rates to determine

publication trends and research productivity.

To document research productivity in the 21 priority areas, NIOSH and the 20 NORA

teams, in collaboration with the Institute for Scientific Information – the world’s largest

bibliographical source of information covering more than 16,000 international peerreviewed journals, books and proceedings in the sciences and social sciences– developed

a method for generating baseline bibliographical databases for each of the 21 NORA topic

areas. The baseline publication rates were computed for the period from 1991 through

1996 (the year NORA was launched) and serves as the reference baseline or metric for

evaluating subsequent growth in publication rates in the NORA priority research areas.

Publication rates are being tracked from 1996 for each of the 21 priority research areas.

Statistical tests will be applied to assess the significance of the rate of change in

publications over the baseline period.

NORA Effectiveness Survey

Measuring the amount of money allocated to NORA priority research areas is only one way

to gauge the effectiveness of NORA. The NORA Liaison Committee has administered a

survey to help determine the recognition and impact of NORA. The Liaison Committee

distributed its survey to key associations and professional organizations (see page 24).

The survey will be administered periodically by the Liaison Committee to gauge the

recognition and influence of NORA over time.

Other Tracking Methods

NIOSH is also tracking “hits” on the NORA web site to assess the diffusion of NORA. The

NORA web site has received over 250,000 hits from May 1998 (when the NORA site was

initiated) through February 2000 (the last month for which data are available). The NORA

web site www.cdc.gov/niosh/norahmpg.html contains all NORA documents, white papers,

research summaries, NORA grants information, a calendar of upcoming events, and

partnership team information. The team posters, developed for the 1999 NORA

Symposium, are also available on the NORA web site.

Many teams are using the NORA web site to enhance their communication efforts. Some

teams have also established listservers to communicate among researchers interested in

specific priority research areas. The quarterly NORA newsletter, entitled NORA News, has

also helped improve NORA communication. Feedback from NORA News response cards

reveals that for readers of the newsletter, NORA News is a primary source of information

on NORA. Another communications effort, a compendium describing NIOSH-conducted or

-funded NORA research, will be available in the summer of 2000.
Partnership

NORA Partnerships

NORA has helped demonstrate that there is a new way of doing business at NIOSH.

Although the transformation to the “new NIOSH” was in process prior to NORA, the

development and implementation of the Agenda have proven to many in the private sector

that collaboration with the government is not only possible, but worthwhile.

Research related to the Traumatic Injury Team has proven particularly fruitful. The

Traumatic Injury Team document, Traumatic Occupational Injury Research Needs and

Priorities, is helping to pave the way for future partnerships. The document provides a

foundation for discussion with external partners to explore common research areas. In the

first three examples below, industry approached NIOSH to collaborate on topics related to

the traumatic injury priority research area. All of the following partnership success stories

demonstrate the benefits of partnership for improving worker safety and health. In each,

NIOSH provides its scientific expertise and creative problem-solving skills and the partners

provide the “laboratories” for evaluating interventions in real work settings.

Wal-Mart

The effectiveness of back belts has been questioned in recent years. In 1994, NIOSH

released a report stating that there is inadequate scientific evidence that back belts

actually reduce the risk of back injury. The statement reflected concerns that many

employers were providing (and often requiring) back belts as the only method to prevent

back injury. In partnership with Wal-Mart, NIOSH is completing the most definitive research

study to date on the efficacy of back- supporting belts in preventing first and recurrent low

back injuries. Approximately 9,000 retail merchandise employees at 160 stores in 30

states were followed for two years to determine if low back injury rates in individuals

wearing belts were different from rates in individuals not wearing belts. The results are

currently undergoing scientific peer review and will be published in the near future.

BJC Health System

Back injuries are one of the most common injuries among nursing home employees. BJC

Health System designed and implemented a “best practices” system, and approached

NIOSH for help in scientific evaluation of the program as implemented in Illinois and

Missouri. NIOSH and BJC will evaluate the efficacy of a “best practices” program in

reducing the incidence and cost of back injury among nursing home workers. The “best

practices” program includes: use of specialized, state-of- the-art lifting equipment, training

in lifting techniques, accident investigation, and medical management of injured workers.

A peer review meeting was held in September 1999 to receive comments from a panel of

scientific reviewers and other stakeholders on this intervention effectiveness evaluation.

Data collection is ongoing and the project is scheduled for completion in 2001.

Anthony Crane Rental

Crane operators, on-site workers, and the general public are at risk of serious and possibly

fatal injury due to incidents involving cranes or hoists. In 1994, incidents involving cranes

resulted in 88 fatalities. In addition, damage to property can be extremely costly. Anthony

Crane Rental (ACR) is the largest crane rental company in the world, and has over 3,500

cranes and over 4,000 pieces of aerial lift equipment. NIOSH and ACR are currently

collaborating on a feasibility study examining the effectiveness of crane operator

certification on the prevention of crane-related injuries. The results will help industry, labor,

and the public, as well as guide policy-makers about the value of mandatory certification.

20 National Occupational Research Agenda
National Occupational Research Agenda 21

Navistar, UAW, Aetna US Healthcare

NIOSH is working with Navistar International Transportation, the United Auto Workers, and

Aetna US Healthcare to evaluate the results of expanding workplace-based occupational

safety and health programs to include general health care. The study will assess the

impact of this intervention on health care status, utilization and costs, and worker

productivity.

Asphalt Partnership

In order to reduce worker exposure to asphalt fumes during paving operations, NIOSH

formed a collaborative partnership with government, industry, and labor. The partnership

developed a comprehensive engineering control strategy to reduce exposures to asphalt

fumes during paving operations. The engineering control is a ventilation system attached

to the paver that reduces fume and heat before they can reach the worker. As a result, as

of July 1, 1997, all highway paving machines now have this effective control technology.

This very successful program was a finalist in the prestigious Innovations in American

Government Award Program in 1998. The broad-based network of partnerships created

by NORA has helped foster these continuing and evolving efforts. As such, it is only fitting

that this project received the first NORA Partnership Award in 1999.

Diesel Research Partnership

Based on the success of the Asphalt Partnership, the United Mine Workers of America,

the Bituminous Coal Operators Association, the National Mining Association, and NIOSH

have formed multiple partnerships to reduce miners’ diesel exposure despite the

continuing debate about miners’ exposure to and health effects of diesel particulate

matter. In spite of continuing scientific and regulatory controversy, both labor

representatives and mine operators agree that some action should be taken now to

reduce or eliminate the exposures. The partners are launching multiple research and

intervention activities to quickly arrive at their shared goal.

Department of Veteran Affairs

The Veterans Health Administration (VHA) within the Department of Veterans Affairs (DVA)

employs one of the largest groups of healthcare workers in the U.S. There were 223,602

employees in the VHA as of November 1997. In October 1998, a Memorandum of

Understanding (MOU) was signed by NIOSH and the DVA formally establishing a research

partnership combining NIOSH’s research capabilities and the DVA’s large health care

organization. This unique partnership will make the DVA facilities available to NIOSH for

many types of health care research, and will ultimately lead to better understanding of

prevention interventions for health care workers. Initially, the partnership is supporting a

joint study on latex allergy which will provide NIOSH with new insights into developing more

effective recommendations to protect workers, and will provide the DVA with an accurate

estimate of the extent of latex sensitization among its employees. The partnership has

also sponsored joint participation in an Expert Meeting on Working Conditions and Quality

of Care – looking at the relation between healthcare workers’ health and safety and quality

of patient care – and will co-sponsor Enhancing Working Conditions and Patient Safety:

Best Practices in October 2000, which will explore interventions that improve both worker

and patient safety. Effectiveness of preventive intervention activities will also be studied.

The partnership directly relates to a number of NORA priority areas, including Health

Services Research, Asthma and COPD, Allergic and Irritant Dermatitis, and Special

Populations at Risk.
22 National Occupational Research Agenda

NORA - A Model for Partnership

One of the most encouraging testaments to the success of NORA is the number of

other organizations using NORA as a model for creating research agendas or other

types of partnership and planning. NORA has generated tremendous interest –

especially at the federal level – because of its innovative approach to strategic

planning. NIOSH has shared its experience with many who have sought to

undertake a similar effort. Examples of such planning efforts follow.

International and Foreign National Organizations

• European Agency for Safety and Health at Work

• Istituto Superiore Per La Prevenzione E La S Curezza Del Lavoro (the Italian

Institute for Occupational Safety and Health)

• Japanese National Institute of Industrial Health

• Norwegian National Institute of Occupational Health

Federal Agencies and Programs

• Department of Defense, Deployment Toxicology Research and

Development Master Plan

• Environmental Protection Agency, Human Health Indoors Project

• Chemical Safety and Hazard Investigation Board

• National Committee on Vital and Health Statistics

• Centers for Disease Control and Prevention

• Agency for Toxic Substances and Disease Registry

State Agencies Conducting Occupational Health Research

• Maine

• California

• Washington

Non-Profit Research Organizations

• The Pacific Northwest Agricultural Safety and Health Center, Occupational

Research Agenda for Northwest Farming

• The Chemical Industry Institute of Toxicology
National Occupational Research Agenda 23

NORA Partnership Award

NIOSH presented the first NORA Partnership Award for Worker Health and Safety to the

Asphalt Partnership at the 1999 NORA Symposium. The award recognizes outstanding

NORA partnership activities that lead to improved worker health and safety. Through a

unique collaboration, the Asphalt Partnership brought together diverse partners to achieve

the goal of reducing workers’ exposure to asphalt fumes during highway paving. The

partners included NIOSH, the National Asphalt Pavement Association, the Federal Highway

Administration, the Occupational Safety and Health Administration, the International Union

of Operating Engineers, the Laborers’ Health and Safety Fund of North America, the

Laborers’ International Union of North America, and the Asphalt Institute.

Through use of innovative engineering controls, the partners achieved an unprecedented

accomplishment – 100 percent of an industry voluntarily agreeing to implement control

technology equipment (which reduces worker fume exposure by about 80 percent) on all

new highway pavers produced after July 1997. The partnership formed amid ongoing

controversies surrounding the health effects of asphalt fume exposures and possible

regulatory activity aimed at reducing these exposures. Working together, the partners

avoided the protracted regulatory process and ensured that effective control technologies,

designed and evaluated by NIOSH and its partners, were implemented to protect the

approximately 300,000 highway paving workers across the nation.

This unique partnership was also selected as one of 25 finalists (out of 1,420 applicants) in

the 1998 Innovations in American Government Awards Competition sponsored by the Ford

Foundation, the John F. Kennedy School of Government at Harvard University, and the

Council for Excellence in Government. The prestigious Innovations Award recognizes

excellence in government and celebrates outstanding examples of creative problemsolving in the public sector.

To be eligible for the NORA Partnership Award for Worker Health and Safety, partnership

activities must include collaborative research in at least one NORA priority area that

results in the development of interventions that reduce hazardous exposures or adverse

outcomes. Partners should represent a broad and diverse spectrum of organizations and

individuals, such as manufacturers, end-users, labor, the public health community,

academia, and government. The next award will be given at the 2001 NORA Symposium.
24 National Occupational Research Agenda

Guiding NORA Implementation

Liaison Committee

The NORA Liaison Committee, chaired by Dr. Bonnie Rogers (American Association of

Occupational Health Nurses), consists of 24 members representing industry, labor,

academia, professional organizations, and government (see listing on page 2). The

Liaison Committee’s role is to provide outreach and commentary on the development,

progress, and direction of NORA implementation.

In 1999, the Liaison Committee undertook a survey of key occupational safety and health

professional organizations. Of the 948 respondents, 42 percent reported that they were

aware of NORA. Among this group, 30 percent reported that NORA had changed the

research priorities of their organizations. Twenty percent reported that NORA had

increased funding for their organization’s research and 35 percent responded that NORA

had increased partnerships between both researchers and organizations. Additionally, 47

percent responded that NORA had increased the quality of occupational safety and health

research.

The Liaison Committee is also responsible for administering the NORA Partnership Award

for Worker Safety and Health. The Committee will oversee the nomination and selection

process of this biennial award honoring outstanding partnership activities.

Federal Liaison Committee

The Federal Liaison Committee (see listing on next page) is an interagency working group

guiding the implementation of NORA. In 1999, the Committee undertook the second

biennial survey of federal investment in NORA and in occupational safety and health

research overall. The first survey, covering FY 1996, provided a baseline identifying a total

of only $199 million spent for all occupational safety and health research from the survey

respondents (including NIOSH), compared to $218 million in FY 1998. Although the

overall increase in spending was not large, there was a substantial increase in spending in

NORA priority areas, from $30 million in FY 1996 to $70 million in FY 1998 (see page 9).

Members of the Federal Liaison Committee have also been active in leveraging additional

resources for NORA. In FY 2000, NIOSH and 10 federal partners announced the third

consecutive year of grant funding in the NORA priority research areas (see description on

page 12).
National Occupational Research Agenda 25

Federal Liaison Committee

FEDERAL AGENCY OFFICE/INSTITUTE/DIVISION

Consumer Product Safety Commission

Department of Agriculture Cooperative State Research, Education and

Extension Service

Department of Defense Office of Naval Research

Department of Energy Office of the Environment, Safety and Health

Department of Health Agency for Health Care Research and Quality

and Human Services Agency for Toxic Substances and Disease Registry

Centers for Disease Control and Prevention

Epidemiology Program Office

National Center for Chronic Disease Prevention

and Health Promotion

National Center for Environmental Health

National Center for Health Statistics

National Center for HIV, STD, and TB Prevention

National Center for Infectious Diseases

National Center for Injury Prevention and Control

National Immunization Program

Office of Minority Health

Office of Women’s Health

Food and Drug Administration

Office of Intergovernmental Affairs

National Institutes of Health

Fogarty International Center

National Cancer Institute

National Heart, Lung, and Blood Institute

National Institute on Aging

National Institute of Allergy and Infectious

Diseases

National Institute of Arthritis and Musculoskeletal

and Skin Diseases

National Institute on Deafness and Other

Communication Disorders

National Institute of Environmental Health Sciences

National Institute of Mental Health

National Institute of Neurological Disorders and

Stroke

National Institute of Nursing Research

Office of Women’s Health

Substance Abuse and Mental Health Services

Administration

Department of Justice National Institute of Justice

Department of Labor Bureau of Labor Statistics

Mine Safety and Health Administration

Occupational Safety and Health Administration

Wage and Hour Division

Department of Transportation Federal Aviation Administration

Federal Highway Administration

National Highway Traffic Safety Administration

Department of Veterans Affairs

Environmental Protection Agency National Exposure Research Laboratory

Office of Prevention, Pesticides, and Toxic Substances
26 National Occupational Research Agenda

NIOSH/NORA Partnership Structure

Office of the Director

Washington, DC

Linda Rosenstock, MD, MPH

Office of the Deputy Director

Atlanta, GA

Bryan D. Hardin, PhD

Washington, DC

Office of Health Communications

Office of Policy, Planning & Legislation

Office of Mine Safety & Health Research

Atlanta, GA

Office of Admin. Management Services

Office of Extramural Programs

Cincinnati, OH

Division of Applied Research and

Technology

Division of Surveillance, Hazard

Evaluations, & Field Studies

Education & Information Division

Morgantown, WV

Division of Respiratory Disease Studies

Division of Safety Research

Health Effects Laboratory Division

Pittsburgh, PA

Pittsburgh Research Laboratory

Spokane, WA

Spokane Research Laboratory

NORA Liaison

Committee

NORA Federal

Liaison Committee

Team Name

Team Leader

Team Members

(# NIOSH # External)

Allergic & Irritant Dermatitis

Boris Lushniak

G. Frank Gerberick

6 NIOSH 7 External

Asthma & Chronic Obstructive

Pulmonary Disease Kathleen Kreiss

8 NIOSH 5 External

Cancer Research Methods

Paul Schulte

Elizabeth M. Ward 7 NIOSH 9 External

Control Technology & Personal

Protective Equipment

Lawrence Reed

8 NIOSH 7 External

NORA

PARTNERSHIP

TEAMS

Emerging Technologies

Aaron Schopper

6 NIOSH 8 External

Exposure Assessment

Methods Mary Lynn Woebkenberg

8 NIOSH 6 External

Surveillance Research Methods

Implementation Team John Sestito 7 NIOSH 10 External

Fertility & Pregnancy

Abnormalities

Teresa Schnorr

6 NIOSH 7 External

Health Services

Research

Scott D. Deitchman

5 NIOSH 9 External

Hearing Loss

John Franks

6 NIOSH 10 External

Indoor Environment

Mark Mendell 6 NIOSH 8 External

Infectious Diseases

Thomas K. Hodous

5 NIOSH 14 External

Intervention Effectiveness

Research

Linda Goldenhar

Theodore M. Katz

6 NIOSH 10 External

Mixed Exposures

Frank Hearl 5 NIOSH 8 External

Musculoskeletal Disorders

Lawrence J. Fine

7 NIOSH 11 External

Organization of Work

Steve Sauter

8 NIOSH 8 External

Risk Assessment Methods

Leslie Stayner

5 NIOSH 7 External

Social & Economic

Consequences of Workplace

Illness & Injury

Elyce Biddle

Leslie I. Boden

6 NIOSH 11 External

Special Populations at Risk

Sherry Baron

Rosemary Sokas

7 NIOSH 9 External

Traumatic Injuries

Nancy Stout

7 NIOSH 7 External
National Occupational Research Agenda 27

Partnership Teams

Fundamental to the success of NORA are the contributions of the Partnership Teams.

The Teams’ ability to involve key stakeholders in the priority areas, define research needs,

and leverage resources for research are critical to the implementation of the Agenda.

Each team consists of a team leader, NIOSH researchers, and external partners. The 20

partnership teams have brought together approximately 130 NIOSH researchers and 170

external members (see inside front and back covers for team membership). External

membership includes faculty from public and private colleges and universities, representatives of professional organizations and major industries, leaders in the insurance industry,

health and safety professionals from organized labor, and representatives from other

government agencies. The following summaries highlight the work of each of the 20

NORA Partnership Teams.

Team Summaries

Allergic and Irritant Dermatitis Team

The Allergic and Irritant Dermatitis (AID) Team mission is to develop a broad-based, active,

and lasting group to catalyze research in AID. To date, AID Team accomplishments

include: organizing and co-sponsoring meetings within the occupational safety and health

and dermatology community; enhancing dermatology-related activities through both

intramural and extramural research; and developing research priorities. In September

1998, the team cosponsored the Workshop on Health Effects and Benefits of UV Radiation

and Tanning with the National Institute of Arthritis and Musculoskeletal and Skin Diseases

(NIAMS), NIOSH, and others. The Experimental Contact Dermatitis Research Group,

sponsored by NORA AID Team/NIOSH, the Skin Disease Research Centers at the

University of Texas Southwestern Medical Center, Case Western Reserve University/

University Hospitals of Cleveland, and the Procter & Gamble Company, was convened in

Cincinnati May 20-21, 1999. The purpose of this meeting was to discuss the basic and

applied science of experimental contact dermatitis. On March 9, 2000, the NORA AID

Team/NIOSH sponsored the Donald J. Birmingham Occupational Skin Diseases Session at

the 11th Annual Meeting of the American Contact Dermatitis Society in San Francisco. In

FY 1998, NIOSH and NIAMS co-funded an RFA for irritant dermatitis and funded five

dermatitis projects. In FY 2000, NIOSH funded an inter-divisional intramural research

program, Developing Dermal Policy Based on Lab and Field Studies. Finally, the team has

been working on the development of research priorities in AID (now available in draft form).

Asthma & Chronic Obstructive Pulmonary Disease Team

The Asthma & Chronic Obstructive Pulmonary Disease Team has continued its successful

partnerships with federal agencies to increase resources available for the extramural

community for research on occupational asthma and chronic obstructive pulmonary

disease (COPD). Requests for applications for such research have been jointly supported

with the National Heart, Lung, and Blood Institute in each of the last three years. In

addition, NIOSH has partnered with the CDC’s National Center for Environmental Health

and Agency for Toxic Substances and Disease Registry to fund two cooperative

agreements to ascertain the population-based proportion of incident asthma cases

attributable to occupational exposures. Intramurally, NIOSH sponsors a major initiative on

research for occupational asthma reduction, including projects on building-related asthma

in offices and schools, workplace exacerbation of pre-existing asthma, medical monitoring

for isocyanate asthma, and latex asthma in Veterans Administration hospitals. The team
28 National Occupational Research Agenda

hosted an international symposium on asthma in 1998, a workshop on questionnaire

revisions pertinent to building-related asthma in 1999, and an ad hoc committee of the

American Thoracic Society to prepare a published statement on occupational asthma and

COPD.

Cancer Research Methods Team

The NORA Cancer Research Methods Team has been reviewing methodologies that can

have an impact on occupational cancer research. These methodologies range from the

microlevel (such as structure-activity relationships to predict carcinogens) to the

macrolevel (such as improvements in exposure assessments in epidemiological studies).

The team is planning to publish a white paper on research needs and gaps for cancer

research methods in four areas: carcinogen identification, eidemiologic studies, risk

assessment, and prevention. An important theme will be better integration of laboratory

and epidemiologic research.

Control Technology and Personal Protective Equipment Team

The Control Technology & Personal Protective Equipment Team, in conjunction with the

American Industrial Hygiene Association and the American Society of Safety Engineers,

held a unique conference and workshop in 1998, The Control of Workplace Hazards for the

21st Century: Setting the Research Agenda. It brought together over 250 researchers,

manufacturers, and users of engineering controls and personal protective equipment. The

participants created a future control technology research agenda for six areas: chemical

protective clothing, engineering controls, noise, non-ionizing radiation, respirators, and

traumatic injuries. Draft proceedings from this conference and workshop will soon be

available for public use.

Emerging Technologies Team

The NORA Emerging Technologies Team is working on establishing mechanisms to

ensure that worker health and safety is considered when new technologies are developed

and implemented. The team is also seeking partners who are interested in co-sponsoring

research that attempts to bring advanced and emerging technologies to bear on

occupational safety and health concerns. The team is currently co-sponsoring, along with

the National Science Foundation, the National Institute of Standards and Technology, and

industry, a workshop to be held in conjunction with a meeting of the American Society of

Mechanical Engineers relating to the application of emerging technologies to the field of

ergonomics. The workshop will explore how the development of affordable, objective

means of estimating and measuring ergonomic factors related to musculoskeletal

disorders and hand-arm vibration can enhance research and monitoring capabilities in this

area.

Exposure Assessment Methods Team

The Exposure Assessment Methods Team is composed of 14 members representing

various disciplines (e.g., chemistry, biology, industrial hygiene, occupational health nursing,

toxicology, and epidemiology) from government, academia, labor, and industry. The team

has co-sponsored a symposium on Exposure Assessment with the American Conference

of Government Industrial Hygienists; served on the planning committee of a workshop on

the role of human exposure assessment in the prevention of environmental disease with

the National Institute of Environmental Health Sciences/National Toxicology Program; and

served on the planning committee of the International Symposium on Occupational

Exposure Data Bases and Their Application in the Next Millennium. The team has

completed a draft of a white paper that addresses key exposure assessment issues such

as field study design, monitoring methods development, and toxicology research, along

with education and communication needs relative to exposure assessment.
Fertility and Pregnancy Abnormalities Team

The mission of the Fertility and Pregnancy Abnormalities Team is to assist in the

development and pursuit of reproductive health research. One of the team’s goals is to

increase public awareness and understanding of known reproductive hazards. To do this,

the team is using the NORA web page, the NTP/NIEHS Center web page, and pamphlets

published by NIOSH. The team helped organize the conference, Hazardous Substances

and Male Reproductive Health, held in May 1998 in New York. The conference was

sponsored by the Mount Sinai School of Medicine, NIEHS, NIOSH, and the New York

Academy of Medicine. The team is also developing a paper on current research needs in

the field of occupational reproductive health to help encourage research in areas that are

most in need. NIOSH and NIEHS cosponsored the FY 1999 RFA which included fertility and

pregnancy abnormalities as a targeted research area, a FY 2000 R21 RFA for

developmental grants, and an RFA on endocrine disruptors and reproductive/

developmental effects. The team will also cosponsor an NIEHS workshop in November

2000, Comparing and Contrasting Reproductive Toxicity Testing for Males and Females.

Health Services Research Team

The Health Services Research Team seeks to define and promote research into the

delivery of health care to workers. In June 1999, the team co-hosted the conference,

Functional, Economic, and Social Outcomes of Occupational Injuries and Illnesses:

Integrating Social, Economic, and Health Services Research, in Denver, Colorado. This

conference brought together NORA team members and other researchers in the fields of

occupational health services research and social and economic consequences of

occupational injury and illness. Ten commissioned papers, which have been submitted for

peer-reviewed publication, served as the starting point for discussions of current needs,

challenges, and priorities for research in these areas. Using this information, the Health

Services Research Team is developing a white paper to identify key research priorities.

Team members are also participating in a research project funded by the Robert Wood

Johnson Foundation to create performance measures for occupational health services

provided in managed care. Several research papers from this project have been drafted

for submission to peer-reviewed journals. New research partnerships are being explored

with major industrial employers. Team members also contributed to an announcement of

grant funds for students training in occupational health services research.

Hearing Loss Team

The Hearing Loss Team is finalizing a white paper on the prevention of occupational

hearing loss and plans to publish the document in 2000. The Team is conducting a series

of best practices conferences, the first of which focused on the manufacturing sector and

was held in Detroit, Michigan, in October 1999. The conference was cosponsored by

NIOSH, Wayne State University, and the National Hearing Conservation Association. The

second best practices conference, focusing on construction, was held in March 2000 in

Washington D.C., and was cosponsored by NIOSH, OSHA, and the Laborers International

Health and Safety Fund of North America. Future best practices conferences may

address small business, mining, and agriculture. Proceedings will be available for each

best practices conference as NIOSH publications.

The team is also working on the development of training curricula for the prevention of

occupational hearing loss for Industrial Hygiene and Audiology graduate programs at the

masters level. As a first step in this process, the team conducted an Internet survey of

industrial hygienists and audologists on hearing loss prevention training. Team members

will also be contacting universities and colleges with graduate training in Industrial Hygiene

and Audiology to determine the availability of formal course work. At this time, neither

certifying body requires formal course work or provides curriculum guidance.

National Occupational Research Agenda 29
30 National Occupational Research Agenda

Indoor Environment Team

The goal of the NORA Indoor Environment (IE) Team is to focus and facilitate research

among broadly based multi-sector partnerships that improves the health of workers in

indoor environments. The IE team has produced a draft research agenda giving priority to

specific building-related health effects with the largest estimated adverse health and

economic impacts. It will be published as a scientific article. The draft research agenda, in

combination with the availability of increased NIOSH extramural funding, has already

stimulated a large increase, both in number and in rigor, of IE-related research proposals in

the U.S. NIOSH funded four extramural projects, two in FY 1998 and two in FY 1999.

Three are blinded, controlled intervention studies on ventilation, viral respiratory infections,

and illness absence; the joint effects of volatile organic compounds, ozone, and stress on

health; and the health benefits of in-duct ultraviolet radiation. The fourth study will develop

a hand-held instrument to identify and quantify low concentrations of mixed volatile organic

compounds. The IE team has also developed a request for proposals for inclusion in a FY

2000 CDC RFA to evaluate the health benefits of existing regulations related to ventilation

and other IE parameters. Internally, NIOSH has recently begun a large research initiative in

the Division of Respiratory Disease Studies on respiratory disease in indoor work

environments.

Infectious Diseases Team

The mission of the Infectious Diseases (ID) Team is to review and recommend needed

changes in occupational infectious diseases research efforts, facilitate the development of

new research and collaboration in this area, call attention to national needs in occupational

infectious diseases research, and help in the greater dissemination of research data in the

field. To this end, the team has developed a draft white paper addressing major research

needs, particularly those involving human-to-human transmission, which will be presented

at a session of the American Occupational Health Conference on May 18, 2000, in

Philadelphia to receive external comments. Team members helped in the development

and review of the NIOSH Alert Preventing Needlestick Injuries in Health Care Settings. The

team will also be involved with a session on needlestick injuries to be presented at the

National Occupational Injury Research Symposium in October 2000 in Pittsburgh. As

experts in the infectious disease community, several team members have independently

contributed to other conferences discussing occupational infectious disease issues,

including Tuberculosis Control in the 21st Century (December 1999) and the Fourth

Decennial International Conference on Nosocomial and Healthcare-Associated Infections

(March 2000).

Intervention Effectiveness Research Team

The Intervention Effectiveness Research (IER) Team has been active in carrying out the

team’s mission to: 1) increase the awareness and appreciation of the value of OSH

intervention research, 2) increase the understanding and use of optimal research

methods for conducting IER, 3) promote investment in IER across OSH, and 4) broaden

dissemination of results and lessons learned from occupational safety and health

intervention research. The team has prepared a journal article describing a conceptual

framework which outlines the major phases and activities involved in conducting

intervention research. The team has also developed a case-based workshop exercise to

train health and safety professionals to think critically about important issues when

developing, implementing, and evaluating interventions. The workshop has been

presented at a number of health and safety conferences. The team is also developing a

practical manual for evaluating safety and health interventions in the workplace and

collaborating with the Institute of Labor and Health in Toronto, Canada, in preparing a “How

To” intervention evaluation manual for safety and health professionals.
Mixed Exposures Team

The Mixed Exposures Team has reviewed the recent and past literature and has examined

on-going work both nationally and internationally. Through meetings held in 1999, the

Mixed Exposure Team is building on its analysis of ongoing mixed exposure research to

develop a research agenda. Past analysis lead the team to group the subject into the

following categories: complex mixtures (such as combustion exhausts), mixtures with

identifiable composition, mixed stressor exposures (such as noise and chemicals), and

mixtures associated with particular workplaces or processes (such as coal mine dust).

Although research can be directed at various specific mixtures in each of these

categories, the team is recommending that priority be given toward those studies that

yield a broader understanding of how mixed exposures potentiate the health response, and

to the extent possible, simultaneously carry out the research with real-world mixtures that

affect large numbers of workers. Through application of the priority selection logic, the

team hopes to stimulate research on physiologically based pharmacokinetic modeling,

case studies to develop tools for broad applications in mixed exposure research, and

further work on biomarkers. The team continues to facilitate communications and

collaboration among researchers and those interested in mixed exposures through a list

server and a site on the Internet. Instructions for joining the list server are provided on the

Mixed Exposures Team Internet site at: http://www.cdc.gov/niosh/mixed.html.

Musculoskeletal Disorders Team

The Musculoskeletal Disorders Team is continuing to work on the development of a NIOSH

document that includes a comprehensive National Occupational Research Agenda

directed at prevention of work-related musculoskeletal disorders. Four workshops

(Washington, DC, Chicago, Illinois, Seattle, Washington, and Houston, Texas) were

conducted to identify gaps in existing knowledge and shape the agenda. The document

includes comments from practitioners, academics, and members of the NORA MSD

team. Additionally, in March 2000 at the Applied Ergonomics Conference, the NORA MSD

Team joined in a partnership with the Institute for Industrial Engineers to conduct a

workshop on research needs for interventions in the health care industry. The team will

summarize the findings from the workshop and place them on the NIOSH web page.

Organization of Work Team

Since 1998, the Organization of Work Team has met on a regular basis to consider the

changing nature of work, potential health and safety risks, and prevention strategies. To

better understand knowledge gaps and research needs in these areas, an outreach

workshop with key interest groups was held in March 1999 in Baltimore, MD. Team

members met with representatives from national and international stakeholder

organizations to elicit their viewpoints on three broad topics: 1) how the organization of

work is changing, 2) safety and health implications of these changes, and 3) interventions

for reducing health and safety risks. Information from this meeting is being integrated into

a strategic report by the team on research needs in work organization and health. Also in

1999, the team cosponsored (with the American Psychological Association) a major

scientific conference on work organization and health and delivered technical

presentations on safety and health concerns in the changing organizational environment

at meetings of the European Agency for Safety and Health at Work, the American

Industrial Hygiene Association, the Academy of Management, and the American Public

Health Association. The team has formulated Year 2000 plans for sponsorship of

research symposia on work organization and health at stakeholder conferences, and for a

federal interagency meeting to leverage support for an expanded program of research on

this topic.

National Occupational Research Agenda 31
32 National Occupational Research Agenda

Risk Assessment Methods Team

The Risk Assessment Methods Team has defined ten research areas that will promote

improvements in the methodologies used for risk assessment. One of these research

areas was funded by NIOSH in a Cooperative Agreement with researchers at the University

of North Carolina and will support research to evaluate the degree of concordance

between toxicologic and epidemiologic estimates of risk for carcinogenic hazards. NIOSH,

EPA, and NCI have funded a 1999 RFA for research focusing on the development of

cancer risk assessment methods and practices. The team is currently organizing a

workshop, Future Research to Improve Risk Assessment Methods, that will be held in

August 2000.

Social and Economic Consequences of Workplace Illness and Injury Team

The Social and Economic Consequences of Workplace Illness and Injury Team seeks to

help guide the Nation’s research of the social and economic consequences of workplace

illness and injury over the next decade through increasing the quality and quantity of

research, improving the availability of data to measure social and economic

consequences, and extending the scope of traditional economic and sociologic inquiry into

public health. This team, in conjunction with the Health Services Research NORA

implementation team, sponsored a conference in June 1999 that addressed performance

measures for health services delivered to prevent or treat occupational injury or illness,

measures of the economic and social impact of occupational injury or illness, and research

that integrates these two areas. Following the conference, summaries of each session

discussion were completed and posted to the NORA website. Professional opinion,

judgment, and recommendations from the conference provided direction for developing a

draft national occupational research agenda. Background papers, which were used to fuel

the discussions at the conference, were submitted for publication in a peer-reviewed

journal. In addition to this work, several team members are focusing their efforts on

improving the availability of data. To help identify gaps in existing data sources, a

comprehensive inventory of national data on injury and illness mortality, morbidity, and the

social and economic consequences of those injuries and illness is being compiled. The

Robert Wood Johnson Foundation funded team members to develop and test a

standardized method for creating an interstate database for the study of worker’s

compensation medical care, and the International Association of Industrial Accident

Boards and Commissions is working in collaboration with the team to create an

international data repository of worker’s compensation administrative records.

Special Populations at Risk Team

The Special Populations at Risk Team has identified home health workers as a work sector

disproportionately comprised of special populations at risk and will also explore the “super

healthy worker effect” as a targeted area. The team is also addressing research

directions for the aging workforce and presented a panel discussion at the Fall 1999

State of the Art Occupational Medicine Conference on the topic of the aging workforce.

Team members participated in town meetings sponsored by NIEHS to identify appropriate

mechanisms to address health disparities related to the environment, and facilitated

NIOSH co-sponsorship of a joint RFA soliciting research to eliminate health disparities due

to occupational and environmental exposures. The team will sponsor sessions at the

October 2000 National Occupational Injury Research Symposium in Pittsburgh and the

annual American Public Health Association meeting in Boston in November 2000. The

team assisted in the development of the July-September 1999 issue of the journal,

Occupational Medicine: State of the Art Reviews, which focused entirely on the issues

facing special populations at risk. Several team members also participated in the

development of the Institute of Medicine report, Youth at Work, which was released in
National Occupational Research Agenda 33

November 1998. The research track at the annual Migrant Stream Forum meeting,

established by NORA team members in 1998, is in its third year. The research listserve,

a direct outgrowth of this effort, has proven to be extremely successful.

Surveillance Research Methods Team

The Surveillance Research Methods Team has played an integral role in the selection of

surveillance research methods topics for the FY 1999 grant solicitation and the three new

surveillance RFAs in FY 2000. The Exposure Assessment and Surveillance Research

Methods Teams are discussing exposure surveillance issues with the American Industrial

Hygiene Association to advance a vigorous program of exposure surveillance research, to

partner in the creation of a national occupational exposure database, and to conduct a

new National Occupational Exposure Survey (NOES). Members of the team contributed

significantly to the NIOSH surveillance strategic planning effort and the development of the

NIOSH Worker Health Chartbook 2000.

Traumatic Occupational Injury Research Team

The Traumatic Occupational Injury Research Team continues to foster collaborative

research partnerships with internal and external partners. The team is currently assisting

with planning for the National Occupational Injury Research Symposium (NOIRS) 2000.

This second national symposium will be held in Pittsburgh, PA, in October 2000. A number

of the NORA Teams are participating in this symposium such as Special Populations at

Risk, Organization of Work, Control Technology & PPE, Social and Economic

Consequences, Risk Assessment Methods, and Intervention Effectiveness. This

conference builds on the success of the first NOIRS conference in October 1997. This

first ever national conference on occupational injury research was attended by over 300

occupational safety professionals from a wide variety of disciplines and organizations.

The team has also developed a document describing the needs and priorities for traumatic

occupational injury research in the U.S. Published by NIOSH in 1998, the document,

Traumatic Occupational Injury Research Needs and Priorities, provides a broad framework

of the objectives and research needed to begin filling the gaps in knowledge and furthering

progress toward safer workplaces and practices. Furthermore, it provides a reference and

structure for traumatic occupational injury research which can be used to facilitate new,

and rekindle existing, partnerships and collaborative research to prevent worker injuries

and deaths.
34 National Occupational Research Agenda

Kudos for NORA

NORA has received broad support from many quarters. The following examples are from

May 1999 through February 2000.

The Committee is encouraged with the progress by NIOSH on implementing the

National Occupational Research Agenda [NORA]. The Committee is supportive of

NIOSH’s efforts to further its partnerships with the occupational safety and health

community and the broader public and private public health research community,

and believes these partnerships will be important in the implementation phase.

The Committee urges NIOSH to work with its partners to augment resources

available to the Institute for NORA research.

– Senate Appropriations Report Language, FY 2000

NORA initiatives are so important because they base themselves on the kinds of

interactions that will have to become central issues for our society as the next

century begins.... NORA is a prototype for these kinds of initiatives.

– Kenneth Shine, M.D., President, Institute of Medicine,

National Academy of Sciences

This country is making a transition into a new economy ... an economy that will

present all of us with a whole new series of workplace health hazards to

overcome. In my judgement, NORA is absolutely essential to how we are going to

take on these kinds of issues . . . . From its [NORA’s] beginnings, NIOSH and its

partners have understood that a prerequisite to making workplaces safer in this

new economy is making sure that no one is left out of the decision making

process. That’s really the genius of NORA. . . . I’ve encouraged all my staff to use

NORA as a model for building strong research partnerships.

– Donna Shalala, Ph.D., Secretary, U.S. Department of

 Health and Human Services

By coming together with others who care about the costs of occupational injuries

and illnesses, both in human and economic terms, we all benefit. It is also

important that NORA’s agenda emphasize not only medical problems but the

social and economic concerns also. At the Building and Construction Trades

Department, representing more than three million workers, . . . we are very proud

to be partners in NORA.

– Robert Georgine, President, Building and Construction

Trades Department, AFL-CIO

The highpoint of the year, if not of NAPA’s 44-year history, was the day in April

when NAPA received the first NORA Award, bestowed by the National Institute for

Occupational Safety and Health for the initiative that put engineering controls on

asphalt pavers.

– Mike Acott, President, National Asphalt Paving Association
National Occupational Research Agenda 35

NORA is vitally important. It’s important because it provides clear focus and sets

priorities on health and safety issues. It’s important because it’s resulting in

significantly more resources directed toward the 21 priority areas. And it’s

increasing our understanding. Through the research, it’s helping us anticipate,

identify and provide innovative solutions to health and safety concerns and to

prevent injuries and illnesses before they occur.

– Lawrence Burns, Ph.D., Vice President for Research,

Development and Planning, General Motors Corporation

I was particularly struck by the National Occupational Research Agenda. This

incredible scheme is undoubtedly one of the largest international efforts to develop

and implement a plan to establish research priorities in this sector.

– Antonio Moccaldi, Ph.D., Director, Italian National Institute for

Occupational Health and Safety

 ... research in occupational safety and health matters is vital. We believe that the

NORA process plays a valuable role in this regard, and we plan to continue to

participate fully with NIOSH and other members to promote research.

– James Thornton, President, American Industrial Hygiene Association

The NORA process has proven very successful, and serves as a model of broad

stakeholder influence in priority setting. Most recently, the second phase of the

process has encouraged the National Institutes of Health and other federal

agencies to join NIOSH in sponsoring a number of focused research programs

directly relevant to workplace health and safety.

– Occupational Research Agenda for Northwest Farming
36 National Occupational Research Agenda

NORA Milestones

July 1995 - May 1999

NORA Development

July 1995 .............. NIOSH commits to lead the creation of a research Agenda for

occupational safety and health

September 1995 ... Agenda framework developed and 50 potential topics identified by an

initial working group of internal and external scientists

November 1995 .... First National public meeting convened to provide input into the

Agenda and discuss criteria for priorities

January 1996 ........ Four additional working groups (NIOSH, external researchers, health

professionals, other stakeholders) expand and prioritize research

areas

February 1996 ....... Three town meetings (Boston, Chicago, and Seattle) convened

March 1996 .......... Second national public meeting held to review the draft Agenda

April 1996 ............. Final Agenda unveiled – The National Occupational Research Agenda

identified 21 priority research areas to guide occupational safety and

health research (released on NIOSH 25th Anniversary)

NORA Implementation Year 1

November 1996 .... Partnership teams formed for each priority area to implement NORA

February 1997 ....... First ever survey conducted of federal (non-NIOSH) resources (FY

1996) committed to occupational safety and health research

July 1997 .............. First NORA Implementation Symposium held at the National

Academy of Sciences, Washington, D.C.

NORA Update 1997 document released

NORA Implementation Year 2

November 1997 .... Congress appropriated $5 million for the implementation of NORA

Jan-Feb 1998 ........ Three NIH Institutes each contributed $1 million to NORA research

priorities

March 1998 .......... NIOSH and NIH partners announced a Request for Applications (RFA)

for the largest ever funding for targeted occupational safety and

health research ($8 million)

American Association of Occupational Health Nurses and the

American College of Occupational and Environmental Medicine

established a joint research award, giving emphasis to NORA in the

selection criteria

April 1998 ............. NORA logo created

May 1998 ............. NORA and the asphalt partnership both selected as semifinalists

(two of 100 semifinalists – two of 19 federal semifinalists) for the

Ford Foundation and Harvard University’s 1998 Innovations in

American Government Awards Program from an initial pool of 1,420

applicants

First issue of the NORA newsletter, NORA News, distributed

NORA Web site mounted

July 1998 .............. NORA Update 1998 document released

September 1998 ... Asphalt research partnership selected as one of 25 finalists in the

1998 Innovations in American Government awards program

First private sector funds (Aetna U.S. Health Care) leveraged for

NORA research (musculoskeletal disorders project)
NORA Implementation Year 3

October 1998 ........ First NORA research grants announced–50 grants totaling $8

million make up the single largest infusion of funding ever by the

federal government for extramural investigator-initiated occupational

health and safety research

NIOSH received permission to trademark the NORA logo

Congress continued to provide support for NORA through an $11

million appropriation in the FY 1999 NIOSH budget

February 1999 ....... The President’s FY 2000 budget proposal to Congress included $12

million for NORA to support both intramural and extramural research

and related activities

March 1999 .......... Second survey of federal (non-NIOSH) resources (FY 1998)

committed to occupational safety and health research conducted

Liaison Committee conducted two surveys to determine the

effectiveness and reach of NORA among associations and private

industry

NIOSH/NIH invited NORA grant applications for FY 1999 ($9 million)

April 1999 ............. NIOSH/EPA/NCI announced RFA for $1.5 million for research

focusing on the development of cancer risk assessment methods

and practices

May 1999 ............. NORA Update 1999 document released

First NORA Partnership Award For Worker Health and Safety

awarded to the Asphalt Research Partnership

NORA Symposium 1999: Partnership for Research held at the

National Academy of Sciences, Washington, D.C.

NIOSH announced a cooperative agreement with the Association of

Schools of Public Health to solicit applications for intervention

effectiveness research.

NIOSH announced an RFA to fund research on intervention

effectiveness

August 1999 ......... NIOSH/NIH invited applications through a general program

announcement (PA) for research in the 21 NORA priority areas

NIOSH/NCI/NIEHS announced a PA on research methods for

occupational cancer

NIOSH announced the availability of approximately $500,000 in

grants to train occupational health services researchers

NORA Implementation Year 4

October 1999 ........ NIOSH awarded $5.4 million in grant funds for 23 projects in seven

NORA areas

November 1999 .... Congress continued to provide support for NORA through a $11.3

million appropriation in the FY 2000 NIOSH budget

NIOSH/NIEHS and five other NIH partners announced a $5 million

RFA to stimulate new research on risk disparities among special

populations

February 2000 ....... The President’s FY 2001 budget proposal to Congress included $4.9

million to support research under NORA

March 2000 .......... NIOSH announced RFAs for intervention effectiveness ($1.2 million);

surveillance research ($2.5 million); exploratory research in allergic

and irritant dermatitis, social and economic consequences of

workplace injury and illness, health services research, and fertility and

pregnancy abnormalities ($1 million); agriculture-related injuries to

children ($1.6 million) and musculoskeletal disorders (0.9 million).

April 2000 ............. NIOSH/EPA/NIEHS announce a $5 million RFA on Mixed Exposures

National Occupational Research Agenda 37
38 National Occupational Research Agenda

Summary

The implementation of NORA has been a huge success in its first four years. Those

dedicated to NORA and occupational safety and health have produced:

• An enthusiastic and productive, broad-based NORA Liaison Committee.

• Successful efforts of 20 NORA teams, including outreach; conferences and symposia;

and production of white papers, documents, and journal articles.

• The participation of a large number of federal agencies in NORA activities.

• A successful grants process which has produced record-breaking funding for targeted

occupational safety and health research in Fiscal Years 1998, 1999, and 2000.

• Two surveys (in Fiscal Years 1996 and 1998) of federal occupational safety and health

research investment.

• Evidence that a national research agenda was, and continues to be, needed and that

NORA research priority areas were well chosen.

• Recognition that NORA continues to be used as a model for public-private partnerships

and is being widely used by other organizations in similar planning efforts.

• For the first time, a broad-based network of public and private partnerships in

occupational safety and health.
(continued from inside front cover)

Infectious Diseases, cont.

Amanda L. Edens (Occupational Safety and Health)

June Fisher (San Francisco General Hospital)

David Henderson (National Institutes of Health)

Janice Huy (NIOSH)

Robert Lyerla (National Center for Infectious

Diseases/CDC)

Marissa A. Miller (National Institute of Allergy and

Infectious Diseases/NIH)

Adelisa L. Panlilio (National Center for Infectious

Diseases/CDC)

Gary Roselle (Veterans Affairs Headquarters)

Kevin Seifert (Becton Dickinson and Company)

Teresa Seitz (NIOSH)

Hillary Sigmon (National Institutes of Health)

Kent A. Sepkowitz (Memorial Sloan-Kettering Center)

Intervention Effectiveness Research

Linda M. Goldenhar (NIOSH) lyg9@cdc.gov

Theodore M. Katz (NIOSH) tmk1@cdc.gov

Robin Baker (University of California)

Denis R. Bourcier (The Boeing Company)

Ann Brockhaus (Organizations Resources Counselors,

Inc.)

Larry Chapman (University of Wisconsin)

Jim Collins (NIOSH)

Cathy Heaney (Ohio State University)

Tony LaMontangne (Dana Farber Cancer Institute)

John Martonik (Occupational Safety and Health

Administration)

Ivan Most

Paul Landsbergis (Cornell University)

Ted Scharf (NIOSH)

Scott P. Schneider (Laborers’ Health and Safety

Fund of North America)

Raymond Sinclair (NIOSH)

Margie Wallace (NIOSH)

Mixed Exposures

Frank Hearl (NIOSH) fjh1@cdc.gov

Nancy Bollinger, (NIOSH)

Hank Gardner, (U.S. Army Center for Environmental

Health Research)

Manuel Gomez, (American Industrial Hygiene

Association)

Hugh Hansen, (Agency for Toxic Substances and

Disease Registry)

Robert Herrick, (Harvard School of Public Health)

Richard C. Hertzberg, (Environmental Protection

Agency)

Vera Kommineni,(NIOSH)

Daniel Lewis, (NIOSH)

Alan Lunsford, (NIOSH)

Joe L. Mauderly, (Lovelace Respiratory Research)

Carlos, Marentes (Rural Coalition)

Pam Susi, (Center to Protect Workers Rights)

Musculoskeletal Disorders

Larry Fine (NIOSH) ljf4@cdc.gov

Gunnar Andersson (Rush-Presbyterian-St. Luke’s

Medical Center)

Vernon Putz Anderson (NIOSH)

Lida Orta-Anes (International Union, United Auto

Workers)

Bruce Bernard (NIOSH)

Robert E. Bonner (AETNA)

Stephen Brightwell (NIOSH)

LaMont Byrd (International Brotherhood of

Teamsters)

Cheryl Fairfield Estill (NIOSH)

Hongwei Hsiao (NIOSH)

Tom Leamon (Liberty Mutual)

Jim Panagis (National Institute for Arthritis and

 Musculoskeletal and Skin Diseases/NIH)

Brian Peacock (General Motors Corporation)

Priscilla Shoemaker (American Health Care

Association)

Barbara Silverstein (SHARP – Washington State

Dept. of Labor & Industrial)

Tom Slavin (Navistar International Transportation

Corporation)

Laura Welch (George Washington University)

Thomas R. Waters (NIOSH)

Organization of Work

Steven L. Sauter (NIOSH) sls4@cdc.gov

W. Stephen Brightwell (NIOSH)

Michael Colligan (NIOSH)

Joseph J. Hurrell (NIOSH)

Theodore M. Katz (NIOSH)

Gwendolyn Keita (American Psychological

Association)

David LeGrande (CWA)

Nancy Lessin (Massachusetts AFL-CIO)

Richard A. Lippin (The Lippin Group, Inc.)

Jane Lipscomb (University of Maryland)

Lawrence Murphy (NIOSH)

Robert H. Peters (NIOSH)

Sydney Robertson (Organization Resources

Counselors, Inc.)

Jeanne Stellman (Columbia University)

Naomi G. Swanson (NIOSH)

Lois E. Tetrick (University of Houston)

Risk Assessment Methods

Leslie Stayner (NIOSH) lts2@cdc.gov

Mike Attfield (NIOSH)

Elaine Faustman (University of Washington)

William Fayerweather (Corporate Epidemiologist)

Dale Hattis, (Clark University)

Herman Gibb (EPA)

Frank Mirer (United Auto Workers)

Al Poland (NIOSH)

William Perry (Occupational Safety and Health

Administration)

Chris Portier (National Institute of Environmental

Health Sciences/NIH)

Mark Torrasson (NIOSH)

James T. Wassell (NIOSH)

Social & Economic Consequences of Workplace

Illness & Injury

Elyce Biddle (NIOSH) egb6@cdc.gov

Leslie I. Boden (Boston University)

Benjamin C. Amick III (New England Medical Center)

Laura Blanciforti (NIOSH)

Thomas W. Camm (NIOSH)

Brian T. Day (NIOSH)

Ross Eisenbrey (OSHA)

Ted Katz (NIOSH)

Paul R. Keane (NIOSH)

Chuck Levenstein (University of Massachusetts,

Lowell)

Carolyn Madden (University of Washington)

Ted Miller (National Public Service Research

Institute)

Sharon Morris (University of Washington)

Robert Reville (The RAND Corporation)

Harry Shannon (Institute for Work & Health)

Eve Spangler (Boston College)

Emily Spieler (University of West Virginia)

Special Populations at Risk

Rosemary Sokas (NIOSH) rrs8@cdc.gov

Sherry Baron (California Department of Health)

SBaron@dhs.ca.gov

Joni Berardino (National Center for Farmworkers

Health)

Dawn Castillo (NIOSH)

Gwendolyn Cattledge (NIOSH)

Letitia Davis (Massachusetts Department of Public

Health)

Gayle DeBord (NIOSH)

Howard Frumkin (Emory University)

Jim Grosch (NIOSH)

Frances C. Henderson (Alcorn State University)

Charles Lee (United Church of Christ)

Pamela Tau Lee (Labor Occupational Health

Program)

Leslie MacDonald (NIOSH)

Rex Tingle (OSHA)

Jennie Ward Robinson (NIOSH)

David Wegman (University of Massachusetts, Lowell)

Surveillance Research Methods

John P. Sestito (NIOSH) jps4@cdc.gov

Henry Anderson (Wisconsin Dept. of Health and

Social Services)

Robert Castellan (NIOSH)

Joe Dubois (Occupational Safety and Health

Administration)

Richard Ehrenberg(NIOSH)

Barbara Fotta (NIOSH)

Eric Frumin (UNITE Health and Safety Department)

Alice Greife (Central Missouri State University)

Denise Koo (Epidemiology Program Office, CDC)

Wayne M. Lednar (Eastman Kodak)

Jane McCammon (NIOSH)

John Myers (NIOSH)

Steve Newell (Organization Resources Counselors,

Inc)

Earl Pollack (Center to Protect Workers’ Rights)

Lee Sanderson (NIOSH)

Diane Wagener (National Center for Health

Statistics/ CDC)

William Weber (Bureau of Labor Statistics)

Traumatic Injuries

Nancy Stout (NIOSH) nas5@cdc.gov

Christine Boldt (NIOSH)

William Borwegen (AFL-CIO, CLC)

Christine M. Branche (NCIPC, CDC)

George Conway (NIOSH)

Timothy R. Fisher (American Society of Safety

Engineers)

James Harris (NIOSH)

Alan F. Hoskin (National Safety Council)

Lynn Jenkins (NIOSH)

Herb Linn (NIOSH)

Stephen Luchter (National Highway Traffic Safety)

Gordon R. Reeve (Ford Motor Company)

Gordon Smith (Center for Injury Research)

Lisa J. Steiner (NIOSH)
For additional information, contact NIOSH at:

1-800-35-NIOSH

(1-800-356-4674)

Fax: 513-533-8573

or visit the NIOSH web site at

www.cdc.gov/niosh

DHHS (NIOSH) Publication No. 2000-143