National

Occupational

Research

Agenda

UpdateJuly, 1998

21 Priorities for the 21st Century

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
TEAMS

(continued inside back cover)

NORA Teams

Bold type indicates team leader(s)

Allergic & Irritant Dermatitis

Boris Lushniak (NIOSH) bdt1@cdc.gov

G. Frank Gerberick (Proctor & Gamble)

gf@pg.com

Stephen Berardinelli, Sr. (NIOSH)

David Bernstein (University of Cincinnati)

Raymond Biagini (NIOSH)

Mark Boeniger (NIOSH)

Carol Burnett (NIOSH)

Richard Fenske (University of Washington)

James Johnson (Lawrence Livermore

National Lab)

Mike Luster (NIOSH)

Alan Moshell (National Institute of Arthritis

and Musculoskeletal and Skin Diseases/

NIH)

Al Munson (NIOSH)

Frances Storrs (University of Oregon)

Susan Wilburn (American Nurses

Association)

Asthma & Chronic Obstructive

Pulmonary Disease

Kathleen Kreiss (NIOSH) kxk2@cdc.gov

John Balmes (University of California San

Francisco)

Raymond Biagini (NIOSH)

Robert Castellan (NIOSH)

Jeffery Fedan (NIOSH)

Paul Henneberger (NIOSH)

Paul Hewett (NIOSH)

Suzanne Hurd/Gayle Weinmann (National

Heart, Lung and Blood Institute/NIH)

Susan Kennedy (University of British

Columbia)

Hillel Koren (Environmental Protection

Agency)

Edward L. Petsonk (NIOSH)

Phillip Morey (AQS Services)

Gregory Wagner (NIOSH)

David Wegman (University of Massachusetts)

Cancer Research Methods

Elizabeth Ward (NIOSH) emw3@cdc.gov

James Bond (Chemical Industry Institute of

Toxicology)

Paul Brandt-Rauf (Columbia University School

of Public Health)

Mary Ann Butler (NIOSH)

David Dankovic (NIOSH)

Ronald Herbert (National Institute for

Environmental Health Sciences/NIH)

Ann Hubbs (NIOSH)

Carol Jones (Occupational Safety and Health

Administration)

Myra Karstadt (Environmental Protection

Agency)

Carrie Redlick (Yale University)

Nathaniel Rothman (National Cancer

Institute/NIH)

Christine Sofge (NIOSH)

Michael Sprinker (International Chemical

Workers Union Council)

Ainsley Weston (NIOSH)

Control Technology and Personal

Protective Equipment

Fred Kissell (NIOSH) fak8@cdc.gov

Dale Avery (NIOSH)

Steven Berardinelli (NIOSH)

Donald Campbell (NIOSH)

David de Vries (American Society of Safety

Engineers)

Richard Duffy (International Association of Fire

Fighters)

Michael Flynn (University of North Carolina at

Chapel Hill)

Christina Gomberg (NIOSH)

Bill Heitbrink (NIOSH)

Bill Kojola (Laborers’ Health & Safety Fund)

Steven Mallinger (Occupational Safety and

Health Administration)

John Meagher (American Industrial Hygiene

Association)

Lawrence Reed (NIOSH)

Daniel Shipp (Industrial Safety Equipment

Association)

Emerging Technologies

Max Kiefer (NIOSH) myk3@cdc.gov

Nicholas Ashford (Massachusetts Institute of

Technology)

Kennith Brock (Liberty Mutual Insurance Group)

Tai Chan (General Motors Corporation)

David Conover (NIOSH)

Elaine Cullen (NIOSH)

Jack Finklea (National Center for Injury

Prevention and Control/CDC &CPWR)

Richard Hartle (NIOSH)

Max Kiefer (NIOSH)

Raymond Lovett (West Virginia University)

Larry Reed (NIOSH)

Paul Schlecht (NIOSH)

Jeffery Welsch (NIOSH)

Exposure Assessment Methods

Mary Lynn Woebkenberg (NIOSH)

mlw2@cdc.gov

Martin Abell (NIOSH)

Larry Elliott (NIOSH)

Mike Keane (NIOSH)

Paul Knechtges (Naval Medical Research &

Development Command/DOD)

David Pegram (Department of Energy)

Elizabeth Reh (NIOSH)

Bonnie Rogers (University of North Carolina,

American Association of Occupational Health

Nurses)

Gary Spies (Monsanto Company)

James Weeks (George Washington University)

Kenneth Williams (NIOSH)

Fertility & Pregnancy Abnormalities

Teresa Schnorr (NIOSH) ths1@cdc.gov

Coleen Boyle (National Center for

Environmental Health/CDC)

Kenneth Bridbord (Fogarty International

Center/NIH)

Barbara Grajewski (NIOSH)

Ronald Gray (Johns Hopkins University)

Michele Marcus (Emory University)

Melissa McDiarmid (University of Maryland)

Eisuke Murono (NIOSH)

Steven Schrader (NIOSH )

Health Services Research

Scott Deitchman (NIOSH)

sed2@cdc.gov

Joan Buchanan (Harvard University)

William Bunn (Navistar International

Transportation Corporation)

Mary Cummings (Agency for Health Care

Policy and Research )

Janie Gordon (University of Maryland)

Jay Himmelstein (University of

Massachusetts)

Thomas Hodous (NIOSH)

Janice Klink (NIOSH)

David Michaels (City University of New York)

Jonathan Myers (NIOSH)

Kent Peterson (Occupational Health

Strategies, Inc.)

Kathleen Rest (University of Massachusetts)

Linda Rudolph (California Department of

Industrial Relations)

Rosemary Sokas (Occupational Safety and

Health Administration )

Hearing Loss

John Franks (NIOSH) jrf3@cdc.gov

Patricia Brogan (Ford Motor Company)

Alton Burks (NIOSH)

John Casali (Virginia Tech University)

Steven Hacker ( Solutia, Inc.)

Howard Hoffman (National Institute on

Deafness and other Communication

Disorders/NIH)

Daniel Johnson (ANSI/ISO Standards)

Carol Merry (NIOSH)

Anthony Miltech (Commercial Auditory

Product Mfg.)

Douglas Ohlin (U.S. Army Center for Health

Promotion and Preventive Medicine)

Ed Thimons (NIOSH)

Randy Tubbs (NIOSH)

Indoor Environment

Mark Mendell (NIOSH) mfm0@cdc.gov

Darryl Alexander (American Federation of

Teachers)

William Cain (University of California, San

Diego)

William Fisk (Lawrence Berkeley National

Laboratory/DOE)

John Girman (Environmental Protection

Agency)

Cynthia Hines (NIOSH)

Paul Jensen (NIOSH)

Kay Kreiss (NIOSH)

Hal Levin (ASTM/ASHRAE)

Donald Milton (Harvard University)

David Spannbauer (General Services

Administration)

Ken Wallingford (NIOSH)
VISION

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.

Message from NIOSH

This has been an exciting year for the National Occupational Research Agenda (NORA).

In addition to the hard work of the Partnership Teams, which essentially drives the

implementation of the Agenda, we have many successes to capture in this document.

For example, Congress provided NIOSH with $5 million in our 1998 budget to support

research in NORA priority areas. This and other NIOSH investments—together with

matching resources from three institutes in the National Institutes of Health (the

National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National

Institute of Environmental Health Sciences, and the National Heart, Lung, and Blood

Institute)—resulted in a $24 million three year commitment, the largest ever single

infusion of extramural funding targeted for investigator-initiated occupational safety

and health research.

Earlier this year, we began distributing NORA News, a newsletter designed to improve

communication about NORA issues. We have also mounted a NORA site on the NIOSH

homepage (http://www.cdc.gov/niosh). In addition to providing all available information about NORA, the site will be used to gauge interest in the Agenda as we track

“hits” on the website. These activities are the first steps in our plans to increase

communication and awareness about NORA.

I am excited to report that NORA was selected out of 1,420 applicants as one of 100

semifinalists (one of 19 Federal semifinalists) for the Ford Foundation and Harvard

University’s 1998 Innovations in American Government Awards Program. Although

those involved with NORA are aware of its innovative and forward-thinking approach to

addressing occupational safety and health problems, it is always encouraging to have

external validation. Yet another confirmation of the success of NORA is the number of

other organizations using NORA as a model for their agenda setting and planning

activities.

An unexpected success of NORA, generated by the partnerships formed in the

development of NORA and fostered in its implementation, is the collaborative work

between NIOSH and other partners from the public and private sector outside the

scope of the research agenda. The benefits of the NORA network of broad-based

partnerships are indeed being felt in many aspects of occupational safety and health.

Although some critics feared that the creation of NORA was merely an exercise, I’m

happy to report that two years after its release, NORA is thriving.

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

National Occupational Research Agenda 1
LIAISON

Liaison Committee Perspective

As NORA enters its third year of implementation, the 20 NORA Teams continue to

demonstrate the power of collaboration in the occupational safety and health community. Partnerships are also a key theme for the NORA Liaison Committee, which

consists of members from industry, labor, academia, professional organizations, and

government, as we look for ways to encourage and expand research partnerships in

the NORA process.

NORA is clearly making a substantial difference in targeting specific research to

improve the health and safety of America’s workforce. The Liaison Committee is

committed to tracking this impact on occupational safety and health research across

the country. This aerial view is necessary to gauge how NORA is progressing towards

its ultimate goal of prevention. NIOSH is already tracking some measures of NORA

success such as funding allocations, scientific publications, projects funded, and

scientific and lay literature appearances of NORA. The Liaison Committee is interested in building on these measures to determine the success of NORA in the future,

such as through a survey of stakeholders, citations of NORA funded studies, regulations or consensus standards from NORA research, international new initiatives, and

the impact of NORA on safety and illness.

As we look ahead to the long-term goal of prevention, NORA is successfully meeting

its interim goal of catalyzing interest and research activity. Several health and safety

organizations and agencies here and abroad are finding that NORA is a useful model

for their programs. For example, the American Association of Occupational Health

Nurses (AAOHN) and the American College of Occupational and Environmental

Medicine (ACOEM) have established a joint research award with a selection criteria

based on NORA priority areas. The purpose of the award, which will be presented

annually at the joint AAOHN and ACOEM conferences, is to recognize research

projects conducted by collaborative research teams of nurses and physicians for the

purpose of improving the knowledge base of occupational and environmental health.

NORA has also been successful in pooling additional funds for occupational safety and

health research, as evidenced in the joint NIOSH-National Institutes of Health request

for grant applications. To capitalize on NORA’s unique ability to leverage funds, the

Liaison Committee is exploring additional ways to stretch limited research dollars and

to encourage research partnerships, particularly between the private sector and

Federal agencies.

The Liaison Committee has enjoyed our interactions with the NORA partnership

network thus far and looks forward to increased interaction as NORA implementation

proceeds.

Bonnie Rogers, R.N., Ph.D.

Chairperson, NORA Liaison Committee

American Association of Occupational Health Nurses

Liaison Committee

Robin Baker

American Public Health Association

Jordan Barab

American Federation of State, County and

Municipal Employees

Thomas F. Bresnahan

American Society of Safety Engineers

Drew Brodkin

Association of Occupational and

Environmental Clinics

William B. Bunn

Navistar International Transportation

Corporation

Tai Chan

General Motors Corporation

Gwendolyn Keita

American Psychological Association

Heidi Klein

National Association of County and City

Health Officials

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

Joseph Main

United Mine Workers of America

Franklin Mirer

United Auto Workers

Clifford Mitchell

American College of Occupational and

Environmental Medicine

Carolyn Phillips

Chemical Manufacturers Association

Robert J. Pleasure

Center to Protect Workers’ Rights

Beth Resnick

National Association of County

and City Health Officials

James C. Rock

American Industrial Hygiene Association

Jane Roemer

National Safety Council

Bonnie Rogers (Committee Chair)

American Association of Occupational

Health Nurses

Margaret M. Seminario

AFL-CIO

Frank White

Organization Resources Counselors, Inc.

2 National Occupational Research Agenda
BACKGROUND

An Agenda for the 21st Century

 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

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 a need to address changes in the U.S. workplace as well as the

increasingly diversified U.S. workforce. The distribution of jobs in our economy

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

workweeks, shiftwork, 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, minorities will represent 28% of the workforce, and women

approximately 48%.

NORA also addressed the broadly recognized need to target 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 workers sustain disabling injuries on the job, 16

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

diseases.

National Occupational Research Agenda 3
BACKGROUNDThe economic burden of this continuing toll is also an issue, especially since occupational safety and health research in both the public and private sector faces increasing

fiscal constraints. Data from a NIOSH-funded study published in 1997 showed that in

1992, indirect and direct costs (including administration costs) of occupational injuries

and illnesses totaled $171 billion ($145 billion for injuries and $26 billion for diseases). These costs compare to $33 billion for AIDS, $67.3 billion for Alzheimer

Disease, $164.3 billion for circulatory diseases, and $170.7 billion for cancer (see

graphic 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 two 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, we hope to

better position the Nation to address the toll of workplace injury and death.

Each day, an average of

9,000 workers sustain

disabling injuries on the job.

Each day 16 workers die

from an injury sustained at

work and 137 workers die

from work-related diseases.

In 1992 the total indirect

and direct costs, including

administration costs, of

occupational injuries and

illnesses was $171 billion.

“Although great strides have

been made in improving

worker protection since the

Occupational Safety and

Health Act was passed in

1970, workplace hazards

continue to inflict a

tremendous human and

economic toll. With this

agenda, we’re teaming up

with private industry, labor

and others who know that

safe workplaces are good

for the bottom line of people

and profits.”

– Donna E. Shalala

Secretary HHS

Cancer

$200

150

100

50

0

$ in Billions

Circulatory

Diseases

Diseases

Injuries

Alzheimer

Disease

Occupational AIDS

Diseases &

Injuries

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

4 National Occupational Research Agenda
IMPLEMENTATION

National Occupational Research Agenda 5

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 Coordination &

Special Programs

Cincinnati, OH

Division of Biomedical & Behavioral Science

Division of Surveillance, Hazard

Evaluations, & Field Studies

Division of Physical Sciences & Engineering

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 Library

NORA Liaison

Committee

NORA Federal

Liaison Committee

Team Name

Team Leader

Team Members

(# NIOSH # External)

Allergic & Irritant Dermatitis

Boris Lushniak

7 NIOSH 7 External

Asthma & Chronic Obstructive

Pulmonary Disease

Kathleen Kreiss

8 NIOSH 6 External

Cancer Research Methods

Elizabeth Ward

6 NIOSH 8 External

Control Technology & Personal

Protective Equipment

Fred Kissell

7 NIOSH 7 External

NORA

PARTNERSHIP

TEAMS

Emerging Technologies

Max Kiefer

5 NIOSH 5 External

Exposure Assessment

Methods

Mary Lynn Woebkenberg

6 NIOSH 5 External

Surveillance Research Methods

John Sestito

7 NIOSH 9 External

Fertility & Pregnancy

Abnormalities

Teresa Schnorr

4 NIOSH 5 External

Health Services

Research

Scott Deitchman

4 NIOSH 10 External

Hearing Loss

John Franks

5 NIOSH 7 External

Indoor Environment

Mark Mendell

5 NIOSH 7 External

Infectious Diseases

Robert Mullan

4 NIOSH 9 External

Intervention Effectiveness

Research

Linda Goldenhar

5 NIOSH 9 External

Mixed Exposures

Frank Hearl

6 NIOSH 8 External

Musculoskeletal Disorders

Larry Fine

7 NIOSH 8 External

Organization of Work

Steve Sauter

7 NIOSH 8 External

Risk Assessment Methods

Leslie Stayner

5 NIOSH 7 External

Social & Economic Consequences of Workplace

Illness & Injury

Elyce Biddle

5 NIOSH 10 External

Special Populations at Risk

Gwen Cattledge

4 NIOSH 9 External

Traumatic

Injuries

Nancy Stout

7 NIOSH 7 External
IMPLEMENTATION 6 National Occupational Research Agenda

“. . . the process was

impressive for its

thoroughness and

engagement of so many

individuals and groups.”

– NIOSH Board of

Scientific Counselors

NORA Implementation:

Liaison Committee

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

Association of Occupational Health Nurses) consists of 22 members representing

industry, labor, academia, professional organizations, and government. The Liaison

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

and direction of NORA implementation.

The Liaison Committee has formed two subcommittees to provide insight into the

development of measures and goals for NORA and explore new ways to leverage

resources. The Measures and Goals Subcommittee, chaired by William Bunn of Navistar,

has provided valuable input into the formulation of a tracking system for NORA research.

The Subcommittee is also creating a survey of the occupational safety and health

community that will attempt to gauge the effectiveness of the Agenda.

Clifford Mitchell from the American College of Occupational and Environmental Medicine

heads the subcommittee addressing the often complex issue of resource leveraging.

The Subcommittee is trying to help reduce the private sector’s hesitation towards

partnering financially with Federal agencies in addition to addressing the all too common

challenge of stretching limited research dollars. The support and vision of the entire

Liaison Committee continues to advance the implementation of the Agenda.

Partnership Teams

Fundamental to the contributions of NORA is the success of the Partnership Teams. The

Teams’ ability to partner with 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 120 NIOSH researchers and 150 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, major manufacturing industries, leaders in the insurance

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

other government agencies.

The teams have been very active. As expected, each team is proceeding somewhat

differently. Many teams are writing white papers—documents that summarize the

research in a priority area, define gaps, and lay out opportunities for collaboration. In

some areas, a well-defined research agenda currently exists (for example in asthma

research) so a white paper is not necessary. The following 10 NORA teams have

completed or are currently writing white papers:

• Control Technology and Personal • Intervention Effectiveness Research

Protective Equipment • Mixed Exposures

• Emerging Technologies • Organization of Work

• Health Services Research • Surveillance Research Methods

• Hearing Loss • Traumatic Injuries

• Indoor Environment

“NORA is an innovative and

integrated program, pooling

the scientific and

managerial talents of all

stakeholders for the sole

purpose of improving

workers’ health and safety.”

– Tai Chan, Ph.D., CIH

GM Global Research and

Development
Conferences and workshops are also popular and effective ways for NORA teams to

crystalize research needs and communicate with their partners. NIOSH and its

partners have sponsored the following major meetings related to NORA as a whole or

to specific priority areas:

NORA Meetings

Workplace-Related Skin Diseases and September 25-26, 1996

Exposure Assessment Workshop

Pneumonitis in the Machining January 28-29, 1997

Environment Workshop

Latex Allergy Conference March 1997

National Occupational Research July 1, 1997

Agenda Symposium

National Occupational Injury October 15-17, 1997

Research Symposium

1998 Applied Workshop on February 23-25, 1998

Occupational and Environmental

Exposure Assessment

Control of Workplace Hazards for March 10-12, 1998

the 21st Century

Three Musculoskeletal Meetings March 25, 1998 - Chicago, IL

to Set Research Agenda April 20, 1998 - Seattle, WA

April 27, 1998 - Washington, DC

Round Table Discussion on the April 24-26, 1998

Organization of Work at the Society

for Industrial and Organizational

Psychology Conference

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

the Work Place Conference

Latex Allergy Satellite Downlink May 5, 1998

Teleconference

Hazardous Substances and Male May 14-15, 1998

Reproductive Health

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 documents. The following summaries

describe the work of three teams (Musculoskeletal Disorders, Work Organization, and

Asthma and COPD) and provide a flavor of the work being conducted by the Partnership Teams.

IMPLEMENTATION

National Occupational Research Agenda 7
IMPLEMENTATION 8 National Occupational Research Agenda

Musculoskeletal Disorders Team

Musculoskeletal disorders are the largest single problem facing American workers

today, costing between $13 and $20 billion annually. In order to develop a detailed

research agenda for addressing these conditions, the NORA Musculoskeletal Disorders Team held three regional meetings (Chicago, IL, Seattle, WA and Washington, DC)

to solicit information from an array of partners regarding research needs. Eleven

sectors were represented (heavy manufacturing, light manufacturing, health care,

agriculture, food processing, office ergonomics, transportation, warehousing, forest

products, construction, and maritime) and over 100 companies, unions, universities,

associations, societies, hospitals and Federal and State organizations.

Following a general session, the participants divided into smaller focus groups. NORA

Musculoskeletal Disorders Team members facilitated the group discussions about

intervention effectiveness research needs, fundamental research issues, unique

ergonomic issues not addressed by traditional models, and surveillance needs.

Despite the differences between the targeted industry sectors, uniform issues

emerged based on the group discussions. These common elements include: the

need to measure cost and effectiveness of ergonomics programs and training, the

need for objective exposure and diagnostic tools, increased knowledge about medical

intervention and management of musculoskeletal disorders, better understanding of

work organization and psychosocial issues, and the need for user-friendly communication products.

The meetings confirmed the general support for NORA and the Team’s approach to

tackling musculoskeletal research. Based on the input from these meetings, the team

will continue developing a draft agenda. The next two major steps in the process are

to identify the specific themes from the three meetings and to seek greater input from

the community of researchers.
IMPLEMENTATION

National Occupational Research Agenda 9

Organization of Work

The Organization of Work Team has focused its efforts on the following three areas:

developing a draft white paper defining the area of work organization and setting out

research needs and gaps; signing a cooperative agreement with the American

Psychological Association (APA) to establish new graduate-level training programs in

work organization and health; and focusing a joint APA-NIOSH scientific conference

around the topic of organization of work.

The draft white paper, entitled Organization of Work and Occupational Safety and

Health Research–Gaps Analysis, attempts to bring focus to a subject that the Team

states “is not yet a defined field of study or systematic body of literature.” The paper

presents a conceptual framework that covers the impact of issues at the National,

industry, and shop floor levels and identifies significant knowledge gaps regarding the

organization of work and health.

In September 1997, the American Psychological Association (APA) and NIOSH signed

a cooperative agreement to fund the development and implementation of graduatelevel training programs in the area of work organization, stress, and health in university

settings. Seventeen universities competed for funding, and awards have been made

to three universities for training to begin this Fall. Although this joint training

activity pre-dated NORA, Organization of Work Team members played an instrumental

role in developing the agreement and recommending guidelines for evaluating the

applicants.

The Team is also responsible for explicitly focusing the APA/NIOSH Conference on

Stress and Health around work organization. The Fourth Annual Conference on

Occupational Stress & Health: Organization of Work in a Global Economy will be held

on March 11-13, 1999. The Conference is also being sponsored by 18 other U. S.

and international organizations, including the Japan Society of Occupational Mental

Health, the National Centre for Occupational Health, Republic of South Africa, the

National Safety Council, and the Communications Workers of America. The conference topic list includes areas of emphasis that relate to the research gaps identified

by the NORA Team such as organizational policies and work design, new work

contracts such as contingent and temporary work, and advances in research methodologies.

The Team will also hold a two-day workshop in Washington D.C. in 1998 to bring in

partners and interest groups from labor, industry, academia, and government to work

with the team to refine organization of work research objectives and strategies.
IMPLEMENTATION

Asthma & Chronic Obstructive

Pulmonary Disease

The Asthma and Chronic Obstructive Pulmonary Disease Partnership Team is engaged

in many diverse activities, including addressing the emerging problem of latex allergy.

Through the efforts of the Team, the 4th National Health and Nutrition Examination

Survey (NHANES), organized by the National Center for Health Statistics, will include

blood samples for natural rubber latex antibody to be analyzed at NIOSH. Natural

rubber latex is a major concern in the health care industry because it causes asthma,

dermatitis, and sometimes anaphylactic shock in workers who develop latex allergy.

The NHANES IV survey will allow NIOSH to estimate prevalence of allergic sensitization

of individuals employed in various occupations.

In addition, other substantial NIOSH activity in the area of latex allergy is integrally

related to the NORA process, including the publication of the Alert on occupational

latex allergy, participation with the FDA and others in a recent nationwide Continuing

Medical Education program that highlighted the problem of occupational latex allergy,

and collaborative research with the Medical College of Wisconsin to evaluate interventions for preventing latex allergy among health care workers.

In other areas, the Team is partnering with the American Thoracic Society (ATS) by

participating in a working group to revise the 1978 ATS/DLD (Division of Lung

Diseases of the National Heart Lung and Blood Institute) standardized respiratory

questionnaire. The questionnaire has been widely used for 20 years to study the

epidemiology of chronic lung disease and bronchitis. Currently, it has limited utility for

the often work-related problems of asthma and hypersensitivity pneumonitis. NIOSH is

supporting the development of occupational and environmental components of the

revised questionnaire through a consensus approach of invited experts.

10 National Occupational Research Agenda

“The Association of

Occupational and

Environmental Clinics

frequently becomes involved

in regional issues. In the

Northwest, an important

occupational health question

—development of a

respiratory disease in crab/

seafood processors—was

brought up by clinics serving

this population. The NORA

emphasis on asthma was

extremely helpful in

directing a preliminary

research effort addressing

this question through a

Health Hazard mechanism.

The process has resulted in

important industry contacts,

that will likely lead to

important research studies

of occupational asthma in

the crab-processing industry

in the future.”

– Drew Brodkin, M.D.

Occupational and

Environmental

Medical Program

University of Washington
National Occupational Research Agenda 11 PARTNERSHIPS

Spurred by NORA

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 has proven to many in the private

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

For example, NORA has opened many doors with corporate America.

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

Traumatic Injury Team has produced a document that will help pave the way for future

partnerships. The document will provide a foundation for discussion with external

partners to explore common research areas.

In the following three examples, industry approached NIOSH to collaborate on topics

related to the traumatic injury priority research area. These success stories demonstrate the benefits for both industry and government with NIOSH providing its scientific

expertise and creative problem-solving skills and industry providing 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 using (and often requiring) back belts as the only method to prevent

back injury.

In what promises to be the most definitive research study to date, NIOSH teamed with

Wal-Mart to determine the efficacy of back supporting belts in preventing first and

recurrent low back injuries. Approximately 8,000 retail merchandise employees at

160 stores are being followed for two years to determine if low back injury rates in

individuals wearing belts are different from rates in individuals not wearing belts.

Results of the study are expected in the Summer of 1999.

“NIOSH has had direct

positive impact on the United

States through its proactive

work in crafting a National

Occupational Research

Agenda (NORA). NORA is an

excellent example of the

private/public sector

partnership encouraged by

this country’s congressional

leaders.”

– Jerry P. Ray, CSP

President, American Society

of Safety Engineers
12 National Occupational Research Agenda PARTNERSHIPSBrowning-Ferris Industries (BFI)

NIOSH has identified various hazards associated with moving refuse collection vehicles

in addition to documenting fatalities that occurred when workers were struck by trucks

during backing procedures. BFI, the second largest waste management company in

the world, recently commissioned a laboratory study to examine the effects of truck

camera vision systems on back-up collisions. BFI and NIOSH are now collaborating to

field test these research results in addition to examining ergonomic issues associated

with manual handling of medical waste. The results of the joint NIOSH-BFI research will

not only be useful for BFI but may have applications in other companies and industries.

Barnes Jewish Christian (BJC) Hospital Health System

Back injuries are a major concern for workers at nursing homes. The BJC Hospital

Health System asked NIOSH to evaluate whether a “best practices program” that

implements mechanical patient lifts and recommended manual patient transferring

methods will be effective in reducing the incidence of back injury, injury-related costs,

and subsequent disability. The research also includes an evaluation of medical

management programs and worker training.

Other Research Partnerships

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. This 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 is a semifinalist in the

prestigious Innovations in American Government Awards Program. The broad-based

network of partnerships created by NORA has helped foster these continuing and

evolving efforts.

“NORA presents an

outstanding mechanism for

collaboration between

government and industry.”

– William B. Bunn, M.D., J.D.

Navistar International

Transportation Corp.
National Occupational Research Agenda 13 PARTNERSHIPS

Federal Partnership Team –

Expanding Research Support

The Federal Liaison Committee is an active interagency working group guiding the

implementation of NORA. Last year, the Committee undertook the large task of

assessing the Federal investment in NORA and occupational safety and health

research overall. A survey administered to all Federal partners (see listing on next

page) revealed that NIOSH Federal partners spent $15 million on NORA-related

research in FY 96 (out of a total of $39 million for all work-related research). The

survey will be conducted every two years to track changes in investments from the FY

96 baseline.

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

additional resources for NORA. In March 1998, NIOSH, in partnership with three other

Federal agencies, announced an $8 million investment—the largest single infusion of

funding ever—in investigator-initiated occupational safety and health research. The

investment will support grants for studies in select NORA high priority areas and

represents a three-year commitment of $24 million.

Joining with NIOSH as co-sponsors for the NORA grants initiative are three institutes in

the National Institutes of Health: the National Institute of Arthritis and Musculoskeletal

and Skin Diseases (NIAMS), the National Institute of Environmental Health Sciences

(NIEHS), and the National Heart, Lung, and Blood Institute (NHLBI). In addition, the

portion of the initiative dealing with older workers is of interest to the National Institute

on Aging (NIA) in NIH.

NIOSH and its co-sponsors invited proposals for research grants in the following areas

(NORA priority areas are bolded):

• Occupational irritant dermatitis, musculoskeletal disorders,

traumatic injuries, indoor environment, and asthma and chronic

obstructive pulmonary disease;

• Nature and magnitude of special risk factors for older and/or minority

workers (special populations at risk);

• Social and economic consequences of workplace injury and illness,

and health services research;

• Intervention effectiveness research in: musculoskeletal disorders,

traumatic injuries, asthma and chronic obstructive pulmonary

disease, work organization, and control technology and personal

protective equipment.

Three types of grants will be funded: (1) research project grants for projects designed

to establish, discover, develop, elucidate, or confirm information relating to occupational safety and health; (2) demonstration project grants for projects designed to

address the technical or economic feasibility of implementing a new or improved

procedure, method, technique, or system for preventing occupational safety and

health problems; and (3) pilot study grants for preliminary evaluation in developing the

foundations for future, more comprehensive studies. Awards are expected to be as

high as $250,000 per year for traditional research and development projects, and

$50,000 per year in direct costs for pilot studies.

“The NORA concept was a

brilliant idea that will . . .

(advance) the science of

occupational health.”

– Zack Mansdorf

Immediate Past President,

American Industrial Hygiene

Association (1997-98)
14 National Occupational Research Agenda

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

Department of Energy Office of the Environment, Safety and Health

Department of Health and Human Services Agency for Health Care Policy and Research

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, Sexually Transmitted Disease, 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

• Public Health Practice Program Office

Food and Drug Administration

Health Resources and Services Administration

Intergovernmental Affairs

National Institutes of Health

• Fogarty International Center

• National Cancer Institute

• National Heart, Lung, and Blood Institute

• National Institute of Allergy and Infectious Diseases

• National Institute of Arthritis and Musculoskeletal and Skin Diseases

• National Institute of Environmental Health Sciences

• National Institute of Mental Health

• National Institute of Neurological Disorders and Stroke

• National Institute of Nursing Research

Substance Abuse and Mental Health Services Administration

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

National Highway Traffic Safety Administration

Department of Treasury Internal Revenue Service

Environmental Protection Agency National Exposure Research Laboratory

Office of Prevention, Pesticides, and Toxic Substances

Executive Office of the President Office of Science and Technology Policy
TRACKING

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.

Out of an overall operating budget in FY 96 of $165.3 million, the NIOSH baseline

investment was $15.4 million (approximately 9% of the budget) in the NORA priority

areas. Of this, $8.7 million was devoted to intramural research (NIOSH-conducted)

and cooperative agreements (NIOSH-funded extramural research that NIOSH initiates

and participates in) and $6.7 million for research grants (extramural investigator

initiated projects). A redirection of resources in FY 97 nearly doubled this investment

to $28.1 million. A new $5 million special Congressional appropriation to NIOSH in FY

98 for NORA, coupled with additional reinvestment of baseline monies into NORA

priority areas, resulted in an estimated $46.9 million of research (about 25% of the

budget) in NORA priority areas for FY 98. 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 budget can be

redirected. An ongoing effort has been in place since the start to assure that these

shifts are “real” rather than merely a reporting artifact with consistent definitions used

and an independent evaluation team assessing projects for NORA relatedness.

NIOSH NORA Investment

National Occupational Research Agenda 15

Grants

Intramural Research and Cooperative Agreements

1996 1997 1998*

$50

40

30

20

10

0

15.4

28.1

46.9

$ in Millions

* FY 98 numbers are estimates.
16 National Occupational Research Agenda

Allergic &

Irritant

Dermatitis

Asthma &

Chronic

Obstructive

 Pulmonary

 Disease

Fertility &

Pregnancy

Abnormalities

Hearing

Loss

Infectious

Diseases

Lower

Back

Disorders

Musculoskeletal

 Disorders of

the Upper

Extremities

FY FY FY

96 97 98

FY FY FY

96 97 98

FY FY FY

96 97 98

FY FY FY

96 97 98

FY FY FY

96 97 98

FY FY FY

96 97 98

FY FY FY

96 97 98*

$5.0

4.5

4.0

3.5

3.0

2.5

2.0

1.5

1.0

.5

0

Extramural

Intramural

Dollars in Millions

Traumatic

Injuries

Emerging

Technologies

Indoor

Environment

Mixed

Exposures

Organization

of Work

Special

Populations

 at Risk

Cancer

Research

Methods

FY FY FY

96 97 98

FY FY FY

96 97 98

FY FY FY

96 97 98

FY FY FY

96 97 98

FY FY FY

96 97 98

FY FY FY

96 97 98

FY FY FY

96 97 98

$5.0

4.5

4.0

3.5

3.0

2.5

2.0

1.5

1.0

.5

0

Dollars in Millions

NIOSH NORA Investment by Priority Research Area, FY96-98
National Occupational Research Agenda 17 TRACKING

Control

Technology

 &

Personal

Protective

Equipment

Exposure

Assessment

 Methods

Health

Services

Research

Intervention

Effectiveness

Research

Risk

Assessment

Methods

Social &

Economic

Consequences

of Workplace

Illness & Injury

Surveillance

Research

Methods

FY FY FY

96 97 98

FY FY FY

96 97 98

FY FY FY

96 97 98

FY FY FY

96 97 98

FY FY FY

96 97 98

FY FY FY

96 97 98

FY FY FY

96 97 98

$6.0

5.0

4.0

3.0

2.0

1.0

0

Dollars in Millions

Extramural

Intramural

*FY 98 numbers are estimates.
Other (non-NIOSH) federal funding

As part of NORA, a first-ever Federal survey of occupational safety and health research

was undertaken that identified a total of only $204 million for all occupational safety

and health research from all Federal sources. The FY 96 baseline for NORA from nonNIOSH Federal sources was about $15 million. Federal partners have agreed to

perform the survey biannually so that the next survey will assess FY 98 expenditures.

Tracking Partnership Products

Requests for Applications (RFAs)

In FY 98, NIOSH and three institutes of the National Institutes of Health (NIH) joined

together to target research applications from the extramural research community in

11 of the 21 priority areas (total available funds = $24 million over 3 years).

Team Products

In addition to the collaborative research efforts highlighted earlier, team products are

being tracked. Ten of the 20 NORA teams are developing white papers to describe

research issues and gaps in the specific priority areas. Partnership Team activity can

also be measured through conferences and workshops. In FY 97, NIOSH and its

partners sponsored four major meetings related to NORA as a whole or to specific

priority areas; ten such meetings have been held (or are scheduled) in FY 98.

TRACKING“NORA is critically important

to focusing available

resources to the most

important occupational

illnesses of our time.”

– James C. Rock, Ph.D.

President-Elect, American

Industrial Hygiene Association

18 National Occupational Research Agenda

$2.0

1.5

1.0

.5

0

Dollars in Millions

Allergic & Irritant Dermatitis

Asthma & COPD

Fertility & Pregnancy Abnormalities

Hearing Loss

Infectious Diseases

Musculoskeletal Disorders

Lower Back Disorders

Traumatic Injuries

Emerging Technologies

Indoor Environment

Mixed Exposures

Organization of Work

Special Populations at Risk

Cancer Research Methods

Control Technology & PPE

Exposure Assessment Methods

Health Services Research

Intervention Effectiveness Research

Risk Assessment Methods

Social & Economic Consequences

Surveillance Research Methods

FY96 NORA-Related Budget Allocations

Reported by Federal Partners
National Occupational Research Agenda 19 TRACKING

Occupational Low Back Injury Publications

150

125

100

75

50

25

0

Number of Publications

92 93 94 95 96

Years

Back Injury

Tracking the Literature

and Recognition of NORA

Bibliometrics

Tracking scientific literature over time is being used as a measure of whether NORA is

having the intended effect of stimulating increased research in the priority areas.

Baseline data are being assembled for all priority areas (for example, for occupational

low back disorders, publications have been steady at about 114 per year during

1992-96).

In addition to scientific publications, NIOSH will track popular literature citations, trade

journal and media references and “hits” on the NORA homepage to assess the

diffusion of NORA.

This tracking should show the effects of an enhanced NORA communication strategy

to increase knowledge about NORA among current and potential NORA partners. In

the past year, NIOSH has developed a NORA logo, a quarterly NORA newsletter

entitled NORA News, and a NORA exhibit program. An interactive NORA website has

also been created (http://www.cdc.gov/niosh/norhmpg.html). The site, when

completely operational, will contain all NORA documents, white papers, research

summaries, calendar of upcoming events, and partnership team information. Future

communications efforts include a compendium of NIOSH conducted or-funded NORA

research, outreach for partnership teams, and articles for the popular press.
20 National Occupational Research Agenda REPLICATIONNORA – 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 ongoing planning efforts include the following:

• The Director of the Italian National Institute for Occupational Safety and

Health is planning a priority-setting effort in Italy, using NORA as the model.

• The Norwegian National Institute of Occupational Health is also conducting a

priority setting process based, in part, on NORA.

• The Environmental Protection Agency is considering using NORA for their

Human Health Indoors Project as they explore how the EPA should protect human

health indoors in the 21st century.

• Washington State is undertaking a state-wide needs and priorities planning

process for health and safety much influenced by the NORA process.

• The Pacific Northwest Agricultural Safety and Health Center organized a farm

summit modeled after NORA to develop areas of consensus about key agricultural

safety and health problems that can be addressed by research and intervention

programs. The results of the summit will be used to help shape the Center’s

priorities.

• The Chemical Safety and Hazard Investigation Board, after learning about

NORA in the American Journal of Public Health, has requested more information on

NORA and will use it as a model as they form their own research agenda.

• The American Association of Occupational Health Nurses (AAOHN) and the

American College of Occupational and Environmental Medicine (ACOEM)

have recently partnered to establish a joint research award. As stated by the

AAOHN Executive Director, “In support of the work of NIOSH and to promote the

National Occupational Research Agenda (NORA), emphasis has been give to NORA

in the selection criteria.”

• The Chemical Industry Institute of Toxicology, Chemical Manufacturers

Association, and other organizations have recently undertaken a prioritization

activity using some strategies of NORA development. Eight of the topics identified

in their process closely relate to NORA priority areas.
National Occupational Research Agenda 21 REPLICATION

The research and products created under the Agenda are also replicable and applicable to many jurisdictions and organizations. For example, the landmark NIOSH

position on occupational latex allergy, developed through the NORA process, has also

been adopted by many States and has influenced other Federal agencies and

professional organizations. NIOSH itself is relying on lessons from the NORA process

in other Institute efforts, including development of a national strategy for occupational

safety and health surveillance.

To facilitate the replication of NORA by other organizations, NIOSH has published an

article on the process of developing the Agenda in the American Journal of Public

Health, “The National Occupational Research Agenda: A Model of Broad Stakeholder

Input into Priority Setting” (Am J Public Health. 1998; 88:353-356).

In an editorial in the same issue, “NORA—More than a Name,” Dr. David Wegman of

the Department of Work Environment at the University of Massachusetts, Lowell,

states that: “NORA provides a sound template for future cooperative work across the

full range of public and private partners. The work that went into this consensus effort

was both collaborative and creative; now the task is to implement the agenda and

realize its potential. A report on the progress in the year since NORA was announced

is encouraging. At the same time, there is much more to be done.” (Am J Public

Health. 1998; 88:349-350).
22 National Occupational Research Agenda MILESTONESNORA Milestones

July 1995 – July 1998

July 1995 .......................... NIOSH commits to lead creation of an Agenda

September 1995 ............... Agenda framework developed and 50 potential topics

identified by initial working group of internal and external

scientists

November 1995 ................ First National public meeting to provide input into Agenda

and discuss criteria for priorities

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

researchers, health professionals, other stakeholders)

expand and prioritize priority areas

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

convened

March 1996 ...................... Second National public meeting to review Agenda and

draft report

April 1996 ......................... Final Agenda—National Occupational Research Agenda—

identifies 21 priority research areas to guide occupational

safety and health research (released on NIOSH 25th

Anniversary)

November 1996 ............... Partnership teams formed to implement the NORA

priorities

January 1997 .................... First Best Practices Conference for Musculoskeletal

Disorders, Chicago, IL

February 1997 .................. First ever survey of Federal (non-NIOSH) resources

committed to occupational safety and health research

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

National Academy of Sciences, Washington, DC

“. . . congratulations on a

fine piece of work. [NORA]

is engaging to read, tightly

and cleverly organized, and

makes a very convincing

case for pursuing research

in the priority areas it

identifies. This document

should serve us well in the

coming years. It deserves

wide circulation. Kudos to

all who worked on it.”

– Kathleen M. Rest,

Ph.D., MPA

NACOSH Chair, University of

Massachusetts Medical

Center, Occupational Health

Program
National Occupational Research Agenda 23 MILESTONES

July 1997 .......................... NORA Update 1997 Document Released

October 1997 ................... The Traumatic Injury NORA Team convened the first ever

National Occupational Injury Research Symposium,

Morgantown, WV

November 1997 ................ Congress appropriates $5 million for the implementation

of NORA

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

research priorities

March 1998 ...................... Largest ever funding for targeted occupational safety and

health research (approximately $8 million RFA) announced

by NIOSH and NIH partners

March 1998 ...................... American Association of Occupational Health Nurses and

the American College of Occupational and Environmental

Medicine partner to establish a joint research award, with

emphasis given to NORA in the selection criteria

May 1998 ......................... NORA selected as one of 100 semifinalists (one of 19

Federal semifinialist) for the Ford Foundation and Harvard

University’s 1998 Innovations in American Government

Awards Program from an initial pool of 1420 applicants.

May 1998 ......................... First issue of the NORA newsletter, NORA News,

distributed

May 1998 ......................... NORA Website posted

July 1998 .......................... NORA 1998 Update Document released
24 National Occupational Research Agenda SUMMARY

Summary

The first two years of NORA have proven successful. The hard work and commitment

of those involved has 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.

• The participation of a large number of Federal agencies in NORA activities including

the largest ever funding for targeted occupational safety and health research.

• The first survey of Federal occupational safety and health (including NORA)

research investment.

• The evidence that a national Research Agenda was, and continues to be, needed

and that NORA research priority areas have been well chosen.

• The recognition that NORA is 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.
TEAMS

(continued from front cover)

Infectious Diseases

Robert J. Mullan (NIOSH) rjm1@cdc.gov

Jordan Barab (American Federation of State,

County, and Municipal Employees)

Yvonne Boudreau (NIOSH)

Joel Breman (Fogarty International Center/NIH)

Naresh Chawla (Food and Drug Administration)

Yvette Davis (National Center for HIV, STD and

TB Prevention/CDC )

William Denton (Denton International)

June Lunney (National Institute of Nursing

Research/CDC)

Adelisa Panlilio (National Center for Infectious

Diseases/CDC)

Jack Parker (NIOSH)

Teresa Seitz (NIOSH)

Kent A. Sepkowitz (Sloan-Kettering Cancer

Center)

Craig Shapiro (National Center for Infectious

Diseases/CDC)

Intervention Effectiveness Research

Linda Goldenhar (NIOSH) lyg9@cdc.gov

Robin Baker (University of California, Berkeley)

Ann Brockhaus (Organization Resources

Counselors Inc.)

Larry Chapman (University of Wisconsin)

Sarah Glavin (General Accounting Office)

Anthony LaMontangne (Harvard University)

Paul Landsbergis (Cornell University)

Daniel Murphy (St. Paul Fire & Marine

Insurance Co.)

Carolyn Needleman (Bryn Mawr University)

Nancy Nelson (NIOSH)

Scott Schneider (Center to Protect Workers’

Rights )

Raymond Sinclair (NIOSH)

Naomi Swanson (NIOSH)

Margie Wallance (NIOSH)

Mixed Exposures

Frank Hearl (NIOSH) fjh1@cdc.gov

Gregory Burr (NIOSH)

John Bucher (National Institute for

Environmental Health Sciences/NIH )

Henry Gardner (Department of Defense)

Manuel Gomez (American Industrial Hygiene

Association)

Hugh Hansen (Agency for Toxic Substances

and Disease Registry)

Robert Herrick (Harvard University)

Richard Hertzberg (Environmental Protection

Agency)

Vera Kommineni (NIOSH)

Daniel Lewis (NIOSH)

Alan Lunsford (NIOSH)

Carlos Marentes (Rural Coalition)

Joe L. Mauderly (Lovelace Research Institute)

Pam Susi (Center to Protect Workers’ Rights)

Douglas Trout (NIOSH)

Musculoskeletal Disorders

Larry Fine (NIOSH) ljf4@cdc.gov

Vern Putz Anderson (NIOSH)

Bruce Bernard (NIOSH)

LaMont Byrd (International Brotherhood of

Teamsters)

Cherie Fairfield Estill (NIOSH)

Sean Gallagher (NIOSH)

Hongwei Hsiao (NIOSH)

Tom Leamon (Liberty Mutual)

James Panagis (National Institute of Arthritis

and Musculoskeletal and Skin Diseases/NIH)

John Brian Peacock (General Motors

Corporation)

 Thomas Salvin (Navistar International

Transportation Corporation)

Priscilla Shoemaker (American Health Care

Association.)

Barbara Silverstein (Washington State Dept. of

Labor & Industries)

Thomas Waters (NIOSH)

Laura Welch (Washington Hospital Center)

Organization of Work

Steve Sauter (NIOSH) sls4@cdc.gov

Steve Brightwell (NIOSH)

Michael Colligan (NIOSH)

Joseph Hurrell (NIOSH)

Gwen Keita (American Psychological

Association)

David LeGrande (Communications Workers of

America)

Nancy Lessin (Massachusetts Coalition for

Occupational Safety and Health)

Mary Lewis (PPG)

Richard Lippin (ARCO Chemical Corporation)

Jane Lipscomb (University of Maryland)

Lawrence Murphy (NIOSH)

Robert Peters (NIOSH)

Jeanne Stellman (Columbia University)

Naomi Swanson (NIOSH)

Lois Tetrick (University of Houston)

Risk Assessment Methods

Leslie Stayner (NIOSH) lts2@cdc.gov

Michael Attfield (NIOSH)

William Fayerweather (Owens Corning

Corporation)

Herman Gibb (Environmental Protection

Agency)

Dale Hattis (Clark University)

Frank Mirer (United Auto Workers)

William Perry (Occupational Safety and Health

Administration)

Chris Portier (National Institute of

Environmental Health Sciences/NIH)

Christine Sofge (NIOSH)

Mark Toraason (NIOSH)

Gerald Van Belle (University of Washington)

Terry Wassell (NIOSH)

Social and Economic Consequences

of Workplace Illness and Injury

Elyce Biddle (NIOSH) egb6@cdc.gov

Leslie Boden (Boston University)

Ben Amick (New England Medical Center)

Laura Blanciforti (NIOSH)

Thomas Camm (NIOSH)

Brian Day (NIOSH)

Allan Hunt (W.E. Upjohn Institute)

Paul Keane (NIOSH)

Chuck Levenstein (University of

Massachusetts, Lowell)

Cynthia Madden (University of Washington)

Ted Miller (National Public Services Research

Institute)

Sharon Morris (University of Washington)

Harry Shannon (Institute for Work and Health)

Eve Spangler (Boston College)

Emily Spieler (West Virginia University,

School of Law)

Special Populations at Risk

Gwendolyn Cattledge (NIOSH)

gxc8@cdc.gov

Joni Berardino (National Center for

Farmworker Health)

Lorraine Cameron (Michigan Department of

Community Health)

Dawn Castillo (NIOSH)

Letitia Davis (Massachusetts Department of

Health)

Gayle DeBord (NIOSH)

Ann Fidler (Public Health Practice Program

Office/CDC)

Howard Frumkin (Emory University)

Frances Henderson (Alcorn State University)

Charles Lee (United Church of Christ)

Pam Tau Lee (Labor Occupational Health

Program)

Andrea K. Taylor (United Auto Workers)

Anthony Yancey (NIOSH)

Surveillance Research Methods

John Sestito (NIOSH) jps4@cdc.gov

Henry Anderson (Wisconsin Department of

Health and Social Services)

Robert Castellan (NIOSH)

Richard Ehrenberg (NIOSH)

Barbara Fotta (NIOSH)

Eric Frumin (Union of Needletrades,

Industrial and Textile Trade Employees)

Alice Greife (Central Missouri State

University)

Denise Koo (Epidemiology Program Office/

CDC)

Wayne Lednar (Eastman Kodak Company)

Jane McCammon (NIOSH)

Leroy Mickelson (NIOSH)

John Myers (NIOSH)

Steven Newell (Occupational Safety and

Health Administration)

Earl Pollack (Center to Protect Workers’

Rights)

Diane Wagener (National Center for Health

Statistics/CDC )

William Weber (Bureau of Labor Statistics)

Traumatic Injuries

Nancy Stout (NIOSH) nas5@cdc.gov

William Borwegen (Service Employees

International Union)

George Conway (NIOSH)

Alan Hoskin (National Safety Council)

Lynn Jenkins (NIOSH)

Herb Linn (NIOSH)

Stephen Luchter (National Highway Traffic

Safety Administration)

Nancy McWilliams (McWilliams Risk

Management)

Tim Pizatella (NIOSH)

Gordon Reeve (Ford Motor Company)

Bradley Rein (U.S. Department of

Agriculture)

Gordon Smith (Johns Hopkins University)

Karl Snyder (NIOSH)

Lisa Steiner (NIOSH)
For additional information, contact NIOSH at:

National Institute for Occupational Safety and Health

Publications Dissemination

4676 Columbia Parkway

Cincinnati, OH 45226-1998

1-800-35-NIOSH

(1-800-356-4674)

Fax: 513-533-8573

or visit the NIOSH homepage on the World Wide Web at

http://www.cdc.gov/niosh/homepage.html

DHHS (NIOSH) Publication No. 98-141