NIOSH EXTRAMURAL RESEARCH 

AND TRAINING PROGRAM

ANNUAL REPORT OF FISCAL YEAR 2018

Prepared by the Office of Extramural Programs

National Institute for Occupational Safety and Health

Centers for Disease Control

and Prevention

National Institute for Occupational 

Safety and Health
Cover image components by ©Thinkstock.
NIOSH EXTRAMURAL RESEARCH 

AND TRAINING PROGRAM

ANNUAL REPORT OF FISCAL YEAR 2018

Prepared by the Office of Extramural Programs

National Institute for Occupational Safety and Health

William A. Robison, PhD; Donjanea F. Williams, EdD; and Peter Grandillo, MBA 

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Institute for Occupational Safety and Health
ii NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

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organizations or their programs or products. Furthermore, NIOSH is not responsible for the 

content of these websites. All web addresses referenced in this document were accessible as of 

the publication date.

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SUGGESTED CITATION

NIOSH [2019]. NIOSH extramural research and training program: annual report of fiscal year 

2018. By Robison WA, Williams DF, Grandillo P. Atlanta, GA: U.S. Department of Health and 

Human Services, Centers for Disease Control and Prevention, National Institute for Occupational 

Safety and Health, DHHS (NIOSH) Publication No. 2020-108.

DHHS (NIOSH) Publication No. 2020-108

DOI: https://doi.org/10.26616/NIOSHPUB2020108

December 2019
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 iii

FOREWORD

I am pleased to deliver the FY2018 annual report on the National Institute for Occupational Safety 

and Health (NIOSH) Extramural Research and Training Program. The data in this report reflect the 

exceptional work of the extramural community of researchers supported by NIOSH and the Office 

of Extramural Programs.

In this report, we look at how NIOSH invested in our multidisciplinary centers, investigator-initiated 

research projects, and cooperative research agreements. We also report on our training project 

grants, state surveillance programs, small business innovation research, and global health initiatives. This report does not include data on the World Trade Center (WTC) Health Program grants 

program. Information about the WTC Health Program is available on the NIOSH website.

We analyze funding and activity by program area and review extramural research support of 

NIOSH research priorities and goals. We include links to the NIOSH website throughout the report 

for direct access to additional data and information. Section IV describes the public health relevance and accomplishments of our varied and multidisciplinary portfolios with program highlights 

from FY2018.

I would like to acknowledge the work of the NIOSH Office of Extramural Programs in compiling this 

report and the contributions of the extramural research community in protecting the workforce 

by producing new occupational safety and health knowledge and transferring it into practice.

John Howard, MD

Director, National Institute for

Occupational Safety and Health

Centers for Disease Control and Prevention
iv NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

EXECUTIVE SUMMARY

In FY2018, the National Institute for Occupational Safety and Health (NIOSH) funded 151 extramural 

awards totaling $92,151,881. Multidisciplinary centers received 36 awards totaling $59,107,157 

(64%) in these program areas: 

■ $28.4 million for 18 Education and Research Centers

■ $18.6 million for 11 Centers for Agricultural Safety and Health 

■ $6.3 million for 6 Centers of Excellence for Total Worker Health®

■ $5.8 million for 1 National Center for Construction Research and Training

Investigator-initiated and career development research received 48 awards totaling $16,575,147 

(18%). Cooperative research agreements received 33 awards totaling $9,157,411 (10%). Specialty 

training programs received 29 awards totaling $5,470,466 (6%), and 5 small business innovation 

research projects received a total of $1,841,700 (2%). 

Funding for global health initiatives included a cooperative agreement with the World Health 

Organization (WHO) to support the Global Plan of Action on Workers’ Health, which works to 

strengthen the abilities of national health systems to respond to the specific health needs of 

workers. 

NIOSH also cosponsored global occupational safety and health activities with the National 

Institutes of Health (NIH) Fogarty International Center’s Global Environmental and Occupational 

Health (GEOHealth) program. This program supports a multinational network of regional hubs led 

by institutions in low- or middle-income countries that partner with U.S. institutions.

In FY2018, NIOSH extramural researchers wrote 602 peer-reviewed articles in 298 journals. 

Education and Research Centers had the most articles (259) published, followed by investigatorinitiated (R01) research (117). These articles appeared most often in the Journal of Occupational 

and Environmental Medicine.
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 v

TABLE OF CONTENTS

FOREWORD . . .

EXECUTIVE SUMMARY . . 

TABLE OF CONTENTS . .

LIST OF ABBREVIATIONS . . .

Sector Programs  . . 

LIST OF FIGURES . . .

LIST OF TABLES . . .

LIST OF MAPS . . . 

I. NIOSH EXTRAMURAL RESEARCH AND TRAINING PORTFOLIO . .

National Occupational Research Agenda  . 

NIOSH Program Areas  . 

II. NIOSH EXTRAMURAL RESEARCH . .

Funding Distribution FY2018  . 

Summary of All Awards by Type of Funding  . 

Extramural Research Portfolio FY2018  . 

Multidisciplinary Centers  . 

Investigator-initiated Research  . 

Cooperative Agreements  . 

Specialty Training Programs  . 

Small Business Innovation Research  . .

Extramural Research Activity by NIOSH Program Area  . .

Success Rates for Research Project Grants, FY2008–2018  . .

III. EXTRAMURAL RESEARCH GOALS IN FY2018 . . 

Extramural Research Activity by Sector Goals, FY2018  . .

Agriculture, Forestry, and Fishing  . .

Construction   . .

Healthcare and Social Assistance  . .

Manufacturing  . .

Mining  . .

Oil and Gas Extraction  . .

Public Safety  . .

Services  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  24

Transportation, Warehousing, and Utilities  . .

Wholesale and Retail Trade  . .

IV. FY2018 EXTRAMURAL RESEARCH PROGRAM HIGHLIGHTS . . 

Multidisciplinary Centers  . .
vi NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

Centers for Agricultural Safety and Health   . .

National Center for Construction Research and Training  . .

Centers of Excellence for Total Worker Health® . .

Education and Research Centers  . .

Investigator-initiated Research  . .

Research Grants  . .

Cooperative Research Agreements  . .

State Surveillance Program  . .

Specialty Training Programs  . .

Training Project Grants  . .

Emergency Responder Training Program  . .

Miner Safety and Health Training Program  . .

APPENDIX: FY2018 NIOSH Funding Opportunity Announcements 

by Mechanism   . .
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 vii

LIST OF ABBREVIATIONS

SECTOR PROGRAMS

ALL All Sectors or Multiple Sectors

AFF Agriculture, Forestry, and Fishing

CON Construction

HSA Healthcare and Social Assistance

MNF Manufacturing

MIN Mining

OGE Oil and Gas Extraction

PSS Public Safety

SRV Services

TWU Transportation, Warehousing, and Utilities

WRT Wholesale and Retail Trade

LIST OF FIGURES

Figure 1. NIOSH extramural grant distribution, FY2018 . .

Figure 2. Multidisciplinary center awards, FY2018 . .

Figure 3. Cooperative agreements, FY2018 . .

Figure 4. Research funding by sector program, FY2018 . . 

Figure 5. Overall success rates for research project grants, FY2008–2018 . . 

Figure 6. Success rates for R01 applications, FY2008–2018 . . 

Figure 7. Success rates for R03 applications, FY2008–2018 . . 

Figure 8. Success rates for R21 applications, FY2008–2018 . . 

Figure 9. NIOSH extramural research support of goals by sector, FY2018 . . 

LIST OF TABLES

Table 1. NIOSH program areas . .

Table 2. Summary of all awards by type of funding in FY2018 . .

Table 3. Investigator-initiated research and conference grant funding, FY2018 . .

Table 4. Agriculture, Forestry, and Fishing research projects by strategic goal, FY2018  . . 

Table 5. Construction research projects by strategic goal, FY2018 . . 

Table 6. Healthcare and Social Assistance research projects by strategic goal, FY2018 . . 

Table 7. Manufacturing research projects by strategic goal, FY2018  . . 

Table 8. Mining research projects by strategic goal, FY2018 . . 

Table 9. Oil and Gas Extraction research projects by strategic goal, FY2018 . . 

Table 10. Public Safety research projects by strategic goal, FY2018 . . 
viii NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

Table 11. Services research projects by strategic goal, FY2018 . . 

Table 12. Transportation, Warehousing, and Utilities research projects 

by strategic goal, FY2018 . . 

Table 13. Wholesale and Retail Trade research projects by strategic goal, FY2018 . . 

Table 14. ERC Trainees, Graduates, and Employment, FY2018 . . 

Table 15. ERC Graduate employment by work setting, FY2018 . . 

Table 16. Continuing Education Courses by discipline, FY2018 . . 

Table 17. Training project grant trainees, graduates, and employment 

by discipline, FY2018 . . 

Table 18. Emergency responder training classes, FY2018 . . 

LIST OF MAPS

NIOSH Centers for Agricultural Safety and Health. .

Centers of Excellence for Total Worker Health®. .

NIOSH Education and Research Centers. .

NIOSH Sponsored State Occupational Health & Safety Surveillance Program. .

NIOSH Project Training Grants by Discipline. .
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 1

I. NIOSH EXTRAMURAL RESEARCH 

AND TRAINING PORTFOLIO

NIOSH Extramural Research and Training Programs include multidisciplinary research and training 

centers, investigator-initiated research, mentored research scientist development awards, training 

project grants, and small business innovation research projects in occupational safety and health. 

State surveillance programs and global occupational health initiatives enhance the breadth and 

depth of extramural research and training at NIOSH. The Research and Training Portfolio webpage 

describes these programs. The NIH Guide for Grants and Contracts publishes extramural funding 

opportunity announcements. This information also appears in the Funding Opportunities listed 

on the NIOSH Extramural Research and Training Programs webpage. The Appendix of this report 

lists all the NIOSH funding opportunity announcements published in FY2018.

NATIONAL OCCUPATIONAL RESEARCH AGENDA

The National Occupational Research Agenda (NORA) is a partnership program to stimulate new 

research and improved workplace practices. Unveiled in 1996, NORA serves as a research framework for the nation and for NIOSH that identifies and speaks to the most pressing issues in 

work-related safety and health. As steward of NORA, NIOSH launched the third decade in FY2017,

which consists of ten industry sectors and seven cross-sectors representing major occupational 

safety and health issues and outcomes. NORA partners develop broad strategic objectives for 

research in each of those sectors and cross-sectors, and then work on those areas through 

information sharing, partnerships, and enhancing dissemination and implementation of evidence-based practices. 

NIOSH PROGRAM AREAS

NIOSH organizes its research portfolio according to the NORA framework, with ten sector programs and seven cross-sector programs. Additionally, NIOSH has core and specialty program 

areas, which represent essential activities, mandates, special focus areas, and methods to use in 

research that support the sector and cross-sector programs. Each program area has research priorities and goals. This includes the most important goals for the extramural program—projects by 

researchers outside of NIOSH. Research to Practice (r2p) is a central focus of NIOSH programs and 

NIOSH-funded research. The r2p webpage offers more information on the NIOSH r2p program.

Table 1 offers links to more information about these program areas and research priorities. Select 

a name to access its webpage. 
2 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

Table 1. NIOSH program areas

NIOSH Sector Programs

Agriculture, Forestry, and Fishing Oil and Gas Extraction

Construction Public Safety

Healthcare and Social Assistance Services

Manufacturing Transportation, Warehousing, and Utilities

Mining Wholesale and Retail Trade

NIOSH Cross-sector Programs 

Cancer, Reproductive, Cardiovascular, 

and Other Chronic Disease Prevention 

Respiratory Health

Hearing Loss Prevention Traumatic Injury Prevention 

Immune, Infectious, and Dermal Disease Prevention Healthy Work Design and Well-Being

Musculoskeletal Health

NIOSH Core and Specialty Programs 

Authoritative Recommendations Nanotechnology

Center for Direct Reading and Sensor Technologies National Center for Productive Aging and Work

Center for Maritime Safety and Health Studies Occupational Health Equity

Center for Occupational Robotics Research Personal Protective Technology

Center for Motor Vehicle Safety Prevention through Design

Center for Workers’ Compensation Studies Safe • Skilled • Ready Workforce

Emergency Preparedness and Response Small Business Assistance

Engineering Controls Surveillance

Exposure Assessment Translation Research

Health Hazard Evaluations
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 3

II. NIOSH EXTRAMURAL RESEARCH

FUNDING DISTRIBUTION FY2018

In FY2018, NIOSH awarded $92,151,881 in extramural funding. Figure 1 shows the distribution of 

awards by activity. Sixty-four percent (64%) of the extramural funding went to multidisciplinary 

centers, followed by 18% for investigator-initiated and career development research grants. Other 

cooperative research agreements made up 10% of the FY2018 grant distributions, followed by 

speciality training programs (6%), and small business innovation research projects (2%).

Extramural Awards (in millions of dollars), FY2018

Figure 1. NIOSH extramural grant distribution, FY2018

In FY2018, NIOSH presented 151 awards: 33 (22%) for new projects and 118 (78%) for continuing 

awards. Table 2 summarizes all NIOSH extramural awards for FY2018. Of these awards, 

■ 48 (32%) funded investigator-initiated research and career development; 

■ 36 (24%) funded multidisciplinary research and training centers, which include Education and 

Research Centers, Centers for Agricultural Safety and Health, CPWR—The Center for Construction Research and Training, and Centers of Excellence for Total Worker Health®; 

■ 33 (22%) funded cooperative research agreements; 

■ 29 (19%) funded training program grants; and 

■ 5 (3%) funded small business innovation research. 

The Office of Extramural Programs (OEP) webpage has a searchable list of all active awards funded 

by NIOSH and NIOSH funding opportunity announcements.
4 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

SUMMARY OF ALL AWARDS BY TYPE OF FUNDING

Table 2. Summary of all awards by type of funding in FY2018

Award Category Award Mechanism

Number 

of Awards Funding

Multidisciplinary Centers 36 $59,107,157

Education and Research Centers Training Grant (T42) 18 $28,400,861

Centers for Agricultural Safety and 

Health

Cooperative Research Agreement 

(U54)

11 $18,611,221

National Center for Construction 

Research and Training

Cooperative Research Agreement 

(U60)

1 $5,750,000

Centers of Excellence for Total 

Worker Health®

Cooperative Research Agreement 

(U19)

6 $6,345,075

Investigator-initiated Research Grants 48 $16,575,147

Research Grants Investigator-initiated (R01, R03, 

R21, R13, U13)

43 $16,041,598 

Career Developmental Research Mentored Career Scientist (K01) 5 $533,549 

Cooperative Research Agreements 33 $9,157,411

State Surveillance Program Cooperative Research Agreement 

(U60)

26 $6,802,162

Workers’ Compensation Surveillance Cooperative Research Agreement 

(U60)

3 $598,612

Agricultural, Forestry, and Fishing 

Safety and Health

Cooperative Research Agreement 

(U01)

2 $449,999

National Mesothelioma Virtual Bank Cooperative Research Agreement 

(U24)

1 $1,081,638

World Health Organization Cooperative Research Agreement 

(E11)

1 $225,000

Specialty Training Programs 29 $5,470,466

Training Project Grants Training Grant (T03) 27 $4,502,466

Miner Safety and Health Training 

Program

Cooperative Research Agreement 

(U60)

 2 $968,000

Small Business Innovation Research 5 $1,841,700

Small Business Innovation Research Phase I (R43) & Phase II (R44) 5 $1,841,700

Total Extramural Funding 151 $92,151,881
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 5

EXTRAMURAL RESEARCH PORTFOLIO FY2018

NIOSH extramural research includes multidisciplinary centers, investigator-initiated research, and 

cooperative agreements. All applications for extramural funding are peer-reviewed for scientific 

merit and reviewed internally for programmatic relevance. Descriptions of these NIOSH extramural 

research elements follow.

Multidisciplinary Centers

NIOSH funds targeted research and outreach activities through multidisciplinary centers, which 

focus on high-risk industries that contribute disproportionately to work-related injury and illness in 

the United States. A variety of grant mechanisms, including cooperative research agreements and 

center training grants, fund these centers. Two multidisciplinary centers, Centers for Agricultural 

Safety and Health (Ag Centers) and CPWR—The Center for Construction Research and Training, 

perform critical research and training into the many safety and health hazards in agriculture and 

construction. 

Another valuable center, the Centers of Excellence for Total Worker Health®, conducts research 

on the concepts of Total Worker Health (TWH). The Centers of Excellence advance TWH knowledge 

by building the scientific evidence base through research and practice that aims to improve the 

overall safety, health, and well-being of the diverse worker population in our nation. Their research 

examines the integration of occupational safety and health protection with workplace policies, 

programs, and practices to advance worker safety, health, and well-being.

A national network of Education and Research Centers (ERCs) carries out multidisciplinary 

education and research training activities. These university-based centers offer graduate and 

post-graduate training in the core and allied fields of occupational safety and health. Along with 

degree training, ERCs deliver continuing education and outreach to the occupational safety and 

health community throughout the federal health region they serve. 

NIOSH awarded approximately $59.1 million to 36 multidisciplinary centers in FY2018:

■ 18 ERCs received $28.4 million.

■ 11 Ag Centers received $18.6 million.

■ 6 Centers of Excellence for Total Worker Health® received $6.3 million. 

■ CPWR—The Center for Construction Research and Training received $5.8 million (see Figure 2). 

Section IV describes each of these center portfolios and lists individual center grants. 
6 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

Funding for Center Grants: $59.1 Million in FY2018

Figure 2. Multidisciplinary center awards, FY2018

ERCs = Education and Research Centers; Ag Centers = Centers for Agricultural Safety and Health; 

CPWR = National Center for Construction Research and Training; TWH = Centers of Excellence for Total 

Worker Health®

Investigator-initiated Research

Research Grants

Through its funding awards for investigator-initiated research, the NIOSH extramural research 

program supports relevant, quality scientific investigations that aim to help reduce job-related 

injuries and illnesses. These diverse awards include funding for large occupational safety and 

health research projects (R01), small occupational safety and health research grants (R03), and 

exploratory occupational safety and health research grants (R21). 

The extramural research portfolio includes research scientist career development awards (K01), 

which offer mentored training for the next generation of occupational safety and health scientists. 

These competitive K01 awards offer up to 3 years of funding and a scientific focus designed to 

develop the skills and productivity of new career scientists. 

Conference Grants

NIOSH values quality scientific meetings, which help prevent injuries, illnesses, and fatalities caused 

by workplace hazards. NIOSH awards conference grants under research grant mechanisms (R13 

and U13). In FY2018, NIOSH funded one R13 conference grant and two U13 cooperative agreement 

conference grants (see Table 3).
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 7

Table 3. Investigator-initiated research and conference grant funding, FY2018

Grant

Type

New 

Awards

New 

Funding

Continuing 

Awards

Continuing 

Funding

Total 

Funding

R01 8 $3,943,190 21 $10,085,089 $14,028,279

R21 8 $1,698,777 0 $0 $1,698,777

K01 3 $317,549 2 $216,000 $533,549

R03 3 $234,542 0 $0 $234,542

R13 0 $0 1 $20,000 $20,000

U13 1 $30,000 1 $30,000 $60,000

Total 23 $6,224,058 25 $10,351,089 $16,575,147

NIOSH awarded $16.6 million to new and continuing research projects, mentored scientist 

grants, and conference grants in FY2018 (see Table 3). Section IV describes investigator-initiated 

research outputs. 

Cooperative Agreements

NIOSH uses cooperative agreements to partner with state health departments, universities, labor 

unions, and nonprofit organizations in a variety of surveillance and research opportunities. NIOSH 

funds a broad array of cooperative agreements to develop knowledge for preventing work-related 

diseases and injury.

Unlike grants, which are conducted independently of the sponsoring agency, cooperative agreements combine the knowledge of federal and nonfederal researchers to achieve public health 

efforts that would not otherwise occur. A cooperative agreement requires a clear need for a 

program’s staff to do the proposed project. NIOSH evaluates if the cooperative agreement has 

enough importance to deserve committing the staff resources needed during the term of the 

cooperative agreement award.

Cooperative research agreements funded in FY2018 totaled $9.2 million and included long-standing 

state surveillance programs and third-year funding for workers’ compensation surveillance. Agriculture, Forestry, and Fishing (AFF) for forestry safety research, the National Mesothelioma Virtual 

Bank, and the World Health Organization’s Global Health Program also received funding. 

Figure 3 shows how NIOSH distributed funds and how many cooperative research agreements 

received funding. 
8 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

Funding for Cooperative Research Agreements: $9.2 Million in FY2018

Figure 3. Cooperative agreements, FY2018

State Surveillance Program

The state surveillance program supports states to develop their ability to monitor work-related injuries, illnesses, and fatalities. This program helps expand the role of states in conducting in-depth 

surveillance and follow-up through investigations and interventions. These 26 NIOSH-sponsored 

programs contribute to a national occupational health surveillance strategy and create opportunities for research and intervention. The State Surveillance Program webpage focuses on these 

state-based initiatives. Table 2 reports the total number and funding for all state surveillance 

awards (new and continuing) for FY2018. 

Workers’ Compensation Surveillance Program 

The Workers’ Compensation Surveillance Program cooperative agreement helps states increase 

their capacity to compile, analyze, and distribute workers’ compensation data. These agreements 

give resources to state health and workers’ compensation agencies so they can start or expand 

state-based workers’ compensation surveillance and partnering efforts. States can use their data 

to discover trends and emerging issues, along with analyze high-risk occupations, industries, and 

worker populations. This alliance helps prevent work-related injuries, illnesses, fatalities, and hazards within states and across the nation. In FY2018, NIOSH had three cooperative agreements 

related to workers’ compensation surveillance. Table 2 shows the total funding amount for the 

Workers’ Compensation Surveillance Program.
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 9

Agriculture, Forestry, and Fishing

The NIOSH Office of Agriculture Safety and Health began this research cooperative agreement 

program in FY2014 to complete several goals: 

■ Further the understanding of risks and conditions associated with forestry- or logging-related 

occupational injuries, illnesses, and fatalities.

■ Explore methods to reduce risks and prevent or minimize exposure to hazardous conditions in 

these work environments.

■ Translate important scientific findings into prevention practices and products to reduce 

work-related injuries, illnesses, and fatalities in this area. 

The cooperative agreement program also increases knowledge on the effectiveness of current 

interventions and the best ways to make proven interventions widely available to help workers in 

this sector—in particular, addressing the unique needs of vulnerable workers.

National Mesothelioma Virtual Bank 

The National Mesothelioma Virtual Bank advances translational research for the scientific community by collecting quality data and biospecimens for mesothelioma research. This resource gives 

researchers access to de-identified clinical data associated with a multitude of biospecimens. It will 

support scientific discovery, improve detection, and help develop effective treatments for mesothelioma. This work supports research that addresses the complex mechanisms and biological 

changes associated with mesothelioma and its disease progression. The National Mesothelioma 

Virtual Bank may ultimately help improve the quality of life of current and former workers who 

have malignant mesothelioma. 

Global Partnerships 

NIOSH is a member of the Global Network of WHO Collaborating Centers for Occupational 

Health—institutions that carry out activities to assist WHO to improve global worker health. NIOSH 

involvement includes program planning; combined research, training, and management; and interacting with WHO’s Program on Workers’ Health.

NIOSH cosponsored global occupational safety and health activities with the National Institutes 

of Health (NIH) Fogarty International Center’s Global Environmental and Occupational Health 

(GEOHealth) program. This program supports a multinational network of regional hubs led by 

institutions in low- or middle-income countries that partner with U.S. institutions. More information on the work done by this program is available at the GEOHealth website.

Specialty Training Programs

Along with the ERCs described under Multidisciplinary Centers, NIOSH supports professional 

training in occupational safety and health through Training Project Grants (TPGs). Most TPGs are 

academic training programs that support undergraduate, graduate and post-graduate training. 

These programs, located throughout the United States, enrich the national network of graduate 

training that ERCs also offer.

NIOSH funds the Emergency Responder Training Program, a TPG, through the International 

Association of Fire Fighters. This grant supports a comprehensive, nationwide hazardous 
10 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

materials training program for firefighters, paramedics, and other emergency responders across 

the United States.

The Miner Safety and Health Training Program–Western United States cooperative agreement, 

which is also a funded cooperative agreement, connects the mining community with miningrelevant information, resources, and methods. These resources increase the capacity and value of 

safety training for western states’ miners. The Western Mining Safety and Health Training Resource 

Center provides these programs and activities at the University of Arizona, along with the Energy, 

Mining, and Construction Industry Safety Program at the Colorado School of Mines.

Table 2 shows the number and funding of all specialty-training grants (new and continuing) 

awarded in FY2018.

Small Business Innovation Research

The Small Business Innovation Research (SBIR) program stimulates the private sector to innovate 

technology. The SBIR program also helps small businesses to commercially apply federally supported research. In this process, they meet federal research needs as well as their own research 

and development needs. 

The SBIR program funds small businesses in their early stages as they commercialize novel technologies for occupational safety and health. This competitive program helps small businesses join 

in federal research and development, produce life-saving technologies, and create jobs. Improving the return on investment from federally funded research boosts the nation’s economy and 

improves society. 

NIOSH solicits Phase I and Phase II research proposals from science and technology-based firms. 

Phase II proposals are limited to small businesses that complete their Phase I projects. Table 2 

shows awards and funding for all FY2018 SBIR grants.
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 11

EXTRAMURAL RESEARCH ACTIVITY BY NIOSH 

PROGRAM AREA

The third decade of the NORA sector structure organizes the NIOSH research program 

portfolio. Figure 4 shows FY2018 funding for investigator-initiated research and career 

development research across the sectors. Extramural research in FY2018 took place 

across most of the NIOSH sector program areas except Oil and Gas Extraction (OGE). 

All Sectors* (ALL) received the most funding, followed by Manufacturing (MNF) and AFF.

Investigator-initiated research and 

career development funding across sectors, FY2018

Figure 4. Research funding by sector program, FY2018

*Shows projects that contribute to advancing all or most of the NIOSH sector programs, including public 

health activity tools that cut across industry sectors.
12 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

SUCCESS RATES FOR RESEARCH PROJECT GRANTS, FY2008–2018

The success rate of reviewed new applications that receive funding in a fiscal year, calculated as 

a percentage, helps measure the viability of the research grants program. Success rates for new 

awards are calculated for the investigator-initiated research only, which includes the R01, R03, and 

R21 grant mechanisms. The success rate is a function of the number of applications received and 

the number of applications funded.

Figure 5 shows that throughout FY2008–2018, the success rate remained fairly stable until FY2014, 

when it decreased from 17% to 1% in FY2017 due to funding shortages. However, in FY2018, the 

success rate increased to 10%. For FY2008–2018, the mean annual number of applications was 

176, the mean number of awards was 25, and the mean annual success rate was 15%. Figures 6–8 

show the success rates for each research mechanism.

Figure 5. Overall success rates for research project grants, FY2008–2018
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 13

Figure 6. Success rates for R01 applications, FY2008–2018

 Figure 7. Success rates for R03 applications, FY2008–2018
14 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

Figure 8. Success rates for R21 applications, FY2008–2018
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 15

III. EXTRAMURAL RESEARCH GOALS IN FY2018

In FY2018, NIOSH continued to use the same goals from the 

second decade of NORA for extramural research while new 

goals were being developed for the NIOSH Strategic Plan for 

FYs 2019–2023. Extramural researchers respond to these 

goals through research, service, and outreach. NIOSH annually assesses extramural projects that focus on strategic goals. 

In FY2018, extramural research projects addressed 49 of the 

109 (45%) NORA strategic goals. Extramural research in CON 

(Construction) worked on the most goals, followed by AFF, 

MNF, PSS (Public Safety), and SRV (Services). In particular, the AFF sector’s extramural research 

responded to all strategic goals. 

Figure 9 shows the number of strategic goals by 

sector and the number of goals addressed by extramural researchers. It also shows which goals were 

unaddressed or not worked on, as well as those that 

were inactive in FY2018. NIOSH considers goals inactive when they are retired and are no longer being 

addressed by new projects. 
16 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

Figure 9. NIOSH extramural research support of goals by sector, FY2018
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 17

EXTRAMURAL RESEARCH ACTIVITY BY SECTOR GOALS, 

FY2018

To describe NIOSH-funded extramural research in FY2018, NIOSH reviewed the strategic goals by 

industry sectors that projects addressed. Tables in the following sections show how extramural 

research projects focused on the NORA sector strategic goals in FY2018. 

Agriculture, Forestry, and Fishing

Table 4 shows how FY2018 extramural research projects addressed strategic goals in the 

Agriculture, Forestry, and Fishing (AFF) Sector. Extramural research projects supported all nine 

strategic goals for this sector. They most often addressed the SG1 (Surveillance) strategic goal 

(n=20). Four strategic goals (SG4, SG5, SG6, and SG7) were inactive in FY2018.

Table 4. Agriculture, Forestry, and Fishing research projects by strategic goal, FY2018 

Strategic Goal (SG) Extramural Projects

SG1: Surveillance 20

SG2: Vulnerable Workers 6

SG3: Outreach and Partnerships 9

SG4: Agricultural Safety (inactive after FY2016) 8

SG5: Agricultural Health (inactive after FY2016) 10

SG6: Forestry Injuries (inactive after FY2016) 1

SG7: Forestry Illness/Disease (inactive after FY2016) 2

SG8: Commercial Fishing Injuries 2

SG9: Commercial Fishing Illness/Disease 4
18 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

Construction 

Table 5 shows how extramural FY2018 research projects addressed the Construction (CON) 

Sector’s strategic goals. Extramural research FY2018 projects supported 11 of 13 active strategic 

goals for this sector. Two strategic goals (SG2 and SG10) were inactive in FY2018. Surveillance, 

SG14, had the most projects in FY2018 (n=35).

Table 5. Construction research projects by strategic goal, FY2018

Strategic Goal (SG) Extramural Projects

SG1: Falls Prevention 1

SG2: Electrocution (inactive after FY2011) 0

SG3: Struck-by Incident Prevention 1

SG4: Hearing Loss Prevention 4

SG5: Silica 1

SG6: Welding Fumes 1

SG7: Musculoskeletal Disorders 2

SG8: Safety and Health Cultures 1

SG9: Safety and Health Management 2

SG10: Industry and Work Organization

(inactive after FY2011) 1

SG11: Training and Education 0

SG12: Health Disparities 1

SG13: Prevention through Design 1

SG14: Surveillance 35

SG15: Engaging Media 0
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 19

Healthcare and Social Assistance

Table 6 shows how FY2018 extramural research projects in the Healthcare and Social Assistance 

(HSA) Sector addressed strategic goals. Extramural research FY2018 projects worked on 4 of 11 

strategic goals. Research projects did not address seven strategic goals. Extramural research had 

the most projects in SG1, Safety Culture (n=6).

Table 6. Healthcare and Social Assistance research projects by strategic goal, FY2018

Strategic Goal (SG) Extramural Projects

SG1: Safety Culture 6

SG2: Musculoskeletal Disorders 3

SG3: Hazardous Drugs and Chemicals 0

SG4: Sharp Injuries 1

SG5: Infectious Disease 2

SG6: Zoonotic Diseases in Veterinary Medicine and 

Animal Care 

0

SG7: Injuries in Veterinary Medicine and Animal Care 0

SG8: Respiratory Hazards in Veterinary Medicine and 

Animal Care

0

SG9: Reproductive Hazards in Veterinary Medicine and 

Animal Care

0

SG10: Physical Hazards in Veterinary Medicine and 

Animal Care

0

SG11: Cross-cutting Issues 0
20 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

Manufacturing

Table 7 shows how FY2018 extramural research projects in the Manufacturing (MNF) Sector 

addressed their strategic goals. Extramural research supported eight goals in FY2018. Extramural 

research addressed the most projects in strategic goal SG5, Respiratory Diseases (n=7). 

Table 7. Manufacturing research projects by strategic goal, FY2018 

Strategic Goal (SG) Extramural Projects

SG1: Contact with Objects and Equipment 1

SG2: Falls 2

SG3: Musculoskeletal Disorders 3

SG4: Hearing Loss 4

SG5: Respiratory Diseases 7

SG6: Cancer 1

SG7: Vulnerable Populations 1

SG8: Small Business 0

SG9: Emerging Risks 2

SG10: Catastrophic Incidents 0
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 21

Mining

Table 8 shows how FY2018 extramural research projects in the Mining (MIN) Sector addressed 

strategic goals. Extramural research supported three strategic goals in FY2018 and addressed the 

most projects in strategic goal SG1, Respiratory Diseases (n=3).

Table 8. Mining research projects by strategic goal, FY2018

Strategic Goal (SG) Extramural Projects

SG1: Respiratory Diseases 3

SG2: Noise-induced Hearing Loss 2

SG3: Musculoskeletal Disorders 2

SG4: Traumatic Injuries (inactive after FY2016) 0

SG5: Disaster Response and Prevention (inactive after FY2016) 0

SG6: Ground Failure Fatalities and Injuries (inactive after FY2016) 0

SG7: Interventions with New Technologies (inactive after FY2016) 0
22 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

Oil and Gas Extraction

Table 9 shows how FY2018 extramural research projects in the Oil and Gas Extraction (OGE) Sector 

addressed strategic goals. Extramural research projects did not support any strategic goals in 

FY2018. Three strategic goals (SG5, SG7, and SG11) are inactive.

Table 9. Oil and Gas Extraction research projects by strategic goal, FY2018

Strategic Goal (SG) Extramural Projects

SG1: Transportation-related Injuries and Fatalities 0

SG2: Contact Injuries 0

SG3: Falls 0

SG4: Fires and Explosions 0

SG5: Improvement in Workplace Practices, Procedures, 

and Policies (inactive after FY2011) 

0

SG6: Chemical Exposures 0

SG7: Develop Industry-specific Products (inactive after FY2014) 0

SG8: Fatigue 0

SG9: Vulnerable Workers 0

SG10: Small Businesses 0

SG11: Storage and Transportation (inactive after FY2016) 0
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 23

Public Safety

Table 10 shows how FY2018 extramural research projects in the Public Safety (PSS) Sector 

addressed strategic goals. Research projects addressed five strategic goals within this sector. 

Extramural research most often covered strategic goal SG5, Surveillance in Law Enforcement (n=4). 

Table 10. Public Safety research projects by strategic goal, FY2018

Strategic Goal (SG) Extramural Projects

SG1: Chronic Disease in Firefighters 0

SG2: Structural Firefighting Operations 0

SG3: Vehicle-related Injuries in Firefighters 0

SG4: Musculoskeletal Disorders 1

SG5: Surveillance in Law Enforcement 4

SG6: Vehicle-related Injuries in Law Enforcement 0

SG7: Criminal Assaults in Law Enforcement 0

SG8: Cardiovascular Disease in Law Enforcement 1

SG9: Traumatic Injury in Corrections 0

SG10: Infectious Disease in Corrections 0

SG11: Occupational Stress in Corrections 1

SG12: Vehicle-related Injuries in EMS (emergency medical services) 0

SG13: Patient- and Equipment-handling Injuries in EMS 0

SG14: Infectious Disease and Hazardous Exposures in EMS 0

SG15: Work Organization in EMS 0

SG16: Surveillance in EMS 0

SG17: Injuries and Illnesses in Wildland Firefighting 0

SG18: Health and Safety in Wildland Firefighting 1
24 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

Services

Table 11 shows how FY2018 extramural research projects in the Services (SRV) Sector addressed 

strategic goals. Projects supported five strategic goals for this sector. Extramural research most 

often focused on strategic goal SG17, Surveillance (n=30).

Table 11. Services research projects by strategic goal, FY2018

Strategic Goal (SG) Extramural Projects

SG1: Illnesses and Fatal Injuries in Auto Repair 0

SG2: Illnesses and Injuries in Building Services 0

SG3: Health Disparities in Building Services 1

SG4: Illnesses and Injuries in Schools 0

SG5: Injuries in Hotel/Motel Industry 0

SG6: Illnesses in Hotel/Motel Industry 0

SG7: Health Disparities in Hotel/Motel Industry 0

SG8: Injuries/Illnesses in Government 0

SG9: Traumatic Injuries in Recreation and Entertainment Industries 0

SG10: Injuries in Food Services 1

SG11: Violence in Food Services 0

SG12: Injuries/Illnesses in Telecommunications 0

SG13: Traumatic Injuries in Telecommunications 0

SG14: Temporary Labor/Contractors/Contingent Workers 0

SG15: Injuries in Waste Collection, Disposal, and Recycling Industries 0

SG16: Musculoskeletal Disorders 1

SG17: Surveillance 30

SG18: Injuries/Illnesses in Nail and Hair Salons 1
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 25

Transportation, Warehousing, and Utilities

Table 12 shows how FY2018 extramural research projects in the Transportation, Warehousing, 

and Utilities (TWU) Sector addressed strategic goals. Extramural research covered one strategic 

goal for this sector (SG2, Musculoskeletal Disorders).

Table 12. Transportation, Warehousing, and Utilities research projects by strategic 

goal, FY2018

Strategic Goal (SG) Extramural Projects

SG1: Traumatic Injuries 0

SG2: Musculoskeletal Disorders 1

SG3: Health and Wellness Programs 0

SG4: Chemical/Biological/Physical Hazards 0

Wholesale and Retail Trade

Table 13 shows how FY2018 extramural research projects in the Wholesale and Retail Trade (WRT) 

Sector addressed strategic goals. Projects addressed two strategic goals within this sector.

Table 13. Wholesale and Retail Trade research projects by strategic goal, FY2018

Strategic Goal (SG) Extramural Projects

SG1: Musculoskeletal Disorders 1

SG2: Traumatic Injuries 2

SG3: Violence 0

SG4: Vehicle-related Injuries 0

SG5: Small Business Outreach 0

SG6: Vulnerable Workers 0
26 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

IV. FY2018 EXTRAMURAL RESEARCH PROGRAM 

HIGHLIGHTS

Selected outputs, outcomes, and accomplishments of NIOSH-funded extramural research during 

FY2018 are described in this section. The outputs include publications, reports, conference 

proceedings, presentations/posters, databases, tools, methods, guidelines, recommendations, 

education and training materials, inventions, and patents. From October 1, 2017, to September 30, 

2018, NIOSH-funded extramural research led to 602 peer-reviewed publications. Researchers 

published their NIOSH-funded studies in an array of journals related to occupational safety and 

health. Most often, they published in the Journal of Occupational and Environmental Medicine

(n=42), followed by the Annals of Work Exposures and Health (n=24), the Journal of Occupational 

and Environmental Hygiene (n=21), and the Journal of Agromedicine (n=20). We collected publications by extramural researchers from principal investigator reports to NIOSH, the NIH Reporter 

database, the NIOSHTIC-2 database, and the PubMed database. Find a searchable database of 

NIOSH publications, which includes grantee final reports and publications, by using the NIOSHTIC-2

publications search. 

Detailed descriptions of other significant outputs and outcomes of NIOSH-funded extramural 

research funded during FY2018 by grant mechanism follow.
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 27

MULTIDISCIPLINARY CENTERS

NIOSH funds multidisciplinary centers that focus 

on industries with an excessive share of job-related 

injury and illness. Various grant mechanisms, 

including cooperative research agreements and 

center training grants, fund these centers.

CENTERS FOR AGRICULTURAL 

SAFETY AND HEALTH 

The Centers for Agricultural Safety and 

Health (Ag Centers), established as part 

of the NIOSH Agricultural Safety and 

Health Initiative through a cooperative 

agreement, represent a major NIOSH 

effort to protect the safety and health of 

farm workers and their families. These 

centers conduct research, education, 

and prevention projects to respond 

to the nation’s pressing agricultural 

safety and health problems. Right now, 

10 regional Ag Centers throughout 

the country work on regional safety 

and health issues unique to each area. 

NIOSH also supports the National Children’s Center for Rural and Agricultural 

Safety and Health (Child Ag Center)

within the National Farm Medicine 

Center in Marshfield, Wisconsin. With 

a national focus, the Child Ag Center 

strives to enhance the safety of all children exposed to hazards associated 

with agricultural work. 

Public Health Relevance

In 1990, Congress established a national initiative in agricultural safety and health under 

Public Law 101-517. The intention of this initiative, “... when sustained over a period of time, 

would result in a significant and measurable 

impact on ... health effects among rural Americans.” In response, NIOSH began funding the 

Centers for Agricultural Disease and Injury 

Research, Education, and Prevention in 1991. 

In FY 2015, the name changed to Centers for 

Agricultural Safety and Health. These centers 

strive to improve worker safety and health in 

the agriculture, forestry, and fishing industries—jobs that consistently ranked among 

the most dangerous in the United States. 

Although they still rank as some of the most 

dangerous, in the 25 years since the Act took 

effect, there have been significant decreases 

in injuries, illnesses, and death among farm 

workers. Part of the decline in injuries and 

deaths can be attributed to the work done by 

the Ag Centers.

The Ag Centers’ work spans the full researchto-practice continuum. First, they conduct 

basic science to evaluate and quantify an 

issue. Researchers then transfer the results 

into engineering controls, educational outreach efforts, or policy changes aimed at 

preventing or mitigating the problem. The Ag 

Centers’ research helps create and validate 

evidence-based approaches. However, the 

real impact occurs by application of these 

approaches through practical education, outreach, and prevention projects within their 

regions. Geographic diversity in agriculture, 

forestry, and fishing activities drives the need 

for regional engagement by the centers.
28 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

The Ag Centers made significant contributions 

to public health in FY2018:

■ Integrating skill and know-how from 

multiple disciplines, institutions, and 

community partners to solve complex problems.

■ Providing a continuum of basic research 

through translation and outreach 

activities that turn findings into evidence-based prevention programs.

■ Responding to the many cultural, 

ethnic, educational, and language differences that are significant barriers to 

safety and health for many laborers in 

this workforce.

■ Contributing knowledge to agricultural 

industries in the fields of medicine, nursing, industrial hygiene, epidemiology, 

engineering, and education. 
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 29

Research Outputs: 

Publications in FY2018

Ag Center outputs are the products of 

research activities and include publications. 

We collected publications by NIOSH-funded 

extramural researchers from principal investigator reports to NIOSH, the NIH Reporter 

database, the NIOSHTIC-2 database, and the 

PubMed database. From October 1, 2017, to 

September 30, 2018, Ag Centers published 81 

articles in peer-reviewed journals. Find a searchable database of NIOSH publications, which 

includes grantee final reports and publications, 

by using the NIOSHTIC-2 publications search.

Program Highlights in FY2018

Ag Centers Addressing Heat-related 

Illnesses Across the United States

Heat-related illnesses (HRI) include heat 

stroke, heat exhaustion, and heat cramps. 

These are preventable conditions, but are 

common hazards in the Agricultural, Forestry, 

and Fishing Sector. Many outdoor workers 

are at increased risk for HRI as they perform 

strenuous activities in hot environments for 

prolonged periods. Precautions including 

sufficient hydration, acclimatization or adjusting to changes in climate, and awareness of 

HRI symptoms and treatment are effective 

in preventing negative health effects and 

death. However, it takes multilayered efforts 

in research, translation, and education to 

combat elevated heat exposures in agricultural, forestry and fishing. The following 

are a few HRI projects underway at various 

Ag Centers. 

Florida: Heat Stress and Biomarkers 

of Renal Disease

Recently, agricultural workers in Central 

America have experienced a well-documented 

increase in chronic kidney disease. Many 

claim their work in hot environments and 

persistent dehydration leads to adverse renal 

or kidney-related effects. However, there 

is limited understanding of the underlying 

biological processes associated with this problem. Agricultural workers in the United States 

are also at risk, particularly in states with hot, 

extended growing seasons. 

This study measures physiological indicators 

of HRI in Florida farmworkers and includes 

metabolomics analyses to determine negative 

pathways or associations to renal impairment. Researchers are exploring whether 

biomarkers or biological indicators of renal 

damage are present in Mexican migrant 

farmworkers living in the United States when 

compared with Mexican migrant workers not 

in agriculture. They are recruiting 70 agricultural workers and 30 individuals of similar 

heritage who do not work in heat-intensive 

agricultural activities. 

By describing the occupational environment of 

these workers, along with their body anthropometrics or human body measurements, 

dehydration levels, and self-reported HRI 

symptoms, investigators hope to determine if 

biomarkers indicating kidney injury are present. If so, the scientists will focus on whether 

these biomarkers differ in agricultural workers 

when compared to workers not employed 

in agriculture. This is the first study to document the extent of association between heat 

exposure and chronic kidney disease in a U.S. 

migrant farmworker population. Researchers 

aim to better describe the possible metabolic 

pathways affected by heat exposure.

Details:

http://www.sccahs.org/index.php/research/

Texas: The Impact of Thermal Load 

on Shrimp Fishermen’s Use of 

Personal Flotation Devices 

Falls overboard are the second most frequent 

cause of death in the U.S. commercial fishing 

industry and the leading cause of death in 
30 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

southeastern shrimp fisheries, accounting 

for 61% of worker fatalities. The long-term 

goal of this project is to increase the routine 

use of personal floatation devices (PFDs) 

among Vietnamese commercial shrimp 

fishermen in the Gulf of Mexico and, consequently, reduce falls-overboard fatalities in 

commercial fisheries. 

Findings from a prior study showed that 

increased thermal load while working was 

a major barrier to wearing PFDs in the commercial fishing industry. The objective of this 

translation project is to test the impact of heat 

on use of these devices. The investigators will 

also design and test a multimodal and culturally appropriate social marketing campaign to 

increase adoption of Occupational Safety and 

Health Administration/NIOSH recommendations for heat stress reduction and increase 

comfort, access, and acceptability of PFDs. 

By reducing the impact of heat stress while 

working, researchers hope fishermen will be 

more likely to wear PFDs. Overall, this study 

aims to (1) understand, measure, and compare physiological responses to the thermal 

environment and heat stress symptoms, with 

and without PFDs, and cooling devices among 

Vietnamese shrimp fishermen, and (2) identify commercially available personal cooling 

equipment designs that have demonstrated 

comfort and workability. 

Details:

https://www.uthct.edu/swagc-currentprojects

Washington: A Multilevel Approach 

to Heat-related Illness Prevention in 

Agricultural Workers

This project will develop and evaluate a 

multilevel approach to HRI prevention in 

agricultural workers. It builds on the Center’s 

previous HRI work with Washington tree-fruit 

growers and farmworkers who are largely 

foreign-born, Spanish-speaking workers. The 

current study relies on an advisory group that 

includes workers, farm managers, and other 

stakeholders to guide the development, testing, and dissemination of an intervention. 

The project will focus on participatory worker 

HRI education to address risk factors for 

agricultural workers at individual, workplace, 

and community levels. This intervention will 

include tailored recommendations for treefruit growers on how to reduce HRI risk on 

hot workdays, which will be developed using 

data from Washington State University’s 

AgWeatherNet weather station network. 

Researchers will create a final consensus document for workers with recommendations 

for multilevel HRI risk factor assessment and 

intervention development. The Center plans to 

distribute the recommendations to workers, 

growers, housing and healthcare stakeholders, scientists, and public health practitioners.

Details:

https://deohs.washington.edu/pnash/

multi-level-approach-heat-related-illnessprevention-agricultural-workers
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 31

NATIONAL CENTER FOR 

CONSTRUCTION RESEARCH 

AND TRAINING

The CPWR—Center for Construction 

Research and Training received a 

NIOSH National Construction Center

cooperative agreement for 2014–2019 

through an extramural competition. 

The Center, with its diverse 

construction community, leads in 

applied construction research, making 

effective interventions available to 

the construction industry. Along 

with its consortium of six academic 

partners, CPWR researches safety 

and health risks that construction 

workers face on the job, including 

their causes and solutions. Their 

research projects support NORA 

Construction Sector research goals 

as well as emerging issues.

Public Health Relevance

For the past 25 years, the funding for 

CPWR comes through a series of competitive program announcements, as the 

NIOSH-sponsored Center of Excellence for 

Construction Safety and Health Research. For 

FY2018, CPWR’s research activities focused 

on NORA Construction Goals 1 through 15. 

This work included applied research for hazards and health conditions, emerging issues 

research in nanomaterials, construction industry data and tracking, and the distribution 

and transfer of research. Research projects 

also responded to the National Academy of 

Sciences’ recommendations for the NIOSH 

construction research program, including distributing research-to-practice solutions. CPWR 

has cultivated and optimized external partnerships for prevention, protections, research, 

and research translation for protecting U.S. 

construction workers.

Research Outputs:

Publications in FY2018

CPWR outputs are the products of research 

activities and include publications. We 

collected publications by NIOSH-funded 

extramural researchers from principal investigator reports to NIOSH, the NIH Reporter 

database, the NIOSHTIC-2 database, and the 

PubMed database. From October 1, 2017, to 

September 30, 2018, CPWR published eight 

articles in peer-reviewed journals. Find a 

searchable database of NIOSH publications, 

which includes grantee final reports and 

publications, by using the NIOSHTIC-2 publications search.

Program Highlights in FY2018

CPWR Data Center Leading the Way 

in Construction Safety and Health 

Surveillance 

CPWR’s Data Center is prominent in tracking 

industry, employment, and safety and health 

outcome trends in construction, using mostly 

nationally representative datasets. The 

Center analyzes data from more than 40 

sources, including the U.S. Bureau of Labor 

Statistics Survey of Occupational Injuries and 

Illnesses, NIOSH Occupational Hearing Loss 

(OHL) Worker Surveillance Data, National 

Occupational Mortality Surveillance System, 

Occupational Safety and Health Administration (OSHA) Inspection Data, and OSHA 

Chemical Exposure Health Data. 

Through this effort, CPWR increases its construction safety and health knowledge and fills 

gaps in research literature, as well as provides 

construction stakeholders with important, 

timely data. In FY2018, CPWR used these data 

to develop the sixth edition of The Construction 

Chart Book – The U.S. Construction Industry and 

Its Workers. This publication contains the most 

complete data available on all aspects of the 

U.S. construction industry including figures 
32 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

related to economics, demographics, employment/income, education/training, and safety 

and health issues. Additionally, CPWR’s Data 

Center researchers coded all construction 

death cases investigated by the NIOSH Fatality 

Assessment and Control Evaluation program 

between 1982 and 2015 into a database. 

Partnering with NIOSH, CPWR published the 

findings of this project in the Journal of Safety 

Research and in Accident Analysis & Prevention. 

The Center also develops and distributes 

Quarterly Data Reports (QDRs) on high priority 

topics, such as the increased burden of fatal 

injuries among small construction employers. The QDRs have been cited in articles in 

Safety+Health Magazine, Construction Dive, 

Bloomberg Law, etc. Next steps for the Data 

Center are expanding its surveillance efforts 

to include research on sustainable employability, intervention effectiveness, prevention 

through design, longitudinal mortality study, 

and substance abuse.

Details:

https://www.cpwr.com/publications/

research-findings-articles/cpwr-quarterlydata-reports-data-briefs

https://www.cpwr.com/publications/

research-findings-articles/construction-chartbook

https://www.sciencedirect.com/science/

article/pii/S0022437516303991

https://www.ncbi.nlm.nih.gov/

pubmed/28292698

https://www.cpwr.com/research/

construction-face-database

The Exposure Control Database

Despite the need, the construction industry 

lacked an easy-to-use, publicly available data 

system to proactively estimate exposures to 

common hazards and then apply effective controls to mitigate them. To bridge the gap, CPWR 

developed the Exposure Control Database 

(ECD)—an interactive web-based tool designed 

to help estimate exposure to major health 

hazards, including respirable silica, welding 

fumes, noise, and lead. This system uses a predefined list of evidence-based search variables 

to retrieve objective exposure measurements 

based on user input. It then approximates 

likely exposure to the selected hazard and supplements these data with graphical displays. 

CPWR developed the database in collaboration 

with NIOSH researchers through the CPWR/

NIOSH Engineering Control Workgroup. The 

ECD has largely been populated with objective 

exposure measurements from peer-reviewed 

literature and NIOSH reports, as well as 

measurements collected by CPWR’s industry 

partners. The database officially launched 

on August 30, 2018. Since its inception, more 

than 1,400 people from 35 countries have 

accessed the database more than 2,000 

times. These users represent universities, 

government agencies, general contractors, 

insurance companies, and labor unions. 

Details:

http://ecd.cpwrconstructionsolutions.org/

Exploring Emerging Issues in 

Construction Through Small Studies 

The CPWR Small Study Program is unique 

because it creates opportunities to explore 

promising technologies or policy interventions and investigate emerging hazards on 

construction worker safety and health without 

significant use of time or resources. During 

the 25 years of operating this program, CPWR 

received 284 letters of intent and funded 

119 studies that each lasted up to one year. 

This research represents an array of topics, 

organizations, beneficiaries, and locations. 

For example, one small study explored awareness of nano-enabled construction products 

in heavy industrial/commercial construction. 

In this study, while most of those surveyed 

recognized terms like “nanotechnology” and 

“nanoparticles,” only 25% of them knew these 

materials are used in construction materials. 

However, when shown a list of nano-enabled 
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 33

construction products, 44% of survey respondents recognized or had used these products. 

Small studies like this have supported the 

need for training on emerging hazards while 

other studies have informed the design of 

important large-scale research. 

During FY2018, CPWR funded eight small studies centered on topics such as (1) identifying 

fall hazards with drones, (2) preventing risks 

to solar power system installers at the design 

phase, (3) adapting mix-reality technologies 

to visualize possible workplace locations 

of dangerous situations, (4) implementing 

work-zone safety through mobile technology, (5) evaluating new policy changes on 

worker safety outcomes, and (6) exploring 

construction workforce sustainability. Many 

investigators have entered the field of construction safety and health research through 

a CPWR small study. More than 60% of small 

study recipients published their findings in 

peer-reviewed journals.

Details:

https://www.cpwr.com/research/small-studyprogram
34 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

CENTERS OF EXCELLENCE FOR 

TOTAL WORKER HEALTH®

In FY2018, NIOSH funded six Centers 

of Excellence, located throughout the 

United States, to explore and research 

the concepts of Total Worker Health

(TWH). NIOSH defines TWH as policies, 

programs, and practices that integrate 

protection from work-related safety 

and health hazards with the promotion 

of injury and illness prevention efforts 

to advance worker well-being. TWH 

principles aim to broadly integrate 

workplace systems to control hazards 

and exposures, organization of work, 

compensation and benefits, work-life 

balance, and organizational change 

management. Their approach works 

toward a hazard-free workplace for 

all workers. 

The centers made important efforts 

toward TWH:

■ Pilot testing of promising workplace 

policies and programs.

■ Developing and distributing best practices and tool kits. 

■ Creating strategies to overcome barriers for adoption of work-based 

interventions to protect and promote health.

■ Investigating costs and benefits associated with integrated programs. 

■ Promoting increased development and 

application of biological markers of 

stress, sleep, and depression to protect 

workers and improve worker health.

■ Examining the relationships between 

workplace policies and practices and 

worker health outcomes.

Public Health Relevance

The Centers of Excellence develop and evaluate interventions to improve safety, health, 

and well-being—TWH approaches—in highrisk industries that can reduce healthcare 

costs when adopted on a broad scale. The 

centers enable translation from research to 

practice, testing the process and feasibility 

of applying TWH approaches in real-world 

environments through the sectors of manufacturing, healthcare, transportation, public 

safety, services, and construction. They also 

have initiatives focused on small business. 

Efforts include an integrative and comprehensive approach to reduce workplace hazards 

and promote worker health. This approach 

includes identifying the links between workplace culture and personal high-risk behaviors, 

as well as issues that transcend the workplace, 

such as work-family strain.

Research Outputs: 

Publications in FY2018

The Centers’ outputs are the products of 

research activities and include publications. 

We collected publications by NIOSH-funded 

extramural researchers from principal investigator reports to NIOSH, the NIH Reporter 

database, the NIOSHTIC-2 database, and the 

PubMed database. From October 1, 2017, to 

September 30, 2018, the Centers of Excellence published 39 articles in peer-reviewed 

journals. Find a searchable database of 

NIOSH publications, which includes grantee 

final reports and publications, by using the 

NIOSHTIC-2 publications search.

Program Highlights FY2018

Thousands of Healthcare Providers 

Take Training to Help Prevent 

Opioid Misuse 

The effects of opioid use and misuse are not 

isolated to work or home environments and 

the potential for addiction may be preceded 
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 35

by injuries that occur in the workplace. By 

using TWH principles, NIOSH is developing 

solutions to help workers and employers 

facing this epidemic in their communities. 

NIOSH-funded grantees and other partners 

are working to address the opioid crisis. In 

collaboration with partners, the Center for 

Health, Work & Environment and the Mountain and Plains ERC at the Colorado School of 

Public Health developed an evidence-based 

course to share best practices for treating 

patients experiencing pain while monitoring 

for and managing risks for opioid misuse and 

overdose. Intended for a healthcare audience, 

the course features guidelines for assessing 

patients, developing a comprehensive treatment plan, using first-line therapies, initiating 

an opioid trial and regimen, and preventing 

the diversion of legally prescribed or acquired 

opioid medications for unintended or illegal 

use. The course specifically addresses the 

management of pain in worker populations. 

This two-hour webinar provides Continuing 

Medical Education (CME) credits for medical 

providers and prescribers. So far, nearly 3,000 

healthcare workers have taken this training 

and received CME credits, and within the next 

five years, the Center plans to reach 10,000 
36 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

medical providers. The Colorado Department 

of Regulatory Agencies included the course in 

its policies as a mandatory requirement for 

four healthcare-related professional licenses. 

The Colorado Medical Society also endorsed 

it. Additionally, the Colorado State Division of 

Workers’ Compensation is requiring medical 

providers who treat injured workers to take 

the course, as is the state-based workers’ compensation insurer, Pinnacol Assurance. 

Details:

http://learn.chwe.ucdenver.edu/diweb/

catalog/item?id=2284222

http://www.ucdenver.edu/academics/

colleges/PublicHealth/research/centers/

CHWE/Pages/TheCenter.aspx#

https://www.cdc.gov/niosh/topics/opioids/

extramuralresearch.html

https://www.cdc.gov/niosh/topics/opioids/

default.html

New Assessment Tool Evaluates 

Effectiveness of Workplace Safety 

and Health Programs

As more organizations offer increasingly comprehensive programs for workplace safety 

and health, researchers and organizations 

alike look for the best examples and tools to 

measure their effectiveness. With so many 

programs available, how do organizations 

know which one is best? Through a study, 

the Harvard Center for Work, Health, and 

Well-being designed a new tool to help. The 

Workplace Integrated Safety and Health 

(WISH) Assessment measures policies, programs, and practices that promote worker 

safety, health, and well-being. 

The WISH Assessment is an expansion of a 

previous measurement tool, developed by the 

same researchers in this study. These scientists created this latest assessment tool based 

on an extensive review of published literature 

on workplace wellness programs, repeated 

cognitive testing, and semi-structured interviews. They tested and revised the WISH 

Assessment to ensure that its elements were 

clearly understood and effectively measured 

the intended concepts. The tool was finalized 

after identifying six factors for protecting 

and promoting worker safety, health, and 

well-being: (1) leadership commitment; (2) participation; (3) policies, programs, and practices 

that foster supportive working conditions; (4) 

comprehensive and collaborative strategies; 

(5) adherence to federal and state regulations 

and ethical norms; and (6) regular evaluations that guide safety, health, and well-being 

activities. 

Ultimately, the assessment could help direct 

priorities among organizations and guide 

research in workplace policies, programs, 

and practices to improve worker well-being. Next steps include additional testing 

on the WISH Assessment to validate the 

tool across multiple samples and designing 

and testing a scoring system that organizations can use. Harvard researchers are 

planning to use the WISH Assessment in 

a future study focused on the association 

between TWH approaches and quality-of-care 

outcomes in 500 nursing homes.

Details: 

https://www.ncbi.nlm.nih.gov/

pubmed/29389812

https://www.cdc.gov/niosh/research-rounds/

resroundsv4n3.html#d

http://centerforworkhealth.sph.harvard.edu/

Computer Simulation Helps 

Manufacturing Company Improve 

Safety and Health

How do manufacturing companies know the 

best and safest way to design workplaces and 

assign tasks? Ideally, injuries and illnesses 

should be prevented, but historically, companies have adjusted their workplace policies, 

practices, and procedures after an injury 

or illness occurred. The University of Iowa 

Healthier Workforce Center tested the role of 

computer simulation in promoting workers’ 
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 37

well-being by designing safer work. Known as 

digital human modeling, the simulation can 

help predict behavior and hazards and evaluate work design, without putting workers at 

risk or creating costly physical mock-ups. 

Researchers collaborated for a year with a 

manufacturing company to examine digital 

human modeling in a real-world setting. Using 

a commercially available software, researchers 

simulated seven distinct work tasks to identify risks for musculoskeletal disorders and 

develop and evaluate workstation designs 

to reduce risks. They also looked at the connection between nonwork-related risks like 

body mass index and work-related tasks. The 

manufacturing company used the findings 

from this study to update its training procedures and cart-loading recommendations. It 

also used digital human modeling to redesign 

its workstations. 

Researchers determined that digital human 

modeling could help identify work-related 

risks, especially in scenarios that are difficult to assess with traditional approaches. 

However, these scientists caution that more 

research is needed to understand additional 

uses and barriers for using digital human 

modeling to prevent work-related injuries 

and illnesses.

Details:

https://www.tandfonline.com/doi/

abs/10.1080/24725838.2018.1491430?journal

Code=uehf21

https://www.public-health.uiowa.edu/

hwcmw/

https://www.cdc.gov/niosh/research-rounds/

resroundsv4n9.html#c

SHIFT Project Leads to Increased 

Union Engagement in Workplace 

Health and Safety Committees

In the New England area, six healthcare 

facilities now have local labor unions more 

engaged with their health and safety initiatives. This move followed research from the 

Center for the Promotion of Health in the 

New England Workplace (CPH-NEW). In the 

study, a revised version of CPH-NEW’s Healthy 

Workplace Participatory Program was put into 

place in these facilities. The Safety & Health 

through Integrated, Facilitated Teams (SHIFT)

study evaluated this intervention’s effectiveness in increasing the engagement and impact 

of combined, labor-management health and 

safety committees.

Prior to SHIFT, the six facilities had committees 

in place, but they did not meet regularly and 

had limited labor union involvement. Now, 

the committees’ active membership includes 

labor unions, and committee cofacilitators 

are union bargaining unit members. The committees consist of 8–12 workers, with more 

than half of them in nonmanagement roles, 

and they now meet more frequently. Following SHIFT, organizational leaders are also 

more involved in workplace health and safety 

efforts, with one leader from each facility 

serving as a liaison between management, 

the committee, and the SHIFT research team.

Details:

https://www.uml.edu/Research/CPH-NEW/

Research/Healthcare.aspx

https://www.uml.edu/Research/CPH-NEW/

Healthy-Work-Participatory-Program/

Sleep and Workplace Safety Practices 

Among Construction Workers 

The NIOSH TWH Program looks for ways that 

organizations can improve worker health and 

well-being, on and off the job. One aspect 

of home that overlaps into work is sleep. 

Healthy sleep is critical for worker safety 

and well-being, especially for work, such as 

construction, which requires following many 

safety procedures. Knowing how lack of sleep 

affects safety behaviors and how to design 

effective, organizational-level interventions 

can improve worker health and safety. 
38 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

The Oregon Healthy Workforce Center looked 

at the relationship between self-reported sleep 

and lapses in attention, memory, and action 

at work that could impact safety. Researchers 

referred to these lapses as cognitive or thought 

failures. Sleep behavior included quantity or 

duration and quality, which is the feeling of 

being rested. Sleep behavior also includes 

the ability to fall asleep and stay asleep. To 

increase understanding of how these factors 

relate, the study looked at workers’ sleep quantity and quality and workplace safety behaviors, 

including participation in safety procedures. 

The study also looked at reports of minor injuries, such as cuts, bruises, or sprains, which did 

not cause workers to miss work, whether the 

injury required first aid or not. 

The study used information from three surveys 

conducted during 2012–2013, which were completed by more than 318 construction workers. 

Results suggest that workers with more insomnia symptoms are less likely to follow required 

and voluntary safety behaviors and are at 

higher risk for minor workplace injuries due 

to cognitive failures. In addition, workers who 

reported not feeling well rested upon waking, 

on average, also reported that they were less 

likely to follow safety procedures. These findings indicate that organizations can improve 

safety with tools to reduce insomnia symptoms and improve sleep. Researchers’ next 

steps include studying how to reduce workers’ 

insomnia symptoms and improve their ability 

to fall and stay asleep, as well as studying how 

sleep influences day-to-day safety behavior and 

more serious workplace injuries.

Details:

https://www2a.cdc.gov/nioshtic-2/BuildQyr.

asp?s1=20054032&f1=NN&View=f

https://www.cdc.gov/niosh/research-rounds/

resroundsv4n6.html#c

https://www.ohsu.edu/xd/research/centersinstitutes/oregon-institute-occupationalhealth-sciences/oregon-healthy-workforcecenter/about/index.cfm

Focusing on Community to Improve 

Worker Health

Workplaces can play a large role in improving 

worker health, resulting in improved community health. But how can workplaces and 

communities interact to influence the overall 

health of workers? Can workers in precarious 

work arrangements, often characterized by 

low wages and few or no benefits, rely on their 

communities to help them in protecting and 

promoting safer and healthier work? 

The University of Illinois at Chicago (UIC) 

Center for Healthy Work is exploring how to 

implement safer and healthier approaches 

to work that extend into the community. 

Researchers at the Center are engaging with 

local neighborhoods, especially those with 

residents in precarious work, to find ways 

to improve worker health at the community 

level. To identify what works, they are using 

a community health survey, focus groups, 

interviews, and an approach called concept 

mapping. Concept mapping creates a visual 

representation of participants’ thoughts about 

and priorities between health and work. By 

engaging directly with communities and their 

workers, researchers can continue to raise 

awareness of the relationship between communities, work, and health, as well as develop 

new TWH interventions. The Center’s next 

steps include intervention mapping, which 

plots evidenced-based interventions to specific community needs.

Details:

http://publichealth.uic.edu/healthywork

https://healthywork.uic.edu/initiatives/

greater-lawndale-healthy-work-project/

https://www.cdc.gov/niosh/research-rounds/

resroundsv4n9.html#d
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 39

EDUCATION AND RESEARCH 

CENTERS

NIOSH supports professional training 

in occupational safety and health (OSH) 

through training programs in Education 

and Research Centers (ERCs). ERCs 

are university-based multidisciplinary 

centers that offer graduate, postgraduate, and research training in the 

core and allied fields of occupational 

safety and health. ERCs also supply 

continuing education and outreach to 

the OSH community throughout the 

federal health region they serve. ERCs 

are interdisciplinary programs and a 

major part of a network of training 

grants that help ensure an adequate 

supply of qualified professional 

practitioners and researchers. Essential 

ERC components are outreach and 

research-to-practice activities with other 

institutions, businesses, community 

groups, and agencies within their 

region, as well as academic programs. 

Programs respond to area needs and 

carry out new strategies and initiatives 

to meet those needs, with a focus on 

worker health and safety. 

Public Health Relevance

The Occupational Safety and Health Act 

of 1970 (Public Law 91-596) directs NIOSH 

to ensure an adequate supply of qualified 

occupational safety and health personnel. 

NIOSH responded to this mandate by funding 

training programs to increase the number and 

competencies of the occupational safety and 

health workforce in the United States. NIOSHfunded ERCs are central to this response and 

serve a vital role in protecting the health and 

safety of the nation’s workforce. Aligning with 

the goals of Healthy People 2020—to prevent 

diseases, injuries, and deaths due to working 

conditions—ERCs improve occupational safety 

and health through education, research, 

and collaboration. They serve as regional 

and national resources on these issues for 

business, labor, government, and the public. 

ERCs meet the critical need to produce 

researchers and practitioners—vital to 

maintaining workplace health and safety—

and reduce the burden of preventable 

work-related injury, illness, and death 

by performing the following actions: 

■ Providing the necessary knowledge to 

the U.S. workforce to reduce the burden 

of work-related injury, illness, and death.

■ Developing the major research advances 

needed to prevent occupational injuries, illnesses, and fatalities in the 

United States.

■ Providing regional and industry-specific 

outreach and consultation to more than 

5,000 small-, medium-, and large-sized 

U.S. businesses annually.

■ Serving as the primary knowledge 

source for public and government leaders for job-related safety issues without 

duplicating other government programs. 

Research Outputs: 

Publications in FY2018

ERC outputs are the products of research 

activities and include publications. We 

collected publications by NIOSH-funded 

extramural researchers from principal investigator reports to NIOSH, the NIH Reporter 

database, the NIOSHTIC-2 database, and the 

PubMed database. From October 1, 2017, 

to September 30, 2018, the ERCs published 

259 articles in peer-reviewed journals. Find a 

searchable database of NIOSH publications, 

which includes grantee final reports and 

publications, by using the NIOSHTIC-2 publications search.
40 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

Program Highlights FY2018

Trainees, Graduates, and 

Employment of Graduates

In academic year 2017–2018, more than 

300 students graduated from ERC programs 

with specialized training in disciplines including industrial hygiene, occupational health 

nursing, occupational medicine, occupational 

safety, and other closely related occupational 

safety and health fields. The number of students enrolled increased from 732 in FY2017 

to 993 in FY2018. Table 14 shows the number 

of students enrolled, graduates, and employment status during FY2018.
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 41

Table 14. ERC Trainees, Graduates, and Employment, FY2018

Program Area Enrolled Graduates

Employed or seeking occupational 

safety and health employment (%)

Industrial Hygiene 326 110 110 (100)

Occupational Health Nursing 128 41 35 (85)

Occupational Medicine 113 36 36 (100)

Occupational Safety 172 47 45 (96)

Other Related Disciplines 254 68 67 (99)

Total 993 302 293 (97)

Table 15 shows the placement of FY2018 graduates by program area and work setting. We 

consider graduates looking for occupational safety and health employment and not working 

outside their field as remaining in the field.

Table 15. ERC Graduate employment by work setting, FY2018

Work Setting/ 

Program Area

Industrial 

Hygiene 

(n=110)

Occupational 

Health 

Nursing 

(n=41)

Occupational 

Medicine 

(n=36)

Occupational 

Safety

(n=47)

Other 

(n=68)

Total 

(n=302)

Private 

Industry 52 7 2 33 16 110

Federal/

State/Local 

Government

25 4 2 6 19 56

Academic 

Institution 15 5 4 2 19 45

Clinic/Hospital 3 12 22 0 2 39

Other OSH 

Employment 3 3 2 1 2 11

Seeking 

Advanced 

OSH Degree

7 2 2 1 6 18

Seeking OSH 

Employment 5 2 2 2 3 14

Total 110 35 36 45 67 293
42 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

Table 16. Continuing Education Courses by discipline, FY2018

Discipline

Number

of Courses

Number 

of Trainees

Person-Hours 

of Training

Industrial Hygiene 196 4,457 39,215

Occupational Health Nursing 213 6,569 31,262

Occupational Medicine 204 5,757 32,402

Occupational Safety 903 21,398 166,882

Ag Safety and Health 0 0 0

Other 244 8,323 89,443

Total 1,760 46,504 359,204

Continuing Education Outputs

Continuing education of occupational safety 

and health professionals is a required part 

of ERC funding. Each year, NIOSH ERCs train 

thousands of these professionals around 

the United States through course offerings 

in the occupational safety and health core 

and related disciplines. The table above 

shows the continuing education activity by 

discipline. In FY2018, ERCs provided 359,204 

person hours of training to 46,504 occupational safety and health professionals who 

took 1,760 courses.

ERC Program Achievements

Link Found Between Prescription Drug 

Use Before and After Injury

Workers taking opioids or benzodiazepines 

(anxiety medications) prior to a work-related injury were more likely than other 

workers to continue taking the drugs after 

the injury, according to a 2018 publication from the University of Washington 

ERC. Additionally, these workers were also 

more likely to receive workers’ compensation, reports the study in the Journal of 

Occupational and Environmental Medicine. 

To better respond to the nationwide opioid 

crisis, NIOSH supports research on work-related factors on the use of these drugs. 

In one of the first large studies of pre- and 

post-injury use of opioids and benzodiazepines, researchers wanted to understand 

whether taking either drug before a 

work-related injury affected later use. They 

also aimed to find if pre-injury use affected 

the likelihood of receiving workers’ compensation. The study looked at 313,543 

workers’ compensation claims from the 

Washington State Department of Labor 

and Industries with dates of injury from 

January 2012 through December 2015. 

Researchers also reviewed records from the 

Washington State Prescription Monitoring 

Program for opioids and benzodiazepines. 

The design of this study only shows a relationship, not cause and effect, between 

pre- and post-injury use of opioids and 

benzodiazepines. Nevertheless, the study’s 

findings indicate that the risk for long-term 

disability after a work-related injury may 

be greater among workers already taking 
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 43

opioids or benzodiazepines than among 

those who do not take them.

Details:

https://journals.lww.com/joem/

Fulltext/2018/09000/Opioid_and_

Benzodiazepine_Use_Before_Injury_

Among.9.aspx

https://www.cdc.gov/niosh/research-rounds/

resroundsv4n5.html#c

https://www.cdc.gov/niosh/topics/opioids/

extramuralresearch.html

https://www.cdc.gov/niosh/topics/opioids/

default.html

https://deohs.washington.edu/nwcohs

Trainees Help Improve Workplace Safety for 

Los Angeles Transit Workers

The Metropolitan Transportation Authority 

(MTA) of Los Angeles is now using engineering controls developed by ERC trainees at 

University of California, Los Angeles (UCLA). 

MTA is using these controls or strategies to 

protect its 260 workers from hazardous noise 

and welding fumes. This happened following 

a site visit where all the trainees completed a 

walk-through of the MTA maintenance facilities and identified occupational health and 

safety hazards. These included dangerous 

chemicals, hazardous noise levels, and risks 

of musculoskeletal disorders. After collecting 

this information, the ERC trainees and faculty 

discussed and recommended potential controls of these workplace hazards that the MTA 

could use to improve worker safety, health 

and well-being. UCLA planned this industrial 

site visit to educate its trainees and help them 

develop into effective occupational safety and 

health professionals.

Details:

https://erc.ucla.edu/

Effects of Shift Work on Police and 

Security Workers

For law enforcement officers, inadequate 

sleep can be a problem due to shift work, 

long work hours, and scheduling conflicts—

all factors resulting in sleep deprivation and 

other sleep issues. Police officers who do 

not get adequate, quality sleep are at risk for 

motor vehicle crashes due to drowsy driving, 

as well as other health effects. To address 

this issue, a trainee at the New York and New 

Jersey ERC (Mount Sinai School of Medicine) 

led a study focused on how permanent or 

nonrotating shifts and extended work hours 

(12-hour) affect police and security workers. 

The research assessed alertness, sleep, and 

wellness among 39 police and security officers 

who had been working in 8- and 12-hour permanent shifts for at least five years. 

Across the nation, police agencies are 

increasingly adopting these type of work 

arrangements. It has been widely assumed 

that extended hours benefit workers because 

they have more days off and that permanent 

shifts lead to more stable sleep patterns. 

However, according to this study’s findings, 

these arrangements are associated with 

increased sleep problems and decreased 

mental attention. The scientists found that 

12-hour shifts had more negative health 

effects than 8-hour shifts and presented 

these results at the 20th Congress of the 

International Ergonomics Association. 

Details:

https://www.researchwithnj.com/en/

publications/differential-effects-of-8-and-12-

hour-non-rotating-shifts-on-aler

http://www.nynjerc.org/

https://blogs.cdc.gov/niosh-scienceblog/2017/05/16/officer-safety-research/

Long-haul Trucking Survey Describes 

Common Injuries

The combination of long hours of sitting punctuated by periods of loading and unloading 

heavy goods makes long-haul trucking one 

of the highest-risk occupations for musculoskeletal injuries. These injuries occur nearly 

four times more often among long-haul truck 

drivers than among other workers, according 

to the Bureau of Labor Statistics. Despite the 
44 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

higher risk, little information is available about 

the types of injuries that affect long-haul truck 

drivers. Which injuries are the most common? 

How do they occur?

To answer these questions, a study at the 

University of Alabama at Birmingham ERC 

analyzed information from the 2010 NIOSH 

National Survey on Long-haul Truck Drivers. 

The large-scale survey comprised 1,265 longhaul truck drivers in 32 truck stops in five 

regions nationwide: the South, Great Lakes, 

Central, West, and Northeast. Researchers 

required all survey participants to have 

worked as a driver on a large truck (three or 

more axles) for at least 12 months.

Of the truck drivers who completed the 

survey, 95 (7.5%) reported experiencing 

work-related injuries over the past year. 

The most common types of injuries were 

sprains and strains, accounting for 60% of 

injuries reported in the survey. The arms 

were the most commonly affected body part, 

making up 26% of all musculoskeletal injuries reported, followed by the back at 21%. 

Looking at cause, most of the musculoskeletal 

injuries reported (39%) stemmed from falls, 

followed by contact with an object or equipment (34%). 

The findings from this large-scale survey 

underscore the importance of developing 

ways to prevent musculoskeletal injuries 

among long-haul truck drivers. In FY2018, 

this study appeared in the journal Workplace 

Health & Safety. 

Details:

https://journals.sagepub.com/doi/

full/10.1177/2165079917750935

https://www.soph.uab.edu/dsc/

https://www.cdc.gov/niosh/research-rounds/

resroundsv4n5.html#d
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 45

INVESTIGATOR-INITIATED RESEARCH

The NIOSH extramural research program supports 

relevant, high-quality scientific investigations 

that help reduce work-related injuries, illnesses, 

and fatalities. These awards include funding 

for large projects (R01) as well as small projects 

(R03) and exploratory research grants (R21). 

RESEARCH GRANTS

The R01 funding opportunity focuses 

on developing an understanding of 

the risks and conditions associated 

with job-related injuries, illnesses, and 

fatalities. These projects also explore 

methods to reduce risks and prevent 

or lessen exposure to hazardous workplace conditions. The R03 funding 

mechanism supports research projects 

that can be completed in 2 years with 

limited resources, including pilot and 

feasibility studies, secondary analysis of 

existing data, and small, self-contained 

research projects. The R21 mechanism 

encourages research to explore novel 

scientific ideas or develop new techniques, methods, model systems, tools, 

or other applications with the potential 

for significant impact on work-related 

safety and health.

The extramural research portfolio also 

includes mentored research scientist development (K01) awards that offer postdoctoral 

training for the next generation of occupational safety and health scientists. These 

highly competitive K01 awards give up to 

3 years of funding and a scientific research 

focus designed to develop the skills and productivity of new research scientists as they 

transition between postdoctoral training and 

independent research careers.

NIOSH awards conference and scientific 

meeting grants under two research grant 

mechanisms: R13 and U13. Both grants 

support high quality, scientific conferences/

meetings relevant to the safety and health 

of workers, including symposia, seminars, 

and workshops.

Public Health Relevance

The mission of NIOSH is to develop new 

knowledge in the field of occupational safety 

and health and then transfer it to practice. 

The extramural research program advances 

this mission through its research. This work 

helps in identifying workers at risk, developing 

methods for measuring hazard exposures, 

and detecting adverse health effects. The program also helps in determining the frequency 

of job-related hazards, increasing understanding of the causes of work-related diseases and 

injuries, and reducing or eliminating hazard 

exposures. Grantees share research results 

through diverse communication channels, 

including scientific meetings, conferences, 

and workshops.
46 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

Research Outputs: 

Publications in FY2018

Investigator-initiated research outputs are the 

products of research activities and include 

publications. We collected publications by 

NIOSH-funded extramural researchers from 

principal investigator reports to NIOSH, the 

NIH Reporter database, the NIOSHTIC-2 

database, and the PubMed database. From 

October 1, 2017, to September 30, 2018, R01 

grant-funded researchers published 117 articles in peer-reviewed journals. The numbers 

of peer-reviewed publications for the other 

investigator-initiated research mechanisms 

are 7 (R03), 31 (R21), and 17 (K01). Find a 

searchable database of NIOSH publications, 

which includes grantee final reports and 

publications, by using the NIOSHTIC-2 publications search.

Program Highlights FY2018

Award-winning Farm Dinner Theater 

Featured in National Magazine

Project Title: Farm Theater: A Novel 

Safety Strategy Approach for Agricultural 

Communities (R01 Grant). 

Principal Investigator: D. Reed

Agriculture has an excessive worker injury 

rate. An estimated 58,385 work-related adult 

farm injuries (more than six every hour) 

occurred in 2014. In 2016, 417 farmers and 

farm workers died from a work-related injury. 

Additionally, senior farmers and adult farmers 

in the South experience some of the highest 

occupational injury and fatality rates in the 

United States. Reaching farmers with safety 

and health information can be challenging. 

They are rarely in the same place and used to 

working in isolation and taking care of their 

own safety. Additionally, they have little time 

to be away from the farm and their work. 

So what is the best way to break through to 

this high-risk group with safety and health 

information? This project at the University 

of Kentucky developed a new idea—a farm 

dinner theater.

This program works with established community-based Cooperative Extension Agents 

in Kentucky, Tennessee, and Mississippi 

to develop and test a theater intervention 

aimed at positively changing farm work culture and safety behavior. The theater uses 

a didactic reader format where participants 

read from scripts on topics relevant to their 

communities. Examples include falls, hearing 

conservation, skin cancer, intergenerational 

issues of work, equipment operation and 

reaction time, livestock handling, and virtually 

any topic related to the farming community. 

Local actors and farmers put on the plays. 

So far, each performance has a waiting list. 

The Oprah Magazine featured the program, 

along with the study’s principal investigator, 

Deborah Reed, PhD, in an article. The program 

has received numerous awards including the 

American Academy of Nursing’s Edge Runner 

Award and the Search for Excellence in Farm 

Health and Safety from the National County 

Extension Agriculture Agent Organization.

Details:

https://blogs.cdc.gov/niosh-scienceblog/2019/05/10/farm-theater/

https://www.oprahmag.com/life/a27168740/

nurses-saving-the-world/

http://www.uky.edu/nursing/about-us/

news/dr-deborah-reed-named-among-fivenurses-who-just-might-save-world-o-oprahmagazine

http://grantome.com/grant/NIH/R01-

OH010666-04

Link Found Between Cancer Risk and 

Exposure to Viruses in Poultry

Project Title: Case-cohort Study of Cancers 

in Excess in Poultry Workers (R01 Grant).

Principal Investigator: E. Johnson

Among the viruses that commonly infect 

chicken and turkeys are oncogenic viruses, 

which cause cancer. However, there is limited information on how these viruses may 
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 47

influence humans’ risk for cancer. Humans 

in the general population are widely exposed 

to these viruses through poultry and their 

by-products. This lack of knowledge is critical 

because there have not been enough studies 

about the cancer risk in exposed individuals.

To address this gap, this unique project 

studied workers who had been exposed to 

high levels of oncogenic viruses and other 

cancer-causing substances in poultry or 

chicken while working in slaughtering and processing plants. The latter exposure included 

substances these workers were around while 

smoking, curing, and wrapping meat on the 

job or exposed to while off work. 

Researchers focused on connections between 

specific exposures and the development of 

cancers in varied areas, including the lungs, 

brain, pancreas, liver, ovary, buccal cavity, and 

pharynx. Published in the journal Environmental Research, study results showed potential 

links between lung cancer and oncogenic 

viruses from poultry, as well as from the 

other cancer-causing chemicals. In particular, 

the highest cancer risk was for workers who 

had job tasks that included washing, cutting, 

and removing parts of chickens, in addition 

to having direct contact with their blood. 

However, scientists did not find an increased 

cancer risk for office workers and those in the 

packing area of processing plants. Researchers highlight these and other study limitations 

in the publication, but do not provide genetic 

evidence that these oncogenic viruses cause 

cancer in humans. Because this study has 

potential public health implications, especially 

for poultry workers who have high fatality 

rates from cancer, researchers are continuing 

to conduct research in this area. 

Details:

https://www.sciencedirect.com/science/

article/pii/S0013935118304195?via%3Dihub

http://grantome.com/grant/NIH/R01-

OH009572-06

Estimates of Farm Workers’ Physical 

Activity Could Help Prevent Heatrelated Illness

Project Title: Reducing the Risk of Heatrelated Illness in Western Agricultural 

Workers (R01 Grant). 

Principal Investigator: M. Schenker

Farm workers are at high risk for heat-related 

illness in hot temperatures, especially during 

summer crop production. Farming is also 

physically demanding, further increasing the 

likelihood of developing heat-related illness. 

An estimated 30%–40% of U.S. farm workers 

are employed in California. In the past, there 

was limited research on their physical activity 

and how it contributes to heat-related illness. 

Focusing on this issue, researchers at the 

University of California, Davis, estimated 

the physical activity involved in common, 

strenuous farm tasks that could contribute 

to heat-related illness among these workers. 

Study participants included 575 Californian 

workers on 28 farms in the Central and Imperial Valleys. Researchers used devices called 

accelerometers, which are clipped onto a hip 

belt, to measure step counts per minute (cpm) 

during tasks over the course of a work shift. 

They then estimated the time spent in light, 

moderate, or vigorous activity. Researchers 

found the overall average step count for farm 

workers was 345 cpm, defined as light activity. 

Produce carriers had the highest average level 

of physical activity, with 700 cpm, and ground 

pruners, who remove or trim plants, had the 

lowest number at 150 cpm. 

The scientists determined a strong link 

between higher environmental temperature 

and reduced physical activity. Other factors 

associated with decreased physical activity 

included increased age and tasks such as 

ground pruning, sorting or separating, and 

harvesting crops. In contrast, doing irrigation work and performing more than one 
48 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

task at the same time were associated with 

increased physical activity, as well as when 

pay was based on work completed, rather 

than on time. These factors could increase 

the risk for heat-related illness. In FY2018, 

this study was published in the journal Occupational and Environmental Hygiene. 

Details:

https://www.tandfonline.com/doi/full/10.1080/1

5459624.2018.1519319#aHR0cHM6Ly93d3cudGFuZGZvbmxpbmUuY29tL2RvaS9wZGYvMTAuMTA4MC8xNTQ1OTYyNC4yMDE4LjE1MTkzMTk/

bmVlZEFjY2Vzcz10cnVlQEBAMA==

http://grantome.com/grant/NIH/R01-

OH010243-04

https://www.cdc.gov/niosh/researchrounds/resroundsv4n10.html#b

Thirty-year Study on Exposure to 

Endotoxin and Respiratory Disease 

in Textile Workers 

Project Title: Lung Disease in Chinese 

Textile Workers (R01 Grant).

Principal Investigator: D. Christiani 

In the United States, at least five million workers across multiple industries are possibly 

exposed to airborne endotoxin—a dangerous substance released from bacterial cells. 

However, while research shows short-term 

exposure leads to respiratory problems 

like dynamic airflow obstruction, the health 

effects of chronic or long-term contact with 

endotoxin remains unknown. Limited studies 

exist related to this issue, and most of them 

focus on exposure for less than a decade. 

As a result, there is little knowledge on how 

chronic exposure affects the lungs, including the development of lung disease after a 

person is no longer exposed and the underlying causes for severe cases of the illness. 

In a unique study, scientists at the Harvard 

T.H. Chan School of Public Health evaluated 

Chinese textile workers’ exposure over three 

decades to endotoxin and cotton dust. Specifically, they looked into the pulmonary or 

lung-related impact of chronic exposure and 

how these workers’ health was impacted after 

they were no longer around the substances. 

This project is the longest running and largest prospective study involving a cohort of 

textile workers. Study participants included 

919 Shanghai residents who were exposed 

to high levels of cotton dust and endotoxin 

while employed as cotton workers, and the 

majority of them having never smoked. 

Researchers determined the effects of longterm respiratory disease could actually be 

reversed after workers were no longer on the 

job and exposed. The scientists also looked 

into the role that smoking and genetics play 

related to this topic. The findings of this study 

are leading to a better understanding of how 

long-term contact with cotton dust and endotoxin influences chronic respiratory issues. 

Details:

http://grantome.com/grant/NIH/R01-

OH002421-23A1

Bolstering Nighttime Visibility in 

Roadway Work Zones

Project Title: Warning Beacons for Front 

Line Service Worker Safety (R01 Grant).

Principal Investigator: M. Rea

Roadway work zones can be dangerous both 

for motorists and for construction workers 

who build, repair, and maintain streets, 

bridges, and highways. In these areas, a 

variety of complicated road signs, barrels, 

and lane changes could increase the risk of 

motor vehicle crashes. To prevent this issue, 

safety equipment, such as flashing yellow 

warning beacons, is critical. These lights aim 

to get motorists’ attention as they approach 

or drive through work zones and to alert 

them of potential hazards and nearby workers. However, current standards for warning 

beacons include a minimum light intensity to 

ensure risks are seen, but do not identify a 

maximum degree of light intensity to protect 
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 49

against glare or distraction. The standards 

also do not differ between daytime and nighttime conditions despite research showing the 

need for less light intensity at night. 

To address this issue, scientists at Rensselaer 

Polytechnic Institute explored the effect of 

various light intensities and other factors 

on motorists’ ability to detect workers while 

approaching work zones and warning beacons. These other factors included how 

frequently the warning beacons flashed and 

whether or not workers wore high-visibility, 

reflective safety clothing.

Researchers conducted a nighttime field study 

on a test track with four life-sized, cardboard 

workers—two with and two without reflective vests—positioned alongside the track lit 

with warning beacons. Published in Accident 

Analysis & Prevention, the study showed visibility was greatest at night when the warning 

beacons had light intensities (max/min) of 

25/2.5 candelas (cd) and 150/15 cd, and flash 

frequencies of either 1 hertz (Hz) or 4 Hz. 

Furthermore, the reflective vests allowed the 

drivers to see the simulated workers at the 

farthest distance tested, regardless of the frequency and intensity of the warning beacons. 

The findings of this study can help protect 

workers by increasing visibility in roadway 

work zones.

Details:

https://www.sciencedirect.com/science/

article/pii/S000145751830263X?via%3Dihub

https://www.cdc.gov/niosh/research-rounds/

resroundsv4n11.html#d

http://grantome.com/grant/NIH/R01-

OH010165-04

Lighting Interventions to Improve 

Healthcare Workers’ Sleep and 

Occupational Safety and Health 

Project Title: Lighting Interventions to 

Reduce Circadian Disruption in Rotating 

Shift Workers (R01 Grant).

Principal Investigator: M. Figueiro

Healthcare workers can sometimes have sleep 

difficulties because of their circadian rhythm, 

or the internal biological clock that regulates 

sleep, being disturbed. Circadian rhythm disturbance is especially evident for those who 

do rotating or shift work. When individuals are 

exposed to a natural sunrise and sunset, the 

circadian rhythm is synchronized to a 24-hour 

cycle. However, a constant mismatch between 

a person’s circadian rhythm and environment, including lighting, can disrupt normal 

sleep patterns, possibly leading to fatigue, 

injuries, mood changes, and other health 

problems. Lighting on the job that is either 

too intense or too low can disrupt healthcare 

workers’ circadian rhythm, especially for nighttime employees, deceasing their alertness 

and productivity. 

Researchers have been working to increase 

their understanding of circadian rhythms and 

how light of varying wavelengths can support 

or interrupt natural sleep cycles. Specifically, 

NIOSH-funded scientists at Rensselaer 

Polytechnic Institute investigated the effectiveness of using a red-frequency light in work 

settings to help with circadian disruption. As 

reported in the journal Sleep Review, initial 

results show the red light increases alertness 

without stifling melatonin, which can occur 

when people are exposed to certain light 

wavelengths. Decreased melatonin can hinder 

one’s circadian rhythm, causing sleep and 

other health issues. 

This project could significantly benefit shift 

workers by improving their sleep, as well 

as their mood and well-being. In FY2018, 
50 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

researchers on this study collaborated with 

the Light and Health Alliance to develop and 

disseminate short videos on the science 

behind lighting and improved human health. 

Details:

http://www.sleepreviewmag.com/2019/05/

circadian-lighting/

https://www.lrc.rpi.edu/programs/

lightHealth/index.asp

http://grantome.com/grant/NIH/R01-

OH010668-03

Study Identifies Factors Linked to 

Healthcare Workers’ Use of Patient 

Lift Equipment

Project Title: Crossover Study of Factors 

Associated With Patient Lift Equipment Use 

(R21 Grant). 

Principal Investigator: K. Kucera

Lifting and other patient handling tasks account 

for more than half of workers’ compensation 

costs related to musculoskeletal injuries among 

caregivers, including nurses and other healthcare workers. Patient lift equipment and other 

support devices designed to move patients 

have been recommended for safety in the 

healthcare field. However, according to past 

research, these equipment and devices are not 

regularly used despite their increased availability and the implementation of Safe Resident 

Handling policies, trainings, and programs. 

So what leads to the use or nonuse of patient 

lift devices? The answer to this question could 

result in better approaches, including policies 

and trainings, which increase their adoption in 

the workplace. 

This study investigated factors that influence the utilization of patient lift equipment. 

Using a multilevel approach, researchers 

developed a survey related to lifting and 

transferring patients that was completed by 

more than 100 nurses and nursing assistants. 

The survey collected data on demographics, 

work experience, training, patient lifting, 

and lift equipment use, as well as on workers’ exposure to factors possibly linked to 

lift equipment use. A smaller group of these 

workers participated in a lift assessment and 

a case crossover study. The crossover study 

allowed researchers to measure the relationship between the use of lift equipment and 

the factors influencing that use, along with the 

frequency of the use. 

According to the study, the nursing staff used 

equipment to lift or transfer only 21% of 

patients. The use of equipment differed by 

the type of movement being performed. Factors influencing lift equipment use included 

its accessibility, available staff support, the 

extent to which patients are mobile, and 

whether equipment is required for the task. 

Researchers have presented their findings 

in peer-review journals and at national conferences. In addition, they shared the study 

results at nurse executive council meetings for 

hospitals involved in this project.

Details: 

https://www.sciencedirect.com/science/article/pii/

S0020748918302657

http://grantome.com/grant/NIH/R21-OH010542-02

Associations Between Heat 

Exposure, Injury, and Productivity in 

Agricultural Workers 

Project Title: Heat Exposure, Injury Risk, 

and Productivity in Agricultural Workers 

(K01 Grant).

Principal Investigator: J. Spector

Farm workers die from heat-related illness at 

an annual rate 20 times that of other workers in the United States. According to past 

research, exposure to heat could increase 

the risk of traumatic injuries, but there is 

limited information on what is behind this 

association. To address this issue, University 

of Washington researchers investigated the 

relationship between the heat stress that 
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 51

agricultural workers experience, their injury 

risk, and their job productivity. Study participants included more than 12,250 outdoor 

agricultural workers in Washington State. 

Researchers collected various information 

including workers’ compensation traumatic 

injury data, measures of workers’ balance 

and vigilance along with other forms of 

productivity, and local weather reports. Data 

on injury and heat conditions for the majority 

of the workers reflected the period of 2000–

2012. Weather and performance data for a 

smaller sample of 46 workers were collected 

during August and September 2015.

Through methods of statistical modeling, 

researchers estimated associations between 

these data. They found agricultural workers 

who work in warm temperatures are at risk 

for heat-related traumatic injuries. However, 

heat was not linked to decreased vigilance or 

balance. According to study findings, the relationship between heat exposure and worker 

productivity is complicated and likely impacted 

by work factors and economic demands, influencing physical labor and heat exposure. 

Researchers partnered with the Pacific Northwest Agricultural Safety and Health Center 

(Ag Center) to share these findings through 

the media, community events, conference 

presentations, educational trainings in 

English and Spanish, community events, and 

peer-reviewed publications. As a result, they 

reached workers, occupational safety and 

health professionals and researchers, along 

with stakeholders in the community, industry 

and government. 

Details:

https://www.ncbi.nlm.nih.gov/

pubmed/29122180

http://grantome.com/grant/NIH/K01-

OH010672-03
52 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

COOPERATIVE RESEARCH AGREEMENTS

Cooperative agreements allow NIOSH to partner with 

universities, state health departments, labor unions, 

and nonprofit organizations to address important 

public health problems. NIOSH funds a broad array of 

these agreements to develop knowledge in preventing 

job-related diseases, injuries, and fatalities. 

In FY2018, NIOSH funded the state surveillance program to support states in monitoring 

occupational injuries, diseases, deaths, and 

hazards. Other cooperative agreements 

awarded in FY2018 included funding to monitor workers’ compensation claims, funding for 

AFF to support forestry safety research, and 

National Mesothelioma Virtual Bank funding. 

Selected highlights from the state surveillance 

program are provided below. 

STATE SURVEILLANCE 

PROGRAM

The state surveillance program helps 

expand the ability of states to monitor 

work-related health and safety issues. 

The program supports the role of states 

to conduct in-depth surveillance and 

follow-up investigations and interventions. These local state-based skills and 

abilities help NIOSH meet the mandate 

to ensure a safe workplace.

Public Health Relevance

NIOSH values state programs and gives financial and technical support to state health and 

labor agencies to develop and expand their 

occupational health surveillance programs. 

The NIOSH extramural surveillance portfolio 

includes 26 state recipients composed of 49 

projects focusing on work-related injuries and 

death, exposures and hazards, and worker 

populations of interest. These programs use 

and distribute surveillance data to find the 

incidences of job-related injuries, illnesses, 

and fatalities. They help to discover trends, 

research opportunities, emerging issues, and 

high-risk worker populations. The programs 

also create and send out targeted educational 

and prevention materials, adapting materials 

to best protect workers. They often engage in 

outreach and involve partners in public health 

and safety to advance “data into action.”

Research Outputs: 

Publications in FY2018

State surveillance program outputs are the 

products of research activities and include 

publications. We collected publications by 

NIOSH-funded extramural researchers from 

principal investigator reports to NIOSH, the 

NIH Reporter database, the NIOSHTIC-2 

database, and the PubMed database. From 

October 1, 2017, to September 30, 2018, 

the state surveillance program published 

29 articles in peer-reviewed journals. Find a 

searchable database of NIOSH publications, 

which includes grantee final reports and 

publications, by using the NIOSHTIC-2 publications search.
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 53
54 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

Program Highlights FY2018

Opioid-related Deaths Vary by Job in 

Massachusetts, With Highest Rates in 

More Dangerous Jobs

According to a study by the Massachusetts 

Department of Public Health (MDPH), Massachusetts workers died of opioid overdoses 

at vastly different rates depending upon 

their job. The highest rates were seen in construction and extraction, including quarrying, 

mining, and oil and gas removal, followed by 

agriculture, forestry, and fishing. To understand which industries and occupations have 

the highest rate of opioid-related deaths, 

researchers looked at 4,302 publicly available 

death certificates filed in Massachusetts from 

2011 through 2015. They also used data from 

four national surveys to explore occupational 

factors that may contribute to differences 

in rates of opioid-related deaths in different 

occupations and industries. 

Along with focusing on opioid-related deaths 

by occupations, the study also found differences by gender. Overall, most of the 

opioid-related deaths were among males, 

which is similar to findings for all opioid-related overdose deaths in Massachusetts. The 

rate of opioid-related overdose deaths was 

higher among workers employed in industries and occupations that have high rates of 

work-related injuries and illness based on data 

from the Bureau of Labor Statistic Survey of 

Occupational Injuries and Illnesses. The rate of 

fatal opioid overdose was also higher among 

workers employed in occupations with lower 

availability of paid sick leave (data from the 

Bureau of Labor Statistics Employee Benefits 

Survey) and high job insecurity, or the worry 

of becoming unemployed (data from the 

National Health Interview Survey). 

Although more research is needed to understand how injury, job insecurity, paid sick 

leave, and other work factors may contribute 

to opioid overdose deaths, this study’s findings highlight the critical need for immediate 

interventions. Massachusetts Health & Human 

Services Secretary Marylou Sudders says the 

findings are important because they indicate 

occupations where interventions can prevent 

injuries. For example, educational programs 

and policies targeted toward occupations with 

a high rate of fatal opioid overdose should 

aim to decrease workplace hazards that could 

cause injury, resulting in opioid prescriptions. 

The MDPH is currently building on this initial 

work to conduct subsequent analyses using 

more years of death certificate data to analyze 

patterns by race and ethnicity, occupational 

subgroups within the construction sector, substate geography, and toxicology. The MDPH 

is also currently working to develop and 

implement an educational outreach strategy 

targeting high-risk worker groups. 

Details:

https://www.mass.gov/files/

documents/2018/08/15/opioid-industryoccupation.pdf

www.mass.gov/opioidresponse

https://www.cdc.gov/niosh/research-rounds/

resroundsv4n2.html#c

Michigan and New York Raising 

Awareness and Changing Policy on 

Use of Methylene Chloride in the 

United States

In recent years, the Michigan Fatality 

Assessment and Control Evaluation (MIFACE) 

Program and the New York State (NYS) 

Department of Health aimed to increase 

awareness of health and safety risks related 

to methylene chloride in various products, 

including paint strippers. Workers, consumers, and others can be exposed to this 

liquid substance through inhalation or skin 

contact, and the exposure can cause heart, 

liver and nervous system problems, irritation of the skin and eyes, and cancer. 
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 55

Based on information from MIFACE, the Environmental Protection Agency proceeded with 

a proposed rule to ban the manufacturing and 

sales of methylene chloride paint removers 

for consumers. The NYS Department of Health 

also kicked off a weeklong campaign to ban 

these paint removers in stores, sharing data 

on methylene chloride related fatalities with 

lawmakers, nongovernment workers, environmental health advocates, and Occupational 

Safety and Health (OSH) groups in New York 

and a dozen other states. Some New York 

legislators used this information to initiate 

and support a bill to ban the use of the chemical in the state. Additionally, because of the 

efforts in Michigan and New York, 13 major 

retailers, including Lowes, The Home Depot, 

Walmart, and Amazon, announced they would 

stop selling paint removal products containing 

methylene chloride, along with N-methylpyrrolidone (NMP) chemicals.

Details:

https://oem.msu.edu/index.php/workrelated-injuries/work-related-fatalities

https://www.health.ny.gov/environmental/

workplace/occupational_health_surveillance/

https://www.epa.gov/newsreleases/epabans-consumer-sales-methylene-chloridepaint-removers-protecting-public

New York State Workers’ 

Compensation Board Uses 

Surveillance Data to Review 

Legionnaires’ Disease Cases

Legionnaires’ disease is a serious respiratory 

illness that often occurs in older adults and 

individuals with vulnerable immune systems. 

It has been associated with the use of hot 

tubs and air conditioners in large buildings. 

However, little information is available on the 

occupational settings linked to Legionnaires’ 

disease, along with common sources of it 

found in young and healthy workers. 

The New York State (NYS) Department of Health 

launched an investigation into an incident 

where a healthy utility construction worker died 

from the illness. Prior to the fatality, investigators found the outdoor worker was exposed 

to standing water daily and eventually became 

sick with respiratory symptoms that initially 

medical providers did not properly diagnose 

and treat. It was later diagnosed as a severe 

case of Legionnaires’ disease and the worker 

subsequently succumbed to the disease. 

The NYS Workers’ Compensation Board first 

denied this case’s claim as work-related. However, the NYS Department of Health provided 

the board with prior data that connected outdoor work and exposure to standing water 

contaminated with the legionella bacteria, 

which causes the lung disease. Some of the 

data resulted from joint work between the NYS 

Department of Health and NIOSH on a health 

hazard evaluation on Legionnaires’ disease at 

an automobile and scrap metal shredding facility. The Board later reversed its decision related 

to the fatality and planned to use the NYS 

Department of Health’s information to review 

pending cases involving Legionnaires’ disease 

to assess possible occupational causes. 

Details:

https://www.health.ny.gov/environmental/

workplace/occupational_health_surveillance/

New Surveillance System Looks at 

Immediate Hospitalizations and 

Work-related Injury

The Washington State Safety and Health Assessment and Research for Prevention (SHARP) 

occupational safety and health surveillance 

program developed a new surveillance system 

that captures data on immediate work-related 

inpatient hospitalizations. The system links 

hospital discharge data with workers’ compensations claims to identify workers with hospital 

admissions within a day or less of being injured 

on the job. It provides descriptive information 

on high-risk injuries, allowing SHARP to evaluate 

the completeness of mandated employer 
56 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

reporting of these cases and informing its 

injury prevention efforts. A technical report was 

published in FY2018 based on the surveillance 

system data for 2015. This information focused 

on worker demographics, injury descriptions, 

industry and occupation, along with workers’ 

compensation claims. SHARP presented these 

results at the 2018 Council of State and Territorial Epidemiologists Conference in West 

Palm Beach, Florida, along with two agriculture 

safety and health forums in Washington State. 

Recently, the state legislature appointed funds 

for SHARP to expand the surveillance system, 

ensuring its sustainability.

Details:

https://lni.wa.gov/safety-health/safetyresearch/ongoing-projects/immediateinpatient-hospitalizations

Investigation Shows Limited 

Respirator Use Among Emergency 

Responders After Toxic Gas Exposure

Most of the emergency responders dispatched 

to a serious incident involving a toxic gas 

exposure did not use required respirators 

for breathing protection, according to a 

NIOSH-funded investigation from the Texas 

Department of State Health Services. The gas, 

phosphine, forms when pesticides containing 

aluminum phosphide mix with water. These 

pesticides are restricted to certified users 

because short-term exposure can cause respiratory and cardiovascular, or heart and blood 

vessel, complications, and can be fatal. Federal 

regulations require emergency crews on the 

scene with such hazardous substances wear 

personal protective equipment, including a 

respirator. Multiple studies, however, show this 

does not typically happen. Little information is 

currently available on how to increase emergency responders’ compliance. 

The Texas Department of State Health Services 

reviewed this case of phosphine exposure 

among 51 hazardous materials emergency 

responders who evacuated and treated residents at an Amarillo, Texas, home after an 

outdoor pesticide application. The scientists 

reviewed call records from the Texas Poison 

Control Network related to the exposure and 

the results of a standardized health questionnaire completed by the emergency responders 

afterwards. More than 78% (40) of the emergency responders did not wear a respirator 

during the response. Of these, 15 received medical treatment and 7 reported new or worse 

phosphine exposure symptoms within a day 

after the incident. Their symptoms included eye 

pain, headaches, dizziness, abdominal cramps, 

and nausea. 

The majority of the 51 emergency responders 

reported being trained in emergency response 

and understood standard operating procedures within their agency for handling incidents 

with hazardous substances. They gave several 

reasons for not wearing a respirator, including 

being unaware that it was necessary, focusing 

on rescuing people, and being unaware of the 

chemical’s presence. 

These findings show that emergency responder 

trainings alone do not result in proper use of 

respirators during incidences with unknown 

hazardous substances. Few studies exist of 

behavioral interventions related to the use 

of respirators and other personal protective 

equipment among emergency responders. 

Methods for improving compliance with existing 

guidance and regulations are also not well 

understood. Scientists say more research is 

needed to evaluate effective interventions to 

ensure that emergency responders comply with 

current recommendations and regulations for 

personal protective equipment.

Details:

https://www.cdc.gov/mmwr/volumes/67/wr/

mm6713a2.htm

https://www.cdc.gov/niosh/research-rounds/

resroundsv4n7.html#d

https://www.dshs.texas.gov/epitox/default.

shtm
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 57

SPECIALTY TRAINING PROGRAMS

NIOSH funds programs that provide education 

and training in occupational safety and health in 

a variety of ways. Along with the ERCs described 

under Multidisciplinary Centers, NIOSH supports 

professional training in occupational safety and 

health through Training Project Grants (TPGs). 

The Institute also funds the Miner Safety and 

Health Training Program—Western United 

States cooperative agreement, which connects 

the mining community with relevant information, resources, and methods that increase 

the volume and ability of safety training for 

Western States’ miners

TRAINING PROJECT GRANTS

NIOSH supports professional training in 

occupational safety and health through 

TPGs. Most TPGs are academic training 

programs that support undergraduate 

and graduate training. Located throughout the United States, these programs 

enrich the national network of graduate training the ERCs offer. Along with 

TPGs for traditional degree training 

programs, NIOSH supports TPGs that 

respond to the unique training needs 

of specialty groups. These include the 

Association of Occupational and Environmental Clinics (AOEC) Occupational 

Health Internship Program (OHIP). This 

program supplies specialty training and 

increases diversity among health and 

safety practitioners by recruiting and 

mentoring students from underrepresented and underserved minorities. 

Through a TPG, the Alaska Marine Safety 

Education Association expands the network 

of port-based fishing safety instructors in 

Alaska and the United States. They achieve 

this through a train-the-trainer curriculum 

designed for the unique needs of the commercial fishing industry. NIOSH also provides 

funding for the Emergency Responder 

Training Program through the International 

Association of Fire Fighters (IAFF), which this 

report later discusses.

Public Health Relevance

NIOSH uses TPGs as a principal means of providing enough qualified professionals to carry 

out the Occupational Health and Safety Act of 

1970. TPGs help train in specific disciplines to 

meet the needs of a diverse workforce. The 

graduates of TPGs serve a vital role in protecting and promoting the health and safety of 

U.S. workers, aligning with the goals of Healthy 

People 2020—to prevent diseases, injuries, and 

deaths due to working conditions. TPGs also 

serve as important resources on job-related 

safety and health issues for business, labor, 

government, and the general public.

Research Outputs: 

Publications in FY2018

TPG research outputs are the products of 

research activities and include publications. 

We collected publications by NIOSH-funded 
58 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

extramural researchers from principal investigator reports to NIOSH, the NIH Reporter 

database, the NIOSHTIC-2 database, and the 

PubMed database. From October 1, 2017, 

to September 30, 2018, the TPG researchers 

published 27 articles in peer-reviewed journals. Find a searchable database of NIOSH 

publications, which includes grantee final 

reports and publications, by using the 

NIOSHTIC-2 publications search.
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 59

Program Highlights FY2018 238 trainees with specialized training in 

industrial hygiene, occupational safety and Training Project Grant Trainees, medicine, and allied disciplines. These allied Graduates, and Employment disciplines included occupational health 

by Discipline psychology, risk management, occupational 

In academic year 2017–2018, the TPG ergonomics and engineering, environmental 

academic training programs graduated health, and occupational epidemiology.

Table 17. Training project grant trainees, graduates, and employment by discipline, 

FY2018

Program Area Trainees Graduates

Employed in occupational safety and health field 

or seeking advanced training (%)

Industrial Hygiene 304 64 64 (100)

Occupational Safety 240 79 77 (97)

Occupational Medicine 31 17 17 (100)

Allied Disciplines 281 78 75 (96)

Total 856 238 233 (98)

Training Project Grant (TPG) Program 

Achievements

The Positive Impact of an Innovative Trainin-Place Residency Program

In medicine and other fields that require 

years of education and training, fitting 

coursework into a busy work schedule may 

make a career change especially daunting. 

To address the issue, investigators at the 

University of Pennsylvania (UPenn) TPG 

tested a train-in-place program that brings 

training in occupational and environmental 

medicine (OEM) directly to the workplace. 

This approach enables midcareer doctors 

to continue their practices while preparing for certification in OEM. Because some 

doctors may be unaware of the OEM field 

until later in their careers, the program also 

could help relieve the shortage in this field.

During the 2-year program, physicians 

trained at clinical sites located at their workplaces. In addition, participants completed 

18 visits to UPenn’s primary training site. 

Participants received skills training that 

centered on patient visits or rotations. They 

completed individual projects with a mentor’s 

guidance. UPenn faculty periodically visited 

and appraised the various train-in-place locations. From 1997 through 2015, 109 out of 

110 midcareer physicians graduated from the 

program, scored competitively on the occupational medicine certifying examination, and 

achieved all training milestones. Five years 

after graduation, most participants continue 

to practice OEM throughout the United 

States. In addition to geographical diversity, 

work settings varied with program graduates 

joining academia, industry, and government, 

as well as hospitals and clinical settings. 

These findings show that train-in-place 
60 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

programs can help increase the number of 

OEM specialists by overcoming some of the 

barriers faced by midcareer physicians seeking a career change.

Details:

https://www.jgme.org/doi/full/10.4300/JGMED-16-00689.1#abstract

https://www.pennmedicine.org/

departments-and-centers/emergencymedicine/education-and-training/oemresidency-program

https://www.cdc.gov/niosh/research-rounds/

resroundsv4n2.html#d

Creating Cost Effective Interventions and 

Tackling Contemporary Challenges in Safety 

and Health 

Combining classroom and real-world experiences, Ohio University gives TPG trainees 

impactful internships and practical and 

academic knowledge in varied occupational 

safety and health areas like human factors 

engineering, industrial ergonomics, and 

systems safety. Trainees who completed 

internships in Ohio University’s safety 

department in FY2018 helped develop cost 

effective interventions to protect the university’s workforce. For example, trainees 

recommended changing the table legs to 

those that are moveable to make workstations adjustable—a move that was more 

cost effective than purchasing new tables. 

The adjustable workstations allow workers 

to have a normal or erect posture on the 

job and reduce risk factors related to static 

loading or constantly staying in the same 

position. Ohio University trainees also completed internships at state agencies, medical 

facilities, and food processing facilities, as 

well as automobile and heavy equipment 

manufacturing plants. These types of learning opportunities produce graduates who 

are well equipped to take on contemporary challenges facing today’s workforce. 

Graduate Training Aims to Increase 

Diversity in Industrial Hygiene 

Addressing a need for more minority 

occupational safety and health (OSH) professionals, the Tulane University TPG dedicates its 

resources and time to the recruitment of trainees in the field of industrial hygiene—students 

who are in minority groups, are disadvantaged, 

or at a midcareer point. The program focuses 

on raising the number of under-represented 

industrial hygiene professionals in government, 

labor, the private sector, and academia. It 

also allows early and midcareer OSH professionals to have more training opportunities in 

industrial hygiene. The structure of this Accreditation Board for Engineering and Technology 

accredited program in industrial hygiene allows 

graduate students a full-time campus experience or a distance learning opportunity for 

working professionals.

Developing Practitioners and Addressing 

Relevant Occupational Safety and Health 

Issues in Upper New York Region

The University at Buffalo, SUNY TPG aims to 

provide highly qualified occupational safety 

and health (OSH) practitioners in upper New 

York. The TPG’s rigorous graduate program 

includes formal OSH research and real-world 

training, allowing students to gain both scientific and practical experience. During FY2018, 

trainees conducted research on varied topics 

relevant to vulnerable working populations. 

Trainees completed internships to gain valuable experiences on protecting workers’ safety 

and health. Recent graduates of the SUNY 

TPG are working full time in OSH in federal 

government and private industry sectors with 

responsibilities in developing and conducting 

safety training, performing occupational safety 

surveys, inspections, and compliance audits, 

and assisting in effective hearing conservation programs.
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 61

EMERGENCY RESPONDER 

TRAINING PROGRAM

NIOSH funds a TPG in Emergency 

Responder Training Program through 

the International Association of Fire 

Fighters (IAFF). IAFF’s mission through 

the program is to educate emergency 

responders about ways to stay safe and 

healthy. They strive to reduce on-the-job 

injuries, illnesses, and fatalities related 

to emergency response, so responders 

can better protect the communities they 

serve. Training takes place across the 

United States and its territories.

IAFF has a long working relationship with 

NIOSH. The association delivers training to 

firefighters and EMS personnel. IAFF’s record 

emphasizes job-related safety and health as 

part of a complete first responder training plan. 

IAFF’s teachings seek to improve knowledge, 

attitudes, and behaviors so that first responders adopt a safer approach to emergency 

response throughout their career. IAFF training 

is a resource that directly affects decisions firefighters make each day. 

Public Health Relevance

This federally funded training program serves 

as an excellent model for an effective training 

program for first responders. With a team of 

instructors who are both certified fire service 

instructors and hazardous materials (HazMat) 

responders, IAFF provides real-world training 

in HazMat response. Furthermore, IAFF brings 

its training directly to the students in their 

own communities, developing training partnerships with thousands of fire departments 

throughout the United States. Because of this 

community-based learning, local responders 

receive training that addresses their unique 

concerns and challenges. 

As 9-1-1 calls for opioid-associated emergencies continue to increase, all levels of EMS 

providers must be properly trained to handle 

these life-threatening events—including the 

administration of naloxone (NARCAN). In 

response, IAFF developed an Opioid Crisis Toolkit, which uses the protocols, state-of-the-art 

responses, and resources available 

to firefighters. 

Program Highlights FY2018

In FY2018, IAFF delivered 73 classes to 1,370 students, totaling 28,664 contact hours.

Table 18. Emergency responder training classes, FY2018

Class

Title

Class

Length

 Total

Classes

Total 

Students

Total 

Contact Hours

Confined Space Operations 24 hours 3 49 1,176

Illicit Drug Labs 8 hours 8 132 1,056

First Responder Operations 24 hours 52 1,026 24,624

Emergency Response to 

Terrorism Operations: Refresher

8 hours 6 88 704

Train the Trainer 24 hours 1 19 456

Emergency Response to 

Terrorism: Operations

16 hours 1 25 400

Chemical Process Industries 8 hours 2 31 248
62 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

MINER SAFETY AND HEALTH 

TRAINING PROGRAM

Despite many technological and work 

environment advances, mining remains 

one of the most demanding occupations 

in the United States. Because of the 

many challenges in the mining industry, 

the focus areas for mining training must 

cover a wide range of hazards and risks.

The Mine Safety and Health Administration 

(MSHA) Training Academy in Beckley, West 

Virginia, serves the mining community in the 

Eastern United States. Because this training 

program is not easy for miners in the Western 

States to access and certain aspects of mining 

operations differ in eastern and western operations, NIOSH has supported miner safety and 

health training in the Western United States 

since 1999. 

For FY2018, two programs were funded in the 

Western United States: the Colorado School 

of Mines and the University of Arizona. This 

training provides a joint approach to reducing 

injuries to miners and other workers in mining 

operations. It also aims to translate research 

into workplace practices that (1) improve 

mining safety, (2) advance the safety and 

health of miners, (3) enhance the safety and 

health of other workers involved in mining 

operations, and (4) increase the quantity of 

qualified mine safety and health trainers in 

the Western United States.

Several of the main objectives of the training 

program follow: 

■ To develop, deliver, and manage the 

training needs of miners in the Western 

United States.

■ To provide qualified instructors 

and faculty.

■ To start and carry out “train the trainer” 

courses.

■ To evaluate training effectiveness and 

impact on reducing injuries and illnesses 

to miners. 

■ To coordinate with existing training programs, like those offered by MSHA and 

MSHA-funded state programs, and in 

partnerships with industry, miners, and 

other agencies. 

NIOSH intends for the program’s training to be consistent with OSHA and 

MSHA guidelines, without duplicating 

these agencies’ existing trainings. 

Public Health Relevance

The Miner Safety and Health Training Program 

provides critical safety and health training to 

protect workers in one of the most dangerous 

industry sectors in the United States. This program contributes to this overall goal by taking 

the following actions:

■ Expanding the mission of NIOSH in 

protecting and promoting the health of 

mine workers. The trainings improved 

work practices, reduced work-related 

injury and illness, and increased the 

understanding of safety and health 

practices in Western mine worksites.

■ Increasing the safety focus, total health 

awareness, and leadership competency 

of miners, frontline supervisors, superintendents, and managers representing 

operations throughout the United States, 

spanning all major commodity sectors 

in surface and underground mining.

■ Directing the focus of mine-rescue 

training toward learning actual rescue 

skills, resulting in team members 

being better prepared to respond 

to all kinds of emergencies.

The Miner Safety and Health Training Program 

fills an important regional need. During 

FY2018, the program trained 1,280 mine 
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 63

workers through 49 courses. It is critical 

for underserviced populations working on 

mine sites, including contractors, suppliers, 

consultants, equipment manufacturers, and 

small mine operators. The program designs 

and uses active learning strategies for mine 

safety training. It has taught trainers across 

all mining service sectors throughout the 

Western United States ways to improve safety 

training. These activities improve the transfer 

of best safety practices to the workplace while 

increasing the number of workers served. 

Program Highlights FY2018

Development of Framework for Critical 

Control Management 

In FY2018, the University of Arizona aimed to 

develop a framework in the Mining Sector to 

identify the most important critical controls or 

methods to control exposures to occupational 

hazards. To create the framework, university 

researchers used the critical control management approach from the International Council 

on Mining and Metals as a template. They 

then collected input from mining industry 

experts on which controls mining companies 

use to prevent or lessen potential risks from 

material unwanted events. These are defined 

as incidences with major negative effects 

in terms of materials, reputational cost, or 

worker impact. 

A dozen experts, with an average of 22 

years of experience, representing mining, 

geotechnical-equipment manufacturing, and 

consulting companies, along with university 

faculty, provided this input in a workshop. 

Researchers asked participants to identify the 

most important material unwanted events 

and the related critical controls that companies use. The highest priority events included 

rock falls, slope failures, and tailing failures, 

and 65 critical controls were identified to keep 

workers safe during these events. The control 

methods included varied types of monitoring, 

engineering controls, and training. Next steps 

include the University of Arizona developing a 

website and an online database to share their 

findings and collecting additional data on critical controls from others in the Mining Sector.

Colorado School of Mines Implements 

Underground Mine Experience Into New 

Miner Training 

The Colorado School of Mines is one of only 

a few institutions in the Western United 

States that includes an underground mine 

experience in its MSHA Part 46 New Miner 

Training. During this course, trainees spend a 

half day inside the Edgar Experimental Mine 

learning how to prepare for working in an 

underground environment. This preparation 

includes appropriate use of personal protective equipment, along with identifying possible 

hazards related to underground mining, ventilation, and ground support and scaling.
64 NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018

APPENDIX: FY2018 NIOSH FUNDING OPPORTUNITY 

ANNOUNCEMENTS BY MECHANISM 

Funding 

Opportunity Mechanism Title

Investigator-initiated Research

PAR-13-245 K01 Mentored Research Scientist Development Award

PAR-13-129 

PA99-143

R01 Occupational Safety and Health Research

PAR-12-200 R03 NIOSH Small Research Program

PAR-14-246 R13 NIOSH Support for Conferences and Scientific Meetings

PAR-12-252 R21 NIOSH Exploratory/Developmental Grant Program

PAR-14-229 U13 NIOSH Support for Conferences and Scientific Meetings

Training Programs and Centers

PAR-15-352

PAR-10-288

 T03 Occupational Safety and Health Training Project Grants

PAR-15-303 

PAR-10-217

T42 Occupational Safety and Health Education and Research 

Centers

Cooperative Agreements

PAR-14-175 U01 Agricultural, Forestry, and Fishing Safety and Health Research

PAR-15-361 U19 NIOSH Centers of Excellence for Total Worker Health®

RFA-OH-16-010 U24 National Mesothelioma Virtual Bank for Translational Research

PAR-15-353 U54 Centers for Agricultural Safety and Health

OH14-005 U54 National Center of Excellence for the Prevention of Childhood 

Agricultural Injury

PAR-14-227 U60 Workers’ Compensation Surveillance

PAR-14-275 U60 State Occupational Health and Safety Surveillance Program

RFA-OH-13-001 U60 National Center for Construction Safety and Health Research 

and Translation

RFA-OH-17-001 U60 Miner Safety and Health Training Program—Western United 

States

RFA-OH-17-1701 E11 Cooperative Agreement on Global Occupational Health with 

the World Health Organization: Implementing “Global Plan of 

Action for Workers’ Health 2008–2018”

(Continued)
NIOSH Extramural Research and Training Program ■ Annual Report of Fiscal Year 2018 65

Funding 

Opportunity Mechanism Title

Cosponsored Research With the National Institutes of Health 

PA-16-302 R43, R44 PHS 2015-02 Omnibus Solicitation of the NIH, CDC, FDA, 

and ACF for Small Business Innovation Research Grant 

Applications

PA-17-302 R43, R44 PHS 2017-02 Omnibus Solicitation of the NIH, CDC, FDA, 

and ACF for Small Business Innovation Research Grant 

Applications

RFA-TW-14-001 U01 Hubs of Interdisciplinary Research and Training in 

Global Environmental and Occupational Health 

(GEOHealth)—Research

RFA-TW-14-002 U2R Hubs of Interdisciplinary Research and Training in Global 

Environmental and Occupational Health (GEOHealth)—

Research Training
Promoting productive workplaces 

through safety and health research

DHHS (NIOSH) Publication No. 2020-108

DOI: https://doi.org/10.26616/NIOSHPUB2020108