TECHNICAL REPORT

A Guide to the Collection of 

Occupational Data for Health:

Tips for Health IT System Developers

TECHNICAL REPORT

A Guide to the Collection of Occupational Data 

for Health: Tips for Health IT System Developers

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Institute for Occupational Safety and Health
ii | A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers

This document is in the public domain and may be freely copied or reprinted.

Disclaimer

Mention of any company or product does not constitute endorsement by the National Institute 

for Occupational Safety and Health, Centers for Disease Control and Prevention. In addition, 

citations to websites external to NIOSH do not constitute NIOSH endorsement of the sponsoring 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.

Get More Information

Find NIOSH products and get answers to workplace safety and health questions:

1-800-CDC-INFO (1-800-232-4636) | TTY: 1-888-232-6348

CDC/NIOSH INFO: cdc.gov/info | cdc.gov/niosh

Monthly NIOSH eNews: cdc.gov/niosh/eNews

Suggested Citation

NIOSH [2021]. A guide to the collection of occupational data for health (ODH). By Wallace B, 

Luensman GB, Storey E, Brewer L. Morgantown, WV: 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. 2022-101, https://doi.org/10.26616/NIOSHPUB2022101. 

DHHS (NIOSH) Publication No. 2022-101

DOI: https://doi.org/10.26616/NIOSHPUB2022101

October 2021
A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers | iii

Acknowledgements

This guide was produced as part of a project to demonstrate the collection of Occupational 

Data for Health (ODH), a set of core data elements about a patient’s work. It is based on work 

done by subject matter experts at the National Institute for Occupational Safety and Health 

(NIOSH)/Centers for Disease Control and Prevention (CDC) and through contracts with 

Attain, LLC and Professional Staffing Partners.
This page intentionally blank.
A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers | v

Contents

Acknowledgements......................................................... iii

A Guide to the Collection of Occupational Data for Health (ODH) . . . . . . . . . . . . . . . 1

Background ............................................................ 1

About This Document..................................................... 1

General Guidance ....................................................... 2

Interoperability.......................................................... 2

ODH Vocabulary ......................................................... 3

Industry ......................................................... 4

Occupation ...................................................... 4

Industry and Occupation Search............................................. 5

Example of an Occupation Search .................................... 6

Data Collection ......................................................... 7

General ......................................................... 7

When Employment Status Is Collected ................................. 7

When Retirement Is Collected........................................ 7

When Jobs Are Collected (Past Or Present Jobs) .......................... 7

When Longest Held (Usual) Work Is Collected............................ 8

When Voluntary Work Is Collected .................................... 8

When Combat Zone Periods Are Collected .............................. 9

When Work of Household Members Of Minors Is Collected ................. 9

Recommended User Interface Wording and Tips ................................ 9

Introduction for Collecting ODH............................................. 9

Prompts and Examples for Industry and Occupation ............................. 10

Learn More (Tip Tools) .................................................... 10

ODH Data Elements, by Topic............................................... 12

Appendix A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Select Conformance Criteria from the Work and Health Functional Profile ............ 19

Description ...................................................... 19

Key ............................................................ 19
This page intentionally blank.
A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers | 1

A Guide to the Collection of Occupational

Data for Health (ODH)

Background

U.S. workers often spend large amounts of their time at work. While there, they may be exposed to

hazards such as heat, dusts, chemicals, injury, and infectious diseases. Workers may also experience long

hours, strenuous tasks, and irregular schedules that can affect their health and risk of injury. When

work characteristics are considered by medical providers who are helping patients manage chronic or

infectious disease or injury, outcomes may be improved. If the demands of a patient’s job are known,

a more successful return to work after an illness or injury may be achieved. Work-related illnesses are

more likely identified when a person’s work information is known and cases can be reported to public

health authorities, supporting interventions and the reduction of further exposures.

Occupational Data for Health (ODH) is a framework for self-reported, structured, and standardized

patient work information. It is broadly applicable in healthcare as part of the medical record; it is

suitable for many use cases supporting patient care, population health, and public health. The ODH

framework is organized around seven salient topics, each topic containing related data elements. Health

IT vendors and healthcare organizations can choose which topics and data elements are most beneficial

to collect and use as well as where in their work-flow it belongs. It is essential for health IT vendors to

modify their medical record systems to satisfy the needs of their healthcare customers.

Information about paid work, unpaid work (e.g., work on a family farm), and some volunteer work,

especially positions that are most likely to pose health and safety risks, are included. Although the focus

is primarily on the patient’s work information, the potential to use components of ODH for household members for some patients (e.g., newborn or other minor) is also described.

More information can be found at: https://www.cdc.gov/niosh/topics/ehr/default.html. 

About This Document

This document is intended to assist health IT system developers who are implementing collection of

ODH in a system such as an EHR. NIOSH performed usability testing of a series of prototypes to

collect ODH and this document describes requirements and suggestions based on lessons learned from

that work. The goals of this document are to reduce the burden of ODH implementation in health IT 

systems and to improve the patient experience while using the systems to self-report work information. 

Additional requirements are expressed in the HL7® EHRS-FM Release 2 Functional Profile: Work and

Health, Release 1 – U.S. Realm, Informative Document 2019 Apr (WHFP), sponsored by the HL7

Electronic Health Records Work Group (http://www.hl7.org/implement/standards/product_brief.

cfm?product_id=498). Please refer to the WHFP for requirements about other aspects of managing

and using ODH (e.g., maintaining, rendering, exchanging, analyzing, etc.).1

1The bracketed numbers throughout this document refer to reference numbers found in Appendix A, Select Conformance Criteria from the WHFP.
2 | A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers

General Guidance

The collection of Occupational Data for Health (ODH) can be organized around seven topics:

1. Employment Status

2. Retirement Dates

3. Jobs (Past or Present)

4. Longest Held (Usual) Work

5. Volunteer Work

6. Combat Zone Periods

7. Work of Household Members of Minors

ODH data are to be part of the patient’s social history within the medical record and made 

available to clinicians and to clinical decision support and population health applications [17].1

The collection of topics 1 – 6 is appropriate for individuals of working age. Depending on state 

and local laws, such as those pertaining to family-run businesses (e.g., farms and restaurants), 

“working” can start as young as 5 years old and has no upper age limits [16]. At a minimum, it is 

recommended to offer collection of ODH for persons age 16 years old or more. 

Topic 7, Work of Household members of minors, is work information that an organization might 

want to collect about the working members of a household where a minor resides [1]. Data collected 

according to topic 7 is to be in the medical record of the minor (not the household member).

Local implementations of ODH may be customized to collect a subset of the ODH topics and 

data elements found in each topic. This supports a phased-in approach as the collection and use 

of ODH matures within a healthcare organization. Please note, the data elements required for 

interoperability must be collected. Some ODH data elements are also in progression to be included 

in U.S. Core Data for Interoperability (USCDI; https://www.healthit.gov/isa/united-states-coredata-interoperability-uscdi).

Interoperability

The ODH topics are related to sections of HL7 and IHE ODH interoperability messaging 

templates listed here. These templates are being updated to reflect the most recent vocabulary 

and cardinality requirements. The value sets for ODH employment status, work classification, 

and work schedule are currently referenced in interoperability standards as HL7 terminology; 

they are suitable for both U.S. realm and non-U.S. realm use cases.

 HL7 Structured Documents, Public Health and Emergency Response, and Health Standards Integration Work Groups, sponsors. HL7 CDA® R2 Implementation Guide: Consolidated CDA Templates for Clinical Notes; Occupational Data for Health, Release 1 

STU 1 Update 1 – U.S. Realm. 2021 XXX. http://www.hl7.org/implement/standards/

product_brief.cfm?product_id=522.

 HL7 Orders and Observations Work Group, Infrastructure and Messaging Work Group, 

Conformance Work Group, et al., sponsors. HL7 Version 2.9 Messaging Standard – An 

Application Protocol for Electronic Data Exchange in Healthcare Environments 2019 

Dec. http://www.hl7.org/implement/standards/product_brief.cfm?product_id=516.
A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers | 3

 HL7 Public Health Work Group, sponsor. HL7 FHIR Release 4.0.1 Profile: Occupational 

Data for Health (ODH), Release 1.1 (Standard for Trial Use). 2021 XXX ##. http://hl7.

org/fhir/us/odh/history.html.

 IHE PCC Technical Committee. IHE Patient Care Coordination (PCC) Technical 

Framework Supplement: CDA Content Modules, Revision 2.7 – Trial Implementation. 

2021 Feb 26. https://www.ihe.net/resources/technical_frameworks/#pcc.

ODH topics are also included in these products:

 IHE PCC Technical Committee. IHE Patient Care Coordination (PCC) Technical Framework Supplement: Query for Existing Data for Mobile (QEDm), Revision 2.2 – Trial 

Implementation. 2020 Jul 17. https://www.ihe.net/resources/technical_frameworks/#pcc.

 IHE PCC Technical Committee. IHE Patient Care Coordination (PCC) Technical 

Framework Supplement: International Patient Summary (IPS), Revision 1.1 – Trial Implementation. 2020 Jun 17. https://www.ihe.net/resources/technical_frameworks/#pcc.

 IHE PCC Technical Committee. IHE Patient Care Coordination (PCC) Technical 

Framework Supplement to Volume 1, CDA Occupational Data Options, Revision 1.0 – 

Trial Implementation. In press. Approved 2020 Jul. https://www.ihe.net/resources/technical_frameworks/#pcc. This adds ODH to three profiles that are in the PCC Technical 

Framework: Cross-Enterprise Sharing of Medical Summaries (XDS-MS), Exchange of 

Personal Health Record (XPHR), Emergency Department Referral.

 IHE QRPH Technical Committee. IHE Quality, Research and Public Health Technical 

Framework Supplement: Healthy Weight (HW), Revision 2.3 – Trial Implementation 

2020. https://www.ihe.net/resources/technical_frameworks/#qrph.

 HL7 Public Health Emergency Response Work Group and Structured Documents Work 

Group, sponsors. HL7 CDA R2 Implementation Guide: Public Health Case Report – the 

Electronic Initial Case Report (eICR), Release 1, STU Release 2.0 – U.S. Realm. 2020 Feb. 

http://www.hl7.org/implement/standards/product_brief.cfm?product_id=436.

 HL7 Public Health Work Group, sponsor. HL7 FHIR® Release 4.0.1 Implementation 

Guide: Electronic Case Reporting (eCR) – U.S. Realm. Version 1.0.0 (Standard for Trial 

Use). 2020 Jan 29. http://hl7.org/fhir/us/ecr/STU1/.

 HL7 Public Health Work Group, sponsor. HL7 Version 2.6 Implementation Guide: 

Early Hearing Detection and Intervention (EHDI) Results, Release 1, Normative. 2020 

Oct. http://www.hl7.org/implement/standards/product_brief.cfm?product_id=344.

 HL7 Public Health Work Group, sponsor. HL7 Version 2.6 Implementation Guide: 

Critical Congenital Heart Defects (CCHD) Pulse Oximetry Screening Results, Release 

1, Normative. 2020 Aug. http://www.hl7.org/implement/standards/product_brief.

cfm?product_id=366.

ODH Vocabulary

The ODH code system is available in the Public Health Information Network Vocabulary Access 

and Distribution System (PHIN VADS) [6]. Use the search term “ODH” to find it. Downloadable files are also available under the ODH Hot Topics section; these files contain additional 

metadata such as user-friendly 8th grade reading-level descriptions for ODH value set concepts 

other than industry and occupation as well as crosswalks from ODH industry and occupation 

value set concepts to CDC Census industry and occupation value set concepts. The ODH codes 

and concepts found in both the vocabulary access and Hot Topics downloads are the same.
4 | A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers

Industry and occupation are the most difficult concepts to collect. The downloadable files from 

the PHIN VADS Hot Topics section are structured to support searching on words that are relatable to the general public and selection of detailed terms that support aggregation to national 

industry and occupation classification systems. This approach supports the needs of patients and 

their providers, while still satisfying the needs of public health.

There are terms within the ODH occupation and industry value sets that have very similar 

wording to one another. This was done to improve search-ability of the lists. It may help to let 

users know that sometimes they will see choices that seem like the same thing and it is 

acceptable to pick any one that they feel reflects the right selection for them.

Industry

The ODH industry value set was derived from the North American Industry Classification 

System (NAICS). NAICS uses a hierarchical structure. The organization of NAICS is as follows:

– Sector: 2-digit code

 Subsector: 3-digit code

 Industry Group: 4-digit code

z NAICS Industry: 5-digit code

{ National Industry: 6-digit code

NAICS also provides an index with a large number of search-friendly terms, each associated with 

a national industry classification. Each index term was assigned a 6-digit number that was added 

as an extension to the associated 6-digit NAICS code. The value set concepts are structured as: 

index term [national industry classification]. By adding the extension to the classification code, 

the detail provided by the index terms is maintained with the NAICS classification. For more 

information on the NAICS structure: https://www.census.gov/naics/.

An alternative to patient self-reporting of industry as detailed index terms is the pre-classification 

of known employers. While this would not provide the same level of detail, it would build on 

a current workflow. Some healthcare organizations maintain a list of local employers and their 

addresses based on information gathered from their patients. This list is used to facilitate the 

collection of employer information. If the employer is not found on the list, the patient can then 

provide the information. This list could also be leveraged to classify employers by NAICS National 

Industry. The industry classification of each employer could be identified and recorded by the organization for each local employer in advance or as a new employer is added, eliminating the need 

for each patient to search for and select this data element from the ODH industry vocabulary.

Occupation

The ODH occupation value set was derived from the Occupational Information Network-Standard 

Occupational Classification (O*NET-SOC) system. This system was created by O*NET which is 

sponsored by the U.S. Department of Labor/Employment and Training Administration through a 

grant to the North Carolina Department of Commerce. O*NET has extended the Standard 

Classification Code (SOC) system from 800+ classifications to 1100+ classifications. The O*NETSOC Classification System is a hierarchical structure. The organization of O*NET-SOC is as follows:
A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers | 5

– Major Groups

 Minor Groups

 Broad Occupations

z Detailed Occupations

{ O*NET-SOC Occupations

Each SOC Detailed Occupation classification has a 6-digit code; each O*NET-SOC Occupation 

classification has an additional 2-digit extension. O*NET also provides a large list of alternate or 

lay titles, each associated with an O*NET-SOC Occupation classification. To create the ODH 

occupation value set codes, the search-friendly alternate titles were assigned a 6-digit number that 

was added as another extension to the associated O*NET-SOC occupation code. The value set 

concepts are structured as: alternate title [O*NET-SOC occupation classification]. By adding the 

extension to the classification code, the detail provided by the alternate titles is maintained with 

the O*NET-SOC and SOC classifications. For more information on O*NET-SOC: https://

www.onetcenter.org/.

Industry and Occupation Search

The ODH industry and occupation value sets are both large value sets that do not accommodate 

selection through a simple drop-down list.

The latest ODH collection prototype uses a simple key word searching algorithm that also leverages SQL database features to search the ODH industry and occupation value sets. For industry, 

it searches the index terms only. For occupation, it searches the alternate titles only. This overall 

approach was chosen to reduce the number of returned results. There are other approaches to 

searching text that could be used such as type-ahead or hierarchical searches. To date, different 

search methods have not been compared.

The latest ODH prototype uses the following steps to search for an occupation or industry. This 

description is provided as an example, not a recommendation.

1. The native browser spell checking is used as key words are entered. (Limiting the spell 

check to words found in the searched vocabulary was not tested.)

2. The key words entered by the user are parsed and the “common words” are excluded from 

the SQL search. (There are limitations to this approach; some acronyms can be mistakenly 

removed as common words, such as “IT” for “it.”) 

3. Remaining key words are stemmed to improve matches.

4. If the number of words, N, are entered, the union of the results of one or more searches 

are returned to the user for selection.

a. If there are matches for N words, searching stops and the results are returned.

b. If there are no matches for all N words, then searches for N-1 combinations of words 

are attempted and a union of the results is returned.
6 | A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers

c. If no matches are found for N-1 combinations, then the user receives a message to 

refine key words for searching.

d. If more than 20 results are found, the user receives a message suggesting they refine key 

words, with the option to view the results.

Example of an Occupation Search 

Words entered for the search are “Manager of the Nursing Department”

1. In this example, all words are spelled correctly. 

2. “Of” and “the” are removed from search words.

3. “Nursing” is stemmed in search.

4. N=3; words searched are manager, nursing, and department.

5. The O*NET-SOC alternate titles (Specific Occupations in the figure below) are searched.

6. The O*NET-SOC alternate titles do not contain a term that includes all three words, 

therefore the results of searches for the N-1 combinations (manager & nursing, manager 

& department, and nursing & department) is returned.

The results returned to the user are driven by the search-friendly alternate titles (Specific Occupation 

in the figure below). The user is able to review all possible associated O*NET-SOC classifications 

(General Occupation in the figure below) with their descriptions, that are related to the titles found by 

the search. By clicking on each General Occupation, the user is simultaneously presented the related 

Specific Occupations that were found.

In this example, the user might review the alternate titles (Specific Occupations) related to the classification (General Occupation) of Registered Nurses and select (Specific Occupation) Nurse Manager.
A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers | 7

Data Collection 

This section provides recommendations and tips to assist in building health IT system functionality 

to collect and manage all of ODH. Healthcare organizations and health IT vendors collaboratively 

drive which data elements to consider and may choose not to implement the entire framework. 

General

 A recommended feature is to provide the ability for patients to review/update previously 

entered ODH information, particularly the most current data [2,3].

 Each ODH topic has one or more data elements that need to be associated as a single 

occurrence of the topic [12,13].

 Using the ODH value sets to record employment status, work schedule, work classification, 

supervisory level, and household member role type will facilitate interoperability [6,11,14].

 It is recommended that all numeric values be recorded to one decimal place [4].

 Any dates could be collected as MM/DD/YYYYY, MM/YYYY, or YYYY.

 When start/end dates are collected, start date shall be prior to end date.

 A person can have multiple job duties per job or voluntary work position. Collecting job 

duties is optional but recommended [15].

 A person can have multiple occupational hazards per job or voluntary work position. 

Collecting occupational hazards is optional but recommended [15].

When Employment Status is Collected

 The data elements employment status and employment status start date are required to 

support interoperability for this topic. 

 Either start/end dates or observation date can be collected.

 If observation date is collected instead of start/end dates, then it can be saved as the 

start date.

 If start/end dates are collected, then the employment status periods cannot overlap [19].

When Retirement is Collected

 The data element retirement date is required to support interoperability for this topic.

 It is recommended to be able to collect at least two self-reported retirement dates [18].

 Entry of a retirement date is unrelated to a person’s employment status and does not 

signal that the person is no longer employed or seeking employment.

When Jobs are Collected (Past or Present Jobs)

 The data elements (job) industry, (job) occupation, supervisory level, and work classification are or will soon will be required to support interoperability for this topic.

 When a coded industry value cannot be determined, it is recommended that a text value 

be collected. Either a coded value or a text value satisfies interoperability requirements. 
8 | A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers

 When a coded occupation value cannot be determined, it is recommended that a text value 

be collected. Either a coded value or a text value satisfies interoperability requirements. 

 Many people work multiple jobs; it is recommended to be able to collect data elements 

for at least two current jobs [2].

 It is recommended that it be possible to collect a history of current and past jobs [2,20].

 Voluntary work is different than unpaid work. The concept definitions available in PHIN 

VADS provide more clarification.

 For a given job, it is only necessary to retain the most recent entry for work schedule, 

average days worked per week, and average hours worked per day [5].

 A recommended feature is to provide the ability to promote/change jobs with an existing 

employer. A new job would be created with a shell of information already available from 

a previous job: employer name, address, and industry.

When Longest Held (Usual) Work is Collected

 The data elements usual industry and usual occupation are required to support interoperability for this topic.

 When a coded industry value cannot be determined, it is recommended that a text value 

be collected. Either a coded value or a text value satisfies interoperability requirements. 

 When a coded occupation value cannot be determined, it is recommended that a text value be collected. Either a coded value or a text value satisfies interoperability requirements. 

 Usual occupation is the type of work done by a person for the longest amount of time 

during his or her life, not including voluntary work. This can span industries and employers. The concept definitions available in PHIN VADS provide more clarification.

 Usual industry is the kind of business in which a person has worked for the longest time 

while in their usual occupation. The concept definitions available in PHIN VADS 

provide more clarification.

 Therefore, if manual or auto selection functionality is provided, exclude voluntary work 

positions.

 Usual work does not include voluntary work. 

 A recommended feature is to auto-populate values based on the person’s jobs, as determined by the length of time in a single type of occupation. The ability to add/update/

attest must be available.

 Duration is the total quantity of time a person has spent in the occupation they held the 

longest over the course of their life, not including intermittent periods when they were 

not working in that occupation [7]. This can span industries and employers.

 Retaining a history of longest held work is not necessary [8].

When Voluntary Work is Collected

 The data elements industry, occupation, and work classification are or will soon be 

required to support interoperability for this topic.

 When a coded industry value cannot be determined, it is recommended that a text value 

be collected. Either a coded value or a text value satisfies interoperability requirements. 
A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers | 9

 When a coded occupation value cannot be determined, it is recommended that a text value 

be collected. Either a coded value or a text value satisfies interoperability requirements. 

 It is recommended to collect voluntary work as emergency/first responder regardless of 

the number of hours worked.

 It is recommended to collect voluntary work other than emergency/first responders for 

work of 20 or more hours per week.

 The two value set concepts used to describe voluntary work are the only valid entries 

(codes VW & VWDR) for the work classification of voluntary work.

When Combat Zone Periods are Collected

 The data element combat zone period start date is required to support interoperability for 

this topic.

 The capability to collect combat zone periods is not to be limited to workers in military 

service; civilians could also work in combat zones [21].

When Work of Household Members of Minors is Collected

 The data elements industry, occupation, and household member role are or will soon be 

required to support interoperability for this topic.

 When a coded industry value cannot be determined, it is recommended that a text value 

be collected. Either a coded value or a text value satisfies interoperability requirements. 

 When a coded occupation value cannot be determined, a text value may be collected. 

Either a coded value or a text value satisfies interoperability requirements. 

 It is recommended to collect work information for any working member of the household of a minor.

 Retaining a history of current job and longest held work of a household member is not 

necessary.

 For each household member’s work information, collect only a nickname and the person’s 

relationship to the minor, not identifying information.

 This work information is intended to be a part of the minor’s medical record, not the worker.

Recommended User Interface Wording and Tips 

The following wording has been used by established surveys or NIOSH ODH collection prototypes to support self-reporting of work information. It was found to be helpful and is recommended for use.

Introduction for Collecting ODH

Because work information can be collected in a healthcare setting for different reasons, it is 

important to provide context for the collection of ODH.

Health and Work: Your work may affect your health. Your doctor or nurse can give you 

better care if he or she knows what kind of work you do. The information you provide 

becomes part of your medical or personal health record.
10 | A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers

Prompts and Examples for Industry and Occupation

These prompts and search examples supported the entry of productive search terms and selection 

of standardized industry and occupation entries. Industry and occupation can be difficult to 

collect and the use of these prompts and examples is recommended. 

Collecting Industry for a job:2

My employer mainly does/is a(n):

Collecting Industry for a volunteer position: 

My organization mainly does/is a(n):

Collecting Occupation for a job: 

My job is a(n):

Collecting Occupation for a volunteer position: 

I volunteer as a(n):

Learn More (Tip Tools) 

Employment Status and 

Retirement Date

What is “Employment Status and Retirement Date”?

Employment status is your relationship to working for pay, family 

earnings or training.

Retirement date is the month and year you retired from a job. You could be 

both employed (Employment Status) and retired from a previous job.

2

Industry is a difficult concept for some people and collecting that information soon after collecting their employer 

name and address helps. 

(Continued)
A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers | 11

Why are we asking you this?

Helps your care provider understand your financial resources, 

benefits, and demands, which can impact your health.

Jobs What is “Jobs”? 

Information about the type of work you do, your employer, and 

when you work, entered one job at a time. Your current or most 

recent job or jobs is the most valuable.

Why are we asking you this?

The work you do or have done might affect your health. Knowing 

this can help in your care.

Longest Held Work What is “Longest Held Work”?

Information about the work you have done for the longest amount 

of time throughout your working years across all of your jobs. 

Why are we asking you this?

The work you have done the most is important because sometimes 

work can have long-term effects on your health.

Volunteer Work What is “Volunteer Work”?

Work that you choose to do for others without pay or other benefits. 

Why are we asking you this?

Some types of volunteer work can harm your health. For example, volunteer 

firefighters may do tasks that can harm their health or safety.

Combat Zone Periods What is “Combat Zone Periods”?

Times when you were in a place where combat forces operated, or 

where military combat was in progress.

Why are we asking you this?

Both military and civilian workers can have their health affected 

when working in combat zones.

Work of Household 

Members of Minors

What is “Work of Household Members of Minors”?

Information about the work of people who share a home with a 

patient who is a child.

Why are we asking you this?

Some work that adults do can harm the health of children they live with.
12 | A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers

ODH Data Elements, by Topic

The following tables provide a quick reference for the recommended data elements for each ODH 

topic. Organizations may choose to collect a subset of the data elements to meet their needs. 

Employment Status

Data Element Data Type Description

Employment 

Status

Code A person's self-reported relationship to working for pay, 

family earnings, or training (e.g. having one or more jobs, 

searching for work, etc.).

Employment 

Status Start Date

Date Date employment status started or observation date.

Employment 

Status End Date

Date Date employment status ended. NULL if current or observation 

date captured.

Retirement Date

Data Element Data Type Description

Retirement Date Date Date a person self-defines as being retired, usually from a job or 

occupation.

Combat Zone Period

Data Element Data Type Description

Combat Zone 

Period Start Date

Date Date a person self-reports starting military service or 

employment in a combat zone.

Combat Zone 

Period End Date

Date Date a person self-reports ending military service or 

employment in a combat zone.

Jobs (Interoperability Standards: Past or Present Job)

Data Element Data Type Description

Job Start Date Date Date that this job started.

Job End Date Date Date that this job ended. NULL if current

Current Flag Boolean Identifies present job.

Occupation Code Self-reported type of work done in this work situation or 

position (i.e., job).

(Continued)
A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers | 13

Data Element Data Type Description

Occupation 

Description

Text Self-reported brief description or title for this job’s occupation; 

only captured if a value set term is not identified.

Industry Code Self-reported kind of business, i.e., primary business activity, 

conducted by the employing organization for this work situation 

or position (i.e., job). For voluntary work, this is the primary 

activity of the organization that engaged the person.

Industry 

Description

Text Self-reported brief description or title for this job’s industry; 

only captured if a value set term is not identified. 

Employer Name Text Company, organization, or individual that provides compensation (either direct or indirect) for this job, as reported by the 

person. For military, this is the name of the home base. For 

voluntary work this is the organization that engaged the person.

Employer Location Address Legal mailing address of the employer for this job, as 

reported by the person. Duty station for military workers.

Work 

Classification

Code A characterization of the arrangement between an 

employer and a person for a current work situation or 

volunteer position, such as 'paid work, self-employed' 

or 'voluntary work in disaster/emergency response', as 

reported by the person.

Supervisory Level Code An indicator of responsibilities of a person's job for directing 

work and personnel management, as reported by the person. 

Pay grade represents supervisory or personnel management 

responsibilities for U.S. military service, because it conveys 

similar meaning across branches of service. 

Work Schedule Code The typical arrangement of working hours for a person's 

job, as reported by the person.

Daily Work Hours Number Average number of hours per day or shift worked at this 

job, as reported by the person.

Weekly Work Days Number Average number of days in a week worked at this job, as 

reported by the person.

Job Duty Text Brief description of a regular action performed at this job, as 

reported by the person; a person can list multiple job duties.

Occupational 

Hazard

Text Brief description of a hazard specific to the work or work 

environment and with which the person might come in 

contact at this job, as reported by the person. A person can 

list multiple hazards. A hazard is a source of potential harm 

to a person’s physical or mental health. Hazards can be 

biological, physical, psychological, chemical, or radiological 

in nature.

Jobs (Interoperability Standards: Past or Present Job) Continued
14 | A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers

Longest Held Work (Interoperability Standards: Usual Work)

Data Element Data Type Description

Occupation Code Self-reported type of work performed for the longest 

amount of time during a person’s life, regardless of the 

job currently held and regardless of whether or not the 

person performed this type of work for a continuous time.

Occupation 

Description

Text Self-reported brief description or title for usual occupation; 

only captured if a value set term is not identified.

Industry Code Self-reported kind of business, i.e., primary business activity, 

in which a person has worked the longest while in the usual 

occupation.

Industry 

Description

Text Self-reported brief description or title for usual industry; 

only captured if a value set term is not identified.

Duration in Years Number Self-reported total of all periods of time a person has 

spent in their usual occupation as of the date recorded, 

not including any intermittent period(s) where the person 

was not working in that occupation.

Start Year Date Self-reported year that a person started working in their 

usual occupation.

Voluntary Work for Emergency/First Responders (Interoperability Standards: Past or Present Job)

Data Element Data Type Description

Job Start Date Date Date that this job started.

Job End Date Date Date that this job ended. NULL if current

Current Flag Boolean Identifies present job.

Occupation Code Self-reported type of work done in this work situation or 

position (i.e., job).

Occupation 

Description

Text Self-reported brief description or title for this job’s occupation; 

only captured if a value set term is not identified.

Industry Code Self-reported kind of business, i.e., primary business activity, 

conducted by the employing organization for this work situation 

or position (i.e., job). For voluntary work, this is the primary 

activity of the organization that engaged the person.

Industry 

Description

Text Self-reported brief description or title for this job’s industry; 

only captured if a value set term is not identified. 

(Continued)
A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers | 15

Data Element Data Type Description

Organization 

Name

Text Company, organization, or individual that provides 

compensation (either direct or indirect) for this job, as 

reported by the person. For military, this is the name of 

the home base. For voluntary work this is the organization 

that engaged the person.

Organization 

Location

Address Legal mailing address of the organization for this job, as 

reported by the person.

Work 

Classification

Code Concept Code: VWDR

Concept Name: Voluntary Disaster Response/Emergency 

Services

Supervisory Level Code An indicator of responsibilities of a person's job for directing 

work and personnel management, as reported by the person. 

Pay grade is used to represent supervisory or personnel 

management responsibilities for U.S. military service, 

because it conveys similar meaning across branches of 

service. 

Work Schedule Code The typical arrangement of working hours for a person's 

job, as reported by the person.

Daily Work Hours Number Average number of hours per day or shift worked at this 

job, as reported by the person.

Weekly Work Days Number Average number of days in a week worked at this job, as 

reported by the person.

Job Duty Text Brief description of a regular action performed at this job, as 

reported by the person; multiple job duties can be listed.

Occupational 

Hazard

Text Brief description of a hazard specific to the work or work 

environment and with which the person might come in 

contact at this job, as reported by the person. Multiple 

hazards can be listed. A hazard is a source of potential 

harm to a person’s physical or mental health. Hazards can 

be biological, physical, psychological, chemical, or radiological in nature. 

Voluntary Work (Excluding Emergency/First Responders) of 20 or more hours per week 

(Interoperability Standards: Past or Present Job)

Data Element Data Type Description

Job Start Date Date Date that this job started.

Job End Date Date Date that this job ended. NULL if current

Voluntary Work for Emergency/First Responders

(Interoperability Standards: Past or Present Job) Continued

(Continued)
16 | A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers

Data Element Data Type Description

Current Flag Boolean Identifies present job.

Occupation Code Self-reported type of work done in this work situation or 

position (i.e., job).

Occupation 

Description

Text Self-reported brief description or title for this job’s occupation; 

only captured if a value set term is not identified.

Industry Code Self-reported kind of business, i.e., primary business activity, conducted by the employing organization for this work 

situation or position (i.e., job). For voluntary work, this is the 

primary activity of the organization that engaged the person.

Industry 

Description

Text Self-reported brief description or title for this job’s industry; 

only captured if a value set term is not identified. 

Work 

Classification

Code Concept Code: VW

Concept Name: Voluntary work (20 or more hours/wk and 

excludes Disaster Response/Emergency Services)

Work of Household Member of a Minor – Current Job

(Interoperability Standards: Past or Present Job)

Data Element Data Type Description

Household 

Member Role

Code Designates the relationship between the patient and the 

person whose job or work is identified.

Household 

Member Nickname 

Text User defined nickname or description of a unique household member. 

Occupation Code Self-reported type of work done in this work situation or 

position (i.e., job) by the household member.

Occupation 

Description

Text Self-reported brief description or title for this job’s occupation; 

only captured if a value set term is not identified.

Industry Code Self-reported kind of business, i.e., primary business activity, conducted by the employing organization for this work 

situation or position (i.e., job) of the household member. 

For voluntary work, this is the primary activity of the 

organization that engaged the household member.

Industry 

Description

Text Self-reported brief description or title for this job’s industry; 

only captured if a value set term is not identified. 

Employer Name Text Company, organization, or individual that provides 

compensation (either direct or indirect) for this job of the 

household member, as reported by the person. For military, 

this is the name of the home base. For voluntary work this 

is the organization that engaged the household member.

Voluntary Work (Excluding Emergency/First Responders) of 20 or more hours per week 

(Interoperability Standards: Past or Present Job) Continued
A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers | 17

Work of Household Member of a Minor – Longest Held Work

(Interoperability Standards: Usual Work)

Data Element Data Type Description

Household 

Member Role

Code Designates the relationship between the patient and the 

person whose job or work is identified.

Household 

Member Nickname 

Text User defined nickname or description of a unique household member. 

Occupation Code Self-reported type of work done in this work situation or 

position (i.e., job) by the household member.

Occupation 

Description

Text Self-reported brief description or title for this job’s occupation; 

only captured if a value set term is not identified.

Industry Code Self-reported kind of business, i.e., primary business activity, conducted by the employing organization for this work 

situation or position (i.e., job) of the household member. 

For voluntary work, this is the primary activity of the 

organization that engaged the household member.

Industry 

Description

Text Self-reported brief description or title for this job’s industry; 

only captured if a value set term is not identified. 

Duration in Years Number Self-reported total of all periods of time a person has 

spent in their usual occupation as of the date recorded, 

not including any intermittent period(s) where the person 

was not working in that occupation.

Start Year Date Self-reported year that a person started working in their 

usual occupation.
This page intentionally blank.
A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers | 19

Appendix A

Select Conformance Criteria from the 

Work and Health Functional Profile

Description

The following table lists criteria to conform to the recommendations and suggestions found in “A 

Guide to the Collection of Occupational Data for Health.” These and other conformance criteria for 

managing and using ODH (e.g., maintaining, rendering, exchanging, analyzing, etc.) are expressed 

in the HL7® EHRS-FM Release 2 Functional Profile: Work and Health, Release 1 – U.S. Realm, 

Informative Document 2019 Apr (WHFP), sponsored by the HL7 Electronic Health Records Work 

Group (http://www.hl7.org/implement/standards/product_brief.cfm?product_id=498).

Key

The Reference Number below is used in the Guide to identify the supporting criterion. The 

ID# plus the CC# should be used to cross-reference the criterion in the WHFP. Comments

have been added for clarification as needed.
20 | A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers

Select Conformance Criteria from the Work and Health Functional Profile

Reference 

Number ID# CC# Conformance Criterion Comment

1 CP.1.10 21 IF the patient is a newborn or a minor, THEN the 

system SHALL provide the ability to manage the 

newborn’s or minor’s maternal and paternal current/most recent, and “usual” (accounting for the 

greatest number of working years) work information 

including, at a minimum: occupation, industry, current employer name(s). For example: Paternal work 

classification is “self-employed” industry is “taxi 

transportation” with occupation ”taxi driver.”

For clarification, all data 

elements for a job may 

be collected.

2 CP.1.10.1 1 The system SHALL provide the ability to manage the 

patient’s (or decedent’s) current/most recent and 

past work, including: current work classification, occupation, industry, name and address of business of 

employment, start/end dates, and supervisory level.

3 CP.1.10.1 2 The system SHALL provide the ability to manage data 

for two or more current/most recent jobs, including 

volunteer jobs of 20 or more hours per week and/or 

emergency/disaster response volunteer jobs.

4 CP.1.10.1 3 In the U.S., the system SHOULD provide the ability 

to manage numerical data elements (to one decimal 

place) for hours-worked-per-day and days-workedper-week for each current/most recent job.

5 CP.1.10.1 4 The system SHOULD provide the ability to manage 

only the most recently entered work schedule, hours 

worked per day, days worked per week for each job. 

For example, if a person changes schedules often, 

we wouldn’t want to overburden the provider, the 

patient, and the system with several versions of the 

work schedule when the most recent is the most 

clinically relevant. 

6 CP.1.10.1 5 In the U.S., IF the system manages work classification and work schedule for current/past jobs, THEN 

the system SHALL provide the ability to use the U.S. 

Centers for Disease Control and Prevention Public 

Health Information Network Vocabulary Access and 

Distribution System (PHIN VADS) value sets.

(Continued)
A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers | 21

Reference 

Number ID# CC# Conformance Criterion Comment

7 CP.1.10.1 6 The system SHALL provide the ability to manage the 

patient’s usual occupation with related industry start 

year (month, if known, and year) and duration (in 

years, to one decimal) for a person’s usual occupation. Duration is defined as the total of all periods of 

time spent in that type of work, not including intermittent period(s) where the person was not working 

in that occupation. Note: usual occupation may be a 

combination of multiple jobs.

8 CP.1.10.1 7 The system SHOULD provide the ability to render 

only the most recently recorded usual occupation 

and only the most recently recorded usual industry.

9 CP.1.10.1 8 The system SHALL provide the ability to capture a 

person’s usual (longest-held) occupation and usual 

industry only for paid or otherwise compensated 

work (i.e., not for unpaid or voluntary work).

For clarification, usual 

occupation should include 

unpaid work and exclude 

voluntary work.

10 CP.1.10.1 9 The system SHOULD provide the ability to present a 

notification to the user that voluntary work is not to 

be considered in determining a usual occupation and 

a usual industry.

11 CP.1.10.1 10 The system SHALL provide the ability to manage 

work information/ODH using standards-based 

coding schemes. For example: CDC_CensusIndustry 

for industry codes and CDC_CensusOccupation for 

occupation codes are good standards-based coding 

schemes in the U.S.

12 CP.1.10.1 13 The system SHALL provide the ability to link all data 

pertaining to a single job (i.e., data about a job 

cannot be mixed up with other job data.)

13 CP.1.10.1 14 The system SHALL provide the ability to render work 

information per job (i.e., a list of occupations and a 

separate list of industries is not useful; occupation 

and industry must be displayed together for each 

job).

14 CP.1.10.1 22 The system SHOULD provide the ability to integrate 

tool(s) that capture structured industry and occupation data elements (e.g. using the CDC_Census 

coding system), as well as other Occupational Data 

for Health (ODH) elements (e.g., employment status, 

work schedule, hours worked per day, and days 

worked per week).

Select Conformance Criteria from the Work and Health Functional Profile (Continued)

(Continued)
22 | A Guide to the Collection of Occupational Data for Health: Tips for Health IT System Developers

Reference 

Number ID# CC# Conformance Criterion Comment

15 CP.1.10.1 24 The system MAY provide the ability to manage free 

text comments for job duties and work exposures that 

are associated with a past or present job. Example: Job 

Duties = clean the popcorn flavoring tanks. Exposures 

= diacetyl.

16 CP.1.10.1 28 The system SHOULD provide the ability to hide ODH 

for patients who are under the age of 5 years.

17 CP.1.10.1 34 The system SHALL provide the ability to manage ODH 

in social history, regardless of where it is collected 

(e.g., even if collected at registration/admission)

18 CP.1.10.1 39 The system SHALL provide the ability to capture, store, 

update, render, exchange, and manage-data-visibility 

for at least two start dates for a person’s self-identified 

state of being “retired”.

19 CP.1.10.1 43 The system SHALL provide the ability to manage one 

and only one employment status for a given time period, 

including start/end dates. Example: A person may have 

multiple jobs but will only have one employment status 

(i.e. employed, unemployed, or not in labor force).

20 CP.1.10.1 44 The system SHALL provide the ability to maintain a 

history of past and present jobs.

21 CP.1.10.1 45 The system SHALL provide the ability to manage a list 

of date range(s) (i.e., start/end dates) for time spent 

working in a hostile area or combat zone, regardless 

of military service (e.g., defense contractors may be 

working in combat zones).

Select Conformance Criteria from the Work and Health Functional Profile (Continued)
This page intentionally blank.
Promoting productive workplaces through 

safety and health research

DHHS (NIOSH) Publication No. 2022-101

DOI: https://doi.org/10.26616/NIOSHPUB2022101