National Institute for Occupational Safety and Health

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Public Health Service

Centers for Disease Control and Prevention

National Institute for Occupational Safety and Health

National Occupational Research Agenda

National

Occupational

Research

Agenda

Update May, 1999

21 Priorities for the 21st Century
TEAMS

Richard Duffy (International Association of Fire

Fighters)

Mike Flynn (University of North Carolina, Chapel Hill)

Christina Gomberg (NIOSH)

Bill Heitbrink (NIOSH)

Bill Kojola (AFL - CIO)

Steve Mallinger (Occupational Safety and Health

Administration)

John Meagher (American Industrial Hygiene

Association)

Ernest Moyer (NIOSH)

Daniel K. Shipp (Industrial Safety Equipment

Association)

Emerging Technologies

Aaron Schopper (NIOSH) aws0@cdc.gov

Nicholas Ashford (Massachusetts Institute of

Technology)

Kenneth D. Brock (Safety Mgt. Consultant)

Tai Chan (General Motors Corporation)

David Conover (NIOSH)

Jack Finklea (National Center for Injury Prevention and

Control/CDC and CPWR)

James Jones (NIOSH)

Raymond Lovett (The National Environmental

Education and Training Center)

Paul Schlecht (NIOSH)

Randal P. Schumacher (The Jefferson Group)

John Sparks (Environmental Protection Agency)

Jeffrey Welsch (NIOSH)

Exposure Assessment Methods

Mary Lynn Woebkenberg (NIOSH) mlw2@cdc.gov

Martin T. Abell (NIOSH)

Thomas W. Armstrong (Exxon Biomedical Sciences,

Inc.)

Gayle DeBord (NIOSH)

Dennis W. Groce (NIOSH)

Mike Keane (NIOSH)

Paul Knechtges (Naval Medial Research &

Development Command/DOD)

David K. Pegram (Department of Energy)

Beth D. Reh (NIOSH)

Chris M. Reh (NIOSH)

Bonnie Rogers (University of North Carolina)

Gary Spies (Monsanto Company)

Mark Stenzel (Occidental Chemical Corporation)

James Weeks (George Washington University)

Kenneth L. Williams (NIOSH)

Fertility & Pregnancy Abnormalities

Teresa Schnorr (NIOSH) ths1@cdc.gov

Coleen Boyle (National Center for Environmental

Health/CDC)

Kenneth Bridbord (Fogarty International Center/ NIH)

Sally Perreault Darney (Environmental Protection

Agency)

George Daston (Procter & Gamble)

Barbara Grajewski (NIOSH)

Ronald Gray (Johns Hopkins University)

Christina Lawson (NIOSH)

Barbara MacKenzie (NIOSH)

Michele Marcus (Emory University)

Melissa McDiarmid (University of Maryland)

Eisuke Murono (NIOSH)

Steven Schrader (NIOSH)

Michael Shelby (National Institute of Environmental

Health Sciences/NIH)

Health Services Research

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

Joan Buchanan (Harvard University)

William Bunn (Navistar International Transportation

Corporation)

Mary A. Cummings (Agency for Health Care Policy and

Research)

Janice Gordon (University of Maryland)

Jay Himmelstein (University of Massachusetts)

Ted Katz (NIOSH)

Janice Klink (NIOSH)

Kent W. Peterson (Occupational Health Strategics,

Inc.)

Kathleen Rest (University of Massachusetts)

Linda Rudolph (California Department of Industrial

Relations)

Rosemary Sokas (NIOSH)

Gregory Wagner (NIOSH)

Hearing Loss

John Franks (NIOSH) jrf@cdc.gov

Patricia Brogan (Wayne State University)

Alton Burks (NIOSH)

John Casali (Virginia Tech University)

Steven N. Hacker (Solutia, Inc.)

Howard Hoffman (National Institute on Deafness &

Communication Disorders/NIH)

Dan Johnson ( ANSI/ISO Standards)

James Lankford (Northern Illinois University)

Carol Merry (NIOSH)

Anthony Miltich (Digital Hearing Systems Corporation)

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

and Preventative Medicine)

Mark R. Stephenson (NIOSH)

Ed Thimons (NIOSH)

Randy Tubbs (NIOSH)

Indoor Environment

Mark Mendell, NIOSH mfmo@cdc.gov

Darryl Alexander (American Federation of Teachers)

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

Bill Fisk (Lawrence Berkeley National Laboratory/DOE)

John Girman (Environmental Protection Agency)

Cindy Hines (NIOSH)

Paul Jensen (NIOSH)

Kay Kreiss (NIOSH)

Hal Levin (Building Ecology Research Group)

Don Milton (Harvard University)

Mary Prince (NIOSH)

Larry Rexroat (General Services Administration)

Ken Wallingford (NIOSH)

Infectious Diseases

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

James August (American Federation of State, County,

and Municipal Employees)

Jordan Barab (Occupational Safety and Health

Administration)

Yvonne Boudreau (NIOSH)

Joel Breman (Fogarty International Center/NIH)

George W. Counts (Division of Microbiology &

Infectious Diseases/NIAID)

Yvette Davis (National Center for HIV, STD and TB

Prevention/ CDC)

William G. Denton (Denton International)

June Fisher (TDICT Project, Trauma Foundation, San

Francisco General Hospital)

Janice Huy (NIOSH)

(continued inside back cover)

NORA Teams

Bold type indicates team leaders

Allergic & Irritant Dermatitis

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

G. Frank Gerberick (The Proctor and Gamble

Company) gf@pg.com

Stephen P. Berardinelli (NIOSH)

David I. Bernstein (University of Cincinnati)

Raymond E. Biagini (NIOSH)

Mark F. Boeniger (NIOSH)

Carol A. Burnett (NIOSH)

Richard Fenske (University of Washington)

James S. Johnson (Lawrence Livermore National

Laboratory)

Michael Luster (NIOSH)

Alan N. Moshell (National Institute of Arthritis and

Musculoskeletal and Skin Diseases/ NIH)

Albert E. Munson (NIOSH)

James S. Taylor (Cleveland Clinic)

Susan Q. Wilburn (American Nurses Association)

Asthma & Chronic Obstructive Pulmonary Disease

Kathleen Kreiss (NIOSH) kxk2@cdc.gov

John Balmes (University of California, San Francisco)

Robert Castellan (NIOSH)

Jeffrey Fedan (NIOSH)

Paul Henneberger (NIOSH)

Paul Hewett (NIOSH)

Suzanne Hurd/Gail Wienmann (National Heart, Lung,

and Blood Institute/NIH)

Susan Kennedy (University of British Columbia)

Hillel Koren (Environmental Protection Agency)

Edward Petsonk (NIOSH)

Greg Wagner (NIOSH)

David Wegman (University of Massachusetts, Lowell)

Cancer Research Methods

Paul Schulte (NIOSH) pas4@cdc.gov

Elizabeth M. Ward (NIOSH)

Steve Bayard (Occupational Safety and Health

Administration)

Mary Ann Butler (NIOSH)

Dave Dankovic (NIOSH)

Ann F. Hubbs (NIOSH)

Carol Jones (Mine Safety & Health Administration)

Myra Karstadt (Environmental Protection Agency)

Gregory L. Kedderis (Chemical Industry Institute of

Toxicology)

Ronald Melnick (National Institute of Environmental

Health Sciences/NIH)

Paul Brandt-Rauf (Columbia University)

Carrie A. Redlich (Yale University)

Nathaniel Rothman (National Cancer Institute/NIH)

Christine Sofge (NIOSH)

Michael Sprinkler (International Chemical Workers

Union Council)

Mark Toraason (NIOSH)

Ainsley Weston (NIOSH)

Control Technology & Personal Protective

Equipment

Lawrence Reed (NIOSH) ler3@cdc.gov

Dale Avery (NIOSH)

Steven Berardineli (NIOSH)

Donald Campbell (NIOSH)

David deVries (American Society of Safety Engineers)
National Institute for Occupational Safety and Health

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Public Health Service

Centers for Disease Control and Prevention

National Institute for Occupational Safety and Health

National

Occupational

Research

Agenda

Update May, 1999

21 Priorities for the 21st Century
Table of Contents

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

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

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

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

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

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

NIOSH NORA Investment by Priority Research Area ........................ 6

Other Federal Funding ................................................................ 8

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

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

Tracking Partnership Products ................................................................ 15

Requests for Applications (RFAs) ................................................ 15

Team Products ........................................................................ 15

Tracking the Literature and Recognition of NORA ...................................... 17

Bibliometrics ............................................................................ 17

Surveys of NORA Effectiveness .................................................. 18

Other Tracking Methods............................................................ 18

Partnership ......................................................................................................... 19

NORA Partnerships ............................................................................... 19

NORA—A Model for Partnership .............................................................. 21

NORA Partnership Award ....................................................................... 22

Guiding NORA Implementation .............................................................................. 23

Liaison Committee ................................................................................ 23

Federal Liaison Committee ..................................................................... 23

NIOSH/NORA Partnership Structure ........................................................ 25

Partnership Teams ................................................................................ 26

Team Summaries ................................................................................ 26

Kudos for NORA .................................................................................................. 33

NORA Milestones ................................................................................................ 35

Summary ........................................................................................................... 37
VISION

Message from NIOSH

Evidence of the continued success of the National Occupational Research Agenda

(NORATM) can be found in this third annual NORA Update. Funding and support of NORA,

both intramurally and extramurally, increase yearly. The NORA grants program has also

been a huge success. In FY 98, NIOSH and four NIH partners awarded 50 grants totaling

about $8 million dollars in ten NORA priority areas. This represents the largest ever single

infusion of extramural funding for investigator-initiated occupational safety and health

research. The FY 99 Request for Applications (RFA) for NORA research looks just as

promising. NIOSH and five NIH Institutes are expected to award more than $7.5 million in

eight NORA priority research areas. Despite these successes, we and our partners are

aware that extramural researchers still face disappointing odds when submitting their

applications in these high priority areas — with current funding allowing only 14% of

approved grants to be funded (compared to a success rate of over twice that in other

areas funded by the NIH). It is our goal to increase success rates in the next few years.

While the accomplishments are captured in this document, the true essence of NORA will

be found at the NORA Symposium 1999: Partnership for Research. This second

symposium highlights the successes of NORA and brings together over 300 NORA

participants and supporters from across the country. It is this strong public-partnership

network that has made NORA a success. Individuals and organizations throughout

government, labor, industry, and academia continue to believe in the importance of and

need for this national agenda.

As the title suggests, this year’s theme is partnership. Partners from many sectors will

discuss their experiences in using NORA to improve worker safety and health.

The wide range of NORA partners willing to speak on behalf of NORA says more about the

universality and usefulness of NORA than any words I can write. Also at the Symposium,

the first NORA Partnership Award For Worker Health and Safety will be presented

to the Asphalt Partnership. This unique collaboration of government, industry, and labor

embodies the true spirit of NORA partnership. This partnership was also selected as a

finalist in the Ford Foundation 1998 Innovations in American Government awards

program.

We decided to honor partnership because we realize that it is through continued partnership that NORA will achieve its full potential. I’d like to think that the full potential is beyond

our current optimistic thinking; if NORA’s first three years are any indication, I may just be

right.

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

Director

National Institute for Occupational Safety and Health

NIOSH Vision

Delivering on the Nation’s promise:

safety and health at work for all

people...through research and

prevention.

NORA Vision

No single organization has the

resources necessary to conduct

occupational safety and health

research to adequately serve the

needs of workers in the United

States. These constraints mandate

that the entire occupational safety

and health community engage in

collaboration and coordination of its

resources. The National Institute for

Occupational Safety and Health

(NIOSH) and its public and private

partners developed the National

Occupational Research Agenda

(NORA) to provide a framework to

guide occupational safety and health

research into the next decade—for

NIOSH and the entire occupational

safety and health community.

National Occupational Research Agenda 1
LIAISONLiaison Committee Perspective

As chair of the NORA Liaison Committee I have closely watched the evolution of NORA over

the past four years. I’m proud to say that I have been involved with this process from its’

creation though the remarkable successes we see today.

The Liaison Committee embodies the partnership theme reflected in this year’s NORA

Symposium. Our members represent the diverse nature of the field of occupational safety

and health research with representatives from industry, labor, academia, professional

organizations and government. It is through this spirit of partnership and commitment to

NORA that the committee has been able to function so successfully. I’d like to thank the

committee for their dedication and work over the last year.

The Liaison Committee continues to play an active role in tracking the progress of NORA.

Through the Measures and Goals subcommittee, our members have undertaken a survey

to gauge the effectiveness and reach of NORA in associations (see details on page 23).

This year, the Liaison Committee met with the leaders of the NORA Partnership Teams for

the first time. This was a wonderful opportunity to hear first hand the accomplishments

and challenges facing the 20 NORA teams.

The committee is impressed with and supportive of the NORA implementation activities,

especially the NORA grants process. The grant process provides a wonderful example of

the role partnerships can play in advancing our goals. Continued support from NORA

partners will ensure an even more remarkable impact on occupational safety and health

research. I would like to use this opportunity to encourage applications for a NORA-related

research award. The American Association of Occupational Health Nurses and the

American College of Occupational and Environmental Medicine are sponsoring a joint

research award with selection criteria based on NORA priority areas. The purpose of the

award is to recognize joint research projects conducted by collaborative research teams

of nurses and physicians for the purpose of improving the knowledge base of occupational

and environmental health. The deadline for submissions is December 1, 1999. Please

contact Margaret Anderson at AAOHN (1-800-241-8014 x 120, Margaret@aaohn.org) for

more details.

Many individuals and organizations have contributed to the success of NORA. The Liaison

Committee is happy to have been part of this example of true partnership at work.

Bonnie Rogers, DrPH, COHN-S, FAAN

Chair, NORA Liaison Committee

American Association of Occupational Health Nurses

Liaison Committee

James August

American Federation of State County

and Municipal Employees

Robin Baker

American Public Health Association

Thomas F. Bresnahan

American Society of Safety Engineers

Drew Brodkin

Association of Occupational and

Environmental Clinics

William B. Bunn

Navistar International Transportation

Corporation

Tai Chan

General Motors Corporation

William Greaves

American College of Occupational and

Environmental Medicine

Monroe Keyserling

Association of University Programs in

Occupational Health and Safety

Gwendolyn Keita

American Psychological Association

Sandra Lange

National Institute of Environmental Health

Sciences

Tom Leamon

Liberty Mutual Insurance Company

Wayne Lednar

Eastman Kodak Company

Pamela Tau Lee

Labor Occupational Health Program at U.C.

Berkeley

Joseph Main

United Mine Workers of America

Franklin Mirer

United Auto Workers

Carolyn Phillips

Chemical Manufacturers Association

Robert J. Pleasure

Center to Protect Workers’ Rights

Beth Resnick

National Association of County

 and City Health Officials

James C. Rock

American Industrial Hygiene Association

Gerard Scannell

National Safety Council

Bonnie Rogers (Committee Chair)

American Association of Occupational

Health Nurses

Margaret M. Seminario

AFL-CIO

Frank White

Organization Resources Counselors, Inc.

2 National Occupational Research Agenda
BACKGROUND

Background - An Agenda for the 21st Century

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

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

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

Approximately 500 organizations and individuals outside NIOSH provided input into the

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

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

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

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

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

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

of the Agenda also recognized the need to address changes in the U.S. workplace as well

as the increasingly diversified workforce. The distribution of jobs in our economy continues

to shift from manufacturing to services. Longer hours, compressed work weeks, shift

work, reduced job security, and part-time and temporary work are realities of the modern

workplace. By the year 2005, the U.S. workforce will grow to an estimated 147 million,

minorities will represent 28 percent of the workforce, and women approximately 48

percent.

 NORA Priority Research Areas

 CATEGORY PRIORITY RESEARCH AREAS

 Disease and Injury Allergic and Irritant Dermatitis

Asthma and Chronic Obstructive Pulmonary Disease

Fertility and Pregnancy Abnormalities

Hearing Loss

Infectious Diseases

Low Back Disorders

Musculoskeletal Disorders of the Upper Extremities

Traumatic Injuries

 Work Environment and Emerging Technologies

 Workforce Indoor Environment

Mixed Exposures

Organization of Work

Special Populations at Risk

 Research Tools Cancer Research Methods

 and Approaches Control Technology and Personal Protective Equipment

Exposure Assessment Methods

Health Services Research

Intervention Effectiveness Research

Risk Assessment Methods

Social and Economic Consequences of Workplace

 Illness and Injury

Surveillance Research Methods

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

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

Each day, an average of 9,000 U.S. workers sustain disabling injuries on the job, 16

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

diseases.

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

published in 1997 showed that in 1992, direct and indirect costs of occupational injuries

and illnesses totaled $171 billion ($145 billion for injuries and $26 billion for diseases).

These costs compare to $33 billion for AIDS, $67.3 billion for Alzheimer’s Disease,

$164.3 billion for circulatory diseases, and $170.7 billion for cancer (see graphic below).

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

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

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

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

areas.

In the first three years of the implementation of NORA, NIOSH and its partners have

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

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

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

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

a “shotgun” approach to tackling major problems. Through NORA, we hope to better

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

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

4 National Occupational Research Agenda
TRACKING

Measuring the Success of NORA

Tracking Research Funding in NORA

Priority Areas

NIOSH Funding

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

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

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

economic resources in each priority area.

In FY 96, at the time the Agenda was unveiled, the NIOSH baseline investment in the NORA

priority areas was $15.4 million out of an overall operating budget of $165.3 million

(approximately 9 percent of the FY 96 budget). Of this, $8.7 million was devoted to

intramural research (NIOSH-conducted) and cooperative agreements (NIOSH-funded

extramural research that NIOSH initiates and participates in) and $6.7 million for research

grants (extramural investigator-initiated projects). A redirection of resources in FY 97

nearly doubled this investment to $28.1 million. A new $5 million special Congressional

appropriation to NIOSH in FY 98 for NORA, coupled with additional reinvestment of baseline

monies into NORA priority areas, resulted in $46.9 million of research (about 25 percent of

the budget) in NORA priority areas for FY 98.

National Occupational Research Agenda

NIOSH NORA Investment

5

In FY 99, continued Congressional support for NORA as well as ongoing internal resource

allocation has resulted in an estimated $62.4 million of NIOSH research funds (31 percent

of the budget) directed at NORA priority areas. Such an increase is tangible evidence of

NIOSH’s commitment to NORA. This shift is particularly notable given existing Congressional mandates and obligations that limit how much of the NIOSH budget can be

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

are “real” (rather than merely a reporting artifact) using consistent definitions and an

independent evaluation team to assess projects for NORA-relatedness.
6 National Occupational Research Agenda

NIOSH NORA Investment by Priority Research Area, FY 96-99

Disease and Injury

Work Environment and Workforce
National Occupational Research Agenda 7

Research Tools and Approaches

*FY99 numbers are estimates.
TRACKING

Other Federal Funding

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

biennially. The first survey, covering FY 96, provided a baseline identifying a total of only

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

total federal investment of $204 million. The same federal agencies and NIOSH reported

spending $210 million for all occupational safety and health research in FY 98. The

second survey, covering FY 98, welcomed five new federal respondents. Even with the

additional respondents, the total spending in occupational safety and health research by

federal agencies in FY 98 was only $218 million (NIOSH at $187 million and other federal

agencies at $31 million).

The FY 96 baseline for NORA-related research from non-NIOSH federal sources was about

$15 million. The same respondents report having spent $16.2 million on NORA-related

research in FY 98. The new respondents bring the non-NIOSH federal total spent on

NORA-related research in FY 98 to $23.4 million.

8 National Occupational Research Agenda

Federal OS&H Spending FY 96 and FY 98

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

safety and health research.

*
National Occupational Research Agenda 9 TRACKING

In FY 98 like FY 96, there is no reported spending in the priority area of Indoor Environment. There are reported decreases in spending by non-NIOSH federal agencies in some

priority areas, e.g. Fertility & Pregnancy Abnormalities and Traumatic Injuries and

increased spending is seen in others, e.g. Allergic & Irritant Dermatitis and Hearing Loss.

In sum, there has been an increase overall at the federal level in NORA-related research,

but this has in general come in redirection to rather than new resources in NORA priority

areas. Federal partners will continue to perform the survey biennially, with the next survey

assessing FY 2000 expenditures.

Federal NORA Spending FY 96 and FY 98
10 National Occupational Research Agenda

Federal NORA Spending by Priority Area
National Occupational Research Agenda 11 TRACKING

Sector-Specific Funding

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

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

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

and agriculture) was to apply a matrix approach of coordinated research in some or all of

the 21 priority areas, as appropriate for each sector. As such, it is clear that NORA is

having an impact on sector-focused research. In FY 99, within NIOSH, nearly $30 million is

being allocated to NORA research in agriculture ($9 million), construction ($11.2 million),

and mining ($9.3 million).

NORA Investments by Sector, FY 99*
National Occupational Research Agenda TRACKING

NORA Grant Funding

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

workplace injury and illness. In October 1998, NIOSH and four federal partners awarded

the largest infusion of funding ever by the federal government for extramural occupational

safety and health research. NIOSH joined with the National Heart, Lung, and Blood

Institute (NHLBI), the National Institute on Aging (NIA), the National Institute of Environmental Health Sciences (NIEHS), and the National Institute of Arthritis and Musculoskeletal and

Skin Disorders (NIAMS) to award about $8 million in grants in ten NORA priority research

areas, with NIOSH awarding 38 grants related to the 1998 NORA Request for Announcements (RFA) and the partner NIH Institutes awarding 12 grants (see listing page 14).

FY 98 NORA Grant Awards

12

In 1999, NIOSH and six other federal agencies announced two new RFAs totaling at least

$9 million in nine priority research areas. In March 1999, NIOSH, in partnership with five

other NIH Institutes, announced a new RFA to target grant funding in eight NORA priority

research areas (committing to at least $7.5 million in grant funds). The NIH cosponsors

for this FY 99 NORA grants initiative are: the National Cancer Institute (NCI), NHLBI, NIA,

the National Institute on Deafness and Other Communication Disorders (NIDCD), and

NIEHS.
National Occupational Research Agenda TRACKING

The NIOSH/NIH FY 99 Request for Applications (RFA) invites proposals for research

related to:

• Intervention effectiveness research, i.e., evaluation of safety and health interventions

to protect workers from job-related injuries and illnesses. Proposals can be in any

industry sector, but NIOSH will give special consideration to projects in agriculture,

construction, the service industry (especially health care), and mining.

• Fertility and pregnancy abnormalities associated with occupational exposures.

• Occupational hearing loss, specifically prevention and intervention, including noise

control.

• Methodologies for assessing exposures to hazardous biological, chemical, and

physical agents, including assessment of complex mixtures.

• Methodologies for injury and illness surveillance in the workplace.

• The aging workforce as a special population at risk of job-related injuries and illnesses.

• Asthma and chronic obstructive pulmonary disease.

• Issues in the organization of work relating to demanding work schedules, sleep

disorders, and/or the risk of occupational illness and injury.

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

establish, discover, develop, elucidate, or confirm information relating to occupational

safety and health; (2) demonstration project grants for projects designed to address the

technical or economic feasibility of implementing a new or improved procedure, method,

technique, or system for preventing occupational safety and health problems; and (3) pilot

study grants for preliminary evaluation in developing the foundations for future, more

comprehensive studies.

In April 1999, NIOSH, the Environmental Protection Agency, and the National Cancer

Institute announced the availability of $1.5 million for grant applications for research that

focuses on the development of cancer risk assessment methods and practices. An

emphasis is placed on the development of new methods and practices that reduce the

uncertainties associated with cancer risk assessment, especially uncertainties that are

encountered in extrapolating from animal species to humans. Studies that propose

refinement, validation, or invalidation of existing methods and practices are also acceptable

if they will result in a significant reduction in uncertainty.

NIOSH also committed additional resources in FY 99 to investigator-initiated awards in all

21 priority areas through its regular grants process. NORA is achieving its goals of

improved partnership and increased research in the 21 priority research areas.

13
National Occupational Research Agenda TRACKINGAllergic & Irritant Dermatitis

Role of Vernix as A Natural Biofilm

and Epidermal Protectant

Children’s Hospital Research Foundation

Cincinnati, Ohio

Prediction of Irritation Based on

Exposure Duration

Wright State University

In Vitro Assay for Hapten-Specific Priming

of Human T Lymphocytes

Schepens Eye Research Institute, Boston,

Mass.

Genetic Fingerprints of Irritant Contact

Dermatitis*

University of Texas

Effects of Irritants on Epidermal

Antigen Presentation*

University of Rochester

Asthma & Chronic Obstructive

Pulmonary Disease

A Novel Mouse Model of Isocyanate-Induced

Asthma

Yale University

Respiratory Disease Among Sawmill Workers

University of British Columbia

Pulmonary Effects of Machining Fluid Aerosols

New York University Medical Center

Tuxedo, N.Y.

Estimation of Highest Task Silica Exposures

University of Cincinnati

Passive Sampler for Particles

The University of North Carolina at Chapel Hill

Development of New Personal Aerosol

Samplers

University of Michigan

Isocyanate Antigens & T-Cells that

Cause Asthma*

Yale University

Endotoxin and Bronchial Inflammation Asthma*

University of North Carolina

Isocyanate Dermal Exposures in Autobody

Shops*

Johns Hopkins University

Host Determinants of Organic Dust-Induced

Airway Disease*

University of Iowa

Cardiopulmonary Effects of Particulate

Exposure*

Harvard University

A Community Based Study on Occupational

Asthma* (Pending)

Utah Department of Health

Health Services Research

Evidence-Based Medical Examinations

for Firefighters

Harvard University

Indoor Environment

Prevention of IEQ-Related Absence:

An Intervention Study

Harvard University

Microanalytical System for Indoor

VOC Monitoring

University of Michigan

Intervention Effectiveness Research

Organizational Predictors of

Successful Return to Work

New England Medical Center, Boston, Mass.

ROPS Design and Testing for

Agricultural Tractors

Colorado State University

Leadership Intervention for

Fire Service Personnel

University of Washington.

A New Training Intervention to Prevent

Back Injuries

Rush-Presbyterian-St. Luke’s Medical

Center, Chicago, Ill.

Work Organization and Depression

Among Nursing Home Aides

University of West Virginia

Health & Safety-Pollution Prevention in Hospitals

University of Massachusetts Lowell

Field Study of Hearing Protector

Evaluation Procedure

University of Arkansas

Getting to Zero in Nursing Homes:

Intervention Effectiveness

Department of Labor and Industries

Olympia, Wash.

The Buffalo Police Health Study:

A Baseline Evaluation

University of Buffalo

Musculoskeletal Disorders

An Intervention to Reduce Disability in

Injured Workers

Barnes-Jewish Hospital, St. Louis, Mo.

Quantifying the Use of Keyboard/Mouse

Through Intranet

University of California at Los Angeles

CTS Incidence & Correlates of Workers’

Compensation Claims

University of Massachusetts Lowell

An Animal Model for Repetitive Finger Loading

University of California, Richmond

MSDs in Nurses: Organization and

Physical Work Factors

University of Maryland, Baltimore

Gender Factors in Spinal Stability and

Low-Back Injury*

University of Virginia

Experimental Induction of CTS*

University of California, San Francisco

Tolerance of Intervertebral Disc to

Repetitive Compressive Loading*

University of California, San Francisco

Social and Economic Consequences of

Workplace Illness & Injury

The Employment Impact of Workplace

Injuries in 5 States

Boston University

Functional Limitation & Recovery from

At-Work Injuries

University of California, San Francisco

Special Populations at Risk

Green Tobacco Sickness in Minority

Farmworkers

The University of North Carolina at Chapel Hill

Collecting Elusive Data on Immigrant

Occupational Health

University of Massachusetts, Lowell

Factors Affecting the Health of

Employed Pregnant Women

University of Kentucky Research Foundation

Hispanics and Noise-Induced Hearing Loss

Yale University

Ergonomic Aspects of Older Workers’

Postural Balance

University of Cincinnati

Farmwork and Preterm Low Birthweight

Among Hispanic Women*

University of California, Davis

Traumatic Injuries

On-the-Job Injury in South Texas

Middle School Children

The University of Texas

Etiology of Injury in Drywall and

Residential Carpentry

Duke University

A Case Crossover Study of

Occupational Hand Injuries

Harvard University

Impact of Time and SCBA Tank Utilization

on Injury Prevention in Fire Fighters

Montefiore Medical Center, Bronx, N.Y.

Adolescent Toxic Exposures in the Workplace

Children’s Hospital, Boston, Mass.

* Funded by NIH

Grant Awards Related to the National Occupational Research Agenda (NORA) Grouped by NORA Priority Area

14
National Occupational Research Agenda TRACKING

Tracking Partnership Products

Requests for Applications (RFAs)

In FY 98, NIOSH and NIH awarded 50 grants totaling about $8 million dollars in ten NORA

priority research areas. A Request for Applications (RFA) for a second year of NORA

grants funding was issued in March 1999 by NIOSH and NIH. The agencies expect to

award at least $7.5 million in grant funds in eight of the NORA priority research areas

(total available funds under the RFA is $22.5 million over three years). Also, in FY 99,

NIOSH, the Environmental Protection Agency, and the National Cancer Institute announced

the availability of $1.5 million for grant applications for research that focuses on the

development of cancer risk assessment methods and practices.

Team Products

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

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

NORA’s success. The teams have been very active. As expected, each team is proceeding somewhat differently. Many teams are writing white papers— documents that use

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

research in a priority area, defining gaps, and laying out opportunities for collaboration.

In some areas, a well-defined research agenda currently exists (e.g. asthma) so a white

paper was deemed not necessary. The following 16 NORA teams have completed or are

currently working on white papers:

• Allergic and Irritant Dermatitis

• Cancer Research Methods

• Emerging Technologies

• Exposure Assessment Methods

• Fertility and Pregnancy Abnormalities

• Health Services Research

• Hearing Loss

• Infectious Diseases

• Indoor Environment

• Intervention Effectiveness Research

• Mixed Exposures

• Musculoskeletal Disorders

• Organization of Work

• Social and Economic Consequences of Workplace Illness and Injury

• Surveillance Research Methods

• Traumatic Injuries

15
National Occupational Research Agenda TRACKING

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

From September 1996 through June 1999, NIOSH and its partners have sponsored 20

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

in 1997, ten in 1998 and five scheduled through June 1999). A list of the NORA meetings

follows. In addition to white papers, conferences, and workshops, teams are also

developing surveys, establishing graduate-level training programs, participating in

continuing medical education workshops, and developing documents.

NORA Meetings, September 1996 through June 1999

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

Exposure Assessment Workshop

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

Latex Allergy Conference March 1997

National Occupational Research Agenda Symposium July 1, 1997

National Occupational Injury Research Symposium October 15-17, 1997

1998 Applied Workshop on Occupational and February 23-25, 1998

Environmental Exposure Assessment

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

Three Musculoskeletal Meetings to Set a March 25, 1998 - Chicago, IL

Research Agenda April 20, 1998 - Seattle, WA

April 27, 1998 - Washington, DC

Round Table Discussion on the Organization of Work April 24-26, 1998

at the Society for Industrial and Organizational

Psychology Conference

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

Natural Rubber/Latex Allergy: Recognition, Treatment, May 5, 1998

and Prevention, Satellite Downlink Teleconference

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

Research Workshop on the Risks and Benefits of September 16-18, 1998

Exposure to Ultraviolet Radiation and Tanning

Developing a National Occupational Research Agenda March 8, 1999

for Prevention of Musculoskeletal Disorders

Work, Stress, and Health 99: Organization of Work March 11-13, 1999

in a Global Economy

NORA Symposium 1999: Partnership for Research May 14, 1999

Experimental Contact Dermatitis Research May 21-22, 1999

Group Meeting

Functional, Economic, and Social Outcomes of June 13-15, 1999

Occupational Injuries and Illnesses: Integrating Social,

Economic, and Health Services Research

16
National Occupational Research Agenda TRACKING

Tracking the Literature and Recognition

of NORA

Bibliometrics

One measure of whether NORA is having the intended effect of stimulating increased

research in the priority areas is tracking scientific literature over time or bibliometrics.

To aid in this effort, in October 1998, NIOSH held a bibliometrics workshop to discuss

appropriate measures for tracking the impact of NORA that included using bibliometrics

and citation mapping. NIOSH is actively tracking articles in all 21 priority research areas

published from 1992 through 1996 (baseline) and in subsequent years. Since there is a

delay between the completion of research and its publication in the scientific press, the full

impact of NORA on scientific publications may not be seen for several years.

One example of identifying baseline activity is in the priority area Allergic and Irritant

Dermatitis. In the five years prior to announcing NORA, 1992-1996, the overall number of

peer-reviewed publications has varied between 45 and 65, with a steady increase (from 7

to 30) in the subset dealing with latex dermatitis. This pattern will be tracked in future

years, including citations to NORA and NORA funding, to assess the possible impact of

NORA on research activity in this area.

Occupational Dermatitis Publications

17
National Occupational Research Agenda TRACKING

Surveys of NORA Effectiveness

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

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

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

distributed its survey to key associations and professional organizations. A report of

survey results will be provided at the NORA Symposium 1999 and will be available on the

NORA webpage at http://www.cdc.gov/niosh/norahmpg.html. The survey will be

administered periodically by the Liaison Committee to gauge the recognition and influence

of NORA over time.

In an attempt to better understand the level and types of safety and health research

currently being performed in private industry, as well as to get a sense of industry

awareness of NORA, Organization Resources Counselors, Inc., has circulated a survey to

its Occupational Safety and Health Group, which consists of over 125 of America’s largest

corporations in a wide variety of industry sectors. Survey results will be available in 1999.

Other Tracking Methods

In addition to scientific publications, NIOSH is tracking popular literature citations, trade

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

NORA. The NORA web site has received over 90,000 hits in the nine month period from

May 1998 (the date the NORA site was loaded) through February 1999 (the last month

for which data are available). The NORA web site contains all NORA documents, white

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

and partnership team information.

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

teams have also established listservers to communicate among researchers interested in

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

has also helped improve NORA communication. Another communications effort, a

compendium of NIOSH-conducted or -funded NORA research is expected in 1999.

18
National Occupational Research Agenda PARTNERSHIP

Partnership

NORA Partnerships

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

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

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

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

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

Traumatic Injury Team document, Traumatic Occupational Injury Research Needs and

Priorities, will help pave the way for future partnerships. The document provides a

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

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

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

demonstrate the benefits of partnership for the improved safety and health of workers. In

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

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

Wal-Mart

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

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

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

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

back injury. In what promises to be the most definitive research study to date, NIOSH

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

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

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

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

the study will be reported in 1999.

Barnes Jewish Christian (BJC) Health System

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

Barnes Jewish Christian (BJC) Health System designed and implemented a “best practices” system, and approached NIOSH for help in scientific evaluation of the program as

implemented in Illinois and Missouri. NIOSH and BJC will evaluate the efficacy of a “best

practices” program in reducing the incidence and cost of back injury among nursing home

workers. The “best practices” program includes: specialized, state of the art lifting

equipment, training in lifting techniques, accident investigation, and medical management

of injured workers.

Anthony Crane Rental

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

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

resulted in 88 fatalities. Damage to property can be extremely costly. Anthony Crane

Rental (ACR) is the largest crane rental company in the U.S. and employs 800 crane

operators. ACR and the International Union of Operating Engineers share the responsibility

of certification of crane operators. NIOSH and ACR will collaborate to evaluate data on

crane-related incidents in order to determine whether operator certification is effective in

preventing crane-related injuries. The results will help industry, labor, and the public, as well

as assisting OSHA in determining the value of mandatory certification.

19
National Occupational Research Agenda PARTNERSHIP

Navistar, UAW, Aetna US Healthcare

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

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

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

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

productivity.

Asphalt Partnership

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

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

developed a comprehensive engineering control strategy to reduce exposures to asphalt

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

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

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

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

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

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

that this project received the first NORA Partnership Award.

Department of Veterans Affairs

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

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

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

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

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

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

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

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

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

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

estimate of the extent of latex sensitization among its employees. Effectiveness of

preventive intervention activities will also be studied. The partnership directly relates to the

Health Services Research, Asthma and COPD, and Allergic and Irritant Dermatitis priority

research areas.

20
National Occupational Research Agenda PARTNERSHIP

NORA - A Model for Partnership

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

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

partnership and planning. NORA has generated tremendous interest— especially at the

federal level— because of its innovative approach to strategic planning. NIOSH has

shared its experience with many who have sought to undertake a similar effort. Examples

of such planning efforts follow. The first five summaries are new additions to this comprehensive listing.

• The Japanese National Institute of Industrial Health is using NORA as a model

as the Institute moves forward with the development of a national occupational health

research plan for Japan. Development of the plan was mandated in 1998 by the

Ministry of Labor of Japan and, like the NORA process, will involve the cooperation of

several government agencies and health and safety research organizations.

• The European Agency for Safety and Health at Work is undertaking a planning

effort in the European Union, using NORA as a model.

• The Department of Defense used NORA in developing its Deployment Toxicology

Research and Development Master Plan, “Protecting the Fighting Force”.

• CDC’s National Center for Health Statistics and the National Committee on

Vital and Health Statistics are undertaking a planning process and using NORA as

a model for outreach to stakeholders.

• CDC’s National Center for Injury Prevention and Control is exploring the use of

NORA as a model to develop their National Research Agenda for Injury Prevention and

Control.

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

Institute for Occupational Safety and Health) is undertaking a priority-setting effort in

Italy, using NORA as a model.

• The Norwegian National Institute of Occupational Health is conducting a

priority setting process based, in part, on NORA.

• The Environmental Protection Agency is considering using NORA as a guide for

the Human Health Indoors Project to explore how the EPA should protect human health

indoors in the 21st century.

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

for health and safety much influenced by the NORA process.

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

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

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

programs.

• The Chemical Safety and Hazard Investigation Board is using NORA as a model

to develop its own priorities.

21
National Occupational Research Agenda PARTNERSHIP

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

American College of Occupational and Environmental Medicine (ACOEM)

established a joint research award. As stated by the AAOHN Executive Director, “In

support of the work of NIOSH and to promote the National Occupational Research

Agenda (NORA), emphasis has been give to NORA in the selection criteria.”

• The Chemical Industry Institute of Toxicology, the Chemical Manufacturers

Association, and other organizations undertook a prioritization activity using some

strategies of NORA development. Eight of the topics identified in their process closely

relate to NORA priority areas.

NORA Partnership Award

NIOSH announced the first NORA Partnership Award For Worker Health and Safety at the

1999 NORA Symposium at the National Academy of Sciences in Washington, D.C. The

award recognizes outstanding NORA partnership activities that lead to improved worker

health and safety. To be eligible for the award, NORA partnership activities must include

collaborative research in at least one NORA priority area that results in the development of

interventions that reduce hazardous exposures or adverse outcomes. Partners should

represent a broad and diverse spectrum of organizations and individuals, such as

manufacturers, end-users, labor, the public health community, academia, and government.

The 1999 winner of the NORA Partnering Award For Worker Health and Safety is the

Asphalt partnership. This unique collaboration brought together diverse partners to

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

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

Highway Administration, the Occupational Safety and Health Administration, the International Union of Operating Engineers, the Laborers’ Health and Safety Fund of North

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

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

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

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

new highway pavers produced after July 1997.

The partnership formed amid ongoing controversies surrounding the health effects of

asphalt fume exposures and possible regulatory activity aimed at reducing these exposures. Working together, the partners avoided the protracted regulatory process and

ensured that effective control technologies, designed and evaluated by NIOSH and its

partners, were implemented to protect the approximately 300,000 highway paving

workers across the nation.

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

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

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

Council for Excellence in Government. The prestigious Innovations Award recognizes

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

22
IMPLEMENTATION

Guiding NORA Implementation

Liaison Committee

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

Occupational Health Nurses), consists of 23 members representing industry, labor,

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

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

and direction of NORA implementation.

The Measures and Goals Subcommittee (chaired by William Bunn, Vice President, Health,

Safety and Productivity, Navistar International Transportation Corporation of Navistar) is

helping to guide the tracking of NORA’s progress. The Liaison Committee has devised a

survey to determine the recognition and influence of NORA. The survey was distributed by

members of the Committee (independent of NIOSH) to many associations and professional

organizations. The results of the survey will be presented at the NORA Symposium 1999

and will be available on the NORA web page at http://www.cdc.gov/niosh/norahmpg.html.

In an attempt to better understand the level and types of safety and health research

currently being performed in private industry, as well as to get a sense of industry

awareness of NORA, Liaison Committee member Frank White, Vice President, Organization Resources Counselors, Inc. (ORC), has coordinated a survey of ORC’s Occupational

Safety and Health Group, which consists of over 125 of America’s largest corporations in a

wide variety of industry sectors. The results of this survey will be available in mid-1999.

Federal Liaison Committee

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

group guiding the implementation of NORA. This year the Committee undertook the

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

research overall. The first survey, covering FY 96, provided a baseline identifying a total of

only $204 million spent for all occupational safety and health research from the survey

respondents (including NIOSH) compared to $218 million in FY 98. Although the overall

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

priority areas, from $30 million in FY 96 to $70 million in FY 98.

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

resources for NORA. In March 1999, NIOSH, in partnership with five other federal

agencies, announced the second consecutive year of grant funding in the NORA priority

research areas (see description on page 12).

National Occupational Research Agenda 23
National Occupational Research Agenda IMPLEMENTATIONFederal Liaison Committee

FEDERAL AGENCY OFFICE/INSTITUTE/DIVISION

Consumer Product Safety Commission

Department of Agriculture Cooperative State Research, Education and

Extension Service

Department of Defense

Department of Energy Office of the Environment, Safety and Health

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

 Services Agency for Toxic Substances and Disease

Registry

Centers for Disease Control and Prevention

Epidemiology Program Office

National Center for Chronic Disease Prevention

and Health Promotion

National Center for Environmental Health

National Center for Health Statistics

National Center for HIV, STD, and TB Prevention

National Center for Infectious Diseases

National Center for Injury Prevention and Control

National Immunization Program

Office of Minority Health

Office of Women’s Health

Food and Drug Administration

Intergovernmental Affairs

National Institutes of Health

Fogarty International Center

National Cancer Institute

National Heart, Lung, and Blood Institute

National Institute on Aging

National Institute of Allergy and Infectious Diseases

National Institute of Arthritis and Musculoskeletal and

Skin Diseases

National Institute on Deafness and Other

Communication Disorders

National Institute of Environmental Health Sciences

National Institute of Mental Health

National Institute of Neurological Disorders and

Stroke

National Institute of Nursing Research

Office of Women’s Health

Substance Abuse and Mental Health Services

Administration

Department of Justice National Institute of Justice

Department of Labor Bureau of Labor Statistics

Mine Safety and Health Administration

Occupational Safety and Health Administration

Wage and Hour Division

Department of Transportation Federal Aviation Administration

Federal Highway Administration

National Highway Traffic Safety Administration

Environmental Protection Agency National Exposure Research Laboratory

Office of Prevention, Pesticides, and Toxic Substances

Department of Veterans Affairs

24
National Occupational Research Agenda IMPLEMENTATION

NIOSH/NORA Partnership Structure

Office of the Director

Washington, DC Linda Rosenstock, MD, MPH

Office of the Deputy Director

Atlanta, GA Bryan D. Hardin, PhD

Washington, DC

Office of Health Communications

Office of Policy, Planning & Legislation

Office of Mine Safety & Health Research

Atlanta, GA

Office of Admin. Management Services

Office of Extramural Coordination &

Special Programs

Cincinnati, OH

Division of Biomedical & Behavioral Science

Division of Surveillance, Hazard

Evaluations, & Field Studies

Division of Physical Sciences & Engineering

Education & Information Division

Morgantown, WV

Division of Respiratory Disease Studies

Division of Safety Research

Health Effects Laboratory Division

Pittsburgh, PA

Pittsburgh Research Laboratory

Spokane, WA

Spokane Research Library

NORA Liaison

Committee

NORA Federal

Liaison Committee

Team Name

Team Leader

Team Members

(# NIOSH # External)

Allergic & Irritant Dermatitis

Boris Lushniak

G. Frank Gerberick

7 NIOSH 7 External

Asthma & Chronic Obstructive

Pulmonary Disease

Kathleen Kreiss

7 NIOSH 5 External

Cancer Research Methods

Paul Schulte

Elizabeth M. Ward

8 NIOSH 9 External

Control Technology & Personal Protective Equipment

Lawrence Reed

7 NIOSH 6 External

NORA

PARTNERSHIP

TEAMS

Emerging Technologies

Aaron Schopper

5 NIOSH 7 External

Exposure Assessment

Methods

Mary Lynn Woebkenberg

8 NIOSH 7 External

Surveillance Research Methods Implementation Team John Sestito

7 NIOSH 9 External

Fertility & Pregnancy

Abnormalities

Teresa Schnorr

6 NIOSH 8 External

Health Services

Research

Scott D. Deitchman

5 NIOSH 8 External

Hearing Loss John Franks

6 NIOSH 8 External

Indoor Environment

Mark Mendell

6 NIOSH 7 External

Infectious Diseases Thomas K. Hodous

4 NIOSH 12 External

Intervention Effectiveness Research

Linda Goldenhar

Theodore M. Katz

6 NIOSH 8 External

Mixed Exposures

Frank Hearl

5 NIOSH 9 External

Musculoskeletal Disorders

Lawrence J. Fine

8 NIOSH 11 External

Organization of Work Steve Sauter

8 NIOSH 8 External

Risk Assessment Methods Leslie Stayner

6 NIOSH 7 External

Social & Economic Consequences of Workplace

Illness & Injury

Elyce Biddle

Leslie I. Boden

6 NIOSH 9 External

Special Populations at Risk

Sherry Baron 7 NIOSH 9 External

Traumatic Injuries Nancy Stout

7 NIOSH 6 External

25
National Occupational Research Agenda IMPLEMENTATIONPartnership Teams

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

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

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

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

partnership teams have brought together 130 NIOSH researchers and 160 external

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

includes faculty from public and private colleges and universities, representatives of

professional organizations and major industries, leaders in the insurance industry, health

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

agencies. The following summaries highlight the work of each of the 20 NORA Partnership Teams.

Team Summaries

Allergic and Irritant Dermatitis Team

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

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

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

and dermatology community; enhancing dermatology-related activities through both

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

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

Radiation and Tanning” with the National Institute of Arthritis and Musculoskeletal and Skin

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

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

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

University Hospitals of Cleveland, and the Procter & Gamble Company will convene in

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

applied science of experimental contact dermatitis. In FY 98, NIOSH and NIAMS co-funded

an RFA for irritant dermatitis and funded five dermatitis projects. Additionally, the team has

been working on developing research priorities in AID (now available in draft form).

Asthma & Chronic Obstructive Pulmonary Disease Team

The Asthma and Chronic Obstructive Pulmonary Disease Team has concentrated its

efforts on partnerships with federal agencies to increase resources available for research

on occupational asthma and chronic obstructive pulmonary disease (COPD). For the

extramural research community, the NIOSH partnership with the National Heart, Lung, and

Blood Institute has resulted in requests for applications in both 1998 and 1999. In

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

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

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

occupational exposures. Intramural NIOSH research has benefitted from partnerships with

the Veterans Administration and the National Toxicology Program on latex asthma. The

team hosted an international symposium on asthma last spring, has stimulated two ad

hoc subcommittees of the American Thoracic Society to prepare published statements on

occupational asthma and COPD, and is developing program initiatives on asthma

prevention and building-related asthma (a cross-cutting priority of the Indoor Environmental

Quality NORA team).

26
National Occupational Research Agenda IMPLEMENTATION

Cancer Research Methods Team

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

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

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

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

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

research methods.

Control Technology and Personal Protective Equipment Team

In combination with the American Industrial Hygiene Association and the American Society

of Safety Engineers, the team held a unique conference, “The Control of Workplace

Hazards for the 21st Century: Setting the Research Agenda,” in Chicago in March 1998.

It brought together over 250 researchers, manufacturers, and users of engineering

controls and personal protective equipment. At the conference, the participants set future

directions for control technology research. Six priorities for research were identified:

chemical protective clothing, engineering controls, noise, non-ionizing radiation, respirators, and traumatic injuries.

Emerging Technologies Team

The NORA Emerging Technologies Team is working on the team’s three focus areas: 1)

establishing mechanisms to ensure that worker health and safety is considered when new

technologies are developed and implemented; 2) surveillance systems for tracking the

impact of new technology on worker safety and health; and 3) technology transfer of

safety and health controls and innovations from one industrial sector to another. In March

1998, team members participated in each of the six breakout sessions held during the

“Control of Workplace Hazards for the 21st Century: Setting the Research Agenda”

workshop in Chicago. The team is currently considering a pilot project, in conjunction with

the EPA, to incorporate occupational safety and health considerations into a new or

revised technology which will serve as a model for use by others.

Exposure Assessment Methods Team

The Exposure Assessment Methods Team is composed of 14 members representing

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

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

is involved in symposia with the American Conference of Government Industrial Hygienists,

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

International Symposium on Occupational Exposure Data Bases and Their Application in

the Next Millennium. The team is in the process of developing a white paper describing

research that addresses key exposure assessment issues such as field study design,

monitoring methods development, and toxicology research, along with needs in education

and publications relative to exposure assessment.

27
National Occupational Research Agenda IMPLEMENTATIONFertility and Pregnancy Abnormalities Team

The mission of the Fertility and Pregnancy Abnormalities Team is to assist in the development and pursuit of reproductive health research. One of the team’s goals is to increase

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

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

by NIOSH. The team helped organize the conference, “Hazardous Substances and Male

Reproductive Health,” held in May 1998 in New York. The conference was sponsored by

Mount Sinai School of Medicine, NIEHS, NIOSH, and the New York Academy of Medicine.

The team is also developing a paper on current research needs in the field of occupational

reproductive health to help encourage research in areas that are most in need. NIOSH

and NIEHS are cosponsoring the 1999 RFA which includes fertility and pregnancy

abnormalities as a targeted research area. A workshop is planned for the Fall of 1999 to

discuss ways to bridge the different methodological approaches used by epidemiologists

and toxicologists such as sample size issues, statistical analysis methods, and presentation of results.

Health Services Research Team

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

delivery of health care to workers. The team has been active in planning the upcoming

conference, “Functional, Economic, and Social Outcomes of Occupational Injuries and

Illnesses: Integrating Social, Economic, and Health Services Research,” to be held June

13-15, 1999, in Denver, Colorado. This conference will bring together researchers from

both the Health Services Research and Social and Economic Consequences NORA teams,

and will be used to create position papers for each topic. Team members also participated

in a health services research meeting sponsored by the Robert Wood Johnson Foundation

Workers’ Compensation Health Initiative on September 15 and 16, 1998 which will be

summarized in published conference proceedings. Team members are also participating

in a research project funded by the Robert Wood Johnson Foundation to create performance measures for occupational health services provided in managed care. Several

research papers from this project have been drafted for submission to peer-reviewed

journals. New research partnerships are being explored with major industrial employers.

Hearing Loss Team

The Hearing Loss Team is writing a white paper on occupational hearing loss, developing a

proposed model curricula for graduate students in Audiology and Industrial Hygiene, and

will compile documents based on best practices workshops planned by the team. The

first of these conferences, “Best Practices for Hearing Loss Prevention,” will be held on

October 28, 1999, in Detroit, Michigan. Cosponsors of the conference include: NIOSH,

the National Hearing Conservation Association, the National Safety Council, the American

Hygiene Association, the Michigan Industrial Hygiene Association, the Institute for Noise

Control Engineering, and the Douglas A. Fraser Center for Workplace Issues at Wayne

State University . The team is also working with the NIOSH Office of Health Communication on a research-based communication activity which will provide important hearing loss

prevention messages to health professionals, employers, and workers.

28
National Occupational Research Agenda IMPLEMENTATION

Indoor Environment Team

The Indoor Environment Team has generated a priority research agenda for improving the

health of workers in indoor environments, reflecting available information on public health

and economic impacts of building-related health effects. Inclusion of a draft version of this

research agenda in the NIOSH 1998 RFA stimulated generation of 24 grant applications in

this research area, of which NIOSH was able to fund two: a blinded, controlled intervention

study of the effects on illness absence and respiratory illness of ventilation rate and

building humidification, using a polymerase chain reaction assay to diagnose specific

strains of respiratory infection; and the development of a hand-held microanalytical system

to identify and quantify low concentrations of mixed volatile organic compounds in indoor

environments.

Infectious Diseases Team

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

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

new research and collaboration in this area, call attention to the national needs in occupational infectious diseases research, and help in the greater dissemination of research data

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

research needs, particularly those involving human-to-human transmission. Team

members are working with NIOSH and other CDC staff to help develop and to review an

Alert on needle-stick injuries. The team has also discussed possible collaboration with the

NORA Indoor Environment team on research addressing the hazards of common

infectious diseases in office workers. Particularly with several new team members, we will

reexamine occupational infectious disease activities and needs and our draft white paper

during our face-to-face meeting at the NORA Symposium in May, 1999.

Intervention Effectiveness Research Team

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

the team’s mission to: 1) encourage more testing of interventions to improve health and

safety in the workplace; 2) improve evaluation (measurement, analysis, and documentation) of intervention efforts; 3) make intervention evaluation more accessible to researchers, health and safety professionals, labor, and management, by promoting the development of practical tools and approaches; and 4) broaden dissemination of results and

lessons learned from occupational safety and health intervention research. The team

developed a theoretical model to help clarify the major steps and activities involved in an

intervention effectiveness study, which will be described in a white paper that is in preparation. IER has also developed a case-based workshop exercise to give health and safety

professionals hands-on experience at developing and evaluating a specific intervention.

The team is working with the Institute of Labor and Health in Toronto, Canada, to prepare

an intervention evaluation manual for professionals, and is also developing an

employer-friendly practical manual for evaluating occupational safety and health interventions in the workplace.

29
National Occupational Research Agenda IMPLEMENTATIONMixed Exposures Team

The NORA Mixed Exposures Team is developing a white paper that defines the topic of

mixed exposures, reviews the recent and past literature, and describes on-going work

both nationally and internationally. Combined with an assessment of the regulatory needs

for controlling mixed exposures, the team will produce a document describing a research

agenda. The Mixed Exposure Team is examining mixtures from the perspective of:

complex mixtures (like combustion exhausts), mixtures with identifiable composition,

mixed stressor exposures (such as noise and chemicals), and mixtures associated with

particular workplaces or processes (like coal mine dust). The team is attempting to

facilitate communications and collaboration among researchers and those interested in

mixed exposures through a Listserver and a site on the Internet. Instructions for joining

the Listserver are provided on the Internet site at: http://www.cdc.gov/niosh/mixed.html.

Musculoskeletal Disorders Team

The Musculoskeletal Disorders Team is engaged in developing a National Occupational

Research Agenda on Work-Related Musculoskeletal Disorders. In 1998, the first step in

the process was a series of three workshops in Washington, D.C., Chicago, Illinois, and

Seattle, Washington, where over 150 practitioners (ergonomists, occupational physicians,

and others) used their experience to identify gaps in existing knowledge and determine

what should be included in a national research agenda. In 1998 and 999, the NORA team

developed a draft summary of research ideas in the areas of surveillance, etiological

research, and intervention research. This document was discussed in a fourth workshop

of fifty academicians in March 1999. The team plans to use this input to develop the final

research agenda.

Organization of Work Team

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

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

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

workshop with key interest groups was held on March 9 and 10, 1999 in Baltimore, MD.

Team members met with over 30 representatives from national and international

stakeholder organizations, including universities, labor and management organizations,

government agencies, and professional associations. The meeting consisted of structured activities and plenary sessions designed to elicit stakeholder viewpoints on three

broad topics: 1) how the organization of work is changing, 2) safety and health implications of these changes, and 3) interventions for reducing health and safety risks. Information from this meeting is being integrated into a strategic report on research needs in

work organization and health.

The team also sponsored with the American Psychological Association a major scientific

meeting on work organization and health March 11-13, 1999, in Baltimore. A substantial

proportion of the papers came from international contributors, including scientists from

Asia, Europe, Canada, and South America. One of the poster sessions featured presentations by five different NORA teams. Finally, members of the team have met with interest

groups such as the Academy of Management and the National Advisory Committee on

Occupational Safety and Health to describe the teams’ activities and to seek input and

collaboration.

30
National Occupational Research Agenda IMPLEMENTATION

Risk Assessment Methods Team

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

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

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

of North Carolina. This Cooperative Agreement will support research to evaluate the

degree of concordance between toxicologic and epidemiologic estimates of risk for

carcinogenic hazards. NIOSH, EPA, and NCI have committed to a 1999 RFA for research

focusing on the development of cancer risk assessment methods and practices. The

team is also currently planning a workshop on future directions in risk assessment

methods research that will be held in the summer of 2000.

Social and Economic Consequences of Workplace Illness and Injury Team

The Social and Economic Consequences of Workplace Illness and Injury Team is developing

comprehensive bibliographies of published research on the social and economic consequences of workplace illness and injury. Additionally, the team, in conjunction with the

Health Services Research Team, has been organizing a national conference entitled,

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

Integrating Social, Economic, and Health Services Research,” to be held June 13 - 15,

1999, in Denver, CO. This conference will address performance measures for health

services delivered to prevent or treat occupational injury or illness, measures of the

economic and social impact of occupational injury or illness, and research that integrates

these areas. Researchers from government agencies, public and private research

organizations, academic institutions, and worker groups will provide their individual

professional opinion, judgment, and recommendations for a position paper. To generate

focused discussion, summary reports on the current state of knowledge will be provided.

Special Populations at Risk Team

The Special Populations at Risk Team assisted in the development of the July 1999

volume of the quarterly journal, Occupational Medicine: State of the Art Reviews, which will

focus entirely on the issues facing special populations at risk. Several team members

also participated in the development of the Institute of Medicine report, Youth at Work,

which was released in November 1998. This study, which was cosponsored by NIOSH,

the Robert Wood Johnson Foundation and other federal agencies, included recommendations for data collection and research to guide prevention efforts, as well as a number of

recommendations for regulation, and better preparing youth for the world of work. With

NIOSH funding, several of the team members helped to organize a new research track at

the annual migrant stream forum meeting. As a direct result of this effort a new research

listserve has recently been initiated. The team is also addressing research directions for

the aging workforce.

31
National Occupational Research Agenda IMPLEMENTATIONSurveillance Research Methods Team

The Surveillance Research Methods Team is engaged in a variety of activities to develop and

implement a national agenda for surveillance. The NORA FY 99 RFA includes solicitation for

grant proposals on surveillance research methods. The team has been working with the

Exposure Assessment and Surveillance Research Methods Teams on exposure surveillance

issues.

The Team is also conducting additional outreach to four target groups: NIOSH state

partners, labor, management, and academia. These efforts will provide the team and NIOSH

with insight into external surveillance issues and expand the base of information from which

to frame the team’s vision and recommendations in a white paper for a national surveillance

agenda.

Traumatic Occupational Injury Research Team

The initial activity of the Traumatic Occupational Injury Research Team was assisting with the

sponsorship of the first National Occupational Injury Research Symposium (NOIRS) in

October 1997. This was the first ever national conference on occupational injury research

and was attended by over 300 occupational safety professionals from a wide variety of

disciplines and organizations. The team is currently involved in the planning of the second

Symposium, scheduled for October 2000.

The second major activity of the team was the development of a document describing the

needs and priorities for traumatic occupational injury research in the U.S. Published by

NIOSH in 1998, the document, “Traumatic Occupational Injury Research Needs and

Priorities,” provides a broad framework of the objectives and research needed to begin filling

the gaps in knowledge and furthering progress toward safer workplaces and practices. This

document provides a reference and structure for traumatic occupational injury research

which can be used to facilitate the initiation of new, and the rekindling of existing, partnerships and collaborative research to prevent worker injuries and deaths. The team is

encouraging agencies and organizations to use this document as a basis for planning and

prioritizing their own research and for pursuing new partnerships and identifying topics for

collaborative efforts.

32
National Occupational Research AgendaACCOLADES

Kudos for NORA

NORA has received broad support form many quarters. Below is a sample of recent

comments.

Senate Committee on Appropriations Report Accompanying the FY 1999

NIOSH Appropriation:

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

Occupational Research Agenda [NORA]. The Committee is supportive of NIOSH’s efforts

to further its partnerships with the occupational safety and health community and the

broader public and private public health research community, and believes these partnerships will be important in the implementation phase. The Committee urges NIOSH to work

with its partners to augment resources available to the Institute for NORA research. In

particular, the Committee strongly encourages NIOSH to continue partnering with the

National Institutes of Health to cosponsor and fund extramural research in relevant NORA

priority areas.”

Institute of Medicine, Reducing the Burden of Injury, (October 1999)

“The [Committee on Injury Prevention and Control] applauds NIOSH in its paradigmatic

approach to research priority setting through NORA. The contemporary scientific

community values planning as a tool for setting broad priorities and integrating diverse

research programs.”

Institute of Medicine, Reducing the Burden of Injury, (October 1999)

“The recent undertaking by NIOSH provides a useful model of how to engage public and

private partners to set research priorities based on explicit criteria. Through the National

Occupational Research Agenda, NIOSH was able to examine broadly perceived needs and

systematically address those topics that were most likely to yield gains to protect

workers.”

National Asphalt Pavement Association (September 1998)

“[The asphalt partnership] has evolved into a visible model for the NORA concept of

partnerships in national occupational health and safety research. We are presently

working with NIOSH through NORA to expand our industry partnership and we are

confident that NIOSH will be replicating these successful partnership activities in other

industries.”

National Association of State Universities and Land-Grant Colleges (March

1999)

“. . . we strongly support the National Occupational Research Agenda and believe that an

investment . . . is needed to continue successful implementation of this national research

plan.”

33
National Occupational Research Agenda ACCOLADES

National Center for Environmental Health (November 1998)

“[We] have been impressed by the quality of the National Occupational Research Agenda

developed by NIOSH and think it is time to have a coherent national policy around environmental health as well.”

Occupational Hazards Magazine “Rebirth of NIOSH” (December 1998)

“NORA also is promoting partnerships between research groups which once competed for

the same dollars and organizations which have long histories of being at odds with each

other.”

The American Lung Association and the American Thoracic Society

(April 1999)

“[We] would like to bring to your attention the National Occupational Research Agenda. . . .

In 1996, NIOSH convened a panel of experts from the scientific, labor and corporate

communities to layout a plan for occupational health research . . . We strongly recommend

. . . support for the National Occupational Research Agenda at NIOSH.”

34
National Occupational Research Agenda MILESTONES

NORA Milestones

July 1995 - May 1999

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

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

initial working group of internal and external scientists

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

discuss criteria for priorities

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

health professionals, other stakeholders) expand and prioritize

priority areas

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

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

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

identifies 21 priority research areas to guide occupational safety

and health research (released on NIOSH 25th Anniversary)

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

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

Chicago, IL

February 1997 ............ First ever survey of federal (non-NIOSH) resources committed to

occupational safety and health research

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

Academy of Sciences, Washington, D.C.

July 1997 ................... NORA Update 1997 document released

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

Occupational Injury Research Symposium, Morgantown, WV

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

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

priorities

March 1998 ............... RFA for largest ever funding for targeted occupational safety and

health research ($8 million) announced by NIOSH and NIH

partners

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

American College of Occupational and Environmental Medicine

partner to establish a joint research award, with emphasis given

to NORA in the selection criteria

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

35
MILESTONESMay 1998 .................. NORA and the asphalt partnership both selected as semifinalists

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

Ford Foundation and Harvard University’s 1998 Innovations in

American Government Awards Program from an initial pool of

1,420 applicants.

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

May 1998 .................. NORA Web site mounted

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

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

1998 Innovations in American Government awards program

September 1998 ........ First private sector funds (Aetna U.S. Health Care) leveraged for

NORA research (musculoskeletal disorders project)

October 1998 ............. First NORA research grants announced— 49 grants totaling $8

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

federal government for extramural investigator-initiated occupational health and safety research

October 1998 ............. NIOSH received permission to trademark the NORA logo

October 1998 ............. Congress continues to provide support for NORA through a $12

million appropriation in the FY 99 NIOSH budget

February 1999 ............ The President’s FY 2000 budget proposal to Congress includes

$12 million for NORA to support both intramural and extramural

research and related activities.

March 1999 ............... Second survey of federal (non-NIOSH) resources committed to

occupational safety and health research (FY 98)

March 1999 .............. Liaison Committee conducts two surveys to determine the

effectiveness and reach of NORA among associations and private

industry

March 1999 ............... NIOSH/NIH request NORA grant applications for FY 99 — $7.5

million in awards anticipated

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

focusing on the development of cancer risk assessment methods

and practices

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

May 1999 .................. First “NORA Partnering Award For Worker Health and Safety”

awarded to the Asphalt Research Partnership

May 1999 .................. NORA Symposium 1999: Partnership for Research held at the

National Academy of Sciences, Washington, D.C.

36 National Occupational Research Agenda
SUMMARY

Summary

The implementation of NORA has been a huge success in its first three years. Those

dedicated to NORA and occupational safety and health have produced:

• An enthusiastic and productive, broad-based NORA Liaison Committee

• Successful efforts of 20 NORA teams, including outreach, conferences and symposia,

and production of white papers and documents, and journal articles.

• The participation of a large number of federal agencies in NORA activities.

• A successful grants process which has produced record-breaking funding for targeted

occupational safety and health research in both FY 98 and FY 99.

• Two surveys (FY 96 and FY 98) of federal occupational safety and health research

investment.

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

NORA research priority areas were well chosen.

• Recognition that NORA continues to be used as a model for public-private partnerships

and is being widely used by other organizations in similar planning efforts.

• For the first time, a broad-based network of public and private partnerships in occupational safety and health.

National Occupational Research Agenda 37
Notes
TEAMS

Ann Brockhaus (Organization Resources Counselors,

Robin Baker (University of California, Berkeley)

Theodore M. Katz (NIOSH) tmk1@cdc.gov

Linda M. Goldenhar (NIOSH) lyg9@cdc.gov

Intervention Effectiveness Research

Inc.)

Scott P. Schneider (Laborers’ Health and Safety Fund

Ted Scharf (NIOSH)

Paul Landsbergis(Cornell University)

Anthony LaMontangne (Dana Farber Cancer Institute)

Cathy Heaney (Ohio State University)

Sarah Glavin (General Accounting Office)

Jim Collins (NIOSH)

Larry Chapman (University of Wisconsin)

of North America)

John Bucher (National Institute of Environmental Health

Nancy Bollinger (NIOSH)

Frank Hearl (NIOSH) fjh1@cdc.gov

Mixed Exposures

Margie Wallace (NIOSH)

Raymond Sinclair (NIOSH)

Sciences/NIH)

Hank Gardner (U.S. Army Center for Environmental

Health Research/DOD)

Manuel Gomez (American Industrial Hygiene

Association)

Hugh Hansen (Agency for Toxic Substances and

Disease Registry)

Richard C. Hertzberg (Environmental Protection

Robert Herrick (Harvard University)

Agency)

Gunnar Andersson (Rush-Presbyterian-St. Luke’s

Lawrence J. Fine (NIOSH) ljf@cdc.gov

Musculoskeletal Disorders

Pam Susi (Center to Protect Workers Rights)

Joe L. Mauderly (Lovelace Research Institute)

Carlos Marentes (Rural Coalition)

Alan Lunsford (NIOSH)

Daniel Lewis (NIOSH)

Vera Kommineni (NIOSH)

Medical Center)

Lida Orta-Anes (International Union, United Auto

Vernon Putz Anderson (NIOSH)

Workers)

Brian Peacock(General Motors Corporation)

Tom Leamon (Liberty Mutual)

Hongwei Hsiao (NIOSH)

Sean Gallagher (NIOSH)

Cheryl Fairfield Estill (NIOSH)

La Mont Byrd (International Brotherhood of Teamsters)

Stephen Brightwell (NIOSH)

Robert E. Bonner (AETNA)

Bruce Bernard (NIOSH)

Gwendolyn Keita (American Psychological

Theodore M. Katz (NIOSH)

Joseph J. Hurrell (NIOSH)

Michael Colligan (NIOSH)

W. Stephen Brightwell (NIOSH)

Steven L. Sauter (NIOSH) sls4@cdc.gov

Association)

David LeGrande (Communications Workers of

America)

Nancy Lessin (Massachusetts Coalition for

Occupational Safety and Health)

Sydney Robertson (Organization Resources

Robert H. Peters (NIOSH)

Lawrence Murphy (NIOSH)

Jane Lipscomb (University of Maryland)

Richard A. Lippin (Lyondell Chemical Company)

Counselors, Inc.)

William Perry (Occupational Safety and Health

Frank Mirer (United Auto Workers)

Dale Hattis (Clark University)

Herman Gibb (Environmental Protection Agency)

William Fayerweather (Owens Corning Corporation)

Mike Attfield (NIOSH)

Leslie Stayner (NIOSH) lts2@cdc.gov

Risk Assessment Methods

Lois E. Tetrick (University of Houston)

Naomi G. Swanson (NIOSH)

Jeanne Stellman (Columbia University)

Administration)

Chris Portier (National Institute of Environmental

Al Poland (NIOSH)

Health Sciences/NIH)

Chuck Levenstein (University of Massachusetts,

Paul R. Keane (NIOSH)

Theodore M. Katz (NIOSH)

Brian T. Day (NIOSH)

Thomas W. Camm (NIOSH)

Laura Blanciforti (NIOSH)

Benjamin C. Amick III (New England Medical Center)

Leslie I. Boden (Boston University)

Elyce Biddle (NIOSH)egb6@cdc.gov

Illness & Injury

Social & Economic Consequences of Workplace

James T. Wassell (NIOSH)

Gerald van Belle (University of Washington)

Mark Torrasson (NIOSH)

Christine Sofge (NIOSH)

Lowell)

Ted Miller (National Public Service Research

Carolyn Madden (University of Washington)

Institute)

Emily Spieler (West Virginia University)

Eve Spangler (Boston College)

Harry Shannon (Institute for Work & Health)

Sharon Morris (University of Washington)

Pamela Tau Lee (Labor Occupational Health

Charles Lee (Environmental Protection Agency)

Frances C. Henderson (Alcorn State University)

Program)

Henry Anderson (Wisconsin Dept. of Health and

John P. Sestito (NIOSH) jps4@cdc.gov

Implementation Team

Surveillance Research Methods

David Wegman (University of Massachusetts, Lowell)

Jennie Ward Robinson (NIOSH)

Andrea Kidd Taylor (Chemical Safety Board)

Leslie MacDonald (NIOSH)

Social Services)

Eric Frumin (Union of Needletrades, Industrial and

Barbara Fotta (NIOSH)

Richard Ehrenberg (NIOSH)

Robert Castellan (NIOSH)

Textile Trade Employees)

Steve Newell (Organization Resources Counselors,

John Myers (NIOSH)

Jane McCammon (NIOSH)

Wayne M. Ledner (Eastman Kodak)

Denise Koo (Epidemiology Program Office/CDC)

Alice Greife (Central Missouri State University)

Inc)

Diane Wagener (National Center for Health

Lee Sanderson (NIOSH)

Earl Pollack (Center to Protect Workers’ Rights)

Statistics/CDC)

William Borwegen (Service Employees International

Nancy Stout (NIOSH) nas5@cdc.gov

Traumatic Injuries

William Weber (Bureau of Labor Statistics)

Union)

Stephen Luchter (National Highway Traffic Safety

Herb Linn (NIOSH)

Lynn Jenkins (NIOSH)

Alan F. Hoskin (National Safety Council)

George Conway (NIOSH)

Administration)

Nancy J. McWilliams (McWilliams Risk Management,

Inc.)

Lisa J. Steiner (NIOSH)

Karl Snyder (NIOSH)

Gordon Smith (Johns Hopkins University)

Gordon R. Reeve (Ford Motor Company)

Timothy Pizatella (NIOSH)
For additional information, contact NIOSH at:

National Institute for Occupational Safety and Health

Publications Dissemination

4676 Columbia Parkway

Cincinnati, OH 45226-1998

1-800-NIOSH

(1-800-356-4674)

Fax: 513-533-8573

or visit the NIOSH homepage on the World Wide Web at

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

DHHS (NIOSH) Publication No. 99-124