NIOSH HEALTH HAZARD 

EVALUATION (HHE) 

PROGRAM

2022 Annual Report
1

HHE Requests in 2022 

144 Requests
2

25 Site Visits and Emergency Response Deployments

Outreach

HHE website viewed 38,206 times

HHE reports downloaded 13,818 times

3 New HHE reports published

Most downloaded report of 2022 (575 downloads) 

Evaluation of Occupational Exposures to Opioids, 

Mental Health Symptoms, Exposure to Traumatic Events, 

and Job Stress in a City Fire Department

https://www.cdc.gov/niosh/hhe/reports/pdfs/2018-0015-3384.pdf

36 Presentations

46 Peer-reviewed publications

25 Workplaces 18 States 25 Cities Approx. 33,884 

Miles Traveled
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HHE Final Report Examples from 2022 

Whole-Body Vibration Analysis of 

Golf Course Maintenance Tasks

Management from a golf course was concerned about maintenance 

employees’ exposure to whole-body vibration. 

What NIOSH Did

• Observed work processes, 

work practices, and 

workplace conditions. 

• Measured employees’ exposures 

to whole-body vibration. 

• Held confidential 

employee interviews. 

Key Findings

• Whole-body vibration exposures for most job tasks were 

above occupational action levels. 

• Interviewed employees reported work-related pain and 

discomfort. 

Recommendations

Reduce exposures to whole-body vibration. 

o Avoid driving on golf course areas known to be rough 

and uneven and take the shortest route when possible.

o Reduce driving speeds.

o Replace seats with original equipment seats or a seat 

designed to further dampen whole-body vibration.

o Maintain or replace rough/uneven areas of cart paths.

o Rotate employees between job tasks. 

Encourage employees to report health concerns they think 

are work-related to their supervisors. 

This report is available at: 

https://www.cdc.gov/niosh/hhe/reports/pdfs/2018-0137-3385.pdf

Photo by NIOSH
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Evaluation of Potential Hazards During 

Harvesting and Trimming Cannabis at an 

Indoor Cultivation Facility

Management at an indoor cultivation facility was concerned about

potential hazards during harvesting and trimming of cannabis crops. 

What NIOSH Did

• Measured employee exposures to 

endotoxins. 

• Sampled surfaces for cannabinoids. 

• Assessed area exposures to fungi 

and particulates (trimming and 

harvesting activities). 

• Interviewed cultivation, harvesting, 

and trimming employees. 

Key Findings

• Employees were exposed to endotoxins in the air.

• Employees were concerned about potential exposures at work.

• Trimming employees had exposures to highly repetitive work 

that increased their risk of musculoskeletal disorders.

Recommendations

Reduce exposures to endotoxins in the air and 

dermal exposures to cannabinoids in the workplace.

Reduce risks for musculoskeletal disorders.

Reduce potential exposures to ozone, light, and noise.

Get input from employees about workplace safety and 

health issues and use this input to improve conditions. 

This report is available at: 

https://www.cdc.gov/niosh/hhe/reports/pdfs/2019-0152-3381.pdf 

Photo by NIOSH
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Evaluation of Noise Exposures and 

Hearing Loss at a Forging Company

Metal forging company management and union representatives 

requested an evaluation to assess noise exposures and hearing loss. 

What NIOSH Did

• Measured employees’ 

noise exposures and analyzed 

employees’ hearing tests.

• Measured impact noise and 

noise level frequencies. 

• Interviewed employees about 

noise and hearing loss. 

Key Findings

• Full-shift employee noise exposures that exceeded NIOSH and 

OSHA occupational exposure limits.

• Peak noise levels during hammer impacts were above 

140 decibels; one reached a peak of 155 decibels. 

• Some standard threshold shifts since the baseline audiogram. 

• Employees had hearing loss and hearing worsened with years on 

the job and age, some reported permanent ringing in their ears.

Recommendations

Maintain all equipment to eliminate unnecessary rattles 

and compressed air leakages. 

Implement a “Buy Quiet” program - 

http://www.cdc.gov/niosh/topics/buyquiet/. 

Ensure that workers are properly trained on how to wear 

hearing protection. 

This report is available at: 

https://www.cdc.gov/niosh/hhe/reports/pdfs/2007-0225-3386.pdf

Photo by NIOSH
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What They are Saying

These quotes are from HHE participants who in 2022

commented on our evaluation at their workplace.

The staff were very friendly, professional, and had a 

warm concern for learning about the workplace. 

I appreciate their visit!

∼ cultivation company health and safety staff

The team was extremely professional and a pleasure to work with. 

They were not intimidating to the workforce which is extremely 

important. The crews worked well with the investigators and were 

very receptive of feedback.

∼ city government supervisory employee

An excellent process. The review team was thorough and 

professional. We truly appreciated the care in which the evaluation 

was conducted.

∼ employee requestor at a university

The report was both educative and thorough regarding 

environmental standards in the workplace. While the information 

reported on the facility conditions it also educates the reader on 

what the standards are.

∼ management representative from a school district

The HHE TA was clear, timely, well referenced, and thorough. I have 

shared it with numerous partners who have all found it very helpful. 

One of our colleagues said “This sorta stuff is exactly what the street 

level folks need to make informed decisions – based on 

facts and science, double.”

∼ government health and safety requestor

Our Followback Program

During and after an HHE, we ask for feedback on how well we did, 

how was our communication, were our recommendations helpful, 

and other questions to help us improve what we do.
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HHE Program Visibility Moving Forward

The HHE Program strives to ensure it is known to employees, unions, 

and employers as a safety and health resource. Efforts to increase 

visibility and reach those who might need assistance include:

HHE Program Outreach

• Presentations and publications about the HHE Program and 

completed HHEs at webinars, conferences, meetings, NIOSH 

Sector Councils, HHE reports, trade publications/meetings, 

social media, and scientific publications. 

• Conduct HHE site visits to evaluate a wide variety of 

occupational health hazards and industries across the U.S.

Firefighter Fatality Investigations

• A new column, “NIOSH Corner,” in CRACKYL magazine to share 

NIOSH firefighter-related publications/resources with 

firefighters. The column will share firefighter-related materials 

from across NIOSH, including Fire Fighter Fatality Investigation 

and Prevention Program reports, health and safety advisories, 

National Firefighter Registry for Cancer updates, etc.

Advanced Materials and Manufacturing

• Participating in the American Industrial Hygiene Association 

Nano and Advanced Materials Working Group. Activities include 

training material development and various speaking 

engagements in the industry.

• Increasing knowledge about 3D printing and additive 

manufacturing in healthcare settings. Learning about materials 

and printing processes, controls and ventilation, laboratory setup, and performing exposure assessments. Products include 

prosthetics, instrument design research and development, and 

organ models used in surgical procedure preparation. 

Health Equity

• Ensuring health hazard evaluations are inclusive of foreign-born 

workers by planning early on in a project to incorporate 

interpretation and translation services. 

• Encouraging requests from employees who work in settings 

that put them at higher risk of becoming infected or exposed 

to hazards. 
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What NIOSH is Looking at in 2023
The mission of the NIOSH Health Hazard 

Evaluation Program is to respond to 

requests from employees, employers, and 

union representatives to evaluate potential 

health hazards in their workplace.

These evaluations are done at no cost to the 

requestor. Once the evaluation is complete, 

recommendations are made on ways to reduce or 

eliminate identified hazards. Health Hazard 

Evaluations can help reduce hazards and 

create healthier workplaces.

If you have questions, please contact the HHE Program

Monday–Friday, 9 a.m. – 4:30 p.m. EST

Phone: 1-513-841-4382

@ HHERequestHelp@cdc.gov

NIOSH Health Hazard Evaluation Program

1090 Tusculum Avenue, Mail Stop R-9 

Cincinnati, OH 45226-1988