The Effects of Disaster on Workers: A Study of Burnout

in Investigators of Serious Accidents and Fatalities

in the U.S. Mining Industry

Kathleen M. Kowalski, Ph.D.

Audrey Podlesny

National Institute for Occupational Safety and Health

Pittsburgh Research Laboratory

P.O. Box 18070

Pittsburgh, Pennsylvania 15236

United States

kek2@cdc.gov

Keywords: burnout; accident investigators; occupational safety and health; job

stress

Abstract

The Maslach Burnout Inventory (MBI) was administered and scored for 154 Mine

Safety and Health Administration (MSHA), U.S. Department of Labor, employees

who serve as accident investigators for serious accidents and fatalities as part of their

job duties. The subjects responded anonymously during a workshop on stress. The

subjects consisted of randomly selected individuals, representative of locations

across the country and representative of all mining commodities: coal, metal,

nonmetal, stone, and sand and gravel. The Maslach Burnout Inventory assesses three

aspects of experienced burnout: emotional exhaustion, depersonalization, and

reduced personal accomplishments. The average results of the scores for each of the

three subscales fell in the moderate range for the study group of MSHA accident

investigators. The scores within the moderate range show that the subject population

was at the lower end of the range for emotional exhaustion and depersonalization,

tending toward a lower burnout risk, while the group evidenced a lower sense of

personal accomplishment in their jobs, indicating a higher risk for burnout. It is

concluded that overall this group is at moderate risk for burnout, and the authors

recommend follow-up with this population.
Introduction

American workers are working harder and longer than they have in the past two

decades just to maintain their standard of living. The predicable result is a workforce

more at risk for psychological, physical, and behavioral health problems. During

recent health care reform discussions in regard to United States workers, the costs

associated with work-related chronic ill health were described as representing a

massive drain on the economy, with occupational stress cited as a reason for the

rapid increase in compensation claims.[1] The Northwestern National Life Insurance

Company found that their stress-related disability claims rose from 6% in 1982 to

13% in 1990 [2]. It is of interest to note that disability due to job stress alone, without

evidence of any physical injury or illness, is now a compensable condition in about

one-half of the states in the U.S.[3] At the recent “Work, Stress, and Health ‘99

Conference” it was noted that absences due to stress-related illnesses are a growing

concern.[4]

The study of occupational stress was given new focus in the 1970s when U.S. Public

Law 91-595 established the National Institute for Occupational Safety and Health

(NIOSH). The mission of NIOSH is to ensure a safe and healthy workplace for

America’s workforce. To carry out this mission, the agency conducts research and

makes recommendations for the prevention of work-related disease and injury.

Recently, NIOSH has identified 21 research priorities including the organization of

work that encompasses work-related psycho-social stressors.[5] Thus, occupational

stress has the agency’s rapt attention.

The issue of stress on the job provided a focus for The American Psychological

Association and NIOSH as they joined together in the beginning of 1990 and

declared the 90’s the “Decade of Stress.” [6] Targeted resources have supported work

resulting in a growing body of research on stress on the job. There has been limited

work in the mining industry regarding critical incident stress in mine disasters and

mine rescue.[7, 8] Although the subject population in this study has the potential for

exposure to a critical incident, exposure to day to day, cumulative type stress, which

can lead to burnout, is more likely. To access aspects of experienced burnout, the

Maslach Burnout Inventory (MBI)[9] was administered and scored for a group of

randomly selected Mine Safety and Health Administration (MSHA) accident

investigators. The MBI has three subscales to assess the different aspects of

experienced burnout: emotional exhaustion, depersonalization, and reduced personal

accomplishments. This is the first study of the MSHA accident investigators’

population with respect to worker burnout.

The Human Stress Response

Stress is a normal human characteristic. Although there is imperfect agreement on

the nature of human stress, there are some basic shared concepts. Hans Selye, an

Austrian endocrinologist, described a consistent pattern of mind-body reactions in

1926.[10] He referred to this pattern as the rate of “wear and tear” on the body and
Stressor Stress Response Stress-Related Disease

Figure 1. The Stress Response.

coined the term stress, which refers to the general response of the body to any

demand placed upon it. The demand Selye referred to as the stressor. The stressor

leads to a stress response. The stress response in turn can lead to stress-related

disease (Figure 1).

A stressor can be either psycho-social or biogenic. Psycho-social stressors are

environmental events wherein the individual interpretation plays a key role in the

onset of the response. Biogenic stressors involve stimulants such as caffeine,

nicotine, and amphetamines. Biogenic stressors initiate the stress response directly,

whereas psycho-social stressors initiate the response indirectly. Only those psychosocial stressors interpreted as threatening by the individual will initiate the stress

response. For example, Cannon described the fight or flight response, a physical

response elicited by perceived potentially dangerous situations.[11]

There are two further stress categories: traumatic stress and cumulative stress.

Traumatic stress is faced by workers such as emergency room workers, police

officers, firefighters, and military personnel. This type of stress is directly related

to a critical incident and sometimes referred to as critical incident stress. Critical

incident stress may result in physical and psychological reactions including sleep,

eating, social disturbances, nightmares and sometimes flashbacks. A severe reaction

to a critical incident may result in Post-traumatic Stress Disorder (PTSD).

As noted in the Diagnostic and Statistical Manual of Mental Disorders, Fourth

Edition, the essential feature of PTSD is the development of characteristic symptoms

following exposure to an extreme traumatic stressor involving direct personal

experience of an event that involves actual or threatened death or serious injury, or

other threat to one’s physical integrity; or witnessing an event that involves death

injury, or a threat to the physical integrity of another person; or learning about

unexpected or violent death, serious harm, or threat of death or injury experienced

by a family member or other close associate.[12] The person’s response to the event

must involve intense fear, helplessness, or horror (or in children, the response must

involve disorganized or agitated behavior). The characteristic symptoms resulting

from the exposure to the extreme trauma include persistent re-experiencing of the

traumatic event, persistent avoidance of stimuli associated with the trauma and

numbing of the general responsiveness, and persistent symptoms of increased

arousal. The full symptom picture must be present for more than one month and the

disturbance must cause clinically significant distress or impairment in social,

occupational, or other important areas of functioning.

The second, more common type of stress is the day-to-day, cumulative type stress.

Cumulative stress also has health consequences and may lead to burnout. Pines and
Aronson[13] define burnout as “a state of physical, emotional, and mental exhaustion

caused by long-term involvement in emotionally demanding situations.”

Clearly, obtaining a measurement of stress specific to work is difficult, in that we

know stress in other parts of an individual’s life impacts the work life. Thus, many

researchers are moving toward lifestyle stress measures. Building on the work of

others, Hurrell and Murphy presented a model of job stress and health.[14] To provide

a framework for the reader, this model is presented in Figure 2. As the figure shows,

job stress is seen as a situation in which the working condition interacts with the

individual worker characteristics and results in a disruption, which can lead to a

variety of illnesses.

JOB/TASK DEMANDS

· WORK LOAD

· CONTROL

ORGANIZATIONAL

FACTORS

· ROLE DEMANDS

· MANAGEMENT

STYLES

· CAREER/SECURITY

ISSUES

· INTERPERSONAL

RELATIONSHIPS

PHYSICAL CONDITIONS

· NOISE

· HEAT/COLD

 FINANCIAL STATUS

 FAMILY SITUATION

 SOCIAL SUPPORT

 COPING

 PERSONALITY TRAITS

 STAGE OF CAREER

 DEVELOPMENT

 PHYSOLOGICAL

 HEART RATE

 BLOOD PRESSURE

 PSYCHOLOGICAL

 AFFECT

 JOB DISSATISFACTION

 BEHAVIORAL

 SLEEP PROBLEMS

 SUBSTANCE USE/ABUSE

 HYPERTENSION

 CHD

 ALCOHOLISM

 MENTAL ILLNESS

NON-WORK

FACTORS BUFFER FACTORS

INDIVIDUAL

FACTORS

ACUTE REACTIONS

ILLNESS

JOB STRESSORS

Figure 2. Model of job stress and health. (Hurrell & Murphy, 1998)

Certain jobs are, by their nature, more prone to stress than others. For example,

disaster workers may be thought of as normal people exposed to abnormal

circumstances. When disaster workers respond to a medical emergency, a natural

disaster, a terrorist threat, or an underground mining accident, they are exposed to

traumatic situations. Whether they are first responders, people who happen to be on

the scene, or highly trained professionals such as rescue teams or emergency

personnel, these workers naturally experience normal human responses to their

circumstances. As a result, these workers tend to be at higher risk for occupational

stress illnesses. It is suggested that certain mine industry workers fall into this

category of higher risk because of the hazardous environment in which they must

work, and the types of tasks they do daily on the job. The authors specifically

suggest that the subject population, mine accident investigators, fall into this higher

risk category.

Danger in the Mining Industry
Figure 3. Mine explosion at the portal.

Mining is one of the most dangerous occupations in the world (Figure 3).

Historically, mining has been the industry sector with the highest fatal and nonfatal

injury rates. Even today, it

represents the industry sector

with the highest fatal injury

rate, more than five times the

national average. The mining

industry in the United States is

highly regulated under Title

30 Code of Federal

Regulations, Part 50, Mineral

Resources, and a separate

government agency, the Mine

Safety and Health

Administration (MSHA),

which is part of the U.S.

Department of Labor enforces

the laws concerning mining.

In addition, the National

Institute for Occupational

Safety and Health, under the

Department of Health and

Human Services, includes a

Mine Safety and Health Research Division. This mining division is charged with

providing for the safety and health of the nation’s miners through research.

According to the MSHA Part 50 data, in a recent ten-year period (1989-1998), there

were 240,499 injuries in the mining industry in the United States. This included 988

fatalities, 161,841 non-fatal injuries with days lost, and 77,670 non-fatal injuries with

no days lost.

Role of MSHA Inspectors

MSHA inspectors carry out the day-to-day mine inspections and enforce the mining

safety and health regulations passed by Congress. When a serious injury or fatality

occurs at a mine site, some of these mine inspectors are given a collateral duty as

accident investigators. They become responsible for conducting an investigation into

the accident, determining the cause of the accident, and making recommendations

of any violations. The majority of mining fatalities are a result of falls of ground.

In underground mining, this refers to the fall of the roof onto the victim. In addition,

numerous accidents involve the heavy machinery used to extract the mineral from

the earth. These accidents are sudden and usually the injuries are traumatic to the

body.

Within the last several years, an additional task has been imparted to the

investigators, that of meeting with the families of the victims and presenting the

official report. Approaching this sometimes emotional, always difficult task of
presenting the report to grieving family members while completing the principal task

of fact-finding presents a challenge to the accident investigators and has created, for

some, a conflict of roles.

The consequences of burnout due to these stressors are potentially problematic for

both the individual and the organization. Burnout can result in work of less quality,

job turnover, absenteeism, and low morale. In addition, burnout is correlated with

various self-reported indices of personal dysfunction, including physical exhaustion,

insomnia, increased use of alcohol and drugs, and marital and family problems.

The Instrument

The Maslach Burnout Inventory is a self-administered measure containing three

subscales that assess the different aspects of experienced burnout: emotional

exhaustion, depersonalization, and reduced personal accomplishments. It takes

subjects 10-15 minutes to complete the inventory. According to Maslach, burnout

is a syndrome of emotional exhaustion, depersonalization, and reduced personal

accomplishment.[9] A key aspect of the burnout syndrome is increased feelings of

emotional exhaustion. As emotional resources are diminished, there is a feeling that

the worker can no longer give of him/herself at a psychological level. Another

aspect of the burnout syndrome, according to Maslach, is the development of

depersonalization, which includes negative and cynical attitudes and feelings. A

third aspect of the burnout syndrome, reduced personal accomplishments, refers to

the tendency to evaluate oneself negatively, particularly with regard to one’s work

with people.

Each of these three aspects is measured on separate subscales. The Emotional

Exhaustion subscale assesses feelings of being emotionally overextended and

exhausted by one’s work. The Depersonalization subscale measures a negative

feeling and personal response toward recipients of one’s service. The Personal

Accomplishment subscale assesses feelings of competence and achievement in one’s

work. The frequency that the inventory respondent experiences feelings related to

each subscale is addressed using a seven-point, fully anchored response format.

Burnout is conceptualized as a continuous variable, ranging from low to moderate

to high degrees of experienced feeling. It is not viewed as a dichotomous variable,

which is either present or absent. A high degree of burnout is reflected in high

scores on the Emotional Exhaustion and Depersonalization subscales and in a low

score on the Personal Accomplishment subscale. A moderate degree of burnout is

reflected in moderate scores on the three subscales. A low degree of burnout is

reflected in low scores on the Emotional Exhaustion and Depersonalization subscales

and in a high score on the Personal Accomplishment subscale. The Maslach Burnout

Inventory has been found to be reliable, valid, and easy to administer. The subject

responds to 22 statements using a seven-point Likert scale ranging from never (0) to

everyday (6). There were nine statements scored on the Emotional Exhaustion

subscale, five statements were scored on the Depersonalization subscale, and eight
HOW OFTEN: 0 1 2 3 4 5 6

Never A few

times a

year or

less

Once

a

month

or less

A few

times a

month

Once a

week

A few

times a

week

Every

day

 HOW OFTEN

 0-6 Statements:

 I feel I’m positively influencing others people’s lives through my

work.

 In my work, I deal with emotional problems very calmly.

 I’ve become more callous toward people since I took this job.

Figure 4. Example of Maslach Burnout inventory statements.

statements were scored on the Personal Accomplishment subscale. Examples of

statements are found in Figure 4.

Subjects and Method

The subjects for the present study were 169 MSHA accident investigators from

locations across the country and representative of all mining commodities: coal,

metal, nonmetal, stone, and sand and gravel. Of the 169 subjects, approximately 167

were male, a demographic reflective of the mining industry. The subjects were

participating in a two-week training class that included a 3-1/2 hour workshop

entitled, “Stress, Coping and Grief for Accident Investigators” given by one of the

researchers. Two separate two-week training sessions were offered, one in the spring

and one the following winter. Each training session consisted of four randomly

selected groups; thus, there was a total of eight subject groups. Comparisons were

made between the spring and winter groups, the eight individual groups were

compared to each other, and each group was then compared with the overall average

scores on the three subscales. No significant statistical differences were found

between the groups.

The Maslach Burnout Inventory was administered to the subjects. The instrument

was passed out at the very beginning of class, before introductions, and the students

were asked to fill it out voluntarily. They were asked to include their age and years

of experience in accident investigation (including experience outside the agency).

Fifteen of the accident investigators’ responses were excluded from the analysis (four

investigators did not complete their surveys; four did not note their experience; two

did not note their age; and five did not note their age or experience).

The ages of the investigators (see Figure 5) ranged from 26 to 67 years, with an

average age of 48 years and a standard deviation of 6.62. The ages of the

investigators by category included 10% under the age of 40; 43% were age 40-49;

44% were age 50-59; and 4% of the investigators were age 60 and over.
0

10

20

30

40

50

60

70

26-39 40-49 50-59 60+ 0-5 6-10 11-20 21+

Years

Age Experience

Figure 5. Years of age and experience of MSHA investigators in study.

The group of investigators had 1,558 total years of experience, or an average of

10.1 years with a standard deviation of 8.29. The range was from 0 years

(5 investigators) to 1 investigator having a high of 33 years of experience. The

median was 8 years experience, and the mode was 1 year of experience

(14 investigators). There were 96 investigators (62% of the overall group) with

10 years of experience or less; 24% had 11-20 years of experience; and 14% had

21 years or more of experience.

The data were analyzed by creating XY (scatter) charts with linear trend lines to

illustrate the Emotional Exhaustion, Depersonalization, and Personal

Accomplishment scores in relation to the age and experience of the investigators.

The authors observed that with the exception of a slight increase in Emotional

Exhaustion as age increases, all other trends remained nearly level. Further analysis

of the relationships of the three aspects of burnout revealed that when Emotional

Exhaustion rises, Depersonalization also tends to rise, while Personal

Accomplishment tends to fall. These are all indicators of a higher degree of burnout.

Maslach states that given our limited knowledge about the relationships among the

three aspects of burnout, the scores for each subscale are considered separately and

are not combined into a single, total score.

Anecdotal Data

Many times when the issues of stress and grief are discussed, they trigger specific

situations or memories for individuals. Opportunities to share reactions and

experiences were a part of the workshop, and at the end of the class the groups were

given an opportunity to share their experiences in writing anonymously. In

examining the data from these self-report written anecdotes, two major themes

emerged seen that contributed to the accident investigators’ stress. One was the
demands placed on the investigator from within the organization, and the other,

dealing with the grieving families.

The need for the latest information becomes crucial after a serious accident or fatality

in a mine. Unfortunately, continual demands from headquarters for information can

slow down, interrupt the process, and give a message of lack of trust to the

investigator. One investigator noted:

“Management is 90% of the stress. They want pictures, a preliminary report, and a video immediately.

There is inquisition about what you did every minute and what you ‘should be doing.’ You feel as if

they are second guessing you and they don’t trust you. If a preliminary report is important to

headquarters, then it should be formalized and part of the process. . . . . [I] understand that they need

information, but if I keep getting calls, it interrupts my work.”

Karasek[15] suggested that the amount of work is not as critical to worker health as

the interaction of workload and the amount of control a worker has over the work

and related work processes. This is referred to as “decision latitude.” Demands

placed upon the worker, especially conflicting or unclear tasks, contribute to worker

stress. As one worker reported:

“I was asked by management to go to the deceased miner’s home and spend some time with his family.

At the time it was not clear to me what I was supposed to do. Things went ok, except it was very hard

for me not to get emotionally involved. The victim was a young man in his 20s. I now understand

why it was so difficult [relating to information provided in class concerning death at a young age].

It was one of the hardest things I’ve had to do since I have been with . . . .” [the agency].

The majority of anecdotes dealt with the exchanges with the family of the accident

victim. One worker reported:

“My method of self-preservation is to distance myself from the emotional side of the incident. This

may seem cold, but in no way means that I’m uncaring or unfeeling.”

The Maslach Inventory evidenced this trait in the moderate depersonalization scores,

indicating that emotional distancing is evident in this population.

One of the characteristics of the mining industry is that it is a small, close-knit

community. Many people in the industry know each other, are related to each other,

or our good friends. Mines are not typically located near large cities but mostly in

rural areas near small towns. Thus, when there is an accident, it affects the entire

mining community. Although workers are assigned to their investigations in

different geographic locations from their day to day work location, many of the

subjects had experienced knowing the victim or family.

“After the recovery of the last body. . . . we [the rescue team] were on our way outside. It was a cold,

clear night and you could see the lights outside from inside the mine. I felt very strange inside and

worried what I was going to say to the family . . . . I could hear people crying and praying. What I was

worried about the most was that the young man killed in the roof fall was my friend who had worked

for me some years before. I knew his family and they knew me. I didn’t know who he was until we

almost had him out of the roof fall.”

Another example of this community characteristic:
“A fatal accident occurred where the owner of a small mine was killed . . . . the second person at the

scene was the victim’s nineteen year old son, who helped in the rescue attempts.”

“Recently, I investigated a fatality where a driller had been killed by a falling rock. The driller, a

woman, was a drilling partner with her husband. He was standing just a few feet from her when she

was killed. He told us during the interviews that he knew she was dead, but he just held her for a while

before getting help. The interview was the toughest that I have ever experienced.”

The two themes contributing to the accident investigator’s stress levels and potential

burnout–the organizational demands and the task of interfacing with the families–are

specific to this population and thus it is inappropriate to generalize the data. One

worker, in summing up his experience, wrote:

“After one investigation I actually sat back and reflected on how accidents can happen to anyone

–including myself. I felt I had to get home right then to see my wife and children and spend time with

them. I then had fears for several days that my wife or children may be involved in an accident of

some sort . . . .”

This is a normal reaction, though certainly stressful, for an individual in such

circumstances.

Results and Conclusions

The results of the scores for each of the three subscales of the MBI (Emotional

Exhaustion, Depersonalization, and Personal Accomplishment) fell in the Moderate

range (Figure 6). This indicates that the accident investigators are experiencing

moderate levels of burnout. It is important to remember that low, moderate, and high

are all indicators that the respondents are experiencing some level of burnout.

The accident investigators scored in the lower half of the Moderate range for

Emotional Exhaustion. These scores indicate that the investigators are feeling a

moderate level of being emotionally overextended and exhausted in their work.

The Depersonalization score fell toward the lower end of the Moderate range on the

subscale. The score was 1.8 points from the characterization indicating a low level

of burnout. The need to depersonalize may be interpreted as a necessary component

in accident investigation. In other words, purposefully trying to remove oneself from

the personal/human aspect of the job may facilitate successful completion of the job.

The Personal Accomplishment aspect is scored in the opposite direction from

Emotional Exhaustion and Depersonalization. The Personal Accomplishment score

was in the upper end of the Moderate range, which was 1.1 points from the
0

20

40

60

Emotional

Exhaustion

Depersonalization Personal

Accomplishment

Score

Low Burnout Moderate Burnout High Burnout Score

Figure 6. Average scores on each subscale of the Maslach Burnout

Inventory. Low, moderate, and high burnout are represented by different

shadings on each of the subscales.

characterization, representing a high level of burnout. This indicates that many of

the accident investigators do not feel personal satisfaction and a sense of

accomplishment in their jobs.

In conclusion, the study group of MSHA accident investigators tended toward

emotional exhaustion and depersonalization on the burnout subscales. In addition,

they evidenced a moderate tending toward a low sense of personal accomplishment

in their jobs. Thus, this is a group at moderate risk for burnout.

Discussion and Recommendations

As this was the first study with this interesting population, follow-up is

recommended. Overall, this subject group tended toward burnout. In examining the

data from the students’ self-report written anecdotes, two major themes contributed

to the accident investigators’ stress. Dealing with the grieving families, and meeting

the other demands placed on the investigator from within the organization. A key

finding was that the accident investigators did not evidence a strong sense of

personal accomplishment and importance in the job they were doing when

investigating the accidents.

Based on the anecdotal data, the authors suggest that specific training in working

with grieving families and greater organizational support would be appropriate. In

addition, utilizing local community mental health and/or pastoral services are

suggested. The data suggest that the organization reevaluate the communication

process in the field between headquarters and the investigation site. Generally, the

organization provides support in getting the job done, but there is also evidence that
it contributes to slowing down the process and evidence of a lack of support and trust

for the investigator in the field.

References

[1] Worker Stress, Health Reaching Critical Point, by Patrick A. McGuire Monitor

staff writer, APA Monitor, volume 30 number 5; May 1999.

[2] Northwestern National Life Insurance Company (1991). Employee burnout

America’s newest epidemic. Minneapolis, MN: Northwestern National Life

Insurance.

[3] Elisburg, D. (1995). Workers’ compensation issues for psychologists: the

workers point of view. In Murphy LR Hurrell JJ, Sauter S., Kieta G. eds Job

stress interventions. 

[4] Work, Stress, and Health ‘99 Conference, March 11-13, 1999; Baltimore MD.

Sponsored by the American Psychological Association and the National

Institute for Occupational Safety and Health.

[5] Rosenstock, L. Work organization at the National Institute for Occupational

Safety and Health. J Occup Health Psychol 1997; 2: 7-10.

[6] Stress in the Nineties Conference, sponsored by the American Psychological

Association and The National Institute for Occupational Safety and Health, The

Hyatt Capitol Hill, Washington D.C.; 1991.

[7] Kowalski, K. M. (1995). A Human component to consider in your emergency

management plan: the critical incident stress factor, Safety Science 20, 115-

123.

[8] Kowalski, Kathleen M. (1994). A Human Response to Mine Emergencies: The

Critical Incident Stress Factor; paper prepared for the 84th annual Mine

Inspectors Institute of America, June 12-15, Lexington, KY.

[9] Maslach, Christina (1993). Maslach Burnout Inventory, Second Edition.

California: Consulting Psychologists Press, Inc.

[10] Selye, H. 1993. History of the Stress Concept. In L. Goldberger and S. Breznitz

(Eds.) Handbook of Stress Theoretical and Clinical Aspects. The Free Press,

Macmillian, pp. 7-20.

[11] Cannon W.B. Bodily changes in pain, hunger, fear, and rage. Boston: CT

Branford, 1929.

[12] Diagnostic and Statistical Manual of Mental Disorders (1994) Fourth Edition,

American Psychiatric Association, Washington, D.C.

[13] Pines, A. M. & Aronson, E. (1988) Career burnout: Causes and cures (2nd ed.)

New York: Free Press.

[14] Hurrell, JJ. & Murphy, LR. (1998) Psychological Job Stress, chapter in

Environmental and Occupational Medicine, Third Edition, edited by William

N. Rom. Lippincott-Raven Publishers Philadelphia.

[15] Karasek, RA (1979). Job Demands, Decisions Latitude and Mental Strain:

Implications for Job Redesign Admin Sci Q, 24, 285-307.

Biographies
Dr. Kathleen M. Kowalski is a Research Psychologist with the National Institute for

Occupational Safety and Health, U.S. Department of Health and Human Services.

She is a member and secretary of the Board of Directors of TIEMS, and is the cochair of TIEMS 2000.

Audrey Podlesny is a Statistical Assistant with the Surveillance, Statistics, and

Research Support Activity at the Pittsburgh Research Laboratory of the National

Institute for Occupational Safety and Health.