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NIOSH eNews – April 2015

Volume 12 Number 12 April 2015

From the Director’s Desk

John Howard, M.D.
Director, NIOSH

The Changing Employment Relationship and Its Impact on Worker Well-Being

Work as we know it in 2015 is dramatically different from the 9-to-5 certainty of full-time, uninterrupted, lifetime employment that most people in their twenties could expect a generation ago. The employment relationship is being transformed by various economic and organizational pressures not under the control of any one employer. These pressures arise from financial markets that incentivize corporations to shed all but their core business to contractors. Fierce competition in the globalized world of commerce pressures employers to structure work in the most efficient or leanest way possible. Today’s workplace operates very differently from the workplace of yesterday.

These pressures are changing our traditional concept of the employment relationship. No longer is working for the same employer for one’s entire working lifetime expected; nor is having a defined benefit pension plan that ensures stable retirement income expected; nor is having an employer-sponsored health insurance benefit plan expected. Even the relationship between an employer and a worker has changed dramatically since the 1970s and, according to David Weil in his 2014 book The Fissured Workplace, has led to “declining wages, eroding benefits, inadequate health and safety conditions, and ever-widening income inequality.”

For broad segments of the workforce in virtually every industrial sector, the changing employment relationship can be synonymous with frustration and confusion. Increased workplace stress may lead to significant challenges to the safety, health, and well-being of workers. Increasing numbers of workers enjoy only nonpermanent or part-time contract work or “contingent employment.” Known variously as temporary workers, contract workers, contingent workers, freelancers, or consultants, these workers have many faces. These workers may have to work two jobs just to make ends meet, they may be a single working mother who scrambles to find child care when unexpectedly asked to put in mandatory overtime, or they may be a 55-year-old man who wonders what will happen to his retirement benefits when his company outsources his job, is acquired by a private equity firm and downsizes, or declares bankruptcy. As the employment relationship continues to undergo change, stress related to work organization, scheduling, and staffing may heighten risks for worker injury or illness.

Today, concerns such as these organizational factors determine workplace health just as strongly as the presence of the traditional risks of chemical, physical, and biological hazards. While still tasked to prevent injury and illness from legacy hazards, we must increasingly give comparable attention to the interactions among changing employment patterns and how these new work arrangements impact the safety, health, and well-being of affected workers. For many years, NIOSH’s Work Organization and Stress-related Disorders Programhas conducted research aimed at the elimination of occupational stress arising from work organization issues. The rapid increase in variety of new employment arrangements and their relationship to safety and health requires us to study these changing organizational practices and how they influence risk factors for illness and injury at work.

The need for this type of research is growing. As the Occupational Safety and Health Administration (OSHA) underscored in a recent report, Adding Inequality to Injury: The Costs of Failing to Protect Workers on the Job (, the financial impact of an injury or illness falls especially hard on working men and women who already are the most vulnerable in today’s economy. Often, these are the workers who face minimum-wage or entry-level pay, face bleak prospects for re-employment if they lose their current job or suffer an injury, and have little or no savings to fall back on. If injured at work or sick from work, they may lack access to adequate workers’ compensation benefits or other health insurance. Loss of a paycheck can spell financial catastrophe. “For many injured workers and their families, a workplace injury creates a trap which leaves them less able to save for the future or to make the investments in skills and education that provide the opportunity for advancement. These injuries and illnesses contribute to the pressing issue of income inequality: they force working families out of the middle class and into poverty, and keep the families of lower-wage workers from entering the middle class,” OSHA stated in the report.

The risk for disadvantaged workers is compounded by the changing structure of work in which “more and more, workers are not actual employees of the employer who owns or controls the workplace where they work,” an arrangement that “reduces the incentives for companies to assume responsibility for providing safe working conditions,” the OSHA report contends. At the same time, pressures on workers’ compensation systems designed decades ago “have made it increasingly difficult for injured workers to receive the full benefits” and have shifted costs to injured workers, their families, and to the taxpayer as help is sought from other social services. A recent series of articles by ProPublica, a center for investigative journalism, sounded similar themes (

Over the past few years, NIOSH has begun to recognize the need to design and conduct research in a number of social science areas that will be truly responsive to the new needs of today’s changing workplace. NIOSH has directed attention to the intersection of the changing employment relationship with worker injury and illness. As a result, NIOSH has made investments and stimulated research that will help policymakers effectively meet the challenges that we collectively face in the new employer-worker arrangements of the 21st century. Three new NIOSH programs that grew from the long-standing NIOSH Work Organization Program address the research needs of the 21st century world of work:

  • Total Worker HealthTM Program supports research to better understand the implications of changing work practices, organizational structures, worker demographics, and employment patterns on worker safety, health, and well-being (/niosh/twh/). This research has particular importance for those workers who face the greatest economic setbacks when faced with illness and injury as employer-worker relationships erode; companies restructure, downsize, and merge; and adverse work organization factors increase. By bringing strong science to bear on the problem, we are better able to develop validated recommendations for interventions that can benefit individuals and organizations alike.
  • NIOSH’s Economic Research Program leads innovative research partnerships to better identify and measure the costs of occupational injury and illness—both direct and indirect—and to better understand who bears the burden of those costs. These costs often are under-recognized and under-valued because they have not traditionally been reflected in the standard and limited measurements of cost (/niosh/programs/econ/). These studies are generating a rich body of evidence that provides new insights into issues central to the changing nature of employment. From data-driven analyses about the uncompensated consequences of work-related injuries and illnesses to the mitigating influence of paid sick leave on the risk of occupational injury and illness, the Economics Research Program provides essential data to inform planning, discussions, and negotiations that may have life-changing consequences for workers. As the private and public sector investigates the ramifications of injury and illness in our modern economy, the work of the Economics Research Program will improve their ability to define the burden of cost-shifting between workers’ compensation systems and other health and social insurance programs. These insights are particularly cogent for assuring we recognize both the dollar value as well as the human value of preventing injury and illness on the job.
  • NIOSH’s Center for Workers’ Compensation Studies provides concerted planning, support, and execution of surveillance and research that integrates our goal of injury and illness prevention with a deeper understanding of workers’ compensation systems that are intended to provide loss prevention services and medical and wage benefits to workers who have suffered work-related injury or illness (/niosh/topics/workercomp/cwcs/default.html). By mining the rich, but often overlooked, lode of data from workers’ compensation programs, we and our partners can identify trends and critical risk factors that help us better prevent future losses to workers and their families. For example, several states have been successful in using workers’ compensation data trends to identify risks and develop effective interventions. Workers’ compensation systems also provide important ways to reach employers with safety/health services, training, and messaging. NIOSH has a current extramural grant to encourage state-based departments of health and workers’ compensation bureaus to collaborate further and expand the use of workers’ compensation data and systems for prevention of workplace injury and illness (

I invite you to become familiar with these newer NIOSH programs and consider how you might partner with us to protect, preserve, and promote the well-being of workers in the changing workplace.

John Howard, M.D.
NIOSH Director

NIOSH Releases New Tobacco Report

A new NIOSH report has been released that recommends that all workplaces become tobacco-free and that employers make tobacco cessation programs available to workers. These latest recommendations, which also encompass the use of Electronic Nicotine Delivery Systems (ENDS)—or e-cigarettes—are aimed at protecting workers from the occupational hazards of tobacco and the effects of secondhand exposure to tobacco smoke and emissions from e-cigarettes. To read the full publication, go to   /niosh/docs/2015-113/default.html.

Please Share: Prevention Through Design Credit

On February 19, the U.S. Green Building Council posted a new pilot credit titled “Prevention through Design” to its Leadership in Energy and Environmental Design Pilot Credit Library (/niosh/topics/greenconstruction/default.html). The pilot credit grew out of efforts motivated by a National Occupational Research Agenda Construction goal to integrate safety and health into green rating systems. We ask all those interested in construction safety and health and Prevention through Design to help us get the word out about this pilot credit. Please post it on your websites and share it with your colleagues and partners. Most importantly, take steps to encourage its use so that we can get feedback to improve the credit and show its importance.

New NIOSH Publication on Silica/Asphalt Milling

NIOSH has developed a new document through the Silica/Asphalt Milling Machine Partnership. This document provides best practices to help reduce respirable crystalline silica exposures during asphalt pavement milling in highway construction. NIOSH thanks the partnership for 10 years of successful collaborative research. To access the document, visit /niosh/docs/2015-105. To learn more about engineering controls for silica in construction, visit /niosh/topics/silica/constructionControlMain.html. For more information, contact CDR Duane Hammond at or 513.841.4286.

New NIOSH Divisions Provide a Growing Presence in the Western States

NIOSH announces the formation of the Spokane Mining Research Division (SMRD) and the Western States Division (WSD), both new expansions to the NIOSH family.  Recent approval from the Centers for Disease Control and Prevention (CDC) and the Department of Health and Human Services (DHHS) allows for the search for directors of the SMRD and WSD to begin while strategic development of the Divisions is underway. /niosh/updates/upd-03-13-15.html

NIOSH Study Spans over Thirty Years of Hearing Loss Trends

A new study from NIOSH examines thirty years of hearing loss trends experienced by workers exposed to noise while on the job, across various industries. The study, published by the American Journal of Industrial Medicine, found that while progress has been made in reducing the risk of hearing loss within most industry sectors, additional efforts are needed within the Mining, Construction, and Healthcare and Social Assistance sectors. /niosh/updates/upd-03-04-15.html

NIOSH Article Looks at U.S. Metal and Nonmetal Miner Health

NIOSH recently published an article describing the current knowledge of U.S. metal and nonmetal (MNM) miner health. The lack of a comprehensive surveillance system and existing gaps in the literature and national surveys limit our understanding of the health status of MNM miners, a high-risk and overlooked population. NIOSH reviews current data sources and describes plans for a health program to address these knowledge gaps and to improve miner health. For the full report, go to

NIOSH Collaboration Looks to Reduce Risks on Lobster Boats

Scientists from NIOSH and L’Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST) recently collaborated at the Maine Fishermen’s Forum in Rockport Maine to discuss ways to reduce risks on lobster boats. The forum session focused on reducing risks for repetitive motion injuries as well as designing better deck layouts to prevent getting entangled in ropes and being pulled overboard. Information to reduce risk among fishermen in Quebec can be found at For NIOSH information on reducing risk among fishermen, go to /niosh/topics/fishing/default.html.

New Topic Pages for Workers, Employers, and Healthcare Professionals on Work and Reproductive Health

The NIOSH topic pages on reproductive health (/niosh/topics/repro/) provide information for workers, employers, and healthcare professionals on issues related to men’s and women’s reproductive health, fertility, pregnancy, and breastfeeding. Newly added topic pages contain information on reproductive hazards associated with specific jobs and occupational exposures (/niosh/topics/repro/pregnancy.html).

CDC and NIOSH Staff with Congressman David McKinley

CDC and NIOSH Staff with Congressman David McKinley

Veterans Job Fair

CDC and NIOSH participated in a Veterans Job Fair on Wednesday, March 11, at the Erikson Alumni Center in Morgantown, West Virginia, and hosted by Congressman David McKinley’s office. The purpose was to connect unemployed veterans with businesses that were currently hiring. Business, state, and federal organizations located across West Virginia were in attendance.


Pictured are some of the NIOSH staff deployed to the Ebola response in Freetown, Sierra Leone: Mike Elliott, Jeff Welsh, Melissa Seaton, Renee Funk, Cammie Menendez, Matt Dahm, and Jill Shugart.

Pictured are some of the NIOSH staff deployed to the Ebola response in Freetown, Sierra Leone: Mike Elliott, Jeff Welsh, Melissa Seaton, Renee Funk, Cammie Menendez, Matt Dahm, and Jill Shugart.

NIOSH Staff Assist With Ebola Response

NIOSH staff have deployed to West Africa from all across the Institute in support of CDC’s ongoing response to the Ebola outbreak. NIOSH has deployed as epidemiologists, infection prevention and control specialists, healthcare promotion specialists, safety officers, and logisticians. The country director in Sierra Leone wrote in an email to NIOSH: “Thanks for your ongoing support to the response. We really love having the NIOSH people here.”





New Comparison of Workplace to Non-workplace Suicides

A new NIOSH study published in the American Journal of Preventive Medicine analyzes the upward trend of suicides that take place in the workplace and identifies specific occupations in which individuals are at higher risk. In the study, authors found that those in protective services, farming/fishing/forestry, and automotive maintenance and repair have the highest workplace suicide rates. Authors suggest that a more comprehensive view of work life, public health, and work safety could enable a better understanding of suicide risk factors and how to address them. Suicide is a multifactorial outcome, and, therefore, multiple opportunities to intervene in an individual’s life—including the workplace—should be considered. The workplace can be a potential site to implement such programs and train managers in the detection of suicidal behavior, especially among the high-risk occupations identified in this paper. The article, “Suicide in U.S Workplaces, 2003–2010, a Comparison with Non-workplace Suicides,” can be found at

Sustainable Work, Sustainable Health, Sustainable Organizations

Join NIOSH, the American Psychological Association and the Society for Occupational Health Psychology as we convene the 11th International Conference on Occupational Stress and Health in Atlanta, GA, May 6-9. The conference theme “Sustainable Work, Sustainable Health, Sustainable Organizations” highlights the integral role of occupational safety and health in sustainable growth both for the organization and employee. The conference program and registration information can be found on the Work, Stress and Health Conference web site,

Monthly Features

NIOSH Congratulates

Distinguished Alumni Award

Thais Morata was selected to receive the University of Cincinnati College Of Allied Health Sciences Distinguished Alumni Award for 2015. Each year, the college recognizes alum from each department. Dr. Morata was nominated by the Communication Sciences and Disorders Department (CSD). The CSD policy is to nominate CSD alum from those who have previously been selected as a Commu­nication Sciences and Disorders Outstanding Alum. The award ceremony will take place on April 23.

CDC Honors Winner

Dr. Azman at the CDC Tom Harkin Global Communications Center.

Dr. Azman at the CDC Tom Harkin Global Communications Center

NIOSH researcher Dr. Amanda Azman received the Centers for Disease Control and Prevention (CDC) Honors Award for 2014 for her leadership of the Noise Control Team in the NIOSH Office of Mine Safety and Health Research.


Paper of the Year Award—Respiratory/Inhalation Toxicology at the Society of Toxicology Annual Meeting

NIOSH researcher Linda Sargent, PhD, accepted the Paper of the Year Award in the area of respiratory/inhalation toxicology for the publication “Promotion of lung adenocarcinoma following inhalation exposure to multi-walled carbon nanotubes.” The paper, published in Particle and Fibre Toxicology, was the first to show that multi-walled carbon nanotubes encourage the growth of cells with DNA damage (initiated cells) to form tumors that spread to other parts of the body. This research subsequently supported the decision by  the International Agency for Research on Cancer to designate this specific class of carbon nanotubes as carcinogenic. The award was presented at a reception held at the annual meeting of the Society of Toxicology on March 23.



Cleaning and Disinfecting Safely

A working group, assembled through the NORA Healthcare and Social Assistance Council (/nora/councils/hcsa/) and led by Margaret Quinn and Paul Henneberger, recently  published a report in the American Journal of Infection Control . The report provides a more integrated framework for environmental surface cleaning and disinfection in healthcare. The article outlines effective cleaning and disinfection practices while also protecting the respiratory health of workers. It identifies specific needs for basic knowledge, improved selection and use of products and practices, effective hazard communication and training, and safer alternatives. To read the article go to For more information, contact

News from Our Partners

Michigan Multisource Surveillance System

In March 2015, the results of Michigan’s multisource surveillance system for work-related amputations for the years 2006–2012 was published in Occupational and Environmental Medicine ( The Michigan system reported over twice as many amputations as counted in the employer-based annual Bureau of Labor survey, and the individual reports in the Michigan system were used to initiate follow-back inspections.

Minnesota Updates Mesothelioma Incidence in Taconite Miners and Asbestos Ceiling Tile Workers

In collaboration with the Minnesota Cancer Surveillance System, the Minnesota Occupational Health Surveillance Program updated the mesothelioma incidence in a cohort of 69,000 taconite (iron ore) miners and 5,200 former workers at an asbestos ceiling tile manufacturing plant. The update brings the total known cases to 101 among miners and 39 among ceiling tile workers. All the cases were among males. Due to the extremely long latency of mesothelioma—typically 40 years or more following exposure—new cases will continue to occur.

Nebraska Releases Data Profiles for Local Health Departments

The Nebraska Occupational Safety and Health Surveillance Program recently published Occupational Health Profiles, which provides a snapshot of the worker health and safety status within 20 local public health department districts in Nebraska. Each two-page profile highlights workplace injury and illness data from 2008 to 2012 and features data on hospitalizations, emergency departments, and workers’ compensation claims. The profiles were created to help local public health in Nebraska prioritize and address occupational health issues in their communities. The data profiles are available at

Save the Date! Graduate Summer Institute in Environmental Health Sciences at Johns Hopkins School of Public Health

The Department of Environmental Health Sciences at Johns Hopkins School of Public Health will host a summer institute from June 1–19 with seven full courses and three 1-day short courses offered over the 3-week period. Courses are designed for practicing public health professionals with responsibilities for health, safety, and environmental matters and for students who are interested in learning more about environmental health sciences concepts. For more information, go to


FACE Reports

Salesman Killed When Forklift Falls Off Truck Loading Ramp—Oregon

A Welder Dies When He Is Struck by a Projectile from a Truck’s Hydraulic Tank—California

Auto Technician Mistakes Handicapped-accessible Accelerator Pedal for Brake Pedal and Fatally Pins Co-Worker—Kentucky

Long Haul Trucker Dies After Striking an Embankment at the End of an Interstate Highway Off-ramp—Kentucky

Semi Owner-Operator Dies in Rollover After Speeding Through a Curve—Kentucky

Passenger Dies When Semi-Truck Trailer Hits Cow in Roadway—Kentucky

Semi-Tractor Trailer Driver Hauling Chicken Dies After Striking A Rock Wall—Kentucky

53-Year-Old Male Iron Foreman Dies after Fall from Steel Decking—Kentucky

Coal Truck Driver Fatally Injured in Collision with Another Coal Tractor-Trailer—Kentucky

Semi-truck Driver Dies After Striking A Bridge Abutment—Kentucky

Two Tree Trimmers Die When Struck By Errant Semi Tractor-Trailer—Kentucky /niosh/face/stateface/ky/10ky009.html

Semi-truck Driver Dies After Being Struck by Flatbed Driver in Crossover Collision—Kentucky

Roadside Responder is Struck by a Box Truck and Dies—Kentucky

Two Semis Collide—Fire Ensues; Both Drivers Perish—Kentucky

Tree Trimmer is struck and Killed by Falling Tree Limb—Kentucky

Laborer Falls 55 to 75 Feet to the Ground While Spray Painting Grain Bins—Kentucky

Flagger Struck by Motorist and Killed—Kentucky

Hispanic Laborer is Crushed by Gantry Roller Press While Retrieving a Dropped Hammer—Kentucky

Truck Driver Falls from Tanker Truck to His Death—Kentucky

Factory Manager Bypasses Lockout/Tag-out and is Electrocuted—Kentucky

Farmer and His Employee Died After Collapse and Attempted Rescue in Manure Storage Pit—Iowa

Farm Worker Electrocuted While Pressure-washing Interior of Swine Barn—Iowa

Orchard Laborer Dies when Crushed Between a Motor Grader and Semi-Truck—Washington

Department of Public Works Worker and a Volunteer Firefighter Died in a Sewer Manhole—New York

Machinist Dies After Being Struck by Rotating Steel Bar Stock in Lathe—Washington

Timber Harvester Operator Killed Following a Chain Shot Incident—Washington

Law Enforcement Officer Killed in Line of Duty—Iowa

Restaurant Co-owner Fatally Crushed by a Dumbwaiter Car—New York

Landscaper Working from a Raised Portable Work Platform Was Electrocuted When a Pole Saw Contacts Overhead Power Line—Massachusetts

Vineyard Worker Killed in Fall From Trailer—Oregon

Contract Sanitation Worker Killed Cleaning Meat Blending Equipment—Oregon

Collapsed Roof Trusses Kill Carpenter Foreman—Oregon

r2p Corner (H2)

Memorandum of Understanding Between NIOSH and SAIOH

Recently, NIOSH and the Southern African Institute for Occupational Hygiene (SAIOH) signed a 5-year agreement. SAIOH and NIOSH plan to use their collaborative efforts and expertise to advance the protection of workers and to promote best practices to improve worker safety and health. In addition, SAIOH and NIOSH plan to work together to develop a plan of action and discuss targets for the activities and initiatives covered in the MOU. For more information, contact Leslie Nickels at (202) 245-0654 or

Health Hazard Evaluation (HHE) Program Update

Precautions Against Lead Exposure Provided to a Battery Recycling Company

Lead overexposures among employees led HHE Program investigators to recommend enclosing the battery breaker and shredder, improving ventilation, and providing more protective respirators for certain jobs. A link to this final report is available at /niosh/hhe/whats_new.html.

Recommendations Provided to Reduce Exposures to Solvents in Dry-cleaning Shops

Evaluations of solvent exposures at three dry-cleaning shops found the potential for air and skin exposures. HHE Program investigators provided recommendations on work practices, housekeeping, equipment maintenance, and the appropriate selection and use of PPE. A link to this final report is available at /niosh/hhe/whats_new.html.


What’s New on the NIOSH Science Blog? Join the Discussion Today!

New NIOSH Communication Products

  • Preventing Work-related Motor Vehicle Crashes /niosh/docs/2015-111/
  • Best Practice Engineering Control Guidelines to Control Worker Exposure to Respirable Crystalline Silica during Asphalt Pavement Milling /niosh/docs/2015-105/
  • Talking Safety – Giving Youth Work Readiness Skills To Keep Them Safe and Healthy /niosh/docs/2015-110/
  • Recommended Practices: Green Tobacco Sickness /niosh/docs/2015-104/
  • Current Intelligence Bulletin 67: Promoting Health and Preventing Disease and Injury Through Workplace Tobacco Policies /niosh/docs/2015-113/


Federal Register Notices of Public Meetings and Public Comment

Interventions to Reduce Shoulder MSDs in Overhead Assembly—Extension
The notice was posted on February 6. Written comments should be received within 60 days.

Future Directions for the Surveillance of Agricultural Injuries
The notice was posted on February 26. Electronic and written comments must be received by May 27.

Coal Workers’ Health Surveillance Program—Reinstatement with Change
The notice was posted on March 18. Written comments should be received within 30 days.

Emergency Self Escape for Coal Miners—New
The notice was posted on March 24. Written comments should be received within 30 days.

For a listing of NIOSH official publications for rules, proposed rules, and notices, go to /niosh/fedreg.html.

Upcoming Conferences and Workshops

FDIC 2015 Conference
April 20–25, Indianapolis, IN

American College of Occupational and Environmental Medicine Conference
May 3–6, Baltimore, MD

11th International Conference on Occupational Stress and Health, Work Stress and Health 2015: Sustainable Work, Sustainable Health, Sustainable Organizations
May 6–9, Atlanta, GA

National Occupational Injury Research Symposium (NOIRS)
May 19–21, Kingwood, WV

2015 Hazmat Conference
May 28–31, Baltimore, MD

American Industrial Hygiene Conference and Expo
May 30–June 4, Salt Lake City, UT

Ninth Annual National Conference on Health Communication, Marketing, and Media
August 11–13, Atlanta, GA

2015 National Safety Council Congress & Expo—Building Safer Workplaces
September 26–October 2, Atlanta, GA

National Fire Protection Association 2015 Backyards and Beyond Wildfire Education Conference
October 22–24, Myrtle Beach, SC

Tenth Symposium on Performance of Protective Clothing and Equipment: Risk Reduction Through Research and Testing
January 28–29, 2016, San Antonio, TX

A comprehensive list of upcoming conferences can be found at

Did You Know?

Did you know that NIOSH recently released its first Blog in its Workplace Medical Mystery Series? Read more at

Please send your comments and suggestions to us by visiting /niosh/contact/.

This newsletter is published monthly via email by the National Institute for Occupational Safety and Health to inform members of the public health community as well as interested members of the general public of Institute-related news, new publications, and updates on existing programs and initiatives.