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NIOSH Research Rounds

NIOSH Research Rounds is a monthly bulletin of selected research conducted by researchers at NIOSH and NIOSH-funded researchers at other institutions.
Volume 5, Number 1 (July 2019)

Inside NIOSH:
Curriculum Improves Adolescents’ Workplace Safety Knowledge, Attitudes, and Intention to Engage in Safety Activities

Young Worker

After receiving instruction on the Talking Safety curriculum, adolescents participating in a NIOSH study scored statistically significantly higher on measures of workplace safety and health knowledge, attitude, and intention to engage in workplace safety activities. iStock/Getty Images

U.S. adolescents (< 18 years) experience a higher rate of job-related injuries compared with adults. Safety education is considered critical to the prevention of these incidents.

To prepare middle- and high-school students for safe and healthy employment, NIOSH and its partners developed a free curriculum, Youth@Work—Talking Safety, built on a theoretical framework of foundational workplace safety and health competencies that are fundamental to all jobs. In a new study published in Prevention Science investigators from the NIOSH Safe-Skilled-Ready Workforce Program examined the impact of the Talking Safety curriculum on students’ knowledge and perceptions of workplace safety and health. The curriculum was delivered by science teachers with strict adherence to the program as it was designed by NIOSH. After receiving curriculum instruction, more than 1,700 eighth graders in Miami-Dade, Florida, the fourth largest U.S. school district, scored statistically significantly higher on the outcomes assessed. Specifically, their average scores increased in workplace safety knowledge (34%); attitude (5%); perceived norms related to workplace safety behaviors (7%); self-efficacy, or confidence in one’s ability to take appropriate action (7%); and behavioral intention to engage in workplace safety activities (7%).

These findings build on previous research by the same investigators and support using this curriculum to provide adolescents with critical life skills for safe and healthy work. A new article from the research team published in the Journal of School Health explores teachers’ perceptions of teaching workplace safety and health topics in their classrooms.

More information is available:

NIOSH Research Rounds is Brought to You By:
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Using Graphs to Improve Studies of Work Exposures in Pregnancy

Pregnant Women Meeting At Ante Natal Class

A NIOSH study used a graphing technique to show how to account for healthy worker effects in studies of work-related exposures in pregnancy. iStock/Getty Images Plus

Workers often tend to be healthier and live longer than their unemployed peers, who may be unable to work due to illness or other issues. A recent study by NIOSH and a university partner aimed to understand how to account for these “healthy worker effects” in studies among pregnant workers. Lead author Candice Johnson, NIOSH epidemiologist, explains the study, published in the American Journal of Epidemiology.

Q: Why did you do this study?
A:  In studies of work-related exposures like chemicals or ergonomic factors, we account for healthy worker effects. The problem is that most of our information on how to account for these effects comes from studies of long-term diseases and deaths. Since pregnancy is a comparatively short, defined period, pregnancy-related studies need a different approach.

Q: How did you do the study?
A: We used a graphing technique to depict when during pregnancy healthy worker effects were most likely to occur. In addition to the healthy hire effect, which refers to healthier pregnant women being more likely to work, we used graphs to look at several possibilities:

  • Situations when socioeconomic differences influence who returns to work after pregnancy.
  • Women with live births leaving the workforce.
  • Women with a previous complicated pregnancy leaving the workforce before the relevant high-risk period occurs.
  • Women leaving the workforce at different times depending on various exposures during pregnancy.

Q: What did you find?
A: Using the graphs, we accurately identified when during pregnancy each healthy worker effect is most likely. By restricting research to these specific times, and to women already working during these times, researchers can account for these healthy worker effects in their studies of work exposures during pregnancy.

More information is available: Structure and Control of Healthy Worker Effects in Studies of Pregnancy Outcomes.

Outside NIOSH:
Stroke Severity, Race, and Socioeconomic Status Predict Return to Work for Stroke Survivors

Nearly 800,000 Americans have either a first-time or a repeated stroke annually, with many of them experiencing mental, emotional, and physical injuries despite improvements in treatment. In fact, stroke is a leading cause of long-term disability and failure to return to work for employees.

In a NIOSH-funded study published in the journal Workplace Health & Safety, researchers at the University of Alabama at Birmingham reviewed 2,586 journal articles and selected 19 relevant studies to identify factors that affect stroke survivors’ return to the job. These factors included stroke severity, disability, race and ethnicity, occupation, level of education, and the existence of mood disorders like anxiety and depression. Workers were more likely to work again after a mild or moderate stroke than a severe stroke. They also were more likely to be Caucasian and of higher socioeconomic status than those who did not return to work. Other findings showed that occupational health nurses can help stroke survivors who return to work by monitoring their health history related to stroke and ensuring the availability of necessary resources, such as support for anxiety and depression and the opportunity for rest breaks.

African Americans are much more likely to have a stroke than other racial and ethnic groups, yet few of the studies focused on them. These results show the importance of future research looking into factors that predict return to work for African American stroke survivors.

More information is available:

Mapping Tool Helps Companies Purchase Safe, Efficient Office Equipment

Office workers are at high risk of experiencing musculoskeletal, or soft-tissue, disorders from repeated motion and awkward positions, such as sitting for long hours in front of a computer. Previous research has shown that safe and efficient, or ergonomic, office equipment can help reduce the risk, but obtaining the right equipment sometimes can be challenging.

In a NIOSH-funded study at Ohio University, researchers used a tool called value-stream mapping to collect information about finding and purchasing, or procuring, ergonomic computer workstations by depicting the process from beginning to end. They first surveyed 548 office workers at a large university about work-related muscle pain associated with computer workstations, including mouse controllers, keyboards, and adjustable chairs, and their satisfaction with the equipment’s procurement. The workers’ average age was 45, almost two-thirds were female, and most reported that they experienced pain in the neck, shoulders, and back. Using the survey results, the researchers created value-stream maps of the procurement process for the computer workstations. Next, they asked 331 workers for details about how they procured the equipment and then revised the value-stream maps based on these responses.

The value-stream maps helped the researchers collect and display information that improved the procurement process, according to the study published in the journal Professional Safety. In other findings, workers expressed much greater satisfaction when their departments consulted an expert in ergonomics before buying new computer workstations. These results highlight that value-stream maps can help companies find and purchase effective ergonomic equipment to help prevent work-related musculoskeletal disorders.

More information is available:


Mention of any company or product does not constitute endorsement by NIOSH.