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Total Worker Health in Action

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Volume 8 Number 4  December 2019

Director’s Buzz


L. Casey Chosewood, MD, MPH

With the holiday season upon us, I want to highlight some of the many lessons learned at the Work, Stress and Health Conference. The challenge of balancing life and work is a common issue for workers across the country, one that is especially felt during the holiday season. Managing workloads, end of year deadlines, family obligations, and additional demands of the season can impact workers at work and at home. Addressing the worker as a whole and acknowledging the complex overlap between work and home can help employers and workers navigate the demands of the whole year through, including a busy holiday season. In addition to presentations by the NIOSH Total Worker Health (TWH) team, Centers of Excellence for TWH, and other partners, this year’s Work, Stress and Health Conference provided opportunities to meet with affiliates and partners to share promising practices and discuss next steps for the field in a TWH Town Hall, as well as a book signing for the recently published Edited Volume on Total Worker Health. We are also proud to feature a recent collaboration with the U.S. Surgeon General’s Office, which highlights the importance of balancing work and non-work commitments. We hope that the features, promising practices, and relevant resources provided in this newsletter can help you and your organizations to celebrate health and stay healthy at work and beyond to prepare for a great New Year ahead.

Don’t forget, you are welcome to join the conversation on Twitter (@NIOSH_TWH), on the NIOSH Total Worker Health LinkedIn Group, or by email at to stay up-to-date on the latest Total Worker Health news, research, events, and more.

To learn more about how Total Worker Health was featured at the Work, Stress and Health Conference, read the feature in the previous issue of our newsletter.

Total Worker Health Exclusive

Oregon Total Worker Health Alliance launches TWH Curriculum for Practitioners

Editor’s note: The NIOSH Office for Total Worker Health developed this feature with co-author Dede Montgomery, MS, CIH, Senior Research Associate for Outreach and Education, Oregon Institute of Occupational Health Sciences, Oregon Healthy Workforce Center, Oregon Health and Science University.

The Oregon Institute of Occupational Health Sciences, including the Oregon Healthy Workforce Center, a NIOSH-funded Center of Excellence for Total Worker Health, recently joined with Oregon Occupational Safety and Health (OSHA) and SAIF Corporation to comprise the Oregon Total Worker Health Alliance. The creation of this body and the leveraging of these three state-based organizations will allow for collaboration and expansion of knowledge and application of Total Worker Health principles. A unique aspect of this alliance is the forging of the partnership between Oregon’s state OSHA, Oregon’s not-for-profit, state-chartered workers’ compensation insurance company, and an Oregon-based academic research institute.

Prior to forming this alliance, these three partners have collaborated on a variety of initiatives impacting occupational safety, health, and well-being. Since the signing, however, the alliance is making a concerted effort in Oregon toward improvements for all workers by using concepts, evidence, and data related to Total Worker Health principles. These efforts include creating a training curriculum.

Development of the Oregon Total Worker Health Alliance training curriculum is currently the most active initiative involving the alliance. The training is designed for occupational safety and health, worker compensation, and human resource practitioners and professions, as well as safety committee members. The foundation of this curriculum is a 3-hour prerequisite class, “Total Worker Health 101: The Basics.” Additional modules address “Workplace Solutions” and “Fatigue and Sleep,” and other topics are in development.

The purpose of the Oregon Total Worker Health Alliance curriculum is to provide consistent, reproducible training that is research-based and supports current practice. Materials used include the “Fundamentals of Total Worker Health Approaches: Essential elements for advancing worker safety, health, and well-being” (CDC/NIOSH, December 2016). The “Basics” class presents the following objectives for participants:

  • Define terms and concepts essential to TWH
  • Identify the five defining elements of TWH
  • Discuss how organizations can effectively implement TWH
  • Develop “next steps” applicable to [each] participant’s organization

The courses have been taught face-to-face at several events and conferences in 2018–2019, including the Western Pulp, Paper, and Forest Products Safety & Health Conference, Oregon Governor’s Safety and Health Conference, University of Washington ERC Continuing Education, and Oregon SHARP Alliance. More sites are scheduled for 2020, such as the Region X VPPPA. Learn more at

Promising Practice for Total Worker Health

A Strategic Community-Level Approach to Worker Health: Healthy Workplaces in Madison County, New York

Chia-Chia Chang, MPH, MBA, NIOSH Office for Total Worker Health

Madison County Department of Health logo

Healthy workers make a healthy community. In addition to the workers themselves, their workplaces are part of neighborhoods and greater society. Workplaces, rather than functioning as islands, play a vital role in the safety, health, and well-being of communities.

Leaders in public health have recognized the impact of the workforce on a community. For instance, the Surgeon General recently highlighted the value of worker well-being to a community, and both the National Academies of Medicine and Robert Wood Johnson Foundation lead initiatives encouraging business engagement in community health. Recognizing the impact that healthy workforces can have on population health, the Department of Health in Madison County, New York, launched a Healthy Workplaces Initiative.

To understand the needs of the local population, the county completed a Community Health Assessment in 2016 and created a Community Health Improvement Plan (CHIP) that highlighted the importance of a healthy working-aged adult population. The next year, the Rural Health Council of Madison County formed the Worksite Wellness Coalition to share promising practices, discuss collaboration opportunities, and learn about how safety and health issues can impact businesses too. The County published a worker profile report, Healthy Workplaces in Madison County, which described the current state of worker safety and health, workforce health disparities, and personal health risks. The report served as a strategic and measurable implementation guide for the initiative by identifying goals, objectives, key measures, and recommendations.

Madison County’s overarching goal was to create healthy social and physical environments by achieving its strategic goal of Healthy Workplaces. To meet the report’s objectives, the County based its key measures on the strategies in New York State’s Prevention Agenda and the national Healthy People 2020 initiative. For implementing its strategic approach, the report outlined the baseline and target measures, the target-setting method, and data sources. It also defined four focus areas to be addressed through research, surveillance, transfer of knowledge to practice, and training opportunities. Collectively, these efforts enabled the development of an action plan, which the county is now implementing.

One of the key activities of the action plan is to pilot an integrated approach in a workplace. The Madison County Department of Health volunteered as a participant and has received input during planning from the Center of Excellence for TWH at the Harvard T.H. Chan School of Public Health’s Center for Work, Health, and Well-being. Two additional employers were recruited for the pilot—Oneida Healthcare and HP Hood, Inc.—and these pilot sites have completed baseline assessments. The pilot sites will soon convene to analyze the results, identify lessons learned, and share resources that were developed with other businesses. The Madison County Department of Health will continue to phase two of the pilot. It plans to serve as a technical advisor and consultant to businesses that want to implement an integrated approach.

Another key outcome of the work being conducted in Madison County was the Healthy Workforce Business Conference, which convened in October 2019. Bringing together employers and stakeholders from Central New York, the conference shared research and best practices focused on three themes: leadership, safety, and wellness. Speakers included experts from NIOSH and the Center for Work, Health, and Well-being. Planning is already underway for another event next year, following positive feedback from conference attendees, with a goal of providing concrete tools that participants can take back to their workplaces.

As a leader in health and well-being for the community, Madison County has created a website providing resources related to the Total Worker Health® approach, including materials from the recent conference and local data. For its leadership and innovative approach to improving the health of its community, NIOSH has recognized Madison County as a NIOSH TWH Affiliate. Through their well-planned strategic framework and public-private collaborations, Madison County provides a promising practice for improving population health by targeting worker safety, health, and well-being.

Spotlight on Opioids in the Workplace

NIOSH Responds to the Opioid Crisis: Vital Information for Workers and Employers

Editor’s note: If you or someone you know needs assistance (in English or Spanish) with mental and/or substance use disorders, prevention, and recovery, please contact SAMHSA’s National Helpline at 1-800-662-HELP (4357) or visit

New NIOSH Toolkit for First Responders

As we continue to address the opioid crisis, practitioners and employers alike can benefit from tools that provide quick and easy-to-digest information on how employees who may encounter illicit drugs can protect themselves in the workplace. NIOSH has released a new virtual toolkit to provide resources to help keep first responders safe when responding to settings where illicit drugs may be present. The toolkit includes training videos, infographics, and postcards that provide information and guidance on safety measures for preventing potential exposures. These resources are based on NIOSH recommendations for how first responders can protect themselves during responses. Find these resources and more on the NIOSH Opioids page.

Update from September’s TWH in Action! Opioid Feature, “NIOSH Employees Take Action to Address the Opioid Crisis in their Communities”

HealthiestNIOSH continues to expand its efforts to address the opioid crisis. Since the first Opioid Awareness Seminar at NIOSH’s Cincinnati location in June, HealthiestNIOSH has expanded its NARCAN training and distribution program to its Washington, D.C., location. Employees learn basic information about the safety and administration of naloxone and can take part in hands-on training on how to acquire, store, and administer the overdose-reversing and life-saving medication.

Meanwhile, HealthiestNIOSH has continued moving forward efforts in Cincinnati by piloting a new Naloxone Safe User Program. This program would make naloxone available for use in the event of an overdose in all three NIOSH buildings in Cincinnati. Currently, several volunteers serve on the safe user team. The team received training, tools, and information on using the onsite naloxone kits safely, if the need should ever arise. HealthiestNIOSH plans to expand its efforts to additional NIOSH sites soon.

Updates from the NIOSH Centers of Excellence for Total Worker Health

  • The Center for Health, Work & Environment hosted a webinar November 13th, titled Health Links™ Webinar: Finding Your “Why” for Total Worker Health®. Watch the archived webinar here. In addition, the Online Certificate in Total Worker Health® program through CHWE has launched! The 15-credit-hour TWH Certificate Program is now completely online. CHWE created a program video (which you can view online) highlighting three of its students in the program and wrote a story about two healthcare-professional students.
  • The Center for the Promotion of Health in the New England Workplace (CPH-NEW) Co-Director Laura Punnett, ScD, has been named advisory board chair of the University of Massachusetts Lowell National Science Foundation “Making WAVES” project to increase diversity of faculty in STEM fields. Suzanne Nobrega, MS (UMass Lowell) and Bill Shaw, PhD (UConn Health) have been named Associate Directors of the CPH-NEW Total Worker Health Center.
  • Harvard’s Center for Work, Health and Well-being was featured in a Minneapolis Star Tribune article about Total Worker Health, entitled “To run a business more responsibly, start with employee health.” Published in October, the article featured the Center’s partnership with HealthPartners, a TWH Affiliate. It focused on a project in which three Minnesota manufacturing companies measured and assessed their policies, programs, and practices related to workplace health and safety and then implemented strategies to make improvements in these areas.
  • The Healthier Workforce Center of the Midwest (HWC) is proud to announce the official launch of Workplace Matters, a mini (<10-minute) podcast series focusing on healthy work design. The podcast tackles a broad range of cost-effective approaches to impact the well-being of today’s workforce. This Fall, the HWC released a two-part video series: an introductory video to the opioid crisis and a companion video providing employers with methods to protect the workplace from prescription opioids. These videos are part of the HWC series Total Worker Health In-Depth, which covers various topics such as ergonomics, nutrition, sedentary work, and the hierarchy of controls. Additionally, employers now have unlimited access to a series of Toolbox Talks developed by the HWC. Traditional and non-traditional workplace hazards are addressed in these free resources.
  • The Oregon Healthy Workforce Center has a new website platform,, that houses resources for workplace safety, health, and well-being. One such resource is the “What’s Work Got To Do With It?” podcast, which is celebrating its one-year anniversary. The state agency that adopted the Oregon Healthy Workforce Center’s COMPASS program for home care workers, the Oregon Home Care Commission, will roll out a new version of the program’s guidebooks adapted to personal support workers. The Commission is also producing an online training for facilitators who will implement the program. Learn more.
  • The University of Illinois–Center for Healthy Work began dissemination in November of the Healthy Work Collaborative Case Study Guide: Examples from the Field. This will guide similar efforts across the country, increasing capacity to foster multisectoral collaboration for policy and systems change. The Healthy Work Collaborative required participating teams to write a case study detailing their time in the Collaborative and their project’s progress. Each case study describes the issue the team addressed (Recognizing the Need); why the team chose its particular approach (Starting the Conversation); how the collaboration functioned and interacted (Building Relationships); what the collaboration accomplished (Gaining Momentum); challenges and opportunities gleaned from the experience (Lessons Learned); and what the team aims to accomplish in the future (Looking Ahead). This January, the Healthy Work Collaborative will produce a toolkit as a companion resource to the case-study guide for use and dissemination nationally.

These are just a few of the updates from the NIOSH Centers of Excellence for Total Worker Health. To learn more about the program and each of the Centers, visit

News from NIOSH TWH Affiliates and Partners

New E-Learning Module from SAIF
Mapping your Total Worker Health® journey, a new interactive eLearning module from SAIF (State Accident Insurance Fund, Salem, Oregon) breaks down the steps for integrating health and safety at your organization. Use the module to watch success stories and practice the process for yourself.

New Publication on Designing Workplaces for Health, Well-being, and Productivity
The Interdisciplinary Center for Healthy Workplaces, a UC Berkeley research center and Total Worker Health affiliate, is announcing the launch of Built to Thrive: How to Build the Best Workplaces for Health, Well-Being, and Productivity. This book demonstrates a TWH approach and decision-making framework that provides actionable steps for readers on implementing the science within their own organizations for a human-centered approach to creating healthy workplaces.

Using AI to Improve Health and Happiness in Offices: An Intelligent Workstation
Researchers of the Center for Intelligent Environments (CENTIENTS) at the University of Southern California are working with the engineering firm Arup on an intelligent workstation that optimizes the office worker’s well-being and productivity through adjustment of postural, thermal, and lighting settings. The intelligent desk uses sensors to infer environmental and physiological conditions, as well as the human state and current task. Learn more about the project in this video and article.

U.S. Surgeon General on Total Worker Health
The U.S. Surgeon General, VADM Jerome Adams, MD, MPH, discusses The Value of Worker Well-Being in a recent article that features the Total Worker Health approach. Learn more about the influence of work and strategies employers can use to foster worker well-being in the article.

The Journey to Be Well in Eugene
This Synergist article, published by the American Industrial Hygiene Association (AIHA), features the implementation of Total Worker Health approaches through a collaborative effort in Eugene, Oregon.

Western Kentucky University Milestones
Total Worker Health Affiliate Western Kentucky University (WKU) has two major milestones to share. First, WKU is a Certified Healthy Workplace Leader 2019 per Health Links! Second, beginning in January 2020, WKU will be a 100% Smoke and Tobacco-Free Campus. This is a notable accomplishment in a state where tobacco is widely grown and used.

To learn more about the Total Worker Health Affiliate program, visit

Conferences, Webinars, and Trainings in Support of NIOSH Total Worker Health


3rd — The Healthier Workforce Center of the Midwest (HWC) traveled to Muscatine, Iowa, on December 3rd to support the University of Iowa College of Public Health’s Business Leadership Network Community Forum, an outreach activity with local employers. The theme of the forum was “Tackling Substance Abuse and Mental Health Issues,” specifically focusing on youth and the workplace.

4th – On December 4th the Healthier Workforce Center of the Midwest (HWC) presented to the Mississippi Valley Human Resource Association (MVHRA), a SHRM (Society for Human Resource Management) affiliated chapter. The MVHRA provides educational and networking opportunities in southeastern Iowa and western Illinois for both members and non-members in the human resource field.

3rd to 5th – The Harvard Center participated again this year in the National Conference on Worker Health and Safety (COSHCON19) on December 3rd to 5th in Baltimore, MD. Two researchers represented the Center at an exhibitor table that included a poster displaying highlights of the Center’s Total Worker Health® research, dissemination of evidence-based practices, workplace and public policy implications of its work, and capacity-building efforts.

16th – Philip Landrigan, MD, presented at a seminar co-sponsored by the Center for Work, Health & Well-being and the Harvard Education and Research Center (ERC) on December 16th at 1:00 pm at the Harvard T.H. Chan School of Public Health. Dr. Landrigan is one of the world’s leading authorities on public health—particularly children’s health—and was recently named the founding director of Boston College’s Global Public Health Initiative.

Save The Date


10th – University of Illinois-Chicago Center for Healthy Work investigators will be presenting at the Wisconsin Workplace Health Symposium in Milwaukee, WI. Christina Welter, DrPH, MPH and Elizabeth Fisher, CHES will be presenting the keynote address, “Improving Health for Workers Employed in Precarious Jobs,” at 8:20 am, followed by “All in a Day’s Work Demonstration” at 9:55 am.


13th to 15th – Save the date for Work Health and Well-Being: Achieving Worker Health. This Harvard T.H. Chan School of Public Health Executive and Continuing Professional Education course is taught by investigators and colleagues from the Center for Work, Health, & Well-being. The course provides participants with skills to implement policies, programs, and practices focused on working conditions impacting both worker and employer safety, health, and well-being outcomes. For more information, visit


Editorial Board

L. Casey Chosewood, MD, MPH, Executive Editor

CDR Heidi Hudson, MPH, Editor-in-Chief

Emily Norton, Managing Editor

Sarah Mitchell, Associate Editor

Seleen Collins, Copy Editor

Steve Leonard, NIOSH Web Publisher

Please send your comments and suggestions to us at

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