Are Agencies Playing It Safe and Secure: An Examination of Worker Protections Pre- and Post-Injury

CDC Congressional Testimony

Testimony before the Subcommittee on Federal Workforce, Postal Service, and the District of Columbia Committee on Oversight and Government Reform – US House of Representatives

John Howard, MD
Director, National Institute for Occupational Safety and Health
Centers for Disease Control and Prevention
US Department of Health and Human Services

Good afternoon Mr. Chairman, Ranking Member Chaffetz and other members of the Subcommittee. My name is John Howard, and I am the Director of the National Institute for Occupational Safety and Health (NIOSH), which is part of the Centers for Disease Control and Prevention (CDC), within the Department of Health and Human Services. I am pleased to be here today to provide an overview on our efforts to prevent injuries and illnesses both in the public safety workforce, and as related to Transportation Security Administration (TSA) workers.

As the lead federal agency in occupational safety and health research, NIOSH strives to increase knowledge of workplace hazards and develop practical, preventative solutions. NIOSH targets its research to focus on relevance, quality, and impact.

Public Safety Workforce

On any given day, public safety workers may respond to emergency calls including involving criminal acts, structural fires, and traumatic injuries. In some cases, they enter uncontrolled environments to rescue potential victims. These duties increase their risks for traumatic injuries and fatalities and place them in contact with biological, chemical, physical and psychosocial hazards associated with cardiovascular disease, cancer and other chronic disorders. Research relating to public safety workers including emergency medical services, firefighting and law enforcement is conducted through the National Occupational Research Agenda (NORA) Services Sector. NORA is a framework to guide occupational safety and health research into the next decade. NORA includes ten Sector Programs, which represent industrial sectors ranging from Agriculture, Forestry, Fishing to Services. Based on Bureau of Labor Statistics (BLS) employment estimates, nearly 69 million workers were employed in the NORA Services Sector in 2008, which is approximately 50% of the entire U.S. workforce. NIOSH and its partners have completed numerous research projects that address occupational hazards within the Services Sector. For example, evaluation of ergonomic risks and possible video display terminal hazards were initiated more than two decades ago. More recently, NIOSH has developed extensive programs to assess the risks faced by workers in public safety and emergency response and participates with many organizations to evaluate new technologies that enhance protection. Recommendations and intervention strategies from the NIOSH Services Sector research program have been adopted by consensus standard bodies as well as individual employers throughout the United States and around the world.

In addition to the primary Services Sector research conducted through NORA, NIOSH also conducts relevant worker fatality investigations though the Fire Fighter Fatality Investigation Program. According to the U.S. Fire Administration, each year an average of 105 fire fighters die in the line of duty. Through the Fire Fighter Fatality Investigation Program, NIOSH conducts in-depth investigations of the events surrounding fire fighter line-of-duty deaths, which identify contributory factors and steps that can be taken by fire departments and others to prevent future deaths under similar circumstances. This program has made over 1,000 recommendations arising from over 450 investigations since its inception in 1998. Furthermore, NIOSH also addresses the Services Sector by responding to requests from employers, employees and their representatives, (including government agencies) through the Health Hazard Evaluation Program (HHE).

Health Hazard Evaluation Program

The HHE program is comprised of a team of health professionals (including doctors and industrial hygienists) who respond to HHE requests in writing, by phone discussions, or by visiting the workplace to evaluate whether a health hazard is present. They assess exposures by measurement and observations, survey employees about their health, and review health and safety-related policies and programs. Based on this information, they make recommendations about how to create a more healthful workplace. This information is shared with all parties at the worksite and is disseminated more widely through reports published in the NIOSH website, and trade and scientific articles and presentations.

Since FY 2003, the NIOSH HHE program has received 218 requests to investigate potential occupational health hazards among police and fire department, emergency medical services, corrections, and Transportation Security Administration (TSA) workers. Workplace exposures cited in these requests have included indoor environmental quality, heat, noise, infectious agents, lead, carbon monoxide, diesel exhaust, and radiation.

TSA Health Hazard Evaluation

NIOSH’s largest response pertaining to TSA was a field investigation released in 2008, which focused on occupational exposure to x-rays from baggage screening machines among baggage screening employees at 12 airports across the nation. The objectives of the study were to assess the work practices, procedures, and training provided to TSA baggage screeners who operated machines that generate x-rays and to characterize baggage screener’s radiation exposures and determine if routine monitoring with radiation dosimeters is warranted. NIOSH provided criteria for airport selection and TSA employee representatives selected the 12 airports for the evaluation to include both small and large facilities, and to include different models and layouts of baggage screening equipment. NIOSH observed the work practices and procedures followed by baggage screeners and took readings around screening machines to detect x-ray emissions. At six airports, NIOSH asked screeners to wear personal monitoring devices or dosimeters to measure x-ray exposures.

NIOSH found that nearly 90 percent of the TSA baggage screeners in the evaluation received no measurable occupational x-ray radiation exposure. However, low doses of x-ray radiation within Occupational Safety and Health Administration permissible exposure limits were found for some baggage screeners1. Factors that may have contributed to the low doses of x-ray radiation included improper maintenance of machines, equipment design limitations, and insufficient training and improper work practices. NIOSH made the following recommendations to address each of these issues:

  • Develop a formal radiation safety program to protect workers from exposures to x-rays;
  • Provide baggage screeners with periodic training on safe work practices;
  • Improve equipment maintenance;
  • Enhance health and safety communication among all employees and management;
  • Conduct limited exposure monitoring for employees to further evaluate potential exposure to x-rays; and
  • Encourage employees to notify supervisors about equipment malfunctions, use proper equipment to clear bag jams in screening machines, and avoid overriding the machines’ safety features.

At the time of the NIOSH report, TSA had begun to implement many of these recommendations. The final HHE report can be found on the NIOSH website at:


As new technologies and products are brought into the marketplace and the workplace, and through the cooperative efforts of workers, management, labor, practitioners and scientists, NIOSH will continue to address the economic and personal impact of occupational disease, disability, and death through high-quality research and effective prevention strategies. I appreciate the opportunity to present to you and thank you for your continued support of NIOSH. I am pleased to answer any questions.

1 Doses for none of the participants in this evaluation exceeded 313 millirem (mrem) over 3 consecutive months (the OSHA quarterly limit that requires employee monitoring).

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