Jan. 9, 2018


NIOSH, BLS, and OSHA Should Strengthen Coordination for Occupational Injury, Illness, and Exposure Surveillance

WASHINGTON – The National Institute for Occupational Safety and Health (NIOSH) should lead a collaborative effort with the U.S. Bureau of Labor Statistics (BLS), Occupational Safety and Health Administration (OSHA), and the states to establish and strengthen regional occupational safety and health surveillance programs, says a new report by the National Academies of Sciences, Engineering, and Medicine.  The nation needs a robust occupational safety and health surveillance system to provide critical information about the relationships between work and injuries and illnesses in order to inform policy development, guide educational and regulatory activities, develop safer technologies, and enable research and prevention strategies that serve and protect all workers.  A smarter surveillance system will minimize the undercounting of occupational injuries and illnesses by making strategic use of different datasets and surveys, and will maximize appropriate use of technologies.

“Ensuring and improving worker safety and health is a serious commitment, and federal and state agencies along with other stakeholders should diligently act upon it,” said Edward Shortliffe, professor of biomedical informatics at Arizona State University and chair of the committee that conducted the study and wrote the report. “We are experiencing rapid changes in the nature of work, and with new risks developing; the nation is in dire need of a smarter surveillance system that tracks occupational injuries, illnesses, and exposures.”

The estimated annual cost of occupation-related injuries, illnesses, and deaths in the U.S. is $250 billion, according to the latest data available from 2007. Occupational health and safety surveillance can provide ongoing, systematic collection, analysis, and interpretation of health data, essential to planning and evaluating public health practices. Currently there is no single, comprehensive surveillance system in the U.S., but rather a continuously evolving set of systems using a variety of data sources that meet different objectives, the report says. So far, the principal focus has been on collecting data on health outcomes, and less attention has been given to collecting information on hazards and exposures.

The report emphasizes the importance and value of sources and quality of inputs to creating a stronger surveillance system. Surveys and assessments designed to count occupational injuries do not capture data on some segments of the working population. For example, the BLS' Survey of Occupational Injuries and Illnesses (SOII) does not include injuries to workers who are self-employed, like independent contractors, or who work on small farms.  The report recommends BLS and OSHA work together to collect more complete, accurate, and robust information on the extent, distribution, and characteristics of work-related injuries and illnesses.

A federal-state partnership can facilitate and serve as a national effort to identify and monitor emerging problems, and to foster prevention programs that can address them, the report says. The committee called attention to enhancing the quality and capacity of informatics, particularly in NIOSH, using advanced computational and analytical tools, and monitoring advances in information technology. NIOSH, OSHA, and BLS should also work together to encourage education and training of the surveillance workforce in disciplines necessary for developing and using surveillance systems, including epidemiology, biomedical informatics, and biostatistics.

Implementing a household survey to record occupational injuries and illnesses will also help fill gaps in the data for populations of workers who are missing from employer-based injury reporting, by obtaining input directly from the worker, the report says.  Additionally, OSHA’s electronic employer-based reporting initiative needs to be accompanied by a solid plan for analyzing, interpreting, and disseminating the information, the committee said. Specifically, OSHA should collaborate with BLS, NIOSH, state agencies, and other stakeholders to maximize the effectiveness and utility of the reporting initiative for surveillance.

The report also notes that work-related disease (versus injury) information has been lacking in the surveillance system. NIOSH should work with state occupational safety and health surveillance programs to develop a methodology and coordinated system for surveillance of both fatal and nonfatal occupational disease using multiple data sources.  Furthermore, the committee called for an immediate collaborative effort of federal agencies to initiate the development of a comprehensive approach for exposure surveillance that builds and updates a database of risks and exposures to predict and locate work-related acute and chronic health conditions for prevention.

The study was funded by the NIOSH, BLS, and OSHA. The National Academies of Sciences, Engineering, and Medicine are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, technology, and medicine.  The National Academies operate under an 1863 congressional charter to the National Academy of Sciences, signed by President Lincoln.  For more information, visit http://national-academies.org

Riya V. Anandwala, Media Relations Officer
Andrew Robinson, Media Relations Assistant
Office of News and Public Information
202-334-2138; e-mail news@nas.edu

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Copies of A Smarter National Surveillance System for Occupational Safety and Health in the 21st Century are available at www.nap.edu or by calling 202-334-3313  or 1-800-624-6242. Reporters may obtain a copy from the Office of News and Public Information (contacts listed above).


Division on Earth and Life Studies

Committee on Developing a Smarter National Surveillance System for Occupational Safety and Health in the 21st Century

Edward H. Shortliffe* (chair)
Professor of Biomedical Informatics
College of Health Solutions
Arizona State University

David K. Bonauto
Research Director
Safety and Health Assessment and Research for Prevention
Washington State Department of Labor and Industries

David L. Buckeridge
Department of Epidemiology, Biostatistics, and Occupational Health
McGill University

Steven B. Cohen
Vice President
Division for Statistical and Data Sciences
RTI International
Washington, D.C.

Letitia K. Davis
Occupational Health Surveillance Program
Massachusetts Department of Public Health

Gerald F. Kominski
Professor of Health Policy and Management, and
Center for Health Policy Research
University of California
Los Angeles

Scott A. Mugno
Vice President for Safety, Sustainability, and Vehicle Maintenance
FedEx Ground
Moon, Pa.

Kenneth D. Rosenman
Professor of Medicine, and
Division of Occupational and Environmental Medicine
Michigan State University
East Lansing

Noah S. Seixas
Professor of Exposure Sciences
School of Public Health
University of Washington

Margaret M. Seminario
Director of Safety and Health
Washington, D.C.

Glenn M. Shor
California Census of Fatal Occupational Injuries Program, and
Research and Policy Advisor to the Director
California Department of Industrial Relations
San Francisco

David H. Wegman
Professor Emeritus
Department of Work Environment
University of Massachusetts


Peggy T. Yih
Staff Officer

*Member, National Academy of Medicine