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Background Following a work-related permanent impairment, injured workers commonly face barriers to safe and successful return to work (RTW). Examining workers' experiences with the workers' compensation (WC) system could highlight opportunities to improve RTW outcomes. Objectives included summarizing workers': (1) appraisal of several WC-based RTW programs, and (2) suggestions for vocational rehabilitation and WC system improvements to promote safe and sustained RTW. Methods In telephone interviews, 582 Washington State workers with work-related permanent impairments were asked whether participation in specified WC-based RTW programs helped them RTW and/or stay at work. Suggestions for program and system improvements were solicited using open-ended questions; qualitative content analysis methods were used to inductively code responses. Results Most respondents reported positive impacts from RTW program participation; for example, 62.5% of vocational rehabilitation participants reported it helped them RTW, and 51.7% reported it helped them stay at work. Among 582 respondents, 28.0% reported that no change was needed to the WC system, while 57.6% provided suggestions or critiques. Reduce delays/simplify process/improve efficiency was the most frequent WC system theme-mentioned by 34.9%. Among 120 vocational rehabilitation participants, 35.8% reported that no change was needed to vocational rehabilitation, while 46.7% (N = 56) provided suggestions or critiques. More worker choice/input into the vocational retraining plan was the most frequent vocational rehabilitation theme-mentioned by 33.9%. Conclusions This study's findings suggest that there is substantial room for improvement in workers' experience with the WC system. In addition, injured workers' feedback may reflect opportunities to reduce administrative burden and to improve worker health and RTW outcomes.

BACKGROUND: Transportation road maintenance and repair workers, or ‘maintainers’, are exposed to hazardous and variable noise levels and often rely on hearing protection devices (HPD) to reduce noise exposure levels. We aimed to improve upon HPD use as part of the HearWell program that used a Total Worker Health(®), participatory approach to hearing conservation. METHODS: Full-shift, personal noise sampling was performed during the routine task of brush cutting. Work activities and equipment were recorded and combined with 1-min noise measures to summarize personal noise exposure levels by equipment. Using noise monitoring results, HPD noise reduction ratings, and input from worker-based design teams, a noise hazard scheme was developed and applied to the task and equipment used during brush cutting. RESULTS: Average (standard deviation) and maximum L(eq) 1-minute, personal noise exposure levels recorded during brush cutting included chainsaws at 92.1 (7.6) and max of 111 dBA, leaf blowers at 91.2 (7.5) and max 107 dBA and wood chipper at 90.3 (7.3) and max of 104 dBA. The worker-designed noise hazard scheme breaks down noise exposures into one of three color bands and exposure ranges: red (over 105 dBA), orange (90–105 dBA), or yellow (85–90 dBA). The scheme simplifies the identification of noise levels, assessment of noise hazard and choice of appropriate hearing protection for workers. CONCLUSION: Combining noise exposure assessment with intervention development using participatory methods, we characterized noise exposure and developed an intervention to educate and assist in protecting workers as they perform noisy tasks.

Background Within the mining industrial sector, workers in the mining and oil and gas extraction (OGE) industries have demonstrated disparities in chronic health status compared with the general working population. However, we know much less about miner and OGE worker health once retired. This study separately compares chronic illnesses in retired miners and OGE workers with all other retirees. Methods National Health Interview Survey (NHIS) public data were analyzed for the years 2007-2017 to estimate weighted unadjusted and adjusted prevalence of selected health conditions (cancer, cardiovascular disease, high cholesterol, diabetes, hypertension, respiratory conditions, health status, and hearing loss) in retirees. Three retired worker groups (miners, OGE, and other retirees) were defined using the respondents' longest-held industry and occupation. Results Higher prevalence of a number of adverse health conditions was noted in miners and OGE workers when compared with all other retirees. A significantly higher adjusted prevalence of hypertension, hearing loss, functionally limiting lung problems, and fair or poor health was seen in miners over other retirees. Retired OGE workers demonstrated a significantly higher adjusted prevalence of both hearing loss and poor health status. Conclusions Miners and OGE workers have higher morbidity during their working years, and this study demonstrates that poorer health appears to continue into retirement. These results suggest the need to expand occupational health and safety programs in the mining sector to improve the health of workers into retirement. Future studies that include more robust information on workplace exposures are needed to evaluate the long-term health of retired workers.

Background The National Supplemental Screening Program (NSSP) uses a Total Worker HealthTM approach to address U.S. Department of Energy (DOE) former worker health. This article provides the design of the integrated occupational health screening and promotion program. Methods The NSSP implemented a web-based relational health records system to process demographic, exposure, and clinical data. We present medical findings for 12,000 DOE former workers that completed an initial NSSP medical screening between October 1, 2005 and October 4, 2013. We discuss the DOE former worker participant population and the exposure-based and non-occupational medical screening tests used. Results The NSSP identified potential occupationally related health conditions in 40.5% of those screened. Notably, we identified 85.8% of participants with addressable non-occupational health conditions, many of which were previously undiagnosed. Conclusion The NSSP demonstrates that the identification of potential occupational health issues in conjunction with addressable non-occupational health conditions provides former workers with information to more effectively manage health. Am. J. Ind. Med. 59:200–211, 2016. © 2016 Wiley Periodicals, Inc.

Background Worker training is a core component of the OSHA Hazardous Waste Operations and Emergency Response (HAZWOPER) standard, but few studies have considered what motivates managers to provide HAZWOPER training to employees or what they value in that training. Methods In 2012, four university-based programs conducted an exploratory survey of managers who sent employees to HAZWOPER courses. Results from 109 respondents were analyzed. Results Forty-two percent of respondents cited regulations as the most important reason to provide HAZWOPER training; many indicated they would provide less training if there were no standard in place. Three-quarters (74%) reported training had improved workplace conditions. Fewer than half said they were likely to involve trained employees in aspects of the organization's H&S program. Discussion Compliance with regulatory requirements is an important factor shaping managers' training delivery decisions. Managers recognize positive impacts of training. These impacts could be enhanced by further leveraging employee H&S knowledge and skills. Am. J. Ind. Med. 58:780–787, 2015. © 2015 Wiley Periodicals, Inc.

Objectives Through use of a nationally representative database, we examined the variability in both self-rated health and overall mortality risk within occupations across the National Occupational Research Agenda (NORA) Industry Sectors, as well as between the occupations within the NORA Industry sectors. Methods Using multiple waves of the National Health Interview Survey (NHIS) representing an estimated 119,343,749 US workers per year from 1986 to 2004, age-adjusted self-rated health and overall mortality rates were examined by occupation and by NORA Industry Sector. Results There was considerable variability in the prevalence rate of age-adjusted self-rated poor/fair health and overall mortality rates for all US workers. The variability was greatest when examining these data by the Industry Sectors. In addition, we identified an overall pattern of increased poor/fair self-reported health and increased mortality rates concentrated among particular occupations and particular Industry Sectors. Conclusions This study suggests that using occupational categories within and across Industry Sectors would improve the characterization of the health status and health disparities of many subpopulations of workers within these Industry Sectors. Am. J. Ind. Med. 54:748–757, 2011. © 2011 Wiley-Liss, Inc.

A mail survey was conducted among emergency responders who received training at the New Jersey/New York Hazardous Materials Worker Training Center. Responses indicate that technical topics are extremely important (i.e., decontamination, personal protection); that the vast preponderance of trainees felt confident in their ability to recall specific critical concepts in a crisis; and that 42% of respondents (75) had experienced an incident that would have resulted in injury or death without training. Phone surveys for details of specific incidents reported by 43 of the 75 mail survey respondents revealed that anecdotal data provide powerful evidence of the value of training; that extensive and uniform training is needed across jurisdictions; that training should emphasize the technical aspects of health and safety, and should include demonstration and hands-on techniques; and that integrated organizational support for implementation of health and safety practices is critical. Am. J. Ind. Med. 33:241–246, 1998. © 1998 Wiley-Liss, Inc.

Renewable energy production may offer advantages to human health by way of less pollution and fewer climate-change associated ill-health effects. Limited data suggests that renewable energy will also offer benefits to workers in the form of reduced occupational injury, illness and deaths. However, studies of worker safety and health in the industry are limited. The Mountain and Plains Education and Research Center (MAP ERC) Energy Summit held in April 2011 explored issues concerning worker health and safety in the renewable energy industry. The limited information on hazards of working in the renewable energy industry emphasizes the need for further research. Two basic approaches to guiding both prevention and future research should include: (1) applying lessons learned from other fields of occupational safety and health, particularly the extractive energy industry; and (2) utilizing knowledge of occupational hazards of specific materials and processes used in the renewable energy industry. Am. J. Ind. Med. 56:1359–1370, 2013. © 2013 Wiley Periodicals, Inc.

From the point of view of an epidemiologist with experience in community air quality standards, occupational health standards, radiation standards, and water quality standards, reasons are given for discarding the assumption that occupational health protection should be based on threshold concepts. The weakness of worker health protection based on prescription of maximal exposure levels is noted, regardless of whose judgement is used for such levels.

The attack on the World Trade Center on September 11, 2001 was the worst assault on the American homeland in the 225-year history of the United States. It was also the most massive acute environmental disaster that ever has befallen New York City. The destruction of the twin towers released thousands of tons of toxic materials into the air of lower Manhattan—asbestos, particulate matter, lead, soot, PCBs, and dioxins. Workers and children were the groups at greatest risk of exposure. The threat to human health was compounded in the months after September 11 by the bioterrorist attacks involving anthrax. Responses to the attacks on the World Trade Center involved extraordinary heroism. They demonstrated the ability of the American health care system and of individual health workers to respond magnificently to an unprecedented crisis. But, the he response also underscored deep problems in the nation’s public health infrastructure. These problems must be addressed and the necessary improvements to the system must be made, if mistakes are not to be repeated in future disasters. The following were the most important lessons learned for public health

Gram-negative bacterial endotoxins, implicated in adverse worker health responses, were found in settled and airborne dust samples obtained from poultry and swine confinement units. Results of the Limulus amebocyte lysate gel test found endotoxin levels in dust samples ranged from 4.5 to 47.7 micrograms of FDA Klebsiella endotoxin equivalents/gm. Differences in endotoxin levels between dust samples may have been due to variables in time, geographic locations, confined animals, confinement buildings and equipment, and methods of sample collection. Animal confinement workers are potentially exposed to large amounts of gram-negative bacterial endotoxins; however, the respiratory health effects of such exposures to animal confinement workers have yet to be determined.