A Smarter National Surveillance System for Occupational Safety and Health in the 21st Century (2018) / Chapter Skim
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Summary
Pages 1-14
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Information about the circumstances in which workers are injured or made ill on the job and how these patterns change over time is essential to develop effective prevention programs and target future research. The nation needs a robust OSH surveillance system to provide this critical information for informing policy development, guiding educational and regulatory activities, developing safer technologies, and enabling research and prevention strategies that serves and protects all workers.
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From page 2... ...
-- called on the National Academies of Sciences, Engineering, and Medicine to undertake a study to develop a vision and steps toward a national surveillance system for occupational safety and health for the 21st century (see Statement of Task in Box 1-1)
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State agencies also play a critical and complementary role in partnership with federal agencies. State agencies collect, analyze, and disseminate data from local sources to guide preventive action at the state, regional, and local levels; provide aggregated data to federal agencies for national surveillance; and fill in gaps in national surveillance data.
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Robust and collaborative federal leadership built on strong ties with states and other relevant stakeholders is critical to successful OSH surveillance. Engagement of the community of users who need occupational safety and health surveillance information for action is essential.
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Next, the committee explored promising new developments, such as the household survey, electronic health records, autocoding of occupational information, electronic reporting, use of workers' compensation data, and improvements in occupational hazard and exposure surveillance. Then the committee considered ways to enable an effective national OSH surveillance system, including a clear rationale and prioritization for surveillance, coordination of surveillance strategies, effective use of information technology, and utilizing practitioners with appropriate skills.
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along with development of new resources, such as voluntary within-industry partnerships to engage collectively in exposure surveillance. Individual workers will play an essential role in the smarter system, independent of employer relationship, by participating in population health surveys that incorporate occupational information (e.g., the Household Survey of Occupational Injuries and Illness, the National Health Interview Survey, the Behavioral Risk Factor Surveillance System, and the Medical Expenditure Panel Survey)
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The coordinating entity should: • develop and regularly update a national occupational safety and health surveillance strategic plan that is based on well-articulated objectives; • coordinate the design and evaluation of an evolving national system of systems for OSH surveillance and for the dissemination of surveillance information provided by these systems; • publish a report on progress toward the strategic plan's implementation at least every 5 years, documenting advances toward achieving a 21st Century Smarter Occupational Safety and Health (OSH) Surveillance System; and • engage partners, including other federal health statistics agencies, state agencies with OSH responsibilities, and stakeholders.
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The overall system will need to be founded on a close working relationship between federal and state partners because coordinated federal and state systems offer immense advantages over either operating independently. The report accordingly stresses the value of an effective federal-state partnership and strengthened state efforts, both to facilitate and serve a national effort to identify and monitor priority conditions and emerging problems, and to foster prevention programs at the level that can best address these concerns (see Recommendation C)
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Consequently, a sequence of efforts is designed to construct a robust exposure component of the envisioned surveillance system. The report calls 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 (see Recommendation H)
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One of the major inputs to OSH surveillance is through the SOII and the report discusses needed enhancements to the SOII, including that would better inform public health actions for underserved populations. Injury and illness recording can be improved by better characterizing work-related injuries and illnesses in a manner that enhances usefulness at the worksite as well as at national and state levels (see Recommendation A)
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. Another largely untapped resource for injury surveillance data is the workers' compensation system, and the report promotes the expanded use of workers' compensation data for occupational injury and illness surveillance (see Recommendation F)
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For OSH surveillance, a forward-looking aspect of data collection and processing concerns how best to remove the barrier to recording and interpreting occupational information in medical records and in population surveys of all types. The report accordingly recommends that NIOSH, with an evolving biomedical informatics capacity, lead efforts to establish data standards and software tools for coding and extracting occupational data in electronic health records.
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. Appropriate and timely attention to surveillance findings, routine or new, is essential for prevention and thus requires that a smooth and centralized mechanism be established for timely ongoing dissemination of cross-agency information to all relevant actors (see Recommendation O)
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More can be done to inform and improve these efforts through strengthening OSH surveillance in the United States. With the rapid changes in the nature of work in the United States, and with new risks added to those that have always existed, the nation clearly needs a smarter OSH surveillance system of systems for the 21st century.
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