Development, use, and availability of a job exposure matrix based on national occupational hazard survey data.

A job exposure matrix has been developed based on potential exposure data collected during the 1972-1974 National Occupational Hazard Survey (NOHS). The survey sample was representative of all U.S. non-agricultural businesses covered under the Occupational Safety and Health Act of 1970 and employing eight or more employees. Potential worker exposure to all chemical, physical, or biological agents was recorded during the field survey if certain minimum guidelines for exposure were met. The job exposure matrix (JEM) itself is a computerized database that assists the user in determining potential chemical or physical exposures in occupational settings. We describe the structure and possible uses of the job exposure matrix. In one example, potential occupational exposures to elemental lead were grouped by industry and occupation. In a second example, the matrix was used to determine exposure classifications in a hypothetical case-control study. Present availability as well as future enhancements of the job exposure matrix are described.

Compliance with OSHA record-keeping requirements.

The Occupational Safety and Health Act of 1970 requires employers to maintain records of workplace injuries and illnesses. To assess compliance with the law, data from the National Occupational Exposure Survey (NOES) were examined. Of the 4,185 companies with 11 or more employees, 75 per cent maintained OSHA Form 200 designed for recording illnesses and injuries. The number of employees and the presence of a union were positive determinants in the record maintenance. Of companies with 500 or more employees, 95 per cent kept records compared with 60 per cent of companies with between 11 and 99 employees.

Occupational lead poisoning in Ohio: surveillance using workers' compensation data.

To determine the utility of workers' compensation (WC) data in a system for the surveillance of occupational lead poisoning, we reviewed workers' compensation claims for lead poisoning in Ohio. For the period 1979 through 1983, 92 (81 per cent) of the 114 claims attributed to lead met our case definition of lead poisoning. The likelihood that a company had a case of lead poisoning was strongly correlated with the number of claims against the company. Thirty companies accounted for the 92 cases; two companies accounted for 49 per cent of these. Inspection by the Occupational Safety and Health Administration (OSHA) occurred at 14 of these companies, all of which were cited for violations of the OSHA lead standard. Comparison of the Standard Industrial Classification (SIC) codes for the 14 companies inspected by OSHA with the 15 companies not inspected by OSHA revealed that OSHA inspected battery manufacturers, non-ferrous foundries, secondary smelters, and primary lead smelters, but not bridge painters, manufacturers of electronic components, mechanical power transmission equipment, pumps, and paints, nor a sheriff's office where firing range slugs were remelted to make new bullets. Neither the number of cases of lead poisoning at a company nor the size of a company was related to the likelihood of being inspected by OSHA. Claims for WC appear to be a useful adjunct to an occupational lead poisoning surveillance system; their usefulness should be compared to that of other systems such as laboratory reports of elevated blood lead levels in adults.

The prevalence of screening in industry: report from the National Institute for Occupational Safety and Health National Occupational Hazard Survey.

Data from 4,500 workplaces surveyed by the National Institute for Occupational Safety and Health (NIOSH) in the National Occupational Hazard Survey (1972 to 1974) and National Occupational Exposure Survey (1981 to 1983) show an increase in both preplacement and periodic medical screening in US industries during the past decade. The distribution of screening is primarily related to plant size, but also varies considerably by industry type; further, plants with industrial hygiene and safety programs and/or unions are more likely to provide screening examinations than those without, irrespective of plant size. As for workers potentially exposed to selected chemical hazards, the first survey provides no consistent evidence that such workers were more likely to receive exposure-specific tests than other workers. The significance of these findings is discussed in the context of the proposed framework for medical screening practices developed by NIOSH researchers.

Medical screening in the workplace: proposed principles.

Medical screening and biological monitoring are two techniques in a continuum of practices used to prevent occupational disease. Medical screening is the examination of workers for pathological conditions. Biological monitoring is the examination of the worker for the presence of an intoxicant or its metabolite. These techniques are common in industry, and are frequently components of health standards recommended by the National Institute for Occupational Safety and Health (NIOSH) to the Occupational Safety and Health Administration. However, an underlying set of principles for medical screening and biological monitoring in the workplace has not been delineated. In this paper, a modification of the principles for screening in the community is proposed that will be more appropriate to the workplace. This modified set of principles is not a statement of the policy of NIOSH on this important subject, but rather a presentation of the authors' views as a starting point for dialogue on these issues.

Occupational health reporting systems--USA.

The three-fold purpose of this paper is to (1) describe the occupational hazard and health effect information systems used by the National Institute for Occupational Safety and Health (NIOSH), (2) highlight the parts of these data systems that are relevant to the topic of this dermatologic disease and chronic trauma workshop, and (3) to note the inadequacies of existing data systems in the United States.

Sentinel Health Events (occupational): a basis for physician recognition and public health surveillance.

A Sentinel Health Event (SHE) is a preventable disease, disability, or untimely death whose occurrence serves as a warning signal that the quality of preventive and/or therapeutic medical care may need to be improved. A SHE (Occupational) is a disease, disability, or untimely death which is occupationally related and whose occurrence may: 1) provide the impetus for epidemiologic or industrial hygiene studies; or 2) serve as a warning signal that materials substitution, engineering control, personal protection, or medical care may be required. The present SHE(O) list encompasses 50 disease conditions that are linked to the workplace. Only those conditions are included for which objective documentation of an associated agent, industry, and occupation exists in the scientific literature. The list will serve as a framework for developing a national system for occupational health surveillance that may be applied at the state and local level, and as a guide for practicing physicians caring for patients with occupational illnesses. We expect to update the list periodically to accommodate new occupational disease events which meet the criteria for inclusion.

Uses of computer-generated maps in occupational hazard and mortality surveillance.

The purpose of the present paper was to describe five ways in which computer-generated maps for 3,073 United States political subdivisions (counties) are being used as a part of the National Institute for Occupational Safety and Health surveillance system. Four maps show the approximate spatial location of potential workplace hazards in terms of (i) worksites, (ii) estimates of the proportion of workers at risk for US counties, and (iv) counties within a selected state. A fifth map shows age-standardized county-level mortality for a cause of death associated with an occupational risk. These five types of maps represent first efforts to present and disseminate information in an effective format and to generate occupational health surveillance leads that may warrant further research.

Developing a national occupational health surveillance system in the United States.

The United States National Institute for Occupational Safety and Health (NIOSH) is developing a national information base for the identification of workplace hazards and for the detection of work-related disease, disability, or mortality. In the first national occupational hazard survey completed in 1974, surveyors observed more than 85,000 tradename products in a probability sample of 5,000 US workplaces. Manufacturers of these tradename products have given NIOSH information about the chemical ingredients in more than 60,000 products. Prior to this survey the ability to identify and inform workers of the potential hazards to which they were exposed was limited. The occupational health effect surveillance system is presently based on data obtained from three data systems, the national Health Interview Survey, the Social Security Administration Disability Award File and proportionate mortality ratio studies conducted by several states. Industry and associated disease rubrics identified by these data systems become topics for more intensive analysis culminating in brief reports called surveillance intelligence bulletins (SIBs). This paper gives an example of work in progress in developing an SIB concerned with accidents among loggers.

Exploring the use of death certificates as a component of an occupational health surveillance system.

An effort has been made to explore a case-finding surveillance system for occupationally-related disease using death records. A sentinel health event, here lung cancer in young males, was selected to seek unusual associations with occupations as listed on the death records. Fishermen appeared to be over-represented and population studies cited suggest lung cancer in this occupation deserves further exploration. Further efforts of this type could test the usefulness of an occupational health surveillance system based on the death certificate.