eNews: November 2024

From the Director’s Desk

Drowsy Driving Prevention Week^® and Worker Safety and Health

A 2017 analysis showed 37% of U.S. workers got less than the recommended minimum 7 hours of sleep. Fatigue and acute feelings of drowsiness can affect the ability to drive safely. Fatigue can come from inadequate or poor-quality sleep, long hours of work or driving, physical exertion, shiftwork, stress, or sleep disorders such as sleep apnea. In the United States, more than one in five (21%) fatal crashes involve a drowsy driver.

The National Sleep Foundation hosts Drowsy Driving Prevention Week^® the first week of November each year to encourage everyone to prioritize sleep and only drive when alert and refreshed. NIOSH uses this as a time to focus on the importance of sleep. We also highlight the steps employers and workers can take to stay safe behind the wheel.

High levels of fatigue can affect any worker in any job. Fatigue can have a variety of safety-critical impacts, such as reduced focus, slowed reaction time, and impaired decision-making skills. No amount of experience, motivation, or professionalism can overcome your body's biological need to sleep.

NIOSH recently coauthored a systematic review that found where safety culture is strong, a fatigue risk management system can help both employers and workers to reduce the safety and health risks of fatigue. These systems can promote alertness among workers, identify fatigue-prone tasks, and lessen fatigue and its potential consequences.

NIOSH has two virtual centers to foster collaboration in this area. The NIOSH Center for Motor Vehicle Safety conducts research on driver safety. It provides tools to help employers and workers prevent motor vehicle crashes and injuries caused by fatigued driving and other risk factors. The NIOSH Center for Work and Fatigue Research focuses on the health and safety risks associated with nonstandard work schedules and other sources of fatigue.

Employers and workers can take steps to prevent the chain of events that could lead to a fatigue-related crash. Here are some useful NIOSH resources:

• The Driver Fatigue on the Job webpage provides actions employers and workers can take to reduce the risk of fatigue-related crashes and injuries.

• The How to Choose the Right Fatigue Detection Technology for Your Workplace infographic outlines factors for employers to consider when selecting this technology as part of a comprehensive safety management approach.

• The Oil and Gas Employers: How to Prevent Fatigued Driving at Work fact sheet offers guidance for oil and gas extraction industry employers. This industry often has workers who drive long distances during work and for commutes.

Other resources are also available. For example, learn a multi-level approach to managing occupational sleep-related fatigue in a NIOSH authored article. And find a practical guide for fleet safety professionals on managing driver fatigue, published by a NIOSH partner and a nonprofit dedicated to improving work-related driver safety.

We can all increase awareness of the causes, effects, and ways to reduce the risks of fatigue while driving and working. Good sleep habits, such as keeping fixed sleep hours and avoiding screen time and alcohol before bed, are important to your health and safety both on and off the job.

Research Rounds

Medical Costs and Incremental Medical Costs of Asthma Among Workers in the United States

NIOSH study authors: Anasua Bhattacharya, Girija Syamlal, and Katelynn E. Dodd

Why is this study important?

Asthma is a chronic respiratory disease that can decrease quality of life and affect the ability to be active and work. Costs to individuals and society for asthma treatment are high. In the United States, an estimated 20 million adults in the United States have asthma. This study estimated asthma-associated medical costs, including those that remain after controlling for the effects of other factors. These factors include sex, age, region, race or ethnicity, education, income, health insurance coverage, and smoking, among others.

What is work-related asthma?

Work-related asthma is a type of asthma caused or worsened by exposure to respiratory hazards encountered in the workplace. It accounts for about 16% of adult asthma.

How did you do the study?

We estimated the medical costs of asthma and the incremental medical costs of asthma in workers requiring treatment using results from the Medical Expenditure Panel Survey from 2018 to 2020. This nationwide survey compiles cost and use of healthcare and health insurance coverage in the United States.

What did you find?

On average, an estimated 8.2 million out of 176 million workers received at least one medical treatment for asthma each year. Medical costs of treated asthma were $21 billion annually, which was higher than medical costs for workers without treated asthma. Per worker, these costs amounted to an estimated $457 each year. Characteristics that were associated with the highest per-worker annual medical costs of treated asthma include:

• Utility and transportation industries ($898)
• Western region ($768)
• Inpatient hospital admission ($754)
• Hispanic ethnicity ($693)
• Males ($650)
• Aged 35–44 years ($534)

What are the next steps?

Developing programs to prevent and treat work-related asthma may help improve worker health and well-being. Additionally, these programs may help control medical costs related to asthma treatment.

The Safe Home Care Intervention Study: Implementation Methods and Effectiveness Evaluation

Study authors: Susan R. Sama, Margaret M. Quinn, Rebecca J. Gore, Catherine J. Galligan, David Kriebel, Pia K. Markkanen, John E. Lindberg, and Pamela J. Fallon, University of Massachusetts (Study link)

Coaching Home Care Clients to Prepare Their Homes for Safe Care Visits: A Mixed-Methods Study to Evaluate a Nurse-led Educational Intervention Process

Study authors: Pia K. Markkanen, Rebecca J. Gore, Susan R. Sama, John E. Lindberg, Catherine J. Galligan, and Margaret M. Quinn, University of Massachusetts (Study link)

Why are these studies important?

Home care (including home health and personal care) is one of the fastest-growing industries, with a projected above-average increase by 2032, according to the U.S. Bureau of Labor Statistics. Home care also presents unique safety challenges for workers and clients. Since the workplace often is a private home, safety awareness is important for both home care workers and their clients.

How did you do the study?

Working with an extensive home care industry partnership network, we designed and tested a combination of motivational interviewing and coaching by nurse managers to empower clients to make safety improvements to their home environment. Materials included a safety handbook and video focusing on both physical and psychological safety. For example, tips to improve physical safety include removing hazards that could cause people to slip, trip, or fall. To improve psychological safety, the coaching provided specific ways clients can help establish mutual respect and communication with their home care workers.

Three home care agencies and two elder services participated in the study. Nurse managers and home care aides evaluated the coaching's effectiveness in improving safety. Results included 35 clients who received the coaching compared with 23 who did not.

What did you find?

Two-thirds of clients who received the coaching followed suggested safety changes, most often by reducing slip, trip, and fall hazards. The nurse managers found the coaching straightforward to conduct and useful for the clients. They reported that nearly all clients (94%) were engaged in the coaching, and some intended to make safety improvements after the study ended.

What are the next steps?

This inexpensive coaching method could be used to improve safety by individuals, families, and organizations of all sizes who hire home care workers.

Highlights

Upcoming Webinar on NIOSH Hazard Review Document

NIOSH will hold a webinar December 3, at 1 p.m. (EST) to discuss the draft Hazard Review document titled "Wildland Fire Smoke Exposure Among Farmworkers and Other Outdoor Workers." Presenters will provide an overview of the document's content and purpose. Register to join the webinar. The deadline for public comment in the Federal Register notice has been extended to January 10, 2025.

NIOSH and MSHA Release Guide to Prevent Opioid Use Disorder in the Mining Industry

NIOSH and the Mine Safety and Health Administration (MSHA) released a new publication titled Implementing Effective Workplace Solutions to Prevent Opioid Use Disorder: A Resource Guide for the Mining Industry. Employers can use this guidance to assess, plan, and implement practices to support mine workers' mental health and address harmful opioid use. Read the press release to learn more.

NIOSH Launches New Center for Firefighter Safety and Health

NIOSH has launched a new, virtual Center for Firefighter Safety, Health, and Well-being! With the goal of better protecting firefighters, the Center aims to identify and prevent new and emerging hazards earlier and faster.

World Trade Center Advisory Committee Nominations Requested

The World Trade Center (WTC) Health Program is seeking nominations for candidates to serve on the Scientific/Technical Advisory Committee. The purpose of the committee is to review WTC-related scientific and medical evidence. It makes recommendations to the program's administrator on additional program eligibility criteria, research needs, and health conditions. The deadline for nominations is November 11. Learn more in the Federal Register Notice or contact Dr. Tania Carreón-Valencia.

Free Training on the NIOSH Industry and Occupation Computerized Coding System

NIOSH is offering online, 2-day training sessions for using the NIOSH Industry and Occupation Computerized Coding System (NIOCCS). The coding system is a free web application that converts industry and occupation text into standardized codes. The training includes an overview of occupation and industry data collection, a NIOCCS demonstration, and information on preparing data for analyses. Register by email for the 6-hour training (times are in EST). Each session is limited to 50 attendees:

1. November 4 (10 a.m.–2 p.m.) and November 5 (10 a.m.–12 p.m.)
2. December 2 (10 a.m.–2 p.m.) and December 3 (10 a.m.–12 p.m.)
3. December 12 (10 a.m.–2 p.m.) and December 13 (10 a.m.–12 p.m.)

NIOSH and the Sikh Coalition Collaborate for Respirator Safety

NIOSH and the Sikh Coalition have signed a partnership agreement on respiratory safety. Together, they aim to explore respirator effectiveness for workers with beard bands who cannot shave for religious, cultural, medical, or other reasons. For more information on the partnership or the project, contact Jonisha Pollard.

Federal Register Notices

Meeting of the Mine Safety and Health Research Advisory Committee

The notice was posted on September 9. The meeting will be held on November 7.

Proposed Data Collection Submitted for Public Comment and Recommendations: Coal Workers' Health Surveillance Program (CWHSP)

The notice was posted on September 3. Comments must be received by November 9.

Solicitation of Nominations for Appointment to the World Trade Center Health Program Scientific/Technical Advisory Committee

The notice was posted on October 3. Nominations must be received by November 11.

Request for Public Comment on the Draft Hazard Review: Wildland Fire Smoke Exposure Among Farmworkers and Other Outdoor Workers

The notice was posted on September 13. Comments must be received by November 12.

Agency Forms Undergoing Paperwork Reduction Act Review: "Assessing Adoption and Implementation of the National Institute of Occupational Safety and Health's (NIOSH) Outputs"

The notice was posted on October 16. Comments must be received by November 14.

World Trade Center Health Program: Request for Information; Cooperative Research Agreements

The notice was posted on October 23. Comments must be received by November 22.

Request for Public Comment on the Draft Skin Notation Profiles: Allyl Alcohol, Formamide, Formic Acid, Phenothiazine, and Picric Acid

The notice was posted on October 28. Comments must be received by December 27.

New Communication Products

FACE Reports

• Hotel Employee Drowns in Swimming Pool—Kentucky
• Lumber Mill Employee Fatally Struck by Forklift—Oregon

Health Hazard Evaluation Report

• Evaluation of Silica Exposures During Drywall Sanding

NIOSH Science Blog

News From Our Partners

National Action Alliance Webinar on Healthcare Workers' Burnout

Join the National Action Alliance on November 12, 12–1 p.m. (EST), for a webinar titled "Addressing Healthcare Workforce Burnout." This webinar is second in the series on Workplace Safety and Wellbeing. Discussions will explore strategies for reducing staff burnout including evidence-informed interventions to address organizational challenges. Register now!

Updates From State Fatality Assessment and Control Evaluation (FACE) Programs:

• Hazard Alert: Workers Killed in Confined Spaces—This Hazard Alert (in Spanish) from Kentucky involves preventing working in confined spaces. To help prevent similar occurrences, the alert provides prevention recommendations and requirements.
• Fatality Narrative: Framer Struck by Beam After Falling From Scissor Lift—This Fatality Narrative (as a slideshow) from Washington State involves a framer struck by a beam after falling from a scissor lift. To help prevent similar occurrences, the narrative provides prevention recommendations and requirements. View both the Spanish Fatality Narrative and Spanish Slideshow.
• Fatality Narrative: Truck Mechanic Struck by Trailer Air Suspension Spring—This Fatality Narrative (as a slideshow) from Washington State involves a truck mechanic struck by an air suspension spring. To help prevent similar occurrences, the narrative provides prevention recommendations and requirements.

NORA

Upcoming Sector Council Meetings:

Construction Council Meeting

Join the NORA Construction council when they meet November 20–21. Virtual attendance to a portion of the meeting is available. Please contact Douglas Trout for the meeting invite.

Healthcare and Social Assistance Council Meeting

Join the NORA Healthcare and Social Assistance council when they meet December 12 at 1 p.m. (EST). Please contact Suzanne Tomasi for the meeting invite.

Immune, Infectious, and Dermal Disease Council Meeting

Join the NORA Immune, Infectious, and Dermal council when they meet December 13 at 12 p.m. (EST). Please contact Seth McCormick for the meeting invite.

Editorial & Production Team

Director

John Howard, M.D

Editor in Chief

Christina Spring

Managing Editor

Tanya Headley

Section Editor

Anne Blank, Research Rounds

Kiana Harper, Highlights & Monthly Features

Contributing Editor

Sarah Mitchell

Copy Editor

Cheryl Hamilton

Technical Support

Steve Leonard, Adobe Technical Lead