Saturday, March 13, 1999
8:00 - 10:00 a.m.
Stress, Overload, and Performance: High Standards or High Stakes?
Linda T. Fatkin*, M.A., B.C.E.T.S., and Linda F. Mullins, B.S., U.S. Army Research Laboratory
The experience of chronic stress has permeated our civilian and military workforce and is fueled by unrealistic expectations and incessant demands for optimal performance. The demand for high productivity in the midst of streamlined resources often results in groups of employees who experience fewer tangible accomplishments, while caught in a pattern of ceaseless striving. Recent research conducted with Army Recruiters has classified recruiting as a high-risk occupation that includes consistently high levels of stress related to personal, situational, and organizational factors. In spite of the common problems identified by active recruiters, some seem to possess stress-resilient characteristics while others are more vulnerable to the effects of stress. Results from the present study indicate that specific personality factors and overall life stress contribute to recruiter performance.
Study participants included 90 active-duty military recruiters from urban, suburban, and rural environments. Recruiter profile data was obtained from the Trait version of the Multiple Affect Adjective CheckList, Revised (MAACLR), the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ), and the Life Events Form. A performance percentage was calculated for each recruiter by dividing the number of individuals recruited by the number of recruits required to complete their mission.
Cluster analysis was used in order to identify relatively homogeneous groups of recruiters based on personality characteristics and experience of life stress. Analysis of the MAACLR traits revealed two subgroups of recruiters with two distinct profiles. A t-test conducted between cluster groups and recruiters’ percent of mission accomplished indicated that the recruiters in a "low dysphoria" group achieved 91% of their required mission, while a "high dysphoria" group accomplished only 69% of their mission. Although ZKPQ clusters differed on the emotionality subscale, there were no significant performance differences found between the "stable" or "less stable" groups. Results of the analysis of two Life Stress clusters indicated that a "low stress" group accomplished 105% of their mission, while the "high stress" group met only 75% of their mission requirements.
These findings are consistent with current speculations that declines in recruiting mission performance are related to recruiters’ vulnerability to certain stressors. In addition to personality mediators in the stress-performance relationship, significant contributors to high Life Stress levels must be identified to enhance the efficacy of realistic organizational countermeasures.
CORRESPONDING AUTHOR: Linda T. Fatkin, M.A., B.C.E.T.S., U.S. Army Research Laboratory, AMSRL-HR-SB, Aberdeen Proving Ground, MD 21005, USA
Work Content as a Moderator between Work Demands and Fatigue
Fred R.H. Zijlstra*, Robert A. Roe, and Ad J.J.M. Vingerhoets, Work & Organizational Research Centre, Tilburg University, Tilburg, The Netherlands
In this study the moderating effect of work content on the relationship between specific work demands and fatigue resulting from those demands will be investigated. Due to technological innovations (information-, and communication technology), social-economic changes (75% of people nowadays is employed in the service sector), the face of work has changed. Many people work with "virtual" objects (information), and/or tools (software tools) (Zijlstra, et.al. 1996). As a consequence work demands have also changed. Generally it is believed that these changing demands have let to the fact that work has intensified (cf. Aronson, 1989), which causes many people to complain about fatigue, and work pressure. In this study we will investigate the specific contribution of various work demands in causing fatigue for three modern types of work: people working with a) people, b) data, and c) things.
A national cross-sectional survey has quite recently been executed (spring 1998) among the working population in the Netherlands (N=973). In this survey questions on job characteristics, detailed questions on work demands (quantity, complexity, physical demands, responsibility, attentional demands, multiple tasks, emotional demands, time characteristics, interruptions and hindrances), work content (according a distinction made by Fine (1955): working with "data," "people," or "things"), have been formulated, and established scales for the measurement of fatigue, work pressure, burn-out, and job control have been used.
First of all professional groups will be selected according to the classification made by Fine, jobs in which people work primarily with respectively data, people, or things. For each group it will be determined, with the help of regression techniques, what the relative contribution from each specific job demand is to fatigue, work pressure, and or burn-out, and to what extent job control moderates this relation. It will be tested whether there will be one model that describes the relation between work demands and health outcomes, moderated by job control, for each group. Or whether different models are needed, thus resulting in "health risk profiles" for each category. For example, according to the literature we can expect to find that emotional demands are quite strong in job categories in which people work with people, which may result in a relatively high risk for burn-out. Furthermore we expect that attentional demands may be rather prominent in the profile of job categories in which people work with data.
This will help in understanding what factors cause fatigue and work pressure, which seems to be a general complaint in present days. Furthermore it will help in formulating specific measures for job redesign to reduce risks for well-being and (mental) health.
What is Food to One Man Is Poison to Another
(*) Rosalind C. Barnett, Ph.D., Karen C. Gareis, Ph.D., Brandeis University, and Lena Lundgren, Ph.D., Boston University
At a time marked by an increase in the number of dual-earner couples and in the length of the average work week of highly educated employees, there is heightened interest in reduced-hours work. It is often argued that a shorter work week is one way to reduce strain and distress, especially among married professionals in dual-earner couples. Yet the empirical literature on the relationship between the absolute number of hours worked and distress outcomes is inconsistent.
Reducing one’s work hours may entail forgoing certain aspects of one’s job; among reduced-hours doctors, most forgo teaching and research. Perhaps the tradeoff of giving up some aspects of work to gain more non-work time is more stressful for some workers than for others. Unfortunately, relatively little attention has been paid to the role of tradeoffs. In this analysis, we hypothesized that ease of tradeoffs would be a more powerful predictor of three quality-of-life outcomes (psychological distress, job-role quality, and intention to leave one’s job) than would number of hours worked.
The sample comprised 141 part-time Boston-area physicians in dual-earner couples, with part-time defined as working no more than the median number of hours per week worked by other physicians of one’s one gender (50 for men, 40 for women). Participants completed a 1-hour interview and a 20-minute questionnaire. Ease of tradeoffs was measured by asking participants to indicate on a scale from 1 (none) to 5 (a great deal) the degree of distress experienced due to the discrepancy between the professional activities they would like to perform and their current work arrangement.
Overall, the physicians reported moderate ease of tradeoffs, with an average rating of 2.7 (SD = 0.9). We estimated simultaneous multiple regression models with ease of tradeoffs and work hours as the predictors, controls for age, gender, household income, medical specialization, number of children at home, and negative affectivity, and three outcomes: psychological distress, job-role quality, and intention to leave one’s job within a year. We also tested for moderating effects of age and medical specialization on these relationships. For all three QOL outcomes, ease of tradeoffs was a significant predictor, whereas work hours was not. The relationships between ease of tradeoffs and QOL indicators did not differ by age or medical specialization. In this sample, then, ease of tradeoffs was a stronger predictor of outcomes than was work hours.
Thus, the subjective meaning of reducing work hours has to be taken into account in assessing the QOL correlates of reduced-hours career options in the professions. These findings may help clarify the inconsistency in previous analyses of the relationship between number of hours worked and distress outcomes.
CORRESPONDING AUTHOR: Rosalind Barnett, Brandeis University Women’s Studies Program, Mailstop 082, Waltham, MA 02454-9110, USA
Inside the Black Box: Fit Mediates Work-hours/Burnout Relationship
(*) Rosalind C. Barnett, Ph.D., Karen C. Gareis, Ph.D., Brandeis University, and Lena Lundgren, Ph.D., Boston University
Interest has recently been expressed in understanding the processes that mediate the relationship between job stress and stress-related outcomes. In this analysis, we estimated the mediating effect of "fit" on the relationship between one job condition, number of hours worked, and burnout, a syndrome including feelings of emotional exhaustion, lack of professional efficacy, and cynicism. We conceptualize fit as the extent to which workers realize the various components of their work-family strategies; i.e., their plans for optimizing their own work and non-work needs, as well as those of other members of their work-family social system.
The sample comprised 141 part-time Boston-area physicians in dual-earner couples, with part-time defined as working no more than the median number of hours per week worked by other physicians of one’s one gender (50 for men, 40 for women). Participants completed a 1-hour interview and a 20-minute questionnaire. We developed a 9-item measure of fit asking respondents to assess on a 7-point scale how well the number and distribution of their work hours and flexibility of their work schedule met their needs. They were also asked to rate how well their own and their partner's schedules met their own, partner's, and children's needs. Thus, fit represents a subjective assessment of the degree to which each spouse has optimized her/his work schedule. The scale has acceptable psychometrics: Cronbach a = .85, test-retest correlation over 1-3 months = .78. Burnout was assessed with a modified version of the Maslach Burnout Inventory.
The results of structural equation modeling supported the mediation hypothesis: Including an indirect path from work hours through fit to burnout resulted in a significant improvement in model goodness-of-fit compared to the direct-effects model without such a path. At any level of work hours, employees whose work hours were more or fewer than they and their partner preferred and whose work hours were distributed differently than they or their partner would prefer were more disengaged, distracted, and alienated at work than were their counterparts who were working their preferred schedules.
Thus, the relationship between number of hours worked and burnout depends upon the extent to which work schedules meet the needs of the worker, her/his spouse, and their children.
CORRESPONDING AUTHOR: Rosalind Barnett, Brandeis University Women’s Studies Program, Mailstop 082, Waltham, MA 02454-9110, USA
Alertness and Performance after Brief Nap under Prior Sleep Deficit
Masaya Takahashi*, B.A., and Heihachiro Arito, D.M.Sc., National Institute of Industrial Health, Japan
Objective: To examine whether a brief nap during post-lunch rest would maintain subsequent alertness and performance when sleep on the previous night had been shortened.
Methods: Ten healthy volunteers, who had taken a prior 4-h sleep at home with wrist actigraphy, participated in the study (mean age 22 years). Subjects were exposed to both nap and no-nap conditions in a counterbalanced order, separated by at least one week. The nap condition included a nap of 15 min (12:30-12:45) on a bed during post-lunch rest. The nap was monitored by the electroencephalogram, electromyogram, electrooculogram, and electrocardiogram (ECG). The corresponding time period under the no-nap condition and the testing intervals involved reading in the laboratory under surveillance by the experimenter. We measured auditory P300 event-related potential, subjective sleepiness (Visual Analogue Scale), and 5-min ECG at 10:00, 13:15, and 16:15, and task performances of logical reasoning and digit span at 10:20, 11:30, 13:35, 14:45, 16:35, and 17:45.
Results: Total sleep time (TST) before the nap condition was similar to that before the no-nap condition, as determined by the actigraphy (3.4 vs. 3.6 h). The nap produced significant decreases in P300 latency at 13:35 (323 vs. 343 ms) and subjective sleepiness at 13:35 and 14:45 compared to the no nap. The accuracy of the logical reasoning task (percentage of correct responses) was significantly higher after the nap at 13:35 than after the no nap. Other measures did not differ significantly between the nap and no-nap conditions at any testing times. The TST during the nap was 10.1 min (stage 1= 5.2, stage 2= 3.6, stage REM= 1.4 min [n=2]), without slow-wave sleep (stages 3+4 sleep). The sleep latency was 3.8 min.
Conclusion: A brief nap during post-lunch rest is helpful for maintaining subsequent alertness and performance even under prior sleep deficit, particularly around the afternoon dip.
Corresponding author: Masaya Takahashi, National Institute of Industrial Health, 21-1, Nagao 6-chome, Tama-ku, Kawasaki, 214-8585, Japan
Job Stress and Fatigue: Work Scheduling as an Effective Countermeasure
Patrick Sherry & Shannon Huebert, University of Denver
Shiftwork and long periods of time without rest may negatively impact health and well-being of individual workers (Paley and Tepas, 1994). Few studies have investigated the effects of fatigue on railroad personnel. Myrtek, et. al. (1994) studied the effects of stress and fatigue in European locomotive engineers. A survey of US railroad engineers and conductors also found high levels of reported sleepiness, fatigue, and frustration associated with irregular work schedules (Sherry & Hubert, 1998).
Due to the variable scheduling of freight trains by some carriers railroad locomotive engineers and conductors the predictability of scheduling rest during off hours is challenging. Anecdotal reports indicate that unexpected calls and delayed departures create additional difficulty for employees in scheduling their rest. The purpose of this study was to evaluate the effectiveness of work scheduling as an approach to the management of job stress and fatigue in a railroad setting. Accordingly, the research questions were intended to determine whether following the adoption of work scheduling programs that participants would: a) obtain greater amounts of sleep b) report greater levels of alertness; c) report lower levels of fatigue; d) report lower levels of job stress.
A total of 113 persons completed surveys in the study. Measures included the Stanford Sleepiness Scale (Stanford Sleepiness Scale-LT), the Eppworth Sleepiness Scale, the Sleep Adjective Checklist, the Job Stress Scale, the Job Satisfaction Scale, and Hours of Sleep Scale. Study participants were identified as being one or three scheduling conditions: Time Windows (TW), Assigned Days Off (ADO), or Control Group (CG). Time Windows for the TW participants were included in various time windows which were exactly 6 hours wide. Four time windows were available for each day. Persons in the assigned Days off condition were expected to work 8 days in a row and then get three assigned days off. Participants in the control condition were from a location that engaged in no scheduling activities, in other words, used the typical variable scheduling approach.
Post-hoc analyses of the effects of the ADO versus the TW schedules indicated that there were significant differences on the SSS-LT (F(1,32)=5.554,p<.025), Job Stress (F(1,33)=5.46,p<.026), and Job Satisfaction (F(1,33)=4.31,p<.046). These differences indicate that the participants in the Assigned Days Off condition reported more alertness, fewer feelings of job stress and anxiety, and greater job satisfaction than participants in the Time Windows condition.
Results of this study suggest that scheduling approaches can have a beneficial effect upon employees feelings of fatigue and stress. Following the adoption of a Time Windows or an Assigned Days Off approach respondents in this study reported a decrease in feelings of sleepiness and fatigue and job stress. Furthermore, these data were collected, when the employees were coming on duty, after having been rested, thus, the results are even strongly suggestive of the impact of these scheduling approaches.
Coping with Shiftwork Problems: A Pilot Study with a Developmental Approach
Alexandra Brady Elnick, M.A., Wayne State University
Recent research on coping and defense in adulthood (Diehl et al., 1996) indicates that people tend to endorse different strategies as they mature. This suggests that as people gain work experience, they may endorse more mature forms of coping when confronted with specific work-related problems such as those associated with shiftwork. Four major problem areas are associated with shiftwork (Spelten et al., 1993). The coping literature indicates that people of different ages cope the same in some situations and differently in others (Strack & Feifel, 1996). Although a multitude of coping measures exist (Schwarzer & Schwarzer, 1996), none have been shown to be definitive for identifying successful coping strategies that develop from handling work-related problems across the working life span. Building on Ihilevich and Gleser’s (1986) approach, a shiftwork-specific coping instrument was constructed to examine how workers of different ages (21-55) report they would endorse strategies to cope with problematic shiftwork situations. The primary objective of this pilot study was to evaluate whether the new coping instrument would reveal age differences in coping. The second objective was to determine how these strategies relate to psychosomatic responses. The third objective was to examine whether individuals endorse the four coping strategies consistently across these situations.
Examination of correlations between age and four coping strategies (emotion-focused, action-oriented, reversal, and transformative) revealed a statistically significant decrease in the endorsement of emotion-focused responses with age but not with work experience. None of the other strategies conceptualized to represent more mature responses to handling problems demonstrated a significant relationship with either chronological age or years of work experience. Emotion-focused coping also showed a statistically significant positive association with somatic complaints and depressive symptoms, while more conceptually mature responses did not even reveal a significant negative association. Investigation into the consistency of endorsing coping strategies across eight hypothetical situations revealed that only emotion-focused responses were selected consistently across these problematic situations. This finding suggests that the extent to which a worker would endorse more developmentally mature responses depends more on the situation and is less likely a characteristic pattern for an individual.
In conclusion, this study provided evidence that coping with worklife is a complex process and that age alone is insufficient for examining how workers learn to cope with problems that impact their health and well-being across the working lifespan.
CORRESPONDING AUTHOR: Alexandra Brady Elnick, M.A., MC: 480-106-269, GM Research & Development Center, 30500 Mound Rd., Warren, MI 48090-9055
The Maastricht Cohort Study on Fatigue and Psychological Distress at Work: Design and First Results
IJmert Kant, Ph.D., Helga J. van den Elzen, Ph.D., Anna J.H.M. Beurskens, Ph.D., Ute Bültmann, M.Sc., Gerard M.H. Swaen, Ph.D., Department of Epidemiology, Maastricht University.
Fatigue and psychological distress at work affects the personal performance and may lead to sick leave and work disability. So far, most studies on this subject have been cross-sectional. However, these studies did not reveal the aetiology and prognoses of fatigue which is a prerequisite for effective prevention and treatment.
For this reason, at Maastricht University a large scale cohort study has been started in May 1998. The aims of this study are to investigate the risk factors for the development and the prognoses of fatigue and psychological distress at work. By using a longitudinal design causal relationships can be established. Furthermore, the incidence and prevalence of fatigue at work and the effectiveness of different treatments will be investigated within this cohort study. The Maastricht cohort study includes seven different projects and is part of the Netherlands concerted research action on ‘Fatigue at work’ granted by the Netherlands Organization of Scientific Research (NWO).
The etiology and prognoses of fatigue are quit complex and determined by many potential risk factors of which some interact with each other. Moreover, fatigue has different dimensions and different expressions (i.e. fatigue, burnout, sick leave and work disability) which in their turn may affect the prognostic variables and determinants. This ‘feedback’ mechanism adds an extra time-related dimension to the research on fatigue at work. To deal with these complex relationships a conceptual model was developed. This model takes into account the multi-factorial etiology, the different dimensions of fatigue and the feedback mechanism. Based on this model the Maastricht cohort study was designed.
The Maastricht Cohort study surveys a heterogeneous study population of 15.000 employees of different companies and follows them for 3 years. At baseline, participants completed a self-administered questionnaire on work, private situation, personality and fatigue. Follow-up consist of fatigue (perception, complaints and sick-leave) as reported by the participants and record linkage to the company’s sick-leave / work disability registry systems.
In the paper the conceptual model, the subsequent study design and results at baseline will be presented.
CORRESPONDING AUTHOR: IJmert Kant, Ph.D., Department of Epidemiology, Maastricht University, PO box 616, 6200 MD Maastricht, The Netherlands.
Working Hours: A Psycho-social Study with Workers who Have Fixed Schedules and Flexible Schedules in a Medium-sized Private Industry
Martins, Mônica Mastrantonio; Master Degree - Pontifícia Universidade Católica - P.U.C. - São Paulo - Brazil. The present research aimed to establish relations between time and workers who have fixed and flexible working hours in a pasta industry in the city of Londrina, Paraná, Brazil.
Working time is defined as a psychological and social construction, which orientates individuals and defines practices of workers. The approach used links Social Psychology and Norbert Elias (European sociologist) proposals for studying time.
To understand these interactions, "Field Research" was adopted and three techniques were applied to obtain data. First step: weekly visits to factory for a period of three months. All information was registered in a Field Diary. Second step: elaboration and application of a time questionnaire with open and closed questions to salesmen of the factory (flexible working hours). Third step: preparing and interviewing six workers who had fixed working hours and six who had flexible working hours. The total of twelve interviews were recorded and based on topics like: working hours, shifts, overtime, meal time, time spent in daily journeys to work, working time and leisure time, preference to fixed or flexible hours and complaints about time.
The data obtained was organized like this: detailed description of the visits made to the factory was shown in the Field Diary; thematic organization of topics derived from the time questionnaire; record and transcription of interviews provided comparison between workers with flexible or fixed time.
Results show that the Field Diary gives the context in which questions about time are bought up in the factory. Questionnaires applied with salesmen illustrate through collective proverbs the various meanings attributed to time. Interviews demonstrated that time and activity are strongly related in the definition of working hours. Workers with fixed working hours conceived working time control cards as positive factors. On the other hand, workers with flexible hours view the absence of them as a sign of status and power, but also complained of difficulties in having free time away from work.
Finally, although working hours depend on multiple factors and interactions, workers apprehension of time should always be considered in order to develop less suffering working times in factories.
CORRESPONDING AUTHOR: Mônica Mastrantonio Martins, M.D., Department of Social Psychology, Rua: Capitão Messias, 99 - apto 22 - Perdizes - São Paulo - S.P. - BRAZIL 05004.020
National Occupational Research Agenda: Musculoskeletal Disorders
Laura S. Welch, MD for the NORA Musculoskeletal Team. Washington Hospital Center
Work-related Musculoskeletal Disorders (WMSDs) account for a major component of the total cost of work-related illness in the United States. The Bureau of Labor Statistics reported that for those cases involving days away from work, in 1994 approximately 32% of the total, or 705,800 cases, were the result of overexertion or repetitive motion.
NIOSH has launched National Occupational Research Agenda (NORA), a collaborative effort between NIOSH and its partners to guide occupational safety and health research over the next decade. As part of the NORA process, a team of experts representing a broad range of industry, labor, and government interests has been assembled to evaluate the status and define future research needs in the area of WMSDs. The agenda will serve as a blueprint for building a national research program by identifying high priority research problems and issues.
The interactive poster will outline the steps being taken by this NORA team to develop a research agenda, and provide the details of our findings from three practitioner focus groups that were held in Chicago, Seattle, and Washington DC. Practitioners from a wide range of industry sectors were asked a series of questions regarding research gaps, intervention effectiveness, surveillance, and implementation needs. We solicit input and participation of the researchers and practitioners attending the conference.
CORRESPONDING AUTHOR: Laura S. Welch, MD, Washington Hospital Center, 100 Irving St., NW, Washington DC 20010, USA
Reviewing the Role and History of the Federal Government in Occupational Safety and Health Research
V. R. Nathan, Ph.D., M.P.H., J. Ward-Robinson, Ph.D., G.H. Cattledge, Ph.D. National Institute for Occupational Safety and Health
In 1970, Congress passed the Occupational Safety and Health Act to assure, "so far as possible every working man and woman in the Nation safe and healthful working conditions." The Act created the National Institute for Occupational Safety and Health (NIOSH) to identify the causes of work-related diseases and injuries, evaluate the hazards of new technologies and work practices, create ways to control hazards so that workers are protected, and make recommendations for occupational safety and health standards. The Act also created the Occupational Safety and Health Administration (OSHA) to promulgate and enforce standards. In the year 2000, it will be 30 years since the passage of the Occupational Safety and Health Act. Since that time, substantial progress has been made in improving overall worker protection. Much of this progress is attributed to actions guided by occupational safety and health research within NIOSH. Although progress has been made, few advances focus on the issues that affect minority populations (workers of color, young workers, older workers, disabled workers, genetic susceptible workers, and women workers).
This poster session will describe strategic actions taken through executive orders and initiatives by the federal government to promote minority health with emphasis on minority occupational health. Special emphasis will be focused on the National Occupational Research Agenda (NORA) and Healthy People 2000.
Organization of Work: Implications for Safety and Health and Research Directions
NORA Organization of Work Team Members
The National Institute for Occupational Safety and Health (NIOSH), in collaboration with an interdisciplinary team of researchers and practitioners from industry, labor, and academia, is developing a "National Occupational Research Agenda" (NORA). The purpose of NORA is to guide occupational and health research into the next decade – not only for NIOSH but for the entire U.S. occupational safety and health community. One of the identified priority areas is the organization of work and its effects on employee’s health and safety. Organization of work refers, in general, to management and supervisory practices and production processes and to their influence on the way jobs are designed and performed in the workplace.
Although organization of work is a newly recognized topic of study in occupational safety and health, a sizable body of research has documented the relevance of various organization of work factors to worker health and well-being. For example, these factors have been recognized with respect to workstation design and automated safety controls. There is an extensive literature linking job characteristics such as worker autonomy or control, workload pressure, and supervisory practices to job stress. In recent years, these types of factors have been further implicated as key risk factors for cardiovascular disease, musculoskeletal and psychological disorders. However, much is yet to be learned in this emerging field of study. For example, we have little capacity for tracking changes in management or production practices and identifying and evaluating their impact on the safety and health of working people; information on the effects of these practices on job conditions are limited and inconsistent; and studies on health and safety outcomes are few.
The NORA Organization of Work Team, over the past 18 months in collaboration with industry and labor stakeholders, has sought to identify essential research and other requirements to better understand how the organization of work is changing, safety and health implications of these changes, and prevention measures. This poster presents the research needs identified thus far and solicits input and reactions from conference attendees.
CORRESPONDING AUTHOR: Lois E. Tetrick, PhD, Department of Psychology, University of Houston, Houston, TX 77204-5341, USA
The NORA Intervention Research Team
Linda M. Goldenhar, Ph.D., National Institute for Occupational Safety and Health (NIOSH); Paul Landsbergis, Ed.D., Cornell University Medical Center; Raymond C. Sinclair, Ph.D. (NIOSH); Remaining Team Members
Occupational intervention effectiveness research (IER) includes studies to determine the effectiveness of (1) safety and health training program, (2) health communications, (3) changes in work environment or practices, and (4) control technologies (e.g., use engineering techniques, personal protective equipment, specific work practices). NIOSH and its partners in the National Occupational research Agenda (NORA) effort recognize the importance of this by making IER one of the 21 NORA priority areas by establishing an IER NORA team.
The mission of the NORA IER team is to identify and promote strategies to: (1) encourage more testing of interventions to improve health and safety in the workplace; (2) improve evaluation (measurement, analysis and documentation) of intervention efforts; (3) make IER more accessible to researchers, health and safety professionals, labor and management, by promoting the development of practical tools and approaches; and (4) broaden dissemination of results/lessons learned from occupational safety and health IER.
To date, we have developed a three-dimensional model to help clarify the major steps involved in an IER study. That model has been presented at a number of scientific meetings including the American Public Health Association, the National Occupational Injury research Symposium, and the biannual NORA meeting. A manuscript describing the model in is being drafted.
The team also developed a case-based workshop for occupational health and safety professionals to demonstrate how an intervention might be adequately evaluated. It was pilot-tested at the 1998 Adult Blood Lead Surveillance meeting.
We have collaborated with scientists at The Institute for Work and Health in Canada to develop an IER manual for safety and health professionals. Related to this, the team has been working on an easy-to-use manual for employers on how to effectively develop, implement, and evaluate interventions. The team believes that both the benefits and the how-to of IER must be presented in different ways to different stakeholder groups (such as employers and occupational health specialists).
Partnership is one of our main guiding principles. We hope to leverage our resources through partnerships with outside agencies interested in measuring intervention effectiveness. We invite all interested parties to collaborate with us.
CORRESPONDING AUTHOR: Linda M. Goldenhar, Ph.D. NIOSH, 4676 Columbia Parkway, Cincinnati, OH, 45226.
The NORA Social and Economic Consequences of Workplace Illness and Injury Team
Elyce Biddle, National Institute for Occupational Safety and Health (NIOSH)
The Social and Economic Consequences of Workplace Illness and Injury team was established to help guide research over the next decade for NIOSH, as well as the general occupational safety and health community, in examining the impact of occupational injuries and illnesses on workers, their families, employers, communities, and the nation; in describing and measuring the effects of medical care on these costs; and in targeting and evaluating the economic benefit of prevention efforts. Understanding the total human and economic impact of occupational injuries and illnesses is crucial to setting priorities and shaping other components of the occupational safety and health research agenda.
This team, in conjunction with the Health Services Research NORA implementation team, is sponsoring a conference (June 13-15, 1999) that will address performance measures for health services delivered to prevent or treat occupational injury or illness, as well as measures of the economic and social impact of occupational injury or illness, and research that integrate these areas. Professional opinion, judgment, and recommendations from this conference will provide direction for developing a national occupational research agenda in these areas.
This conference will facilitate exploration of specific research topics that will allow researchers in each area to (a) share recently completed research findings and preliminary results of ongoing research; (b) identify substantive and methodological problems and share methods of addressing those problems; and (c) identify areas of research interest or need in occupational health services, social and economic consequences of injury or illness, as well as areas that can benefit from integration with methods from the other areas.
Specific topics for the conference will include the current state of knowledge about economic and social consequences of work injury and illness on occupational safety and health; data and methods to measure the social and economic impacts of workplace injuries and illnesses on injured workers and their families, on employers, and on other relevant groups; and promising areas of methodology and data development to pursue in this area.
Further topic areas will include evaluation criteria to assess the quality of occupational health services; the integration of medical services and workplace prevention services for the identification and reduction of workplace hazards; and the data and methods needed to evaluate such interventions. Related research topics will include the primary medical, labor market, organizational, and individual factors that affect whether workers will return to work for their pre-injury employers, the time lost from work after the injury, subsequent unemployment and changes in occupation, and the critical data and research needs in this area.
Corresponding Author: Elyce Biddle, NIOSH, 1095 Willowdale Road, Morgantown, WV 26505