The databases available to examine national patterns and trends of US worker health and safety are out dated, and in general, incomplete. The National Health Interview Survey (NHIS), a multipurpose household survey of the US civilian noninstitutionalized population conducted annually since 1957 by the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention (CDC), has collected demographic, health, and employment data on over 450,000 US workers aged 18 years and older in a probability sampling of the entire US population, with a Mortality Follow Up with cause of death from 1986 through 1995. Therefore, the NHIS database allows for longitudinal analysis of mortality data as a retrospective cohort study, as well as cross-sectional and trend analysis of the aggregate morbidity data collected annually representative sample of all US workers for the past 2 decades. Using this uniquely representative and large database of the NHIS 1986-94 surveys with Mortality Follow-Up, the objectives of this proposed study are to evaluate the time trends for morbidity, and the longitudinal mortality associated with industry and occupation for the US worker. After assembling the cohort of employed persons aged 18 and older, the Investigators will examine the cause specific mortality and reported health and disability as summarized data for all annual NHIS interviews from 1986-1994, as well as the morbidity time trends, by industry and occupation. Hypotheses have been generated based on the historical literature; these hypotheses can be tested not only in terms of specific industry/occupational subgroups, but also in subgroups determined by important confounding variables such as age, gender, race/ethnic, socio-economic status, and geographic region (depending on the subgroup sample size). The costs of injury and disease in terms of lost work time and the use of medical services can be evaluated by specific industry/occupational subgroups; cause-specific mortality by industry/occupational subgroups, as well as by the same confounding variables, will also be determined. The investigators propose to create 2 Study Monographs, one on Morbidity and one on Mortality, to be made publically available on a linked Study Website so that researchers and the general occupational health community can use these data to compare to prior studies, to develop new research hypotheses, and to use the data as a surveillance tool to evaluate time trends and occupational disease in the US for the past 2 decades in both genders and in a variety of ace-ethnic subpopulations. This study proposal satisfies at least 3 NIOSH research priority areas (NORA): 1) surveillance research methods providing unique mortality and morbidity data on the entire US workforce; 2) unique mortality and morbidity data on older, race-ethnic, lower socio-economic and gender-specific worker subpopulations in the US; and 3) unique data on social and economic costs of workplace disease and injury. In addition this application is responsive to Program Announcement """"""""Occupational Safety and Health Research (PA-99-143J.
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