Work-related injuries and illnesses (WRlls) are a significant public health problem in Massachusetts (MA), imposing preventable human and economic costs. State-based surveillance of these injuries and illnesses and workplace hazards is essential to effectively target intervention and prevention activities and to monitor progress. State-based surveillance can also provide information to fill gaps in national surveillance. Since the late 1980's, with substantial support from NIOSH and others, the MA Department of Public Health (DPH) has built a successful Occupational Health Surveillance Program (OHSP). OHSP has developed comprehensive case-based surveillance and intervention systems for a number of priority health conditions. A system for responding to urgent sentinel occupational health events is in place, as is a unique statewide system for surveillance of sharps injuries to hospital workers. Over the years, OHSP has expanded its capacity to use the growing number of population-based health data sets to characterize work-related health problems in the state, and annually generates 23 state Occupational Health Indicators. Committed to using data for action, OHSP collaborates with multiple agency and community partners to address identified health and safety problems. OHSP activities have resulted in changes in individual worksites and contributed to both broad-based policy changes and technological innovations to reduce workplace risks and, in turn, to reductions in the incidence of several targeted occupational health outcomes. Three interrelated themes are central to OHSP's work: 1) the essential link between surveillance and intervention (surveillance to practice); 2) use of the existing public health infrastructure to address occupational health concerns at the state and local levels (integration); and 3) special emphasis on addressing the needs of underserved workers, consistent with DPH's mission to reduce health disparities (occupational health equity). OHSP is proposing to build on its extensive occupational health surveillance experience and network of partners to continue and enhance an Expanded Program for occupational health surveillance and prevention. The overarching aim of the proposed program is to reduce the incidence of WRlls in MA. The proposed Expanded Program includes fundamental surveillance activities and four Priority Focus Areas (PFA) surveillance and intervention projects addressing occupational health conditions and/or populations that have been identified as priorities with input from key stakeholders in the state.
Specific aims are to: 1. Continue Fundamental Occupational Health Surveillance activities, including generation of Occupational Health Indicators; 2. Continue and enhance the Young Workers Injury Surveillance and Prevention Project, expanding the population under surveillance to include young adults; 3. Continue and enhance the Massachusetts Fatality Assessment Control and Evaluation Project; 4. Continue and enhance the Hospital Workers Project conducting surveillance and prevention of sharps injuries and patient handling musculoskeletal disorders; 5. Continue the surveillance and prevention of work-related asthma and explore approaches to conducting surveillance of other work-related lung diseases in MA. Each of these projects involves collection, analysis, and dissemination of data on occupational health outcomes and collaboration with multiple internal and external partners to promote use of the data to improve worker safety and health. The proposed set of surveillance and prevention activities share a number of objectives and needs and provide important opportunities for collaboration and synergies across projects. As a new cross-cutting initiative, OHSP will generate local area employment and WRIl data to promote consideration of working conditions in community public health planning and practice. Increased emphasis on effective communication will enhance translation of surveillance findings to practice in MA workplaces and communities, with a continued emphasis on reaching vulnerable workers.
The proposed Expanded Program will lead to reductions in hazards in MA workplaces, provide new information to effectively target broader based prevention activities, contribute to policy changes to promote worker safety and health, and increase consideration of the impact of work on health in public health practice more generally. It will foster sustained and enhance partnerships thereby strengthening the state infrastructure for occupational health and safety in MA, and it will increase surveillance capacity in the region.
