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eNews: Volume 21, Number 2 (June 2023)

Volume 21, Number 2 (June 2023)

From the Director’s Desk

John Howard, M.D., Director, NIOSH

Takin’ Care of Small Businesses

As of 2021, the United States had just over 8 million businesses, according to the U.S. Census Bureau. Of those, 7 million had fewer than 20 employees. Businesses of this size employ almost a quarter of the American workforce. The number jumps to half of all workers if we look at businesses employing fewer than 100 people.

These small businesses and their workers are vital to the national economy, as well as to the communities in which they operate. As important as they are, small businesses tend to have fewer resources dedicated to safety and health activities. They are also overrepresented in some of the more dangerous industries while being less likely than a larger company to have professional safety experts on staff.

The NIOSH Small Business Assistance Program supports small businesses by studying the special needs of these companies and making NIOSH research easier to adopt in their workplaces. The program works with intermediary organizations, such as chambers of commerce and bureaus of workers’ compensation.

In 2019, NIOSH began working with the Occupational Safety and Health Administration (OSHA) to update OSHA’s long-standing publication, Small Business Safety and Health Handbook. The handbook includes information on the benefits of an effective safety and health program, contains self-inspection checklists for employers to identify workplace hazards, and provides key workplace safety and health resources for small businesses.

Researchers in NIOSH’s Small Business Assistance Program have learned through regularly interviewing small business owners that these owners value health and safety information that is brief, easy-to-understand, and practical. They appreciate tools like checklists to ensure their employees get the job done efficiently and safely. Based on this feedback, NIOSH and OSHA periodically update the handbook with new, easy-to-understand information and additional checklists.

In the handbook’s May 2023 update, a new checklist was added for each of four safety and health topics that were not yet addressed: infection control, ergonomics, workplace violence, and young workers.

We hope that this information—as well as future research and additions to the handbook—will continue to contribute to the safety and health of the millions of Americans who work in small businesses.

Research Rounds

Workplace Violence Against Healthcare Workers Using Nationally Representative Estimates of Emergency Department Data

NIOSH study authors: Imani Carey and Kitty Hendricks

What did this study find?
Workplace violence continues to be a serious problem in the healthcare industry. From 2015 to 2017, more than 1 million work-related injuries among healthcare workers required treatment in the emergency department. Nearly one in seven of these injuries resulted from intentional violence by another person. By body part, the head and face were most likely to be injured, followed by the arm, wrist, and hand.

In other findings, differences in risk emerged by gender and age. Although more than half of injuries resulting from violence by patients occurred among women, the rate of injury from workplace violence for men was more than double the rate for women. Yet, more women work in the healthcare industry. Younger healthcare workers also had a higher rate of injury than those older than 25 years. Nearly one third of patient-caused, intentional injuries occurred among 25- to 34-year-olds.

How did you do the study?
We identified violence-related workplace injuries treated from 2015 to 2017 using the National Electronic Injury Surveillance System–Occupational Supplement, a NIOSH surveillance system of nonfatal, work-related injuries treated in emergency departments. We then calculated the risk of violence-related injury by gender and age.

Why is this study important?
Workplace violence harms both healthcare workers and patient care. Compared with workers in other industries, healthcare workers are more likely to suffer an injury at work resulting from violence. In fact, most of the violence-related, nonfatal workplace injuries in 2018 occurred among healthcare workers, according to the U.S. Bureau of Labor Statistics.

What are the next steps?
Additional research aimed at understanding its underlying causes is critical to preventing workplace violence and protecting healthcare workers.

Impact of Work Schedules of Senior Resident Physicians on Patient and Resident Physician Safety: Nationwide, Prospective Cohort Study

Study authors: Laura K. Barger, Matthew D. Weaver, Jason P. Sullivan, Salim Qadri, Christopher P. Landrigan, and Charles A. Czeisler, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital

Why is this study important?
In 2011, the Accreditation Council for Graduate Medical Education (ACGME) issued new work hour guidelines limiting resident physicians in their first post-graduate year (PGY1) to work shifts of 16 hours or less. However, the ACGME retained longer work shifts of up to 28 consecutive hours for senior resident physicians, suggesting that their experience prepares them to make patient care decisions during longer shifts. Since research is scant in this area, we assessed the association between long work weeks and work shifts and patient and resident physician safety in senior resident physicians (second post-graduate year [PGY2] and up).

How did you do the study?
We enrolled 4,826 senior resident physicians nationwide to complete 38,702 monthly, web-based reports of their work hours and patient and resident safety for eight academic years (2002–2007 and 2014–2017).

What did you find?
Working more than 48 hours per week was associated with an increased risk of self-reported medical errors, preventable errors resulting in patient harm, and preventable deaths, as well as near-miss crashes, exposures to contaminated bodily fluids, sharp injuries to the skin, and attention failures. Working 60–70 hours per week was associated with more than twice the risk of a medical error and almost three times the risk of preventable errors resulting in patient harm, including death.

What are the next steps?
Our results suggest that lower work-hour limitations would reduce risks for PGY2+ resident physicians and their patients. At the same time, workload and other factors will need to be considered as safer work schedules are implemented.

the cover of a handbook that depicts a small business owner looking at information on a tablet

Image by OSHA

NIOSH eNews is Brought to You By:

John Howard, M.D., Director
Christina Spring, Editor in Chief

Managing Editor
Tanya Headley

Section Editor
Anne Blank, Research Rounds
Kiana Harper, Highlights & Monthly Features

Contributing Editors
Sarah Mitchell

Copy Editor
Cheryl Hamilton

Technical Support
Steve Leonard, Technical Lead
Matt Osborne, Web Developer

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Highlights

Call for Comments: Youth Research Cohort Within World Trade Center Health Program
NIOSH is seeking feedback through a Federal Register Notice on the best approach for establishing a youth research cohort within the World Trade Center (WTC) Health Program. This program plans to conduct future research studies on the health and educational impacts on people 21 years or younger at the time of their WTC exposure. NIOSH also posted a Request for Information seeking input on best practices for assembling and engaging a cohort that sufficiently represents this group of 9/11-impacted youth. Please share these requests with interested colleagues, partner organizations, or others.

a green graphic that reads june: national safety month: an nsc initiative

June is National Safety Month
NIOSH is joining the National Safety Council in June to observe National Safety Month. Preventable injuries, commonly known as “accidents,” are the fourth-leading cause of death in the United States. Join us as we work together to highlight leading causes of preventable injury and death so people can live their fullest lives. Be sure to follow us on Twitter, Facebook, and Instagram all month for tips and information on the weekly topics.


Register Now for the Next NIOSH Expanding Research Partnerships Webinar!
NIOSH is hosting the next Expanding Research Partnerships Series webinar, “New Approaches to Occupational Safety and Health (OSH) Training,” on June 14, 11:00 a.m.–12:30 p.m. (ET). This installment will explore leveraging collaboration to address key challenges to occupational safety and health research, training, and practice. See the full speaker list and register.

WTC Health Program Scientific/Technical Advisory Committee Meeting Notice and Request for Comment
NIOSH published a Federal Register Notice on May 26 with details on the WTC Health Program Scientific/Technical Advisory Committee (WTCHP–STAC) public meeting. The virtual event will be June 21, 11 a.m.–4 p.m., and June 22, 11:00 a.m.–1:30 p.m. (ET). The meeting will focus on the new youth research cohort being established by the WTC Health Program. For additional information on the agenda, as well as how to submit oral or written comments, please visit the Federal Register Notice or STAC meeting webpage.


Monthly Features


Federal Register Notices

Board of Scientific Counselors, National Institute for Occupational Safety and Health, National Firefighter Registry Subcommittee
The notice was posted on May 1. Comments must be received by June 6. The meeting will be held on June 13.

Advisory Board on Radiation and Worker Health, National Institute for Occupational Safety and Health
The notice was posted on April 17. Comments must be received by June 7. The meeting will be held on June 14.

Advisory Board on Radiation and Worker Health, Subcommittee for Procedure Reviews, National Institute for Occupational Safety and Health
The notice was posted on May 1. Comments must be received by June 14. The meeting will be held on June 21.

World Trade Center Health Program Scientific/Technical Advisory Committee
The notice was posted on May 26. Comments must be received by June 22. The meeting will be held on June 21 and 22.

Proposed Data Collection Submitted for Public Comment and Recommendations: Noise Exposures and Hearing Loss in the Oil and Gas Extraction Industry
The notice was posted on May 12. Comments must be received by July 11.

World Trade Center Health Program; Youth Research Cohort; Request for Information
The notice was posted on April 26. Comments must be received by August 24.


News from Our Partners

Silicosis: Emerging Trends and How to Screen for Early Detection
Wisconsin’s Department of Health Services identified 68 probable silicosis cases and interviewed four of those patients. Two patients were stone fabrication workers diagnosed before 40 years old. They are among the first stone fabrication cases identified in the Midwest. The associated publication in the Wisconsin Medical Journal encourages clinicians to obtain occupational and exposure histories and provides a brief clinical evaluation tool for identifying and reporting silicosis cases.
This study was supported by NIOSH Office of Extramural Programs grant OH010898. 


NORA

Healthcare and Social Assistance NORA Council Meeting – June 22
The NORA Healthcare and Social Assistance Sector Council will host a meeting June 22, from 12–2 p.m. (ET). For the meeting invite, please contact Megan Casey.

Immune, Infectious, and Dermal Diseases Prevention NORA Council Meeting – June 26
Join the IID NORA council for a meeting on June 26, from 12–1 p.m. (ET). For the meeting invite, reach out to Marissa Alexander.


Conferences, Meetings, Webinars, & Events

This page provides a list of publicly available occupational safety and health-related conferences, meetings, webinars, and events sponsored by NIOSH as well as other government agencies, and nongovernment agencies, such as universities, professional societies, and organizations.