Agriculture Reference
In-Depth Information
End outcomes, for purposes of this evaluation, are changes related to health,
including decreases in injuries, illnesses, deaths, and decreases in exposures or risk
factors resulting from the research in the specific program or subprogram. Quanti-
tative data are preferable to qualitative, but qualitative analysis may be necessary.
Sources of quantitative data include
•
Bureau of Labor Statistics (BLS) data on fatal occupational injuries
(Census of Fatal Occupational Injuries) and nonfatal injuries and ill-
nesses (Annual Survey of Occupational Injury and Illnesses).
•
NIOSH intramural surveillance systems, such as the National Elec-
tronic Injury Surveillance System (NEISS), the coal worker x-ray
surveillance program, and agricultural worker surveys conducted by
NIOSH in collaboration with the US Department of Agriculture.
•
State-based surveillance systems, such as the NIOSH-funded ABLES,
and the SENSOR programs (for asthma, pesticides, silicosis, noise-
induced hearing loss, dermatitis, and burns).
•
Selected state workers-compensation programs.
•
OSHA, which collects exposure data, in the Integrated Management
Information System.
The FC is unaware of surveillance mechanisms for many occupationally re-
lated chronic illnesses such as cancers arising from long exposure to chemicals and
other stressors. For many outcomes, incidence and prevalence are best evaluated
by investigator-initiated research.
The strengths and weaknesses of the various sources of outcome data should
be recognized by the ECs. Quantitative accident, injury, illness, and employment
data and databases are subject to error and bias and should be used by the ECs
for drawing inferences only after critical evaluation and examination of whatever
corroborating data are available. For example, it is widely recognized that occupa-
tional illnesses are poorly documented in the BLS Survey of Occupational Injuries
and Illnesses, which captures only incident cases among active workers. Most ill-
nesses that may have a relationship to work are not exclusively so related, and it is
difficult for health practitioners to diagnose work-relatedness; few are adequately
trained to make this assessment. Many of these illnesses have long latency and do
not appear until years after people have left the employment in question. Surveil-
lance programs may systematically undercount some categories of workers, such
as contingent workers. Challenges posed by inadequate or inaccurate measurement
systems should not drive programs out of difficult areas of study, and the ECs
will need to be aware of such a possibility. In particular, contingent and informal
working arrangements that place workers at greatest risk are also those on which
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