Agriculture Reference
In-Depth Information
surveillance information is almost totally lacking, so novel methods for measuring
impact may be required.
In addition to measures of illness and injury, levels of exposure to chemical
and physical agents and to safety and ergonomic hazards can be useful. Exposure
or probability of exposure can serve as an appropriate proxy for disease or injury
when a well-described occupational exposure-health association exists. In such
instances, decreased exposure can be accepted as evidence that the end outcome
of reduced illness has been achieved. That is particularly necessary in cases (such
as exposure to asbestos) in which latency between exposure and disease outcome
(lung cancer) makes effective evaluation of the relevant end outcome infeasible.
As an example of how exposure levels can serve as a proxy, the number of sites
that exceed an OSHA Permissible Exposure Limit (PEL) or an American Confer-
ence of Governmental Industrial Hygienists threshold limit value is a quantitative
measure of improvement of occupational health awareness and reduction of risk.
In addition to exposure level, the number of people exposed and the distribution
of exposure levels are important. Those data are available from multiple databases
and studies of exposure. Apart from air monitoring, such measures of exposure
as biohazard controls, reduction in requirements for use of personal protective
equipment, and reduction of ergonomic risks are important.
Clearly, the commitment of industry, labor, and government to health and
safety are critical external factors. Several measures of this commitment can be
useful for the EC: monetary commitment of the groups, attitude, staffing, and
surveys of relative level of importance. To the extent that the resources allocated
to safety and health are limiting factors, the ECs should explicitly assess NIOSH
performance in the context of constraints.
Questions to Guide the Evaluation Committee
1.
What are the amounts and qualities of end-outcomes data (such as
injuries, illness, exposure and productivity affected by health)?
2.
What is the temporal trend in those data?
3.
Is there objective evidence of improvements in occupational safety or
health?
4.
To what degree has the NIOSH program or subprogram been respon-
sible for improvements in occupational safety or health?
5.
If there is no time trend in the data, how do findings compare with data
from other comparable US groups or the corresponding populations
in other countries?
6.
Is there evidence that external factors have affected outcome measures?
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