Top Construction Problems and the National Occupational Research Agenda (NORA) to address them

1. Top Construction Problems and the National Occupational Research Agenda (NORA) to address them Matt Gillen, MS, CIH NIOSH/CDC NIOSH Construction Program Coordinator ICOH International Scientific Committee in the Construction Industry April 25, Washington, DC

2. Overview • NIOSH and NORA • Utility of Strategic Goals • Methodology Highlights • Resulting Draft goals • Suggestions for International collaboration? Disclaimer – The findings and conclusions in this presentation have not been formally disseminated by the National Institute for Occupational Safety and Health and should not be construed to represent any agency determination or policy

3. NIOSHrole in the U.S. Occupational Safety and Health Framework 3 Regulation/Enforcement Research and Prevention Recommendations Department of Labor (DOL) Department of Health and Human Services (HHS) Centers for Disease Control and Prevention (CDC) Mine Safety and Health Administration (MSHA) Occupational Safety and Health Administration (OSHA) National Institute for Occupational Safety and Health (NIOSH)

4. 4 First decade of NORA 1996-2006(National Occupational Research Agenda) • NIOSH-supported national partnership • Defined research priorities • Expanded resources and effort on the priority topics 21 Research Priorities 8 on Disease and Injury 5 on Work Environment and Workforce 8 on Research tools and Approaches

5. Second Decade of NORA2006-2016 5 Making An Impact ! Why reorient NORA around sectors? • Research increasingly being judged by impact • Moving research into practice through partnerships is key to making an impact • Industry and employee group partners are organized by sector

6. Utility of Strategic Goals and a “National Construction Agenda” ? Vehicle for: • Stakeholder input on the most relevant problems • Encouraging and fostering sector-wide partnerships and activities on a manageable subset of important issues • Steering research towards cohesive relevant topic areas

7. Overview of process Surveillance and research findings Stakeholder NORA Comments NORA Sector Council Member Input Sector Council Discussions to identify “Top 10 Problems” and issues 10 workgroups convert problem topics into Draft Goals

8. NORA Construction Sector Council Categories

9. Criteria for looking at potential topics • What evidence supports this as a top problem? • Who is affected? (what trades or industry divisions) • Why does the problem persist? • What would be the ideal situation? • What stage are we at in our knowledge and understanding of this construction problem? • Can the problem be described using common priority-setting criteria? -Severity, Incidence or Prevalence -Size of exposed population -Need to improve current performance -Likelihood that research will -How much change is needed for near make a difference for term improvement? addressing this problem? • From a construction practice perspective, what stage is the problem at? -For Construction Safety and Health Practitioners? -For Contractors and Workers?

10. Two broad categories emerged OUTCOMES - 3 topics reflecting the most Important types of injuries, fatalities, illnesses, disorders and causes • Reducing Major Sources of Injuries and Fatalities Falls, Electrocution, Struck by and caught between • Reducing Major Health Exposures and Sources of Illness Silica, Welding fumes, Noise • Reducing Major Sources of Musculoskeletal Disorders

11. CONTRIBUTING FACTORS - 7 topics reflecting positive or negative influences affecting the likelihood that prevention and control measures are taken on a construction job • Construction Culture • Management of Safety and Health in Construction • Construction Industry and Work Organization • Training Issues • Vulnerable worker issues • Design for Safety and Prevention Issues • Improved Surveillance for hazards and outcomes

12. How to convert top problems into goals? • Use Logic Model framework for shared understanding on • How research leads to impact • Key roles of construction groups • Different types of goals needed • Use workgroups that include corresponding members • Use common goal template

13. Logic Model Traditional research planning direction

14. Logic Model Insights…. • Impact occurs when final customers (workers and contractors) change practices • Researchers have fewer direct contacts with these final customers • Intermediate groups (unions, trade associations, professionals, others) are in the pivotal middle position • Primary customers for research • Key influence on workers and contractors • Ideal partners for Research and R2P

15. Approach for developing goals Research and R2P Goals should reflect these activities Intermediate Goals Should reflect these activities Strategic Goals Should reflect impact Develop strategic goals first, then work backwards

16. Goal template Strategic Goal 1 Performance Measure 1 Narrative Intermediate Goal 1 Performance Measure Narrative if needed Research Goal 1 Research Goal 2 Research to Practice Goal 3

17. Resulting goals SG 1.0 - Reduce Construction Worker fatalities and serious injuries caused by falls to a lower level (4 IG, 15 R/R2P) SG 2.0 - Reduce fatal and nonfatal injuries from contact with electricity among construction workers. (4 IG, 10 R/R2P) SG 3.0 - Reduce fatal and serious injuries associated with struck-by incidents associated with objects, vehicles, and collapsing materials and structures. (8 IG, 20 R/R2P) SG 4.0 – Reduce hearing loss among construction workers by increased use of noise reduction solutions, practices, and hearing conservation programs by the construction community (4 IG, 13 R/R2P) SG 5.0 – Reduce silica exposures and future silicosis risks among Construction workers by increasing the availability and use of silica dust controls and practices for tasks associated with important exposures. (5 IG, 15 R/R2P)

18. SG 6.0 – Reduce welding fume exposures and future related health risks among construction workers by increasing the availability and use of welding fume controls and practices for welding tasks (5 IG, 16 R/R2P) SG 7.0 - Reduce the incidence and severity of work-related Musculoskeletal disorders among construction workers in the U.S (4 IG, 14 R/R2P) SG 8.0 - Increase understanding of factors that comprise both positive and negative construction safety and healthcultures; and, expand the availability and use of effective interventions to maintain safe work practices100% of the time in the construction industry. (3 IG, 22 R/R2P) SG 9.0 - Improve the effectiveness of safety and health management programs in construction and increase their use in the industry. (5 IG 24 R/R2P) SG 10.0 - Improve understanding of how construction industry organization factors relate to injury and illness outcomes; and increase the sharing and use of industry wide practices, policies, and partnerships that improve safety and health performance. (7 IG 22 R/R2P)

19. Resulting goals SG 11.0 – Increase the recognition and awareness of construction hazards and the means for controlling them through broad dissemination of quality training for construction workers, including non-English speaking workers. (4 IG, 13 R/R2P) SG 12.0 - Increase understanding of how vulnerable worker groups experience disproportionate risks in construction work and expand the availability and use of effective interventions to reduce injuries and illnesses among these groups. (3 IG, 13 R/R2P) SG 13.0 – Increase the use of “prevention through design (PtD)” approaches to prevent or reduce safety and health hazards in construction. (5 IG, 13 R/R2P) SG 14.0 - Improve surveillance at the Federal, State, and private level to support the identification of hazards and associated illnesses and injuries; the evaluation of intervention and organizational program effectiveness; and the identification of emerging health and safety priorities in construction. (3 IG, 14 R/R2P)

20. Key issues • Currently in process of finalizing goals • Getting intermediate goals right is key • WHAT ARE THE MOST IMPORTANT • ACTIVITIES AND SOLUTIONS THAT • WILL LEAD TO ACHIEVING • STRATEGIC GOALS? • Developing Performance Measures • is challenging • Participation and partnering needed • to achieve goals

21. Encouraging Research on the NORA goals NORA National Agenda + NIOSH Construction Program Review Recommendations As main input to: • Next 5 year Cooperative Agreement RFA (late 2008) • NIOSH intramural construction goals and guidance • Partner research using NORA goals Driving research direction from 2009-2014 NA input NORA 2 generated research RFA and intramural guidance NORA Agenda 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

22. International Collaboration • How can international collaboration on common construction goals/priorities be encouraged? • Can we encourage more development of R2P products based on research results originating from other countries? How? • What are best practices for national strategic planning? • What is the best way to engage the industry to meet national goals?

23. Thanks for any comments and suggestions! 23 NORA Construction Sector webpage http://www.cdc.gov/niosh/nora/councils/const/ NORA Construction Sector News http://www.cdc.gov/niosh/news/nora/ construction/NORAconstNewsV1N1.html NORA National Construction Agenda http://www.cdc.gov/niosh/nora/councils/const/pubprod.html NIOSH eNEWs http://www.cdc.gov/niosh/enews/ NIOSH Home Page: www.cdc.gov/niosh

24. Matt Gillen NIOSH/CDC Construction Program Coordinator NORA Construction Sector Council Co-Chair 395 E St SW Washington, DC 20201 202 -245-0651 MGillen@cdc.gov Contact information

25. Supplemental slides – additional goal detail • Strategic goals for Health SG 4 – Noise/Hearing Loss SG 5 - Silica exposures and illnesses SG 6 - Welding fumes and associated illnesses These three share a common template

26. Side by Side look at Intermediate Goal 1

27. Side by Side look at Intermediate Goal 2

28. Side by Side look at Intermediate Goal 3

29. Side by Side look at Intermediate Goal 4

30. Side by Side look at Intermediate Goal 5

31. IG 6.4 – Develop model practices and programs and promote their use by construction owners, governmental groups, professional groups, and best practice employers. (Goals continue on next page) • RG 6.4.1 – Portable health testing program component - Develop, evaluate, and promote “portable” (that is, transferable from one employer to another) options for respirator fit testing to include key information such asfit-certified respirator models,respirator training records, respirator medical evaluations, and welding fume related medical testing that can be maintained for workers as part of a health surveillance program across multiple employers. Develop and disseminate guidance on suitable welding medical surveillance approaches. • RG 6.4.2 – Emission factor and field screening component - Evaluate the feasibility and use of 1) welding “emission factor” data and 2) available direct reading field instruments, for use in a construction-user friendly system to provide pre-job exposure estimates for safe job planning. • RG 6.4.3 – Welding fume exposure database component - Develop and promote the use of a welding fume exposure task database that can be used by safety and health professionals, contractors and competent persons for pre-job exposure estimation and for planning the use of controls.

32. IG 6.4 – Develop model practices and programs and promote their use by construction owners, governmental groups, professional groups, and best practice employers. (Goals continued) • RG 6.4.4 – Pre-job planning component – Develop, evaluate, and promote a straightforward 3-5 step pre-job welding fume hazard review/plan that can be used by competent persons to estimate and plan for project-specific welding exposure hazards. • RG 6.4.5 – Policy driver component - Improve understanding of the economic and policy factors that support or discourage the use of model programs and practices for welding fume control in construction. • R2PG 6.4.6 – Develop demonstration projects to evaluate the effectiveness of program components and practices in addressing needs of key construction stakeholders. Incorporate results into guidance on model practices and programs. • R2PG 6.4.7 – Partner with construction stakeholders and groups to promote the use of model programs and practices by construction owners and best practice employers of all sizes throughout the industry.

33. SG1.0 - Reduce Construction Worker fatalities and serious injuries caused by falls to a lower level • IG1.1 - Identify the top three fall-related problems requiring technical engineering solutions and develop and evaluate options to fill these gaps. • IG1.2 - Expand awareness and use of existing effective fall prevention and protection solutions by construction employers and workers • IG1.3 - Expand the use of “safe-by-design” practices for fall prevention via demonstration projects and guidance. • IG1.4 - Develop and implement a national campaign to reduce fatal and serious injuries associated with construction falls to a lower level.

34. IG 1.1 - Partner with construction stakeholders and safety professionals to identify the top three fall-related problems requiring technical engineering solutions and develop and evaluate options to fill these gaps. • RG 1.1.1 – Inventory existing fall protection technologies and identify three gaps where technical engineering guidance needs to be developed or modified further for fall protection. • RG 1.1.2 – Develop and evaluate engineering interventions and guidelines to address the three fall protection gaps. • R2PG 1.1.3 – Disseminate these solutions and guidelines throughout the industry

35. IG 1.2 - Partner with Construction stakeholders to expand awareness and use of existing effective fall prevention and protection solutions by construction employers and workers • RG 1.2.1 – Work with insurance companies and consultation organizations to identify small contractor implementation obstacles associated with existing fall prevention and protection measures. • RG 1.2.2 – Develop additional protective and cost effective solutions • R2PG 1.2.3 – Develop simple pre-job planning tools for use by small and medium size contractors to improve identification of the most common fall hazards and solutions. • R2PG 1.2.4 – Partner with construction stakeholders to disseminate widely. • R2PG 1.2.5 – Utilize existing information about fall prevention and protection solutions to develop and disseminate trade- specific materials for the major categories of falls from heights associated with fatal and serious injuries to include awareness materials, implementation guidance, business case studies, and training materials in paper and electronic media.

36. IG 1.3 - Partner with architects, engineers, and construction organizations to expand the use of “safe-by-design” practices for fall prevention via demonstration projects and guidance. • RG 1.3.1 – Identify and evaluate 3 existing “safe by design” practices that address falls to lower levels and develop case study materials. • RG 1.3.2 – Identify and evaluate 3 new “safe by design” practices that address falls to lower levels and develop case study materials. • R2PG 1.3.3 – Partner with OSHA, international construction groups, professional societies, trade associations and unions, architect-engineer-and-designer firms, and insurance companies to disseminate case study materials and to expand the use of safe by design approaches • R2PG 1.3.4 – Within 6 years, document effectiveness of implementation of these safe-by-design practices.

37. IG 1.4 - Work with construction partners to develop and implement a national campaign to reduce fatal and serious injuries associated with construction falls to a lower level. • RG 1.4.1 – Evaluate the potential for a “National Construction Fall Prevention Campaign” by assessing: 1) the components and effectiveness of U.S. campaigns on related public health injury topics; and 2) the components and effectiveness of internationally based campaigns on construction injury topics. Prepare a proposal for a U.S. campaign. • R2PG 1.4.2 – Convene a meeting of construction stakeholders and industry leaders to discuss a proposal for a U.S. ”National Construction Fall Prevention Campaign”. If support is provided, develop an action plan for implementation. • R2PG 1.4.3 – If support is provided, implement the action plan in conjunction with construction industry stakeholders and evaluate the resulting impact.