Work-related slip, trip, and fall incidents can frequently result in serious disabling injuries that impact a healthcare employee's ability to do his or her job, often resulting in lost workdays, reduced productivity, expensive worker compensation claims, and diminished ability to care for patients. According to the U.S. Bureau of Labor Statistics 2009], the incidence rate of lost-workday injuries from slips, trips, and falls (STFs) on the same level in hospitals was 38.2 per 10,000 employees, which was 90% greater than the average rate for all other private industries combined (20.1 per 10,000 employees). STFs as a whole are the second most common cause of lost-workday injuries in hospitals. An analysis of workers' compensation injury claims from acute-care hospitals showed that the lower extremities (knees, ankles, feet) were the body parts most commonly injured after STFs and the nature of injury was most often sprains, strains, dislocations and tears. In addition, STFs were significantly more likely to result in fractures and multiple injuries than were other types of injuries. This workbook identifies the top 10 STF hazards specific to healthcare facilities. For each hazard this workbook will: 1. Explain how the hazard contributes to STFs, 2. Identify where the hazard is likely to occur, and 3. Provide recommendations to reduce or eliminate the hazard. Slips, trips, and falls are preventable. This workbook provides guidance on implementing a STF prevention program to protect healthcare workers. The goal of the workbook is to familiarize you with common STF hazards in healthcare facilities so you are able to recognize and reduce the risk to employees. Both visitors and patients will benefit from an STF prevention program in your facility reducing their risk as well.

Noise-induced hearing loss (NIHL) is the most common occupational illness in the United States, with 30 million workers exposed to excessive noise levels every day. Of particular concern is the mining industry; which has the highest prevalence of hazardous noise exposure of any major industry sector and is second only to the railroad industry in prevalence of workers reporting hearing difficulty. This document is for operators, safety personnel, and mechanics in the mining industry who are not specialists in noise control engineering or acoustics. Evaluations of successful and unsuccessful attempts at controlling noise on several large, underground metal mining machines are detailed to illustrate the basic principles of noise control. Once personnel understand the guidelines and principles of noise control, they will be able to evaluate the extent of a noise problem; determine the best approach to the problem; and apply the most appropriate solution. Because of the insidious nature of NIHL, it can go unnoticed until a considerable loss of hearing has occurred. In some cases, diagnosis is delayed because an exposed individual claims to have become accustomed to the noise. In reality, that person may have already suffered irreversible hearing loss.

The National Institute for Occupational Safety and Health (NIOSH) conducted the first comprehensive survey of the U.S. mining population in more than 20 years. The National Survey of the Mining Population captured the current profile of the U.S. mining workforce. Data collection began in March 2008 and continued through August 2008. Randomly selected mining operations in all of the major mining sectors (i.e., coal, metal, nonmetal, stone, and sand and gravel) received the survey and had the option of completing a paper or web-based questionnaire. A total of 737 mining operations returned completed questionnaires and reported data for 9,008 employees. Two sets of data were collected in this national survey. There were questions about the mining operation, including employee training, work schedules, the use of independent contractor employees, and mine communication and safety systems. The employee questions included demographic and occupational questions about individual employees. The survey sample data were weighted in order to provide national estimates of mine and employee characteristics. This Information Circular (IC) is published in two parts-"Part I: Employees" presents the employee-level data and "Part II: Mines" presents the mine-level data. Both parts of this IC include an overview of the survey background, development of the survey materials, sample design and sample selection, data collection and processing, statistical weighting, and lessons learned. The survey data are summarized for the overall U.S. mining industry and the five major mining sectors. The information gathered from the survey respondents is being published only as summarized data so that no single mining operation or employee can be identified.

Chemical exposure in the workplace is a significant problem in the United States. More than 13 million workers in the United States are potentially exposed to chemicals via the skin. Skin disorders are among the most frequently reported occupational illnesses, resulting in an estimated annual cost in the United States of over $1 billion. While the rates of most other occupational diseases are decreasing, skin disease rates are actually increasing. Efforts to reduce or prevent skin problems in many work settings are lacking as too frequently workers, employers, and even occupational health professionals accept skin problems as part of the job. The tolerance of occupational skin problems must be lowered and the methods for assessing and reducing chemical exposures must be improved. As occupational health professionals or employers, it is important that you know how to identify and manage the risk of chemical exposures to the skin and prevent injury and illness associated with dermal exposure risks. This publication will provide workers with: knowledge of the major adverse health effects resulting from chemical exposures to the skin, information on recognizing chemical hazards, knowledge of intervention/prevention strategies, and sources of information related to skin disorders and prevention.

It has been nearly 40 years since the Occupational Safety and Health Act of 1970 was passed. During that time, NIOSH has worked diligently to ensure that U.S. workers are safe from occupational illness, injuries, and fatalities while at work. Our strong scientific foundation has guided our work as we strive to fulfill the responsibilities of the Act, and to carry out the duties entrusted to us by Congress. NIOSH's research and recommendations over the years have made a significant impact in reducing and preventing occupational injuries, illnesses, and fatalities. Our work has lead to recommendations on reducing exposures to asbestos, lead, vinyl chloride, and other toxic industrial agents. As the U.S. economy has changed NIOSH has kept pace by addressing the new occupational hazards that have arisen or become more prominent, such as latex allergies, musculoskeletal disorders, indoor air quality, and workplace violence. And with the goal of achieving even greater impact with our research, NIOSH created the National Occupational Research Agenda (NORA) in 1996. The creation of NORA allowed us to expand our partnerships and leverage resources to meet the needs and challenges of the changing face of work. This document provides a snapshot of our work addressing the safety and health issues that reach across all the U.S. states, industries, and disciplines. Here we have included information about our efforts in traditional and emerging areas such as NORA, research-to-practice, emergency response, nanotechnology, personal protective technology, global collaborations, and other cross-cutting programs. We have also included examples of how NIOSH and our partners are working hard to achieve our shared mission of making the workplace safer and healthier for all workers.

Surveillance is the cornerstone of prevention: It helps us identify new and emerging problems, track and monitor issues over time, target and evaluate the effectiveness of intervention efforts, and anticipate future needs and concerns. Those who have long struggled with these issues in the occupational setting will share my enthusiasm for this first edition of the Worker Health Chartbook. One of the primary goals in compiling the chartbook was to create a resource that could be used by anyone interested in workplace safety and health, including occupational safety and health practitioners, legislators and policy makers, health care providers, educators, researchers, and workers and their employers. In an attempt to reach the widest possible audience, we have made the chartbook available in printed and electronic form. Several Federal agencies worked together to organize the surveillance data sources required to produce this document. This is an important step toward identifying and filling significant gaps in occupational illness and injury information. The success of this initial effort has provided a framework for increased surveillance coordination between NIOSH and our partners in the future. The Worker Health Chartbook serves NIOSH and the occupational safety and health community well by placing surveillance in the hands of those who work to prevent occupational injuries and illnesses. The forethought and collaborative spirit that made all of this possible are commendable and bode well for future efforts to integrate Federal, State, and private-sector surveillance information.

(Information Circular 9505) From the first day of new miner training until the day they retire, mine workers will experience changes due to the normal aging process. It is an unfortunate fact of life that many age-related changes result in diminished physical, sensory, or cognitive capabilities. Of course, workers also gain a tremendous wealth of experience, knowledge, and insight as they age, making them a vitally important resource for their company. Effective leveraging of this precious resource requires both an appreciation of the changes that occur with age and an understanding of methods that can be used to reduce the injury risk that may result. The purpose of this training is to provide the information necessary to accomplish these objectives. Aging workers may not necessarily have a higher injury risk overall; however, the effects of a musculoskeletal injury (MSI) on older workers may be more extreme. MSHA data show that not only does the percentage of MSIs increase when workers are over age 30, so does the number of days lost per injury. Protecting the safety and health of aging workers requires matching the demands of the job to worker capabilities. This means reducing or eliminating risk factors for injuries, such as heavy lifting, awkward postures, static postures, repetitive movements, and/or vibration exposures. In other cases, it may mean improving visibility or streamlining processes. Designing jobs to accommodate the changing capabilities of older workers will not only reduce injury risk for older workers, it will have the added benefit of protecting younger employees as well. Training objectives: After completing this training, miners will: Better understand age-related changes that everyone experiences; Identify work tasks and situations that put older workers at risk; Be familiar with ways to modify jobs to accommodate older workers; Know about lifestyle choices that can keep them healthier both on and off the job.

Surveillance data can be used to identify new emerging pesticide problems, estimate the magnitude of pesticide poisoning, and evaluate intervention and prevention efforts. Recognizing this, the National Institute for Occupational Safety and Health (NIOSH) Strategic Surveillance Plan recommends that States conduct surveillance for acute pesticide-related illness and injury. Since 1987, NIOSH has provided financial and technical support for State-based acute pesticide poisoning surveillance programs. NIOSH is not the only organization that has recommended improved and/or expanded surveillance in this area. Others include the American Medical Association, the Council for State and Territorial Epidemiologists, the United States Government Accountability Office, and the Pew Environmental Health Commission. Despite these recommendations, most States do not conduct acute pesticide-related illness and injury surveillance. Acute pesticide-related illness is a relatively complex disease. Approximately 16,000 pesticide products are currently registered in the United States. In addition, all organ systems are susceptible to pesticide toxicity. The multitude of pesticide products and associated health effects may act as a barrier to establishing surveillance programs. NIOSH developed this guide to provide standards and principles that can help to master this complexity. This document will be useful to agencies that are developing an acute pesticide related illness and injury surveillance program or are interested in maintaining and improving an established surveillance program. The guide provides (1) information about the importance of pesticide poisoning surveillance; (2) mechanisms to improve reporting of cases to surveillance programs; (3) methods to investigate reported cases; (4) guidance on using the case definition; and (5) additional resources on pesticide toxicology, pesticide usage, governmental partners, and surveillance. The goal of this guide is to assist the efforts of our partners to identify pesticide poisoning risk factors. Pesticide poisoning prevention can be achieved by targeting interventions toward these identified risk factors. NIOSH hopes individuals and agencies interested in pesticide poisoning surveillance and prevention (e.g., local, State, and Federal government agencies, community-based organizations, and international agencies) will find this guide useful for identifying and preventing pesticide poisoning.

In 2003, NIOSH co-sponsored a conference that brought together researchers from around the world to discuss the safety and health of commercial truck drivers. NIOSH recognizes that these workers merit attention due to the difficult and dangerous nature of their trade. Truck drivers have an unusually high rate of occupational injury, and one of the highest rates of on-the-job fatality. NIOSH is actively working to improve the safety and health of truck drivers. Current Institute projects will increase our understanding of cause-specific mortality among owner-operator truck drivers, the health effects of diesel exhaust particles, and the influence of work organization on truck driver fatigue. Reducing occupational injury and illness among truck drivers is assisted by a coordinated effort, and this conference was an important step towards establishing a national research agenda. This publication shares the information, insight, and research of the professionals who participated in the conference. Together they provide an overview of the trucking industry, summarize the current state of knowledge regarding truck driver safety and health, and document the topics for future research suggested by the conference participants. NIOSH hopes that these proceedings will be valuable to researchers, industry representatives, policymakers, and the public.

"Respiratory Disease in Agriculture: Mortality and Morbidity Statistics" presents summary tables and figures of occupational respiratory disease surveillance data focusing on various occupationally relevant respiratory diseases for the Agriculture, Forestry, and Fishing industries. The report has seven major sections that provide the following data: (1) highlights and data usage limitations; (2) demographic statistics for agricultural workers; (3) mortality statistics for agricultural workers, including by sex and race/ethnicity; (4) morbidity statistics for agricultural workers, including by sex, race/ethnicity, smoking status, and source of data; (5) recommendations to fill research gaps for respiratory disease in agriculture; and (6) appendices with descriptions of data sources, methods, and other supplementary information.

Commercial fishermen continue to risk their lives and livelihood as they labor to bring food to tables around the world. Few occupations are as dangerous as that of a commercial fisherman's, and we at the National Institute for Occupational Safety and Health place the safety of these workers as a high priority. We call upon the readers of this proceedings volume to join our efforts to support safety training for commercial fishermen and the acquisition and use of safety equipment, including personal flotation devices, survival suits, and radio equipment, for all commercial fishing vessels. While we may not be able to control the harsh environment in which commercial fishing takes place, we certainly can promote safer vessels and survival training for workers in the commercial fishing industry. Fatal traumatic injuries in commercial fishing have resulted in this industry being one of the most hazardous in Alaska, the United States, and many other nations. The International Labour Organization (ILO) and Food and Agriculture Organization (FAO) estimate that 7% of all worker fatalities worldwide occur in the fishing industry, even though this industry accounts for less than 1% of the worldwide workforce. The fatality rate for U.S. commercial fishermen was 168 per 100,000 workers per year from 1994 through 1998, 35 times the overall US occupational fatality rate (4.8 per 100,000 workers per year) (CFOI). Around the world, for example, in Australia, Denmark, Finland, Korea, and Sweden, occupational fishing fatality rates range from 16 to as much as 79 times higher than these countries' overall occupational fatality rate. The ILO has estimated that the fishing industry experiences 24,000 deaths and as many as 24 million nonfatal injuries each year worldwide. To bring together fishermen, fishing safety proponents and professionals, government officials, equipment manufacturers, and other parties interested in fishing safety and health, the Alaska Field Station, National Institute for Occupational Safety and Health, organized the Fishing Industry Safety and Health (FISH) conferences. The first two (Anchorage, Alaska, in 1992, and Seattle, Washington, in 1997) were national in scope. As these were well-attended and included participants wanting to learn from other countries where fishing was of economic significance, we decided to broaden the scope of the next conference. Thus, the first International Fishing Industry Safety and Health Conference (IFISH) was held in Massachusetts, in October of 2000, in collaboration with the Harvard School of Public Health. That meeting was well attended and included representatives from many nations. In late September of 2003, working with the Alaska Marine Safety Education Association, we held IFISHII in Sitka, Alaska, which drew 135 registrants from 18 nations. Forty speakers addressed topics ranging from deck safety needs for crabbers working in northern waters to policy changes affecting Pacific Island States. IFISH II's focus on safer working environments for commercial fishermen is part of a growing international emphasis on the need for collaboration among governments, nongovernmental entities, vessel owners and operators, and fishermen themselves to develop effective safety programs. Although fishermen from Sri Lanka sometimes face different types of problems than do fishermen from Sweden or the United States, all of them are operating offshore, usually at some distance from emergency help. The range of subjects in this proceeding volume is impressive, from risk factor analyses to intervention approaches, some rooted in practicalities and success, some more theoretical. Gathering people from fishing countries spread around the globe at an event like IFISH II helps us all to identify programs, equipment, and policies that are effective in promoting fishing safety.

Underground coal mining companies that operate continuous miner sections often apply to the Mine Safety and Health Administration (MSHA) for approval to take extended cuts to depths of up to 40 ft as a means of improving productivity. Historically, MSHA has granted approval of this practice if the mine has successfully demonstrated the ability to control the roof, methane, and respirable dust while extracting these extended cuts. A key component for controlling dust generated by continuous miners in 40-ft cuts has been the utilization of flooded-bed scrubbers. These fan-powered scrubbers pull dust-laden air from the mining face and remove respirable dust particles by passing the collected air through a wetted filter panel. The filtered air is then discharged back into the mine atmosphere. To effectively use scrubbers in faces that employ exhaust ventilation, the return ventilation curtain or tubing should be located out by the scrubber discharge on the continuous miner, which results in a setback distance from the face of approximately 40 ft. Over the last several years, MSHA has emphasized that mines demonstrate effective dust control before granting approvals for taking extended cuts with extended curtain setbacks. Each mine operator must successfully demonstrate control of workers' dust exposures in standard 20-ft cuts before MSHA considers approving extended cuts. The goal of the research conducted by the National Institute for Occupational Safety and Health (NIOSH) was to compare dust levels generated in 20-ft cuts when using traditional exhaust face ventilation without a scrubber to dust levels in 20-ft cuts when using extended curtain setbacks with a scrubber operating. Dust surveys were completed at three mines, with area and personal sampling conducted to quantify respirable dust concentrations on a cut-by-cut basis. Dust sampling results did not show a statistically significant difference in respirable dust concentrations between these two test conditions (scrubber-on and scrubber-off) at the continuous miner or shuttle car sampling locations at the face. However, with the scrubber operating, respirable dust concentrations in the return airstream downwind of the continuous miner showed reductions of 91 percent, 86 percent, and 40 percent at Mines A, B, and C, respectively. The reductions at Mines A and B were found to be statistically significant when using the Wilcoxon test. Likewise, reductions in respirable quartz dust levels in the continuous miner return were observed at all three mines, with statistically significant reductions of over 80% observed at Mines A and B. Although operation of the flooded-bed scrubber did not impact respirable dust levels in the face area, it did significantly reduce respirable and quartz dust levels downwind of the continuous miner. Consequently, operation of the flooded-bed scrubbers, in conjunction with the dust controls required in the MSHA-approved ventilation plans at these mines, was advantageous from a respirable dust control perspective.

Partnerships are vital to providing safe and healthy workplaces. Nowhere is this principle more realized than in the National Occupational Research Agenda, or NORA. Nearly ten years ago participants from diverse interests and perspectives joined NIOSH to establish a common research vision for the nation. This collaboration sparked a decade of leadership in occupational safety and health research. Occupational injuries and illnesses affect us all. They result in losses of life, impairments in health, and diminished capacity for men and women in their prime. The burden these injuries and illnesses impose on families, communities, businesses, and the U.S. economy is enormous. Innovative research is critical for designing new tools and methods to reduce these burdens, and for anticipating new concerns in a changing workplace. No single agency or institution can face the challenges of mounting such research alone. NORA offers a blueprint for developing effective partnerships. Through NORA diverse parties collaborated to produce innovative occupational safety and health research, and then worked to translate that research into effective workplace practices. By leveraging the talents and resources of many partners, NORA has stimulated important advancements in workplace safety and health.

Since the establishment of the original Immediately Dangerous to Life or Health (IDLH) values in 1974, the National Institute for Occupational Safety and Health (NIOSH) has continued to review available scientific data to improve the methodology used to derive acute exposure guidelines, in addition to the chemical-specific IDLH values. The primary objective of this Current Intelligence Bulletin (CIB) is to present a methodology, based on the modern principles of risk assessment and toxicology, for the derivation of IDLH values, which characterize the health risks of occupational exposures to high concentrations of airborne contaminants. The methodology for deriving IDLH values presented in the CIB incorporates the approach established by the National Advisory Committee on Acute Exposure Guideline Levels (AEGLs) for Hazardous Substances-consisting of members from the U.S. Environmental Protection Agency, U.S. Department of Defense, U.S. Department of Energy, U.S. Department of Transportation, other federal and state government agencies, the chemical industry, academia, labor, and other organizations from the private sector-during the derivation of community-based acute exposure limits. The inclusion of the AEGL methodology has helped ensure that the IDLH values derived with use of the guidance provided in this document are based on validated scientific rationale. The intent of this document is not only to update the IDLH methodology used by NIOSH to develop IDLH values based on contemporary risk assessment practices, but also to increase the transparency behind their derivation. The increased transparency will provide occupational health professionals, risk managers, and emergency response personnel additional information that can be applied to improve characterization of the hazards of high concentrations of airborne contaminants. This will also facilitate a more informed decision-making process for the selection of respirators and establishment of risk management plans for non-routine work practices and emergency preparedness plans capable of better protecting workers.

This guide is intended for nursing home owners, administrators, nurse managers, safety and health professionals, and workers who are interested in establishing a safe resident lifting program. Research conducted by the National Institute for Occupational Safety and Health (NIOSH), the Veterans' Health Administration (VHA), and the University of Wisconsin-Milwaukee has shown that safe resident lifting programs that incorporate mechanical lifting equipment can protect workers from injury, reduce workers' compensation costs, and improve the quality of care delivered to residents. This guide also presents a business case to show that the investment in lifting equipment and training can be recovered through reduced workers' compensation expenses and costs associated with lost and restricted work days.

The focus of this document is to identify and describe strategies for the engineering control of worker exposure during the production or use of engineered nanomaterials. Engineered nanomaterials are materials that are intentionally produced and have at least one primary dimension less than 100 nanometers (nm). Nanomaterials may have properties different from those of larger particles of the same material, making them unique and desirable for specific product applications. The consumer products market currently has more than 1,000 nanomaterial-containing products including makeup, sunscreen, food storage products, appliances, clothing, electronics, computers, sporting goods, and coatings. As more nanomaterials are introduced into the workplace and nano-enabled products enter the market, it is essential that producers and users of engineered nanomaterials ensure a safe and healthy work environment. The National Institute for Occupational Safety and Health (NIOSH) is charged with protecting the safety and health of workers through research and training. An area of current concentration is the study of nanotechnology, the science of matter near the atomic scale. Much of the current research focuses on understanding the toxicology of emerging nanomaterials as well as exposure assessment; very little research has been conducted on hazard control for exposures to nanomaterials. As we continue to research the health effects produced by nanomaterials, particularly as new materials and products continue to be introduced, it is prudent to protect workers now from potential adverse health outcomes. Controlling exposures to occupational hazards is the fundamental method of protecting workers. Traditionally, a hierarchy of controls has been used as a means of determining how to implement feasible and effective control solutions. Elimination; Substitution; Engineering Controls; Administrative Controls; Personal Protective Equipment. Following this hierarchy normally leads to the implementation of inherently safer systems, where the risk of illness or injury has been substantially reduced. Engineering controls are favored over administrative and personal protective equipment for controlling existing worker exposures in the workplace because they are designed to remove the hazard at the source, before it comes in contact with the worker. However, evidence of control effectiveness for nanomaterial production and downstream use is scarce. This document is a summary of available technologies that can be used in the nanotechnology industry. While some of these have been evaluated in this industry, others have been shown to be effective at controlling similar processes in other industries. The identification and adoption of control technologies that have been shown effective in other industries is an important first step in reducing worker exposures to engineered nanoparticles. Our hope is that this document will aid in the selection of engineering controls for the fabrication and use of products in the nanotechnology field. As this field continues to expand, it is paramount that the health and safety of workers is protected.

The 1994 Work-Related Lung Disease Surveillance Report is the third in a series of major surveillance reports compiled by the Division of Respiratory Disease Studies (DRDS), National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention. The purpose of this report is to provide a summary of surveillance data for various occupational respiratory diseases, from a variety of sources, in a readily available format. The majority of the data in this report is for the time period 1968-1990. However, the time period covered varies for some of the data sources. A portion of the data originates from programs and activities administered by DRDS, e.g., information from the Coal Workers' X-Ray Surveillance Program (CWXSP), the National Occupational Health Survey of Mining (NOHSM), and the Sentinel Event Notification System for Occupational Risks (SENSOR). Other data were obtained from publications, reports, and analysis of data provided by the National Center for Health Statistics (NCHS), the Department of Labor (DOL), the Social Security Administration (SSA), the Mine Safety and Health Administration (MSHA), the Occupational Safety and Health Administration (OSHA), the Bureau of Mines (BOM), and the Association of Occupational and Environmental Clinics (AOEC).

This Work-Related Lung Disease (WoRLD) Surveillance Report is the seventh in a series of occupational respiratory disease surveillance reports produced by the National Institute for Occupational Safety and Health (NIOSH). It presents summary tables and figures of occupational respiratory disease surveillance data focusing on various occupationally-relevant respiratory diseases, including pneumoconioses, occupational asthma and other airways diseases, and several other respiratory conditions. For many of these diseases, selected data on related exposures are also presented. The 2007 WoRLD Surveillance Report consists of two volumes. Volume I has three major sections: (1) a section that provides data highlights and data usage limitations; (2) a section comprised of 17 subsections, each concerning a major disease category and (where available) related occupational exposures, and one subsection concerning smoking status; and (3) a section of appendices that provide descriptions of data sources, methods, and other supplementary information. Volume II has nine sections presenting data on respiratory conditions by major industrial sector, as defined by the National Occupational Research Agenda (NORA). Similar to the 2002 WoRLD Surveillance Report, this report includes data on hypersensitivity pneumonitis, asthma, chronic obstructive pulmonary disease, respiratory conditions due to chemical fumes and vapors, and other work-related respiratory conditions, in addition to the pneumoconioses. This report updates pneumoconiosis mortality data published in the 1999 WoRLD Surveillance Report by the addition of currently available data for 2000 through 2004. Pneumoconiosis conditions highlighted include asbestosis, coal workers' pneumoconiosis, silicosis, byssinosis, and pneumoconioses coded as either "unspecified" or "other," and all pneumoconioses aggregated. The current report presents data not included in earlier reports (e.g., the estimated prevalence of asthma, chronic obstructive pulmonary disease, and cigarette smoking based on data from the 1997-2004 National Health Interview Survey). For many of the conditions reported on, the 2007 WoRLD Surveillance Report presents national and state summary statistics such as counts, crude and age-adjusted mortality rates, and years of potential life lost to age 65 and to life expectancy. Proportionate mortality ratios by industry and occupation are based on the most recent decade of data from a subset of states for which usual industry and occupation have been coded for decedents. Also presented are U.S. state- and county-level maps showing the geographic distribution of mortality and, for the pneumoconioses, tables and figures summarizing selected occupational exposure data for asbestos, coal mine dust, silica dust, cotton dust, etc.

Research has shown that an ergonomics process that identifies risk factors, devises solutions to reduce musculoskeletal disorders (MSDs), and evaluates the effectiveness of the solutions can lower worker exposure to risk factors and MSDs and improve productivity. A review of the Mine Safety and Health Administration (MSHA) injury/illness database indicated that 46% of illnesses in 2004 were associated with repetitive trauma and 35% of nonfatal lost days involved material handling during 2001- 2004. Even though these statistics show that MSDs significantly contribute to occupational illnesses and injuries in the U.S. mining industry, few mining companies have implemented an ergonomics process. Despite the many unique challenges in the mining environment, three mining companies partnered with the MSD Prevention Team at the National Institute for Occupational Safety and Health's Pittsburgh Research Laboratory to demonstrate that an ergonomics process could be systematically implemented and effectively integrated with existing safety and health programs. Because these three mining companies were very different in organization, culture, and size, the ergonomics processes had to be modified to meet the needs of each company. A description of how these three companies applied ergonomics and the tools and training used to implement their processes is given. Prior to discussing the case studies, general information on the elements of an ergonomics process is provided. Ergonomics is the scientific discipline concerned with the understanding of interactions among people and other elements of a system to optimize their well-being and overall system performance IEA 2008]. This is generally accomplished by applying ergonomic principles to the design and evaluation of manual tasks, jobs, products, environments, and systems, ensuring that they meet the needs, capabilities, and limitations of people. When integrated with safety and health programs, ergonomics can be viewed as a third leg of a three-pronged risk management approach to reduce musculoskeletal disorder (MSD) rates. Safety focuses on hazards that may result in traumatic injuries, industrial hygiene concentrates on hazards that may cause occupational disease, and ergonomics addresses risk factors that may result in MSDs and other conditions, such as vibration-related illnesses. By applying ergonomic principles to the workplace with a systematic process, risk factor exposures are reduced or eliminated. Employees can then work within their abilities and are more efficient at performing and completing tasks. The benefits of applying ergonomic principles are not only reduced MSD rates, but also improved productivity and quality of life for workers. The purpose of this document is to provide information on implementing a successful ergonomics process that is part of the organizational culture.

An analysis of accident/injury data for 2001 through 2005 from the Mine Safety and Health Administration (MSHA) revealed that powered machinery accounted for nearly 40% of the total underground coal injuries reported and 62% of all fatalities. Underground coal miners work in an environment with limited space for lateral movement and in awkward postures, including kneeling on one or both knees. During informal discussions, MSHA and the United Mine Workers of America expressed concerns about the velocity of appendages on machines used in such environments. This report describes a study of operator movement relative to the motion of a roof bolting machine boom arm. This work was aimed at reducing the risk of injury to underground coal mine workers from moving machinery. The study used motion capture technology to evaluate human movement in restricted heights and postures while controlling a mockup of a roof bolter boom. Results suggest that boom horizontal swing velocity is an important factor in determining operator safety from pinch point and crush hazards during the boom positioning phase of the bolting sequence. The working height where the machine is operating, the operator's working posture, and the direction of the swing, toward or away from the operator, are also important in determining safe boom velocity.

Refuge chambers may potentially save the lives of miners during a mine emergency. For this reason, it is crucial that miners know how to operate them. Unfortunately, because refuge chambers provide so many services, they can be very complicated and difficult to operate. Therefore, NIOSH has created this document with suggestions for developing manuals and educational materials. A multidisciplinary team comprised of NIOSH engineers, sociologists, psychologists, health communication professionals, and geologists developed the recommendations contained in this document. These recommendations are based on an evaluation of manufacturers' instruction manuals from both the U.S. and globally, interviews with over 20 mining and safety experts, and an extensive literature review. This research, focused on the best practices for refuge chambers, led to the formulation of this document. It is intended to offer suggestions to manufacturers and mine operators on how to create effective and easy-to-understand training manuals for miners as well as tips to create the most comfortable and usable refuge chambers. It should be noted that these recommendations are not meant to substitute for manufacturer-supplied materials but rather to be used in conjunction with manufacturer's materials. Manufacturers should always be consulted for up-to-date information about their chamber. Although different states and different mines refer to underground refuges by different names, this guide will simply refer to underground refuges nearest to the face as refuge chambers, whether inflatable from a skid or constructed from steel. Other popular terms for refuge chambers are rescue chambers, rescue shelters, and refuge shelters. Refuges that are nearer to the shaft, whether a prefabricated refuge chamber or one built into a crosscut, will be referred to as outby refuges because of their location in the mine. Outby refuges can be permanent, semipermanent, or portable and are usually located at every other SCSR cache. Outby refuges are sometimes called hardened rooms, outby shelters, and in-place shelters. When discussing outby refuges and refuge chambers collectively, this guide will refer to them as underground refuges. Other terms for underground refuges include refuge alternatives, locations of safety, and safe havens. The purpose of this document is to provide manufacturers and mine operators with guidance on the development of instructional materials for refuge chamber set up, use and maintenance in support of the Mine Improvement and New Emergency Response (MINER) Act of 2006. This document offers suggestions to aid those responsible for instructing miners in the operation of refuge chambers. Mention of any company or product does not constitute endorsement by the National Institute for Occupational Safety and Health (NIOSH).

Falls represent a serious hazard to workers in many industries. Workers who perform tasks at elevation-workers in the construction, structural metal working, and tree trimming industries, for example-are at risk of falls from heights, with frequently grave or even fatal consequences. Many more workers, in nearly every industry, are subject to falls to floors, walkways or ground surfaces. These falls, characterized as fall on the same level, are responsible for well over half of nonfatal injuries that result in days away from work. The etiology of falls as injury-producing events is multi-factorial, and encompasses multiple mechanisms of exposure. Working at heights involves completely different fall risks than those found on workplace surfaces and floors. The different exposures represent serious safety risks in both cases, resulting in fatal and serious nonfatal injury. To address the various causes of multi-factorial events such as these, there needs to be wide-ranging and multidisciplinary injury-mitigation approaches provided to practitioners based on a wide variety of research methods. To advance our knowledge of occupational fall injuries, the International Conference on Fall Prevention and Protection (ICFPP), held in May of 2010, was convened to provide a forum for researchers from NIOSH, its stakeholders, and the community of fall-prevention specialists and experts to present research findings, recommendations and expert advice on the latest tools and methods to reduce the incidence of injury from falls. At the conference, a wide variety of research approaches and methods were presented, and these approaches reflected the multidisciplinary orientation of the different stakeholders in attendance, as well as the individual interests and expertise of participating researchers. This document represents a wealth of knowledge from experts and informed stakeholders on the best way to understand, prevent, and control fall-related risk exposures. It is anticipated that these presentations will serve to bring together the communities of interest that attempt to prevent and ameliorate fall-related injuries, and will spur efforts that will continue in the form of joint and supported research investigations, research consortia, and informed dialogue in support of a common goal. NIOSH hopes to continue to sponsor forums for the presentation of methods and findings related to occupational fall injury protection and prevention in the future.

Dust surveys were conducted at six underground mines to determine if deep-cut mining practices expose face workers to higher levels of respirable dust by comparing levels during the first 20 ft of advance (regular-cut depth) during the deep cut to levels during the final 10 to 20 ft of advance (deep-cut depth). The studies were conducted at mines where the Mine Safety and Health Administration (MSHA) had approved an extended curtain setback distance with operation of a flooded-bed scrubber to permit taking deep cuts of up to 40 ft. In general, all of the selected mines exercised good dust control practices by maintaining water sprays, scrubber airflows, proper curtain setback distances and providing sufficient airflow to the active faces. These practices minimized variability in dust levels related to factors other than the depth of cut. To ensure proper scrubber functioning, the scrubber screen was back-flushed before commencing each cut. Both exhausting and blowing face ventilation configurations were studied. All of the operations surveyed for this study were able to successfully implement deep-cutting methods without significantly increasing the dust exposures of face workers during the cutting and bolting cycles. For exhausting face ventilation, field data indicate that scrubber airflow is the most important factor for controlling dust. Clogging of the scrubber screen can result in lower airflows; therefore, the screen must be periodically tapped and back-flushed. Data collected for this study indicate that 20-mesh screens should be cleaned for every 40 ft of advance because 22% of the deep-cut sequences surveyed for this study experienced a 20% to 35% decrease in scrubber airflow over the course of the cut. For blowing face ventilation, field and laboratory data indicate that maintaining a proper curtain-to-scrubber airflow ratio of 1.0 and a curtain setback distance that allows the miner operator to stand at the mouth of the curtain helps control dust. Curtain airflows should be measured before activation of the scrubber regardless of ventilation type (exhausting or blowing) to avoid erroneously overinflating the ratio. The curtain setback variance should be greater than the maximum cutting depth to allow miner operators to maintain their position at the mouth of the curtain when the miner is fully extended into the cut. Greater curtain setback distances associated with deep-cutting methods may result in cuts that do not require ventilation curtain, such as the initial heading developments beyond the last open crosscut. For these cuts, dust levels were generally lower during development of deep cuts when compared to regular cuts. However, adequate ventilation of cuts without ventilation curtain is dependent on a properly functioning scrubber. Dust levels on the bolting faces did not appear to be affected by the longer cycles associated with deep-cut mining practices when curtain airflow was measureable and the curtain was periodically advanced in sync with the bolting machine.

Workers from almost every industrial sector and trade routinely experience dermal exposures to chemicals via contact with contaminated surfaces, deposition of aerosols and vapors, and immersion in or splashes from liquids. Such exposures may result in adverse health consequences ranging from direct effects to the skin (e.g., irritant contact dermatitis and corrosion) to systemic effects (e.g., cancers and neurological effects) and to sensitization (e.g., allergic contact dermatitis). Occupational skin diseases have previously been identified as one of the leading causes of occupational illness within the United States workforce with many of the reported skin disorders being associated with chemical exposures. The National Institute for Occupational Safety and Health (NIOSH) is dedicated to controlling and preventing workplace hazards including dermal exposures to chemicals. This document, Indexed Dermal Bibliography (1995-2007), is intended to serve as a resource guide for information on dermal issues within the workplace. The Indexed Dermal Bibliography has been structured to accommodate varying levels of technical background or formal training in identifying and controlling harmful skin exposures. The primary topics covered within the Indexed Dermal Bibliography include: (1) an overview of dermal exposures, (2) hazard identification, (3) exposure characterization, (4) health effects surveillance, (5) risk assessment, and (6) risk control management. This resource guide is not designed to be an exhaustive compilation of materials from the dermal exposure literature, but rather a representative list of available dermal exposure resources.