Spotlight: Welcome to the First NIOSH WorkLife Newsletter
The WorkLife Initiative--Overview
NIOSH Releases Essential Elements of Effective Workplace Programs and Policies for Improving Worker Health
Meeting Addresses the Health and Safety of the Growing Number of Older Workers
Wellness is Now—VA Pilot Program Based on WorkLife Model
News from the WorkLife Centers of Excellence
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	The NIOSH WorkLife Initiative

The National Institute for Occupational Safety and Health (NIOSH) WorkLife Initiative was launched in 2004 to identify and support comprehensive approaches to reducing workplace hazards and promoting worker health and wellbeing. The premise of the WorkLife Initiative, based on scientific research and practical experience in the field, is that comprehensive approaches addressing health risk from the work environment (both physical and organizational) and from individual behavior are more effective in preventing disease and promoting health and safety than each approach taken separately.

Through the work of NIOSH, its many partners in the WorkLife Initiative, and concurrent efforts around the country and throughout the world, there are significant strides being made in the field of comprehensive workplace health and safety protection and health promotion. NIOSH is launching this electronic WorkLife newsletter to share information about new research and practice developments and to serve as a focal point for the many activities taking place in connection with or relevant to the NIOSH WorkLife Initiative.

We expect to publish this newsletter twice a year initially. We invite your comments, ideas, and contributions to theadley@cdc.gov.

The nature of work in the U.S. is changing. The shift from a manufacturing to a service economy, the rise in non-traditional worksites and transient work, corporate mergers and restructuring, the advent of a more diverse and aging working population, and other seismic changes in the workplace and workforce have served to highlight the limitations of a traditional focus on occupational risks alone.

The overall health of workers is influenced by factors both inside and outside the workplace: stress at work and at home; unhealthful diet and limited exercise; smoking; and chronic conditions such as hypertension, asthma, and diabetes, to name a few, which are on the increase. The effects of these various factors cannot easily be divided between “at work” and “non-work.”  Just as workplace conditions can affect health and wellbeing at home and in the community, exposures and activities outside of working hours can substantially determine health, productivity, and wellbeing during work.

There has been a longstanding separation in the public health and employment communities between those interested in control of health risks and hazards from work (occupational health and safety practitioners) and those focused on individual and community health risk reduction outside the workplace (health promotion practitioners).  Advancing knowledge and practice in this area requires that we promote collaboration among practitioners and scientists alike to bridge the divide between these disciplines.

A new approach, reflecting the complexity of influences on worker health and the interactions between work-based and non-work factors, is needed.  A growing body of evidence indicates that coordinated or integrated approaches addressing both health risk from work (physical and organizational) and individual risk factors (such as smoking and diet) are more effective in protecting and improving worker health and wellbeing than traditional isolated programs.

The WorkLife Initiative seeks to improve worker health through better work-based programs, policies, practices, and benefits. The premise of the WorkLife Initiative is that it makes sense to address worker health and wellbeing in a more comprehensive way, taking into account the physical and organizational work environment while at the same time addressing the personal health-related decisions of individuals.  The worksite provides an opportunity to implement programs and policies to prevent both work-related risks and chronic illnesses and injuries that are linked to behavior-related choices.

The aims of the WorkLife Initiative are to:

Toward these goals, the WorkLife Initiative is forming new partnerships, compiling and disseminating best practices, supporting and encouraging expansion of relevant research, and assisting efforts to pilot and test WorkLife theories in workplace settings. NIOSH is supporting and expanding multi-disciplinary research, training, and education beginning with the establishment of three WorkLife Centers of Excellence at the University of Iowa; the University of Massachusetts-Lowell/University of Connecticut; and Harvard University.

The WorkLife Initiative is led by Gregory Wagner, M.D. for more information and updates please go to http://www.cdc.gov/niosh/worklife/ or view the WorkLife Initiative fact sheet http://www.cdc.gov/niosh/worklife/pdfs/worklifesummary8.pdf.

Based on information received from experts and practitioners with experience in industry, academia, labor, government, and the non-profit sector, NIOSH, through its WorkLife Initiative, has developed a list of “Essential Elements of Effective Workplace Programs and Policies for Improving Worker Health and Wellbeing.”  This is intended to be a resource to guide employers and workers interested in improving workforce health and wellbeing through improved workplace programs and policies.

The Essential Elements document identifies twenty components of a comprehensive work-based health protection and health promotion program and includes both guiding principles and practical direction for organizations seeking to develop effective programs.

NIOSH established a public docket and received input from the public, including experts and interested individuals, on the Essential Elements.  The Essential Elements document is an resource that will be enhanced by links to resources that offer specific examples of best practices and model programs, articles from the academic and business literature, and case studies that will help make this list a practical, detailed, and user-friendly “how-to” for those ready to put the Essential Elements into practice. You can view the Essential Elements online at http://www.cdc.gov/niosh/worklife/essentials.html.

As the number of older workers grows, the need for workplace programs and policies to sustain workforce health throughout their working lives has never been clearer. This was a key message from a recent national workshop "Healthy Aging for Workers: Anticipating the Occupational Safety and Health Needs of an Increasingly Aging Workforce" http://www.soeh.org/meeting/meeting.html. Participants in this February meeting, sponsored by NIOSH in collaboration with the Society of Occupational and Environmental Health, the Association of Occupational and Environmental Clinics, CPWR-the Center for Construction Research and Training, the University of Maryland, Work and Health Research Center, the VA, and AARP, explored the research and policy priorities needed to address the health and safety of the growing number of older workers.

By 2050, the US population age 45 and over is projected to grow to more than 170 million, from 93 million today. Greater workforce participation by older men and women is almost inevitable. Older workers may have different physical capabilities, experiences, approaches to work, and life needs than when they were younger. Identifying the implications of those factors for occupational safety and health, and allowing older workers and employers to take best advantage of their skills while reducing risks for work-related injuries and illnesses, will be important for a strong U.S. economy.

The February workshop revisited the 2004 Institute of Medicine report, "Health and Safety Needs of Older Workers" http://www.nap.edu/catalog.php?record_id=10884 and provided a forum for assessing developments in the intervening five years. Watch for the meeting summary and recommendations, expected to be published later this year. NIOSH is also developing a web topic page to provide resources about issues of safety, health, and older workers. Both will be available through the WorkLife web site www.cdc.gov/niosh/worklife.

The U.S. Department of Veterans’ Affairs (VA) has embarked on a multi-year pilot project in twelve VA primary health care facilities to implement a program of comprehensive occupational safety and health protection and workplace health promotion activities aimed at producing a healthier, more productive workforce. The program, called Wellness is Now (WIN) VA, is located in the VA’s VISN 23 Midwest regional network and is being conducted through the VA’s Occupational Health, Safety, and Prevention Health Care Group.

NIOSH is collaborating with the VA to help align the goals, execution, and performance of the pilot project with the WorkLife Initiative model that seeks to integrate workplace safety and health protection with worksite health promotion.

The VISN 23 pilot project adds essential health promotion elements to a strong national occupational safety and health program that includes ergonomics intervention (safe patient movement and handling); work organization assessment; violence prevention; sharps injury prevention; slips, trips, and falls prevention; aging workforce initiatives; and stress reduction components.

Key health promotion features to be introduced through the WIN VA program include a health risk appraisal; physical activity programs to promote improved fitness and ability to work; healthy eating assistance, including nutritional and caloric intake assessment with self-help tools; a tobacco cessation program including counseling and free nicotine replacement; stress intervention at the individual level through a web-based tool to complement national work organization efforts; face-to-face health coaching; healthy living classes and other educational opportunities; and ongoing health prevention monitoring and oversight at the facility level.

The program will take into account the needs and concerns of diverse groups of workers and will work in partnership with employees across the organization.

The VA plans to measure the effectiveness of the program in terms of participation and impact and will measure outcome through such metrics as disability costs and days; workers’ compensation costs; safety data; sick leave; health insurance costs; and employee survey results.

NIOSH looks forward to continuing to work with the VA to provide input and advice and to help assure that pilot implementation reflects the goals and aims of the WorkLife Initiative.

The Director of the WIN VA Program is Ebi Awosika, M.D., M.P.H, and the Program Manager is Sandie Schmunk, M.A., M.S., both based in Minneapolis, Minnesota. For further information about the VA pilot project, contact Sandie Schmunk at sandra.schmunk@va.gov or 612-629-7661.

Healthier Workforce Center for Excellence

The University of Iowa Healthier Workforce Center for Excellence (HWCE), located in the College of Public Health, was funded as a Center of Excellence in 2006 by the National Institute for Occupational Safety and Health.  It was built upon extensive investigator experience in occupational health, ergonomics, injury prevention, preventive medicine, and health promotion.  The HWCE was designed to improve understanding of effective, integrated employee health programs and to translate this evidence base into practice for the benefit of employed populations.

The Center has three main goals:

Goal 1:  To examine the relationships among predictors for absenteeism, work-related injury, workers’ compensation claims, healthcare expenditures, and overall health.

Goal 2:  To implement, evaluate, and compare two integrated health protection/health promotion models for the private and public sectors: An intervention based around an integrated worker safety/health promotion committee; and an intervention using a health counselor to integrate the delivery of health protection and health promotion services in a public sector setting.

Goal 3:  To establish a learning network of interactive partnerships with employers, employee groups including unions, and health care organizations.

The Director of the Center is James Merchant, M.D., Dr.P.H., Professor, Department of Occupational and Environmental Health, and the Deputy Director is Fredric Gerr, M.D., Professor, Department of Occupational and Environmental Health.

For general information related to the UI Healthier Workforce Center for Excellence, contact Alison Amendola, M.B.A., Coordinator of the Center and Director, Outreach Program, at alison-amendola@uiowa.edu or 319-335-4200 or go to http://www.public-health.uiowa.edu/hwce/.

Center for the Promotion of Health in the New England Workplace

The Center for the Promotion of Health in the New England Workplace (CPH-NEW) was funded in 2006 as a Center of Excellence by the National Institute for Occupational Safety and Health.  It is a collaborative research-to-practice initiative led by investigators from the University of Massachusetts Lowell and the University of Connecticut. The goal of the Center is to evaluate several models for integrating workplace health promotion with occupational ergonomic and mental health interventions to improve the health of New England workers. There is a strong emphasis on workplace occupational ergonomic interventions and on worker involvement. Outcomes of particular interest include musculoskeletal health, mental health, and cardiovascular health.

Employers, labor organizations, and government institutions are faced with challenges such as an aging workforce, global trade pressures, and rising health care costs.  This situation has stimulated development of new creative initiatives to benefit both workers and companies.  Some organizations have experimented with participatory efforts that engage employees in the design and implementation of these workplace health promotion efforts.

Two Center research projects will compare employee health and cost-effectiveness benefits of occupational health programs in workplaces with and without health promotion activities.  Another focus is to rigorously evaluate interventions that seek to develop participatory workplace ergonomics programs in conjunction with addressing other health risk factors. The research activities are being carried out in the health care, manufacturing, and public sectors.  A third Center project, in close coordination with the Massachusetts Department of Public Health, will develop and evaluate educational materials for health care and workplace professionals to improve their knowledge and practice skills related to workplace stress and cardiovascular disease.

The principal investigators and co-directors of the Center are Laura Punnett, Sc.D., Professor, Department of Work Environment, University of Massachusetts Lowell, Lowell MA, and Martin Cherniack, M.D., M.P.H., Professor of Medicine and Director of the Ergonomics Technology Center, University of Connecticut, Farmington CT.

For more information, contact:

CPH-NEW at UMass. Lowell: Sandy Sun at 978-934-3268 or cphnew@uml.edu or go to http://www.uml.edu/centers/cph-new/

CPH-NEW at UConn. Jeff Dussetschleger at 860-679-1393 or jdussetschleger@uchc.edu or go to http://www.oehc.uchc.edu/healthywork/index.asp

Center for Work, Health and Wellbeing

The Harvard School of Public Health Center for Work, Health and Wellbeing, located at the Harvard School of Public Health, was funded as a Center of Excellence in 2007 by the National Institute for Occupational Safety and Health.  The goal of the Center is to facilitate, support, and disseminate trans-disciplinary research aimed at protecting and promoting worker health through comprehensive, coordinated programs, including the integration of occupational safety and health and workplace health promotion, as well as other worksite efforts contributing to worker health.

The Center has assembled an accomplished trans-disciplinary team with a track record of collaborative research, representing the varied disciplines of occupational health and safety, social and behavioral sciences, social epidemiology, industrial hygiene, social policy, organizational change, medicine, nursing, economic analysis, and labor relations.  The Center also is fostering and expanding collaborations with diverse employers, labor unions, and intermediary organizations to help shape the Center's direction and influence the dialogue among these constituencies regarding the application of integrated approaches to worker health.

The Center has initiated research in the high-priority employment sector of health care looking at integrated approaches to improving health and safety in health care workers. The Center also is training future and practicing professionals with a stake in worker health on skills and methods for integrating occupational health and safety and workplace health promotion and will disseminate best practices and programs to key stakeholders and health professionals.

The Director of the Center is Glorian Sorensen, Ph.D., M.P.H, Professor of Society, Human Development and Health in the Harvard School of Public Health and Director of the Dana-Farber’s Center for Community-Based Research.

For information, contact Dr. Glorian Sorensen at Glorian_Sorensen@dfci.harvard.edu.