Occupational Health Issues in the USA

Posted on by John Howard, MD

Happy New Year. As we start afresh in 2017 I wanted to share my recent editorial in the British journal, Occupational Medicine, “Occupational health issues in the USA”.  The article highlights some of the occupational safety and health issues identified as needing attention by the industry sector groups of the National Occupational Research Agenda (NORA).  Each area is highlighted below.  We welcome input on how to best protect workers in these areas in the comment section below.

Oil and Gas

The development of the technique of hydraulic fracturing has both increased the energy production quotient in the USA and has increased the size of the workforce involved in drilling, completing, servicing and equipping wells, and performing other activities in preparing oil and gas up to the point of shipment from the producing property. The list of worker risks is long. NIOSH scientists are conducting research to characterize and eliminate the risks faced by workers to respirable crystalline silica, volatile organic compounds, including naphthalene, benzene, toluene, ethylbenzene and xylene, and other hazards. See our related blog.


Job automation (robotics) is disrupting the labor market in many industry sectors. Jobs formerly done by human workers are now done by machines. The availability of relatively inexpensive collaborative robots capable of working in direct contact with human workers has ushered in a new robot era where robotic workers operate alongside human workers and symbiotic workers, i.e. human workers equipped with performance-enhancing robotic devices such as robotic exoskeletons and other capacity-enhancing prostheses. Occupational safety and health professionals will need to take a proactive approach to the assessment and management of the risk profile of occupational robotics. See the related blog on working safely with robots.


The use of sensors has increased exponentially as countless remote wireless sensors are now employed for monitoring the environment, work sites, disaster response, ‘smart’ buildings and facilities and in agriculture and health. Such instruments are valuable tools for detecting and measuring worker exposure in real time—empowering both workers and employers. Exposure assessment practices are being transformed by direct reading and sensor technology. NIOSH began organized research in this area in 2008 with the creation of the Direct Reading Exposure Assessment Methods (DREAM) initiative. NIOSH will build upon and expand the DREAM program to address lessons learned, advances in technology, and stakeholder contributions.


Risk characterization of a new technology to quickly determine if it raises safety and health issues for workers should be a priority for occupational health researchers and practitioners. Engineered nanomaterials and devices demonstrate novel size-dependent properties and behavior that hold great promise in many areas of benefit to society such as new lightweight but stronger materials, new pharmaceuticals, enhanced water filtration, and advances in regenerative medicine The challenge is 2-fold—does the nature of engineered nanomaterials present occupational safety and health hazards, and, if so, how can the benefits of nanomaterials be realized while proactively minimizing or eliminating the potential risks? Although the occupational health implications of advanced manufacturing involving nanomaterials are not yet clearly understood, it is prudent to take precautions to protect workers until the risks can be fully characterized.


The Occupational Safety and Health Administration (OSHA) in the US Department of Labor issued a mandatory national standard to curb lung cancer, silicosis, chronic obstructive pulmonary disease and kidney disease in America’s workers by limiting their exposure to respirable crystalline silica. OSHA estimates that the rule will save over 600 lives and prevent more than 900 new cases of silicosis each year, once its effects are fully realized. Key provisions of the new rule include reducing the permissible exposure limit (PEL) for respirable crystalline silica to 50 mg/m3 of air, averaged over an 8-h shift; requiring employers to use engineering controls (such as water or ventilation) to limit worker exposure; and requiring employers to provide medical exams to monitor highly exposed workers and gives them information about their lung health.  See the NIOSH Silica Topic Page.

Black Lung

In the last decade, over 10,000 miners have died of coal workers’ pneumoconiosis, or what is commonly called black lung disease. Black lung disease, which is caused by inhaling coal mine dust, results in scarring of the lungs, emphysema, shortness of breath, disability, and premature death. While the prevalence of black lung disease had decreased by about 90% from 1969 to 1995, since 1995 the prevalence of black lung cases has more than doubled. Many current underground miners (some as young as in their 30s) are developing severe and advanced cases. In an historic step to eliminate the scourge of black lung disease, the Mine Safety and Health Administration in the US Department of Labor adopted a rule to control miners’ exposure to respirable coal mine dust. The new rule added a number of new protections for coal miners such as the mandatory use of the continuous dust monitor (developed by NIOSH) to determine coal dust exposure in real time. See the NIOSH Coal Workers Health Surveillance Program.

Disaster Science

Given the threats in the world today, protecting first responders from the hazards they may confront is a critically important new area of occupational safety and health research – disaster science responder research. Protecting responders requires a three-pronged approach involving pre-deployment preparedness activities such as training, during-deployment activities such as real-time exposure assessment, and post-deployment activities such as medical monitoring. The goal of the new field of disaster science is to implement a framework that allows for occupational safety and health research to be started quickly when a disaster or emergency occurs, without interfering with the response itself. The types of research conducted may include: the impact of a novel exposure, unexpected or severe health effects, the effectiveness of a proposed intervention, mental health/resilience issues, and disease outcomes with latency periods. See the NIOSH Emergency Preparedness and Response website.

Healthy Workforce

Traditional occupational safety and health protection programs have primarily concentrated on ensuring that work is safe and that workers are protected from the harms that arise from work itself. Total Worker Health®  builds on this approach through the recognition that work is a social determinant of health. Job-related factors, such as low wages, hours of work, workload intensification, interactions with coworkers, and access to paid sick leave, all can have an important impact on the well-being of workers, their families, and their communities. TWH explores opportunities to not only protect workers but also advance their health and well-being by targeting the conditions of work. Scientific evidence now supports what many safety and health professionals, as well as workers themselves, have long suspected—that risk factors in the workplace can contribute to health problems previously considered unrelated to work.

This is only a sampling of what NIOSH and the OSH community will focus on in the coming year and in the next decade of NORA.   Please share your thoughts on how to best protect workers in these areas in the comment section below.


John Howard, MD, Director, National Institute for Occupational Safety and Health.


Posted on by John Howard, MD

11 comments on “Occupational Health Issues in the USA”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    I wish there was more on mold exposure. There has to be something done about the exposure to mold in the work place. I was a victim of mold exposure and I was fired for being so sick with mold exposure due to a leaking ceiling . I couldn’t get a lawyer to defend me because mold is not recognized like it should be. There are very few doctors that treat mold , or have studied the effects that it has on certain people. I was misdiagnosed and spent so much money on doctors and medicine that just made my ailments worse. I have lost my job, I have fell to the lowest point in my life because of the sickness that mold causes. I, myself didn’t know of the dangers of mold, and for over two years I was exposed to it in my place of work and finally after going to many different doctors, I finally discovered what was making me ill. When I finally told supervisor about it, I was treated badly and then fired. I was so terribly sick I couldn’t even function for the first year after I was fired and I still haven’t got the help I need because of my financial situation. Please try to research this topic.

    Sampling for mold is an often fruitless effort when trying to characterize indoor air quality. The better method is to examine the root cause of the mold growth, such as excess moisture. The point of contact for such investigations begins with facility management.

    Have you ever considered leveraging the power of IBM Watson in occupational safety and health?

    I think this technology could be of tremendous benefit in many areas, such as nanotechnology EHS research and analysis, etc

    Thanks for your comment. Yes, advanced computational power is an important tool in the years ahead as more and more data inputs will need to be processed, interpreted and utilized.

    I to Annette have been sick with mold exposure, but it’s n my home but I am financially unable to pay the extreme expenses to have anything done. It’s mostly because now I’m so in debt to medical debt and yes still no relief. I cannot even go back to my ENT because of financial issues. ?

    The Information hear is awesome and detailed. Thanks for sharing.
    Proactive Occupational Medicine.

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Page last reviewed: January 19, 2017
Page last updated: January 19, 2017