Understanding the Economic Benefit Associated with NIOSH Research and Services: A Second Report of NIOSH Impact by RAND

NIOSH continues to quantify the benefits of its research and services in terms of lives saved, injuries or illnesses averted, or increases in worker productivity. Three new case studies highlight the economic benefits of personal dust monitors for coal miners, improved ambulance design, and improved amputation surveillance. These case studies are presented in a new RAND report and add to three previous case studies, as reported in a 2018 NIOSH Science blog. NIOSH tasked RAND with conducting the analyses for both of these reports and provided support throughout the analyses process.

These reports improve our understanding of the extent to which investments in worker safety and health yield an economic benefit. RAND used two metrics to assess the economic benefits of avoided injury and illness. The first is the sum of avoided medical costs and productivity losses. The second is based on broader estimates of society’s willingness to pay (WTP) to avoid illness and death. For both metrics, results were expressed in 2018 dollars.

In the case of personal dust monitors for coal miners, RAND found that NIOSH’s work, including developing and testing prototypes with partners, and conducting outreach to miners, was substantially responsible for the adoption of continuous personal dust monitors (CPDMs). The avoided medical costs and productivity losses by age 73 and 85 were estimated for cases of fatal and nonfatal respiratory disease due to the reduction in exposures to respirable coal mine dust after the adoption of CPDMs. Annualized benefits ranged from $3.6 million to $8.0 million per year, starting in 2016 and extending over 65 years. The WTP estimates ranged from $10.4 million to $25.3 million per year.

The case study on the work to advance ambulance design showed that the work was the result of partnerships with stakeholders that aimed to improve the design of the rear patient compartment by working directly with manufacturers and collaborating with standard-setting organizations. These activities were driven by observation that crashes often cause rear compartment workers and patients to strike or be struck by interior surfaces and objects, owing largely to lack of practical and effective passenger restraints. RAND provided a range of benefit estimates based on alternative assumptions about ambulance redesign effectiveness. Depending on the assumption used, annualized economic benefits ranged from $2.5 million to $8.0 million from 2017 to 2050, with the benefits increasing over time.

In the case study on improved amputation surveillance, RAND found that a NIOSH-supported Michigan program to identify a much greater proportion of the total number of amputation cases led to referrals to the Michigan Occupational Safety and Health Administration (MIOSHA) that discovered more violations and assessed higher monetary penalties than typical inspections in the state during 2003 – 2018. While the estimates were not causal, it is likely that the surveillance program helped MIOSHA better target inspections, leading to a more efficient allocation of scarce inspection resources. Inspections resulting from the surveillance program found 2.60 times as many violations as other inspections and assessed approximately 2.45 times the monetary penalties of a typical inspection. The program substantially influenced other state programs including the one in Massachusetts. The program also provided better information on the extent of amputations in Michigan and industries and firms in which amputations had occurred that were not reported in other sources. The program likely discovered 96 additional violations per year and increased total initial penalties by approximately $47,300 per year. The available data did not enable RAND to quantify the benefit of the program on worker safety and reduction in amputations or measure the program’s spillover effects.

As we shared in our previous blog, for the first report, RAND developed a systematic approach and illustrative case studies to inform the occupational safety and health community about the economic benefits of NIOSH research and services. In this new report, RAND developed a process for selecting case studies for economic evaluation, applied the process to ten potential case studies, and selected three case studies for detailed analysis. RAND identified attributes of case studies that NIOSH can use to choose cases to evaluate:

• Feasibility – having enough information to establish and quantify the link between NIOSH activities and worker outcomes without extensive new data collection
• Impact – number of potentially affected workers, evidence that prevention methods developed or promoted by NIOSH activities are implemented by others, and actual or anticipated risk reduction due to the prevention implementation
• Attribution – clear evidence that changes in worker outcomes occurred in response to NIOSH activities
• Balance – cases that represent a diversity of program areas
• Current NIOSH priorities

One lesson learned from the case study selection process in the new report was that determining feasibility without initiating detailed analyses was challenging; and determining data needs and availability can be time-consuming. We continue efforts to assess the costs associated with NIOSH research efforts but believe that the costs can be substantially smaller than the benefits, as was evident from the NIOSH preliminary, unpublished estimates of costs in the first report. The cases examined in the two RAND reports show that there are many NIOSH research activities that result in millions of dollars in benefits each year for a wide array of workforces.

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

Tim Bushnell, PhD, MPA, Economist, NIOSH Economic Research and Support Office.

Rene Pana-Cryan, PhD, Director, NIOSH Economic Research and Support Office.

Brian Quay, MS, Economist, NIOSH Economic Research and Support Office.

Tapas Ray, PhD, Economist, NIOSH Economic Research and Support Office.