How Tribal Communities Can Use the Health Hazard Evaluation (HHE) Program
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The final blog post in our series celebrating Native American Heritage Month highlights a free program available to anyone, including American Indian and Alaska Native (AI/AN) communities, employers, and workers. Some may not be aware of this service, though it has been part of the National Institute for Occupational Safety and Helath (NIOSH) around for over 50 years.
Below, you will learn more about the Health Hazard Evaluation program and how it could address health and safety concerns that may be present in the most prominent industries in which AI/AN people were found to work (see blog post 2). And if you missed the first blog, which discusses the NIOSH AI/AN initiative and work on the AI/AN Worker Safety and Health Strategic Plan, read about it here!
A program created to assess worksites and make them safer
The Health Hazard Evaluation (HHE) Program is a federal program created to help employers, employees, and unions learn whether health hazards are present at their workplace and recommend ways to reduce hazards and prevent work-related illness. Since starting in the early 1970s, the NIOSH HHE team has completed evaluations of over 16,700 requests from workers, unions, and employers.
How are HHE’s useful?
HHEs are conducted at no cost to employers, employees, or unions. These evaluations come with expert assessment and advice for keeping workers safe.
The closeout report or letter provided at the end of an assessment includes:
- a detailed account of the concerns,
- how the HHE team assessed the hazards, and
- what can be done to reduce or prevent them.
Requests that assisted tribal communities
Over the years, the HHE program has served AI/AN communities by investigating various health concerns and exposures among a range of industries and occupations.
Here are three examples of hazards our team investigated that were requested by AI/AN communities:
Chemical exposures
The Saint Croix Chippewa Indian Tribe requested an HHE to evaluate employees’ potential hazard exposures when applying fiberglass to fish tanks. The fish tanks came unassembled and were an important part of a new aquaculture facility that would grow and harvest salmon and perch. Styrene and acetone, which can cause headache, fatigue, and weakness, among other effects, were the two major exposure concerns during tank assembly. Among the recommendations offered by the HHE team to keep workers safe was to wear personal protective equipment. This included specific respiratory protection until local exhaust ventilation could be implemented. They also recommended properly labeling hazardous chemicals.
Musculoskeletal disorders
At the request of Indian Health Service (IHS), our team assessed concerns about musculoskeletal disorders at IHS dental clinics. One HHE focused on neck injuries, and another examined a broader set of musculoskeletal injuries to the hand, wrist, neck, shoulder, back, and elbow. Dental assistants had concerns about twisting and turning their backs. They also had to extend their reach for dental instruments and stayed too long in one posture. The team suggested workspaces be designed so that the assistant or dentist doesn’t have to get up or twist to use an amalgamator or curing light. They also suggested ways to ensure good posture throughout the workday.
Pesticide exposures
Pesticides and other chemical exposures are common workplace concerns. Years ago, the Colorado River Tribal Council-Tribal Health Department was concerned about pesticide exposure among cotton picker operators, cotton cart workers, and cotton gin workers. Our team measured how much pesticide dust these workers breathed in and got on their skin. A few recommendations were to implement (1) a respiratory protection program, (2) exhaust ventilation, and (3) rigorous housekeeping.
Other exposures evaluated through the HHE Program
- Metals and other contaminants contained in fly ash and possible lead contamination in plumbing and machine shop areas.
- Contaminants (anti-mildew agents) generated from assembling camouflage netting
- Tuberculosis among employees at a medical center
Other examples of worksite assessments and recommendations
Based on data from the Current Population Survey, AI/AN people work most often in the following industries (See blog post 2 to learn more). Click to view HHE reports associated with each industry.
2. Restaurants and other food services
3. Elementary and secondary schools
4.General medical and surgical hospitals
5. General merchandise stores, including warehouse clubs and supercenters
These reports may help you understand the kinds of hazards our team has assessed in these industries, which may include some of the hazards AI/AN workers experience as well. These reports may also give you an idea of what to expect from a worksite assessment and our team’s recommendations.
Learn more about the HHE program
Employees, union officials, or employers can request that their worksites be evaluated for possible health hazards. Watch this video to learn more and see a worksite evaluation in action.
Here are some other resources to learn more:
- NIOSH Health Hazard Evaluation (HHE) Program: Helping to Eliminate Workplace Health Hazards
- NIOSH Health Hazard Evaluation (HHE) Program: Sampling for Exposures
- NIOSH Health Hazard Evaluation (HHE) Program: Measuring Contaminants in the Air at a Workplace
- NIOSH Health Hazard Evaluation (HHE) Program: Medical Testing at a Workplace
- Health Hazard Evaluation Program: What Employers Should Know
- Health Hazard Evaluation Program: What Employees Should Know
If you have questions or would like to learn more, please contact us!
Amy Mobley, MEn, is a Health Communications Specialist in NIOSH’s Health Informatics Branch in the Division of Field Studies and Engineering.
James Couch, PhD, CIH, is Chief of the NIOSH Hazard Evaluation and Technical Assistance Branch in the Division of Field Studies and Engineering.
Elizabeth Dalsey, MA, is a Health Communication Specialist in the Western States Division.