NFL Players Tackling Heart Disease

Many football players are essentially paid to be big—really big—especially those whose job is to block or stop the big guys on the other team.  They also suffer from medical conditions that are work related and claim medical benefits and other benefits available under the Workers' Compensation Act. 

There is a good chance that these players weigh in at sizes that are classified as obese as defined by body mass index (BMI).  In the general population, high BMI generally correlates with high body fat, and we know that high body fat is a risk factor for death (mortality) and heart disease.  Is the same true for elite athletes, for whom high BMI may relate to increased muscularity rather than increased body fat?  What if the athlete plays a position where size simply matters, regardless of whether size is related to muscle or to body fat?   And what happens when former athletes are no longer conditioning at their playing-day levels?  Do professional football players die earlier than or more often from heart disease or cancer than the average American male?   New research from the National Institute for Occupational Safety and Health (NIOSH) helps answer these and other questions.

In 1994, NIOSH published research examining death rates and risk factors for former National Football League (NFL) players.¹  At that time the research was based on all deaths that had occurred through 1991.   After following these players for an additional 16 years, NIOSH has just published new research on the topic in the American Journal of Cardiology.  

The study included 3,439 retired NFL players from the 1959 through 1988 seasons.  The study found that:

• Players had a much lower overall rate of death compared to men in the general U.S. population of similar age and racial mix. On average, NFL players are actually living longer than the average American male. Out of the 3,439 players in the study, 334 were deceased. Based on estimates from the general population, we anticipated roughly 625 deaths.
• Players also had a much lower rate of cancer-related deaths compared to the general U.S. population. A total of 85 players died from cancer when we anticipated 146 cancer-related deaths based on estimates from the general population.
• Players who had a playing-time BMI of 30 or more had twice the risk of death from heart disease compared to other players. Similar findings have been noted in other studies. Offensive and defensive linemen were more likely to have a BMI greater than 30. A BMI of 30 or more is considered obese in the general population whereas a healthy BMI is between 18.5-24.9.
• African American players had a 69% higher risk of death from heart disease compared to Caucasian players.   The study controlled for player size and position and determined that those factors are not the reason for this difference.
• Defensive linemen had a 42% higher risk of death from heart disease compared to men in the general population. A total of 41 defensive linemen died of heart disease, when we anticipated 29 deaths based on estimates from the general population.  Among the 41 defensive linemen who died of heart disease, 8 deaths were due to cardiomyopathy (a specific kind of heart disease that causes the heart to enlarge and can lead to heart failure). We anticipated fewer than two deaths from cardiomyopathy. We saw this increased risk only among the defensive linemen.

Source The NIOSH Science Blog

Read Also: 

Body Mass Index, Playing Position, Race, and the Cardiovascular Mortality of Retired Professional Football Players

"The initial cohort included 3,732 NFL players but 292 players with unknown race and 1 “player” who was actually a trainer were excluded. By the end of follow-up in 2007, the final cohort of 3,439 players contributed 104,776 person-years at risk and 334 deaths. On average the cohort was followed for 26.8 ± 8.7 years (mean ± SD) after retirement from the NFL. For players still alive, the median age at the study end date was 57 years; 60% of the players were white (including 15 Hispanics) and 39% were African-American..."

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WHO Concludes Occupation Exposure to Bitumens Can Cause Cancer

The World Health Organization (WHO)/International Agency for Research on Cancer’s Monographs programme re-evaluated various occupations that entail exposures to bitumens and bitumen emissions, including road paving, roofing, and application of mastic asphalt.

After an 8-day comprehensive review, the Working Group concluded that:

• occupational exposures to oxidized bitumens and their emissions during roofing are ‘probably carcinogenic to humans’ (Group 2A);

• occupational exposures to hard bitumens and their emissions during mastic asphalt work are ‘possibly carcinogenic to humans’ (Group 2B); and

• occupational exposures to straight-run bitumens and their emissions during road paving are ‘possibly  carcinogenic to humans’ (Group 2B).

Bitumens are produced by distillation of crude oil during petroleum refining, and also occur naturally. Bitumens can be  divided into broad classes according to their physical properties and specifications required for the different uses. The  major use of bitumens is in asphalt for road paving; other uses include roofing, waterproofing, and sealing and  painting.  Application of bitumens may generate hazardous emissions.

For over 3 decades the Law Offices of Jon L. Gelman  1.973.696.7900  jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.

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US Announces Effort to Prevent Emergency Responders From Occupational Illness

The National Institute for Occupational Safety and Health (NIOSH) and partners in the U.S. Centers for Disease Control and Prevention (CDC) today announced revised and updated resources to help prevent exposures of emergency response employees to potentially life-threatening infectious diseases in the line of duty.

The resources include:

• A list of potentially life-threatening infectious diseases, including emerging infectious diseases, and specifying those diseases routinely transmitted through airborne or aerosolized means.
• Guidelines describing the circumstances in which emergency response employees may be exposed to such diseases while attending to or transporting victims of emergencies.
• Guidelines for medical facilities making determinations whether such exposures have occurred.

The action was taken as a result of provisions in the Ryan White HIV/AIDS Treatment Extension Act of 2009. In the reauthorization, Congress directed the U.S. Department of Health and Human Services to update resources originally compiled under the Ryan White Comprehensive AIDS Resources Emergency Act, enacted in 1990.

The Secretary of Health and Human Services delegated the task to CDC. NIOSH and CDC’s Division of Healthcare Quality Promotion (DHQP) worked together to develop the required list and guidelines, incorporating input from stakeholders that was received via a public comment process. NIOSH was created under the Occupational Safety and Health Act of 1970 and is a part of CDC.

The updated list of potentially life-threatening infectious diseases which emergency response employees occupationally may be exposed include all that were in an earlier list under the 1990 Ryan White Act:

• Diphtheria
• Hepatitis B
• HIV, including AIDS
• Tuberculosis
• Viral hemorrhagic fevers
• Meningococcal disease
• Plague, pneumonic
• Rabies

New additions include:

• Anthrax, cutaneous
• Novel influenza A and other influenza strains with pandemic severity index greater than or equal to 3.
• Hepatitis C
• Measles
• Mumps
• Pertussis
• Rubella
• Severe acute respiratory syndrome (SARS-CoV)
• Smallpox
• Vaccinia
• Varicella disease
• Select agents

The notice of the action and further details can be found at http://www.gpo.gov/fdsys/pkg/FR-2011-11-02/html/2011-28234.htm

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Deadly Delay: The Chemical Industry's Game Play

The Toxic Substances Control Act (TSCA) is in desperate need of reform. Its weaknesses have allowed chemical companies to exploit the act by thwarting the EPA's attempts to finalize health assessments and delaying regulation of chemicals -- sometimes for decades. The chemical industry's roadblocks often follow predictable patterns:

• Attack early drafts of health assessments
• Force new reviews
• Hold workshops populated with industry-funded panelists
• Introduce new industry-funded studies when assessments are close to final
• Force more reviews
• Enlist elected officials to assist with political interference
• Attack new assessment drafts

Using these tactics, the chemical industry has effectively prevented the EPA from achieving its mission to protect human health.

This report details how the U.S. legal system and TSCA itself have helped the chemical industry to be effective in its efforts to delay regulations. Congress needs to reform TSCA to make it a more effective regulatory tool. The chemical industry should not be able to endlessly postpone regulatory decisions while profiting from unregulated chemical sales until all scientific controversies and uncertainties, large and small, have been eliminated. With good public policy, the EPA should be empowered to make the best decisions it can on a timely basis using existing information, and apply new science to update its evaluations as it becomes available.

Full Report: The Chemical Industry Delay Game : How the Chemical Industry Ducks Regulation of the Most Toxic Substances. By Jennifer Sass. October 2011

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Trench Safety a Focus of NIOSH

Working in a trench is a dangerous occupation, especially when working with old structures. NIOSH has refocussed on this concern this week and published Preventing Worker Death From Trench Cave-ins.

I was in New York City this week and watched two workers as they attempted to excavate on the street near Lincoln Center (see photo). One worker was digging shovel-by-shovel below ground as the worker above ground kept pounding the tops of large boards into the earth with the end of his shovel to act as walls to restrain the side from falling in. Pipes in NYC under the ground are old and many contain asbestos fiber. There were absolutely no pulmonary precautions being observed. 

Recently NJ Courts have held that trench accidents were not a mere fact of industrial life and were beyond intent of Act's immunity provision. A claim was permitted directly against the employer in addition to the workers' compensation action. Van Dunk v. Reckson Associates Realty Corp., 415 N.J.Super. 490 (N.J.Super.A.D. Aug 30, 2010), Certification Granted by 205 N.J. 81 (N.J. Jan 27, 2011).

"Workers who dig or excavate trenches are at risk of death if they enter an unprotected trench and the walls collapse. However, hazards associated with trench work and excavation are well defined and preventable. The OSHA standard for excavation and trenching, known as 29 CFR* 1926 Subpart P, describes the precautions needed for safe excavation work."

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Now Available On-Line: Complete Letter Report On Incorporating Occupational Information in Electronic Health Records

Incorporating Occupational Information in Electronic Health Records: Letter Report

The National Academies Press

The National Academies Press (NAP) was created by the National Academies to publish the reports issued by the National Academy of Sciences, the National Academy of Engineering, the Institute of Medicine, and the National Research Council, all operating under a charter granted by the Congress of the United States. The NAP publishes more than 200 books a year on a wide range of topics in science, engineering, and health, capturing the most authoritative views on important issues in science and health policy. The institutions represented by the NAP are unique in that they attract the nation’s leading experts in every field to serve on their award-wining panels and committees. The nation turns to the work of NAP for definitive information on everything from space science to animal nutrition.

http://www.nap.edu/catalog.php?record_id=13207

Author:

David H. Wegman, Catharyn T. Liverman, Andrea M. Schultz, and Larisa M. Strawbridge, Editors; Committee on Occupational Information and Electronic Health Records; Institute of Medicine

84 pages PAPERBACK $35

Each year in the United States, more than 4,000 occupational fatalities and more than 3 million occupational injuries occur along with more than 160,000 cases of occupational illnesses. Incorporating patients' occupational information into electronic health records (EHRs) could lead to more informed clinical diagnosis and treatment plans as well as more effective policies, interventions, and prevention strategies to improve the overall health of the working population. At the request of the National Institute for Occupational Safety and Health, the IOM appointed a committee to examine the rationale and feasibility of incorporating occupational information in patients' EHRs. The IOM concluded that three data elements - occupation, industry, and work-relatedness - were ready for immediate focus, and made recommendations on moving forward efforts to incorporate these elements into EHRs.

Front Matter (R1-R10) 

Incorporating Occupational Information in Electronic Health Records (1-58) 

Appendix A: Workshop Agenda (59-64) 

Appendix B: Workshop Participants (65-68) 

Appendix C: Committee Biographies (69-74)

Recommendations:
Initial Focus on Occupation, Industry, and Work-Relatedness Data Elements

Recommendation 1: Conduct Demonstration Projects to Assess the Collection and Incorporation of Information on Occupation, Industry, and Work-Relatedness in the EHR

NIOSH, in conjunction with other relevant organizations and initiatives, such as the Public Health Data Standards Consortium and Integrating the Healthcare Enterprise (IHE) International, should conduct demonstration projects involving EHR vendors and health care provider organizations (diverse in the services they provide, populations they serve, and geographic locations) to assess the collection and incorporation of occupation, industry, and work-relatedness data in the EHR at different points in the workflow (including at registration, with the medical assistant, and with the clinician). Further, to examine the bidirectional exchange of occupational data between administrative databases and clinical components in the EHR, NIOSH in conjunction with IHE should conduct an interoperability-testing event (e.g., Connectathon) to demonstrate this bidirectional exchange of occupational information to establish proof of concept and, as appropriate, examine challenges related to variable sources of data and reconciliation of conflicting data.

Recommendation 2: Define the Requirements and Develop Information Models for Storing and Communicating Occupational Information

NIOSH, in conjunction with appropriate domain and informatics experts, should develop new or enhance existing information models for storing occupational information, beginning with occupation, industry, and work-relatedness data and later focusing on employer and exposure data. The information models should consider the various use cases in which the information could be used and use the recommended coding standards. For example, NIOSH should consider how best to use social history templates to collect a work history and the problem list to document exposures and abnormal findings and diagnoses with optional work-associated attributes for possible, probable, or definite causes; exposures; and impact on work.

Recommendation 3: Adopt Standard Occupational Classification (SOC) and North American Industry Classification System (NAICS) Coding Standards for Use in the EHR

NIOSH, with assistance from other federal agencies, organizations, and stakeholders (e.g., Bureau of Labor Statistics, Census Bureau, Council of State and Territorial Epidemiologists [CSTE], National Library of Medicine, National Institute of Standards and Technology, National Uniform Billing Committee, Health Level 7 International [HL7]), should recommend to the Health Information Technology (IT) Standards Committee the adoption of SOC and NAICS to code occupation and industry. Furthermore, NIOSH should develop models for reporting health data from EHRs by occupation and industry at different levels of granularity that are meaningful for clinical and public health use.

Recommendation 4: Assess Feasibility of Autocoding Occupational Information Collected in Clinical Settings

NIOSH should place high priority on completing the feasibility assessment of autocoding the narrative information on occupation and, where available, industry that currently is collected and recorded in certain clinical settings, such as the Dartmouth-Hitchcock health care system, Kaiser Permanente, New York State Occupational Health Clinic Network, Cambridge Health Alliance, and hospitals participating in the National Electronic Injury Surveillance System.

Recommendation 5: Develop Meaningful Use Metrics and Performance Measures

Based on findings from the various demonstration projects and feasibility studies, NIOSH, with the assistance of relevant professional organizations and the Health IT Policy Committee, should develop meaningful use metrics and health care performance measures for including occupational information in the meaningful use criteria, beginning with the incorporation of occupation, industry, and work-relatedness data, and later expanding as deemed appropriate to include other data elements such as exposures and employer.

Recommendation 6: Convene a Workshop to Assess Ethical and Privacy Concerns and Challenges Associated with Including Occupational Information in the EHR

NIOSH should convene a workshop involving representatives of labor unions, insurance organizations, health care professional organizations, workers’ compensation-related organizations (e.g., International Association of Industrial Accident Boards and Commissions, National Council on Compensation Insurance), and EHR vendors to 
.. assess the implications for the patient and clinician of incorporating work-relatedness in the EHR, with respect to workers’ compensation; and
.. propose guidelines and policies for protecting the patient’s non-workrelated health information from inadvertent disclosure and to ensure compliance with the Health Insurance Portability and Accountability Act, workers’ compensation, and other privacy standards.

Enhance the Value and Use of Occupational Information in the EHR

Recommendation 7: Develop and Test Innovative Methods for the Collection of Occupational Information for Linking to the EHR

NIOSH should initiate efforts in collaboration with large health care provider organizations, health insurance organizations, EHR vendors, and other stakeholders to develop and test methods for collecting occupational data from innovative sources. Specifically, NIOSH should evaluate collection methods that involve

.. patient input through mechanisms such as web-based portals and personal health records, and
.. other means such as health-related smart cards, health insurance cards, and human resource systems.

Recommendation 8: Develop Clinical Decision-Support Logic, Education Materials and Return-to-Work Tools

NIOSH, relevant professional organizations, and EHR vendors should begin to develop, test, and iteratively refine and expand

.. clinical decision-support tools for common occupational conditions (e.g., work-related asthma);
.. tools and programs that could be easily accessed for education of patients and caregivers about occupational illnesses, injuries, and workplace safety;
.. training modules for administrative staff to collect occupational information in different care settings; and
.. tools to improve and standardize functional job assessment and return- to-work documentation in EHRs, including standards for the transmission of these forms.

Recommendation 9: Develop and Assess Methods for Collecting Standardized Exposure Data

NIOSH should continue to work with occupational and environmental health clinics and other relevant stakeholders to develop and assess methods for collecting standardized exposure data for work-related health conditions. NIOSH should explore the feasibility of 

.. listing possible or probable exposures in the problem list or elsewhere in the EHR;
.. linking occupational information in the EHR to online occupational, toxicological, and hazardous materials databases, such as the Occupational Information Network (O*NET), the Association of Occupational and Environmental Clinics, and Haz-Map, to enhance diagnosis and treatment of work-related illnesses and injuries; and
.. automatically generating codes for exposures based on narrative text entries.

Recommendation 10: Assess the Impact of Incorporating Occupational Information in the EHR on Meaningful Use Goals

NIOSH, in conjunction with relevant stakeholders (e.g., Public Health Data Standards Consortium, CSTE, Association of State and Territorial Health Officials), should

.. develop measures and conduct periodic studies to assess the impact of integrating occupational information in EHRs, and
.. estimate the economic impact of EHR-facilitated return-to-work practices for both work-related and non-work-related conditions.

The Need to Incorporate Occupational Histories Into Electronic Medical Records

Each year in the United States, more than 4,000 occupational fatalities and more than 3 million occupational injuries occur along with more than 160,000 cases of occupational illnesses. The use of electronic health records (EHRs) has increased rapidly since the passage of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act. Incorporating patients’ occupational information into EHRs could lead to more informed clinical diagnosis and treatment plans as well as more effective policies, interventions, and prevention strategies to improve the overall health of the working population.

At the request of the National Institute for Occupational Safety and Health, the IOM appointed a committee to examine the rationale and feasibility of incorporating occupational information in patients’ EHRs. The committee focused on the potential benefits of the inclusion of occupational information to individual and public health, current systems that use this information, and technical barriers to incorporating occupational information into the EHR. The IOM concluded that three data elements – occupation, industry, and work-relatedness – were ready for immediate focus. To incorporate these data into EHRs, recommendations were made that include assessment of data collection and incorporation, requirements for storing and communicating occupational information, development of metrics and performance measures, and assessment of privacy concerns, among others.

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How To Determine If A Substance Causes Cancer at Work

The National Institute for Occupational Safety and Health (NIOSH) is seeking public input to determine what substances cause cancer and at what level of occupational exposure.

"The National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention (CDC) intends to review its approach to classifying carcinogens and establishing recommended exposure limits (RELs) for occupational exposures to hazards associated with cancer. As part of this effort, NIOSH is requesting initial input on these issues (including answers to the 5 questions in the following section), to be submitted to the NIOSH Docket number 240, for a comment period lasting through September 22, 2011. This information will be taken under consideration and used to inform NIOSH efforts to assess and document its carcinogen policy and REL policy regarding occupational hazards associated with cancer. NIOSH has also created a new NIOSH Cancer and REL Policy Web Topic Page [see http://www.cdc.gov/niosh/topics/cancer/policy.html] to provide additional details about this effort and progress updates."

"NIOSH is announcing a Request for Information on key issues identified and associated with the NIOSH Carcinogen and REL policies. Special emphasis will be placed on consideration of technical and scientific issues with the current NIOSH Cancer and REL Policies that require further examination including the following:Show citation box

(1) Should there explicitly be a carcinogen policy as opposed to a broader policy on toxicant identification and classification (e.g.carcinogens, reproductive hazards, neurotoxic agents)?Show citation box

(2) What evidence should form the basis for determining that substances are carcinogens? How should these criteria correspond to nomenclature and categorizations (e.g., known, reasonably anticipated,etc.)?Show citation box

(3) Should 1 in 1,000 working lifetime risk (for persons occupationally exposed) be the target level for a recommended exposure limit (REL) for carcinogens or should lower targets be considered?Show citation box

(4) In establishing NIOSH RELs, how should the phrase “to the extent feasible” (defined in the 1995 NIOSH Recommended Exposure Limit Policy) be interpreted and applied?Show citation box

(5) In the absence of data, what uncertainties or assumptions areappropriate for use in the development of RELs? What is the utility of a standard ”action level” (i.e., an exposure limit set below the REL typically used to trigger risk management actions) and how should it be set? How should NIOSH address worker exposure to complex mixtures?

Public Comment Period: Comments must be received by September 22, 2011.

The concept of a compensable industrial disease has developed only recently and its acceptance has lagged far behind that of industrial accidents. The original Workers' Compensation Acts, as promulgated from the year 1911 forward by many of the states, did not provide for the recognition of occupational illness and disease as compensable events. As demands have been placed upon the medical system to treat and to prevent occupational illness, the legal system, under social, economic, and political pressure, has sought to provide a remedy for the thousands of injured workers who have suffered and who are continuing to suffer from occupational illness and disease. 

For over 4 decades the Law Offices of Jon L. Gelman  1.973.696.7900  jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.

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World Trade Center dust and 9/11 first responders with cancer, time for U.S. Government to stop withholding benefits

Guest Blog By Edgar Romano*

Many courageous first responders, who saved lives at Ground Zero, have since been diagnosed with cancer, and yet the U.S. government does not pay for their treatment. This Saturday, September 10, CNN will air Terror In The Dust, an investigation by chief medical correspondent Dr. Sanjay Gupta into the consequences of the deadly dust produced by the World Trade Center’s collapse. Gupta speaks with 9/11 heroes and medical experts about the consequences of the carcinogen-filled dust.

A new study released earlier this week by the New York City Fire Department provides good evidence of a link between 9/11 first responders and cancer. The study showed a 32% greater incidence of cancer among firefighters who worked at Ground Zero than those who did not.

"The NIOSH study concluded that the 9/11 debris did contain known carcinogens."

The U.S. government does not pay for cancer treatments of 9/11 first responders. This is because the administrators of the James Zadroga 9/11 Health and Compensation Act made a determination not to cover cancer, based on a study by the National Institute for Occupational Safety and Health (NIOSH). The NIOSH study, published in July 2011 concluded that while the 9/11 debris did contain known carcinogens, first responders were not exposed to dangerous levels. The New York City Fire Department study provides new evidence that, hopefully, will cause lawmakers to reevaluate their decision.

"It took 25 years to draw that connection between asbestos and mesothelioma, and in that time a lot of people died who might otherwise have been screened, treated, and might otherwise have been saved."

In an interview yesterday with John Stewart, a long-time supporter of the first responders and their cause, Dr. Gupta noted that “It took 25 years to draw the connection between asbestos and mesothelioma” and in that 25-year period, many people died without proper care or screening.

Dr. Gupta expressed hope that the Zadroga bill administrators would immediately acknowledge the newly released scientific evidence and give the go-ahead to compensate first responders who have since been diagnosed with cancer. Dr. Gupta also stated that if the link between the World Trade Center’s dust and cancer were officially acknowledged by the Zadroga bill administrators, early screenings for other responders could be authorized, potentially saving lives.

Representatives Charles Rangel, Carolyn Maloney, Jerrold Nadler, Peter King, and Steve Israel have filed a petition with the Zadroga bill Program Administrator that will require him to consider within 60 days whether or not to add coverage for cancers under the Zadroga Act. NIOSH does not plan to release a follow up study until July 2012.

We all owe a debt of gratitude to these first responders. We encourage everyone out there to watch Terror In The Dust, Dr. Gupta’s documentary on environmental hazards at Ground Zero, on September 10, 9:00 p.m. ET.

EDGAR ROMANO received his undergraduate degree cum laude from Brandeis University and his Juris Doctorate from The John Marshall Law School. He is a Senior Partner in the Workers' Compensation Department and has been with the firm since 1995. Mr. Romano is actively engaged in litigating workers compensation claims including those claims arising out of occupational exposure to asbestos and industrial irritants. He has lectured extensively to labor unions and medical providers. Mr. Romano isPresident of the Workers Injury Law and Advocacy Group and is on the Board of Directors of the New York State Workers' Compensation Bar Association. He is a member of the Leader's Forum of the American Association of Justice and Vice-President of the Workers' Compensation Section. He is a member of theNew York State Bar Association, the New York State Trial Lawyers Association, the Jewish Lawyer's Guild, and NYCOSH. Mr. Romano serves on the Advisory Committee of the World Trade Center Medical Monitoring Program at Mt. Sinai Hospital. He is listed in "Who's Who in American Law"..

Mr. Edgar Romano was selected as one of the "Workers' Compensation Notable People for 2008". These selections are made by the LexisNexis Workers' Compensation Law Center, who state that "These exceptional people have worked tirelessly on behalf of their clients and others and have made significant contributions to the workers' compensation system and/or the workplace". For the complete story go to LexisNexis Workers' Compensation. He blogs regularly at Workers' Law Watch where this posted appeared originally on September 8, 2011.

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Census of Fatal Occupational Injuries Summary, 2010

A preliminary total of 4,547 fatal work injuries were recorded in the United States in 2010, about the same as the final count of 4,551 fatal work injuries in 2009, according to results from the Census of Fatal Occupational Injuries (CFOI) program conducted by the U.S. Bureau of Labor Statistics. The rate of fatal work injury for U.S. workers in 2010 was 3.5 per 100,000 full-time equivalent (FTE) workers, the same as the final rate for 2009. Over the last 3 years, increases in the published counts based on information received after the release of preliminary data have averaged 174 fatalities per year or about 3 percent of the revised totals. Final 2010 CFOI data will be released in Spring 2012. 

 Economic factors continue to play a role in the fatal work injury counts. Total hours worked were up slightly in 2010 in contrast to the declines recorded in both 2008 and 2009, but some historically high-risk industries continued to experience declines or slow growth in total hours worked. Key preliminary findings of the 2010 Census of Fatal Occupational Injuries: - The number of fatal work injuries among the self-employed declined by 6 percent to 999 fatalities, more than the decline in their hours worked. 

For additional data, access the BLS Internet site: www.bls.gov/iif/. For technical information about and definitions for the CFOI program, please go to the BLS Handbook of Methods on the BLS web site here: www.bls.gov/opub/hom/homch9_a1.htm.

Table 1. Fatal occupational injuries by event or exposure, 2009-2010
Table 2. Fatal occupational injuries by industry and selected event or exposure, 2010
Table 3. Fatal occupational injuries by occupation and selected event or exposure, 2010
Table 4. Fatal occupational injuries by selected worker characteristics and selected event or exposure, 2010
Table 5. Fatal occupational injuries by State and event or exposure, 2010
Table 6. CFOI participating State agencies and telephone numbers
Technical notes
HTML version of the entire news release

NIOSH to Propose New Criteria for Diacetyl Exposure

The National Institute for Occupational Safety and Health (NIOSH) invites public comment on a draft document, "Criteria for a Recommended Standard: Occupational Exposure to Diacetyl and 2,3-pentanedione.”


For public review and comment, the draft document summarizes current scientific knowledge about the occupational safety and health implications of the food flavorings diacetyl and 2,3-pentanedione, and recommends occupational exposure limits and measures for controlling work related exposures to diacetyl and 2,3-pentanedione, based on the current state of knowledge.


The draft document is available athttp://www.cdc.gov/niosh/docket/review/docket245/default.html for written public comment until Oct. 14, 2011. NIOSH will also hold a public meeting to discuss and obtain comments on Aug. 26, 2011, in Washington D.C.


"Occupational exposure to diacetyl has been associated with severe obstructive lung disease, bronchiolitis obliterans, and decrease in lung function," said NIOSH Director John Howard, M.D. "NIOSH has provided over a decade of research and leadership in this important scientific area. In addition to the recommended exposure limits (RELs), this draft document provides for public comment a comprehensive review of scientific literature, a quantitative risk assessment, and valuable guidance to reduce occupational exposures to diacetyl and 2,3-pentanedione. We invite public comment on the draft Criteria Document to help us develop final recommendations."

The draft document includes, for comment:
For Diacetyl, a recommended exposure limit (REL) of 5 parts per billion (ppb) as an eight-hour, time-weighted average, (TWA) during a 40-hour work week. To further protect against effects of short-term exposures, NIOSH recommends in the draft document a short-term exposure limit (STEL) for diacetyl of 25 ppb for a 15-minute time period.


For 2,3-pentanedione, a recommended exposure limit (REL) of 9.3 parts per billion (ppb) as an eight-hour, time-weighted average, (TWA) during a 40-hour work week. The REL for 2,3-pentanedione in the draft document is based upon the lowest level at which the substance reliably can be detected using the existing analytical method, and should not be misconstrued to imply that 2,3-pentanedione is of lower toxicity than diacetyl. Further, NIOSH recommends a STEL of 31 ppb to limit peak exposures for 2,3-pentanedione on the same basis of analytic method limitation.

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NIOSH Fails to Link Cancer as Zadroga Fund Compensable

The National Institute for Occupational Safety and Health (NIOSH) published a report concluding that cancer is not a compensable disease for the Zadroga World Trade Center Victims Compensation Fund.

The report concludes:
"Based on the scientific and medical findings in the peer-reviewed literature reported in this first periodic review of cancer for the WTC Health Program, insufficient evidence exists at this time to propose a rule to add cancer, or a certain type of cancer, to the List of WTC-Related Health Conditions. "

Although a determination cannot be made to propose a rule to add cancer, or a type of cancer, to the List of WTC-Related Heath Conditions at this time, it is important to point out that the current absence of published scientific and medical findings demonstrating a causal association between the exposures resulting from the September 11, 2001, terrorist attacks and the occurrence of cancer in responders and survivors does not indicate evidence of the absence of a causal association. 

"It is expected that the second periodic review of cancer for the WTC Health Program will be conducted in early to mid-2012 to capture any emerging findings about exposures and cancer in responders and survivors affected by the September 11, 2001, terrorist attacks.

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Hotel Workers Have Work Comp Claims

Long before the Straus-Kahn publicity, hotel workers have been suffering from work related accidents and injuries leading to workers compensation benefits. The US Centers for Disease Control and The National Institute for Occupational Safety and Health have published a brochure and announced a new partnership program to promote innovative research and improve workplace practices.

The National Occupational Research Agenda (NORA) is a partnership program to promote innovative research and improve workplace practices. Unveiled in 1996, NORA is a framework for guiding occupational safety and health research and interventions throughout the nation. NORA stakeholders collaborate to identify critical workplace issues in industry sectors. The National Institute for Occupational Safety and Health (NIOSH) convened a number of these partners to develop the National Services Agenda, which includes safety and health goals for the Accommodations Industry. Groups such as unions, worker organizations, government agencies, and hotel/motel associations can build partnerships to implement these goals and help ensure that hotels are safe for all employees.

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