Study evaluates Oregon's occupational public health surveillance system

Reviewed by Emily Henderson, B.Sc.Jun 26 2020

A recent study evaluating the effectiveness of Oregon's occupational health monitoring system concludes that the state needs to collect and share data about workplace dangers in a more timely, relevant fashion to allow for rapid intervention.

Occupational safety and health surveillance is a type of public health surveillance that collects data on work-related fatality, injury and illness and the presence of workplace hazards. In disseminating this data, occupational health agencies aim to help workplaces implement policies and procedures to keep workers safe.

More timely, complete and sustainable surveillance is going to benefit Oregon workers. The whole purpose for surveillance is to generate quality data that can be used for research and guiding practice. So if the system can provide more timely, complete data in a stable and systematic way, this is going to help improve work safety and health for Oregon workers."

Liu Yang, study author, recent Ph.D. graduate in Oregon State University's College of Public Health and Human Sciences

One of the ways to accomplish this is to develop state-centric health indicators. When something like the COVID-19 pandemic arises, for example, focusing on more local and timely indicators would allow Oregon agencies to quickly provide safety guidance for industries throughout the state.

Yang's evaluation study, published this month in the American Journal of Industrial Medicine, is a collaboration with the Oregon Occupational Public Health Program, which is currently funded by the National Institute for Occupational Safety and Health (NIOSH) to expand state-level surveillance.

The state occupational safety and health surveillance system is based on a national set of occupational health indicators covering work-related injuries, illnesses, and safety-related risk factors. This standardization allows states to report comparable data to national occupational health agencies.

But some of the sources of data have a much slower turnaround than others, so it's difficult to gather all the necessary information at the same time. In Oregon, this has resulted in a 2- to 3-year lag between when a workplace hazard or accident occurs, and when a new indicator is generated and disseminated. Oregon's 2015 health indicator report was not published until 2018.

For the study, Yang, co-author Laurel Kincl, an associate professor in Public Health at OSU, and researchers from the Oregon Health Authority collected data via onsite observations, interviews, focus groups and surveys among stakeholders, along with reviews of existing literature.

They found that Oregon's occupational safety and health surveillance system is easy to operate, regularly updated and flexible in adopting changes, and ranked as highly relevant to users. However, it is not timely; its funding source is not sustainable; and while the quality of data is good overall, there is room for improvement in its sensitivity and representativeness. Because of these shortcomings, most users ranked the system as "moderately" or "somewhat" useful.

To solve the timeliness issue, Yang said, Oregon should adopt state-specific occupational health indicators, using state agency data that can be compiled more quickly. In addition to disseminating safety information to workplaces faster, state-level indicators would produce data that better reflects specific local needs.

State surveillance leaders are already moving in this direction, and have started using emergency department visits and other real-time clinical health sources to track occupational health incidents.

While other types of public health surveillance, such as infectious disease monitoring, are funded as ongoing practice-oriented systems, occupational safety and health surveillance is paid for based on research projects. Program leadership has to come up with new research projects to secure money every five years, which leaves the surveillance system on unstable footing.

Surveillance is more important than ever during the COVID-19 pandemic, as public health agencies need more time-sensitive methods for gathering data on viral outbreaks in workplaces across the state, Yang said. She hopes Oregon will continue to evaluate its surveillance system on a more regular basis going forward.

"Without evaluation, without taking a step back to reflect, you just keep doing things but you don't know whether you're doing right or wrong," she said.