Occupational Surveillance by Industry: The NIOSH NHIS Monograph Series

Background: Traditional occupational health surveillance has focused primarily on occupation rather than on industry. With the new NIOSH National Occupational Research Agenda (NORA), there is an urgent need for detailed health-related data for US Workers in the NORA Industry Sectors. The National Health Interview Survey (NHIS) provides a large and nationally representative sample of all US civilian workers. Methods: Using the currently available 1986-2008 NHIS database for >700,000 US workers >18 years (representing >120 million US workers/yr), after adjustment for sample design, several Monographs have been created on morbidity, disability, mortality, and quality of life issues by NORA subgroup and demographic variables. Results: Differences in the distribution of the demographic factors between NORA Sectors are associated with increased disability and morbidity risks. For example, NORA Sectors with less insurance and access to medical care (e.g. Construction, Agriculture/Forestry/Fishing) were more likely to report both less healthcare utilization and less diagnosis of medical conditions, but also experienced higher mortality rates. With the exception of obesity, Healthcare/Social Assistance workers were also more likely to report better health behaviors (e.g. less current smoking) compared to both Construction and Mining workers. Finally, quality-adjusted life years was lowest among workers in the Agriculture/Forestry/Fishing Sector. Conclusions: The surveillance of the NORA Industry Sector subgroups using the rich array of NHIS health indicators provides a comprehensive understanding of the working population's burden of disease, disability, and mortality, and allows for the identification of priority population sub-groups for workplace interventions designed to enhance worker health and well-being.