3rd EU/US Joint Conference on Occupational Health and Safety
Lemnos, Greece
15-17 October 2003

Kathleen M. Rest
Deputy Director for Program
National Institute for Occupational Safety and Health (NIOSH)

Keynote Address

Good morning. It is an honor to represent the National Institute for Occupational Safety and Health (NIOSH) at this 3rd joint conference on occupational safety and health. On behalf of NIOSH, I would like to extend my greetings to this distinguished audience and express my encouragement and optimism for productive and successful deliberations over the next three days.

As we have in our previous meetings in San Francisco and Luxembourg, we will be dealing with issues of great importance to the workers, employers, and governmental institutions of our respective countries. Indeed, safe and healthy work and workplaces are fundamental to the sustainability of our economic and social systems, which are now increasingly global in nature. And we share a common vision. We all want to prevent work-related injury, illness, and disability, so our nation's workers will go home safely to their families at the end of every day and enjoy a healthy retirement in their older years. We all want to provide work environments that are safe, healthy, and productive so society will benefit from the goods and services being produced.

The world is a very different place than it was when we last met in San Francisco. We recognized then that in the EU and US, the nature and organization of work were changing rapidly. We knew that our respective workforces were changing; they were becoming older and increasingly diverse. New technologies – especially information technologies – were driving changes in how and where people work. And the pace of these changes has not diminished. In the US, the events of September 11 and the subsequent anthrax attacks in postal facilities and government offices have created an entire set of new challenges, including workplace health and safety challenges. Many of the issues we will be dealing with during this

conference -- partnerships, chemicals, workplace organization and stress -- relate directly to all of these new challenges.

Let me talk a little about the topics we have identified for deliberation during this conference – global management of chemicals, stress and its relationship to work organization, improving partnerships, and measuring performance – and set the stage for some action-oriented discussions.

Global Management of Chemicals

Our discussions will focus on three areas: harmonization of systems for hazard communication; setting OELs; and managing risk at the enterprise level. These areas are clearly related. Success will advance worker health and safety and simplify some of the complexities faced by employers who have significant responsibilities in the chemical arena. These areas are important to all of us, and I would like to give you some examples from NIOSH. As you may know, NIOSH is responsible for recommending occupational exposure limits along with other methods to protect workers from adverse health effects due to chemical exposures. We have recently signed an agreement with the Health Council of the Netherlands to partner in the development of documents that evaluate hazardous workplace substances. Through this agreement, we are sharing our expertise and developing documents that can provide the scientific basis for establishing OELs and other recommendations. We are also very excited about the potential of the control banding approach; we are currently integrating control banding efforts into our Small Business Initiative and are evaluating it through our health hazard evaluation program. As our EU colleagues did in their working paper prepared for this conference, I would like to challenge us with some concrete questions to help move us forward.

  • What can be done to promote world-wide adoption of the globally harmonized system? What can we do?
  • How can we do a more effective and efficient job of setting OELS? What are the possible areas for EU/US cooperation in setting OELs? How do we get started?
  • What can be done to promote risk management and risk assessment at the enterprise level, and what can we do to help?

Stress and its Relationship to Organizational Changes and Improvement of the Work Environment.

Stress is a ubiquitous workplace hazard. It can occur in every sector and at every level of the organization. Rapidly changing organizational practices have far outpaced our ability to assess their impact on worker health and safety, but there is growing concern and many research gaps to be filled. The workgroup on this topic will focus on three areas: Workplace violence, changes in work and working hours, and the prevalence and cost of workplace stress. As a research institute, NIOSH is working in all of these areas.

Through its grants program, NIOSH is supporting studies to identify risk factors for workplace violence in four diverse occupational groups -- social service workers, health-care employees, police officers, and long-haul truckers. Another study is focusing on efforts to increase the identification of domestic violence in the workplace.

NIOSH is conducting a prospective study of the relationship between work organization stressors and depression, with a focus on working women. Working women suffer from depression at nearly twice the rate of working men. Work organization factors such as harassment, discrimination, and balancing work and family responsibilities may contribute to these higher rates of depression among women. Findings from this study will provide new knowledge about this important workplace health problem, as well as information on workplace policies and programs that can reduce the prevalence of the disease in this population. NIOSH is also actively developing partnerships with employers, unions, workers, government agencies, NGOs, and others to address workplace violence. In a series of stakeholder meetings, these groups have shared information and identified pressing research and prevention needs for health care settings, retail trades, and security and law enforcement.

At NIOSH, we have identified a host of research gaps and are moving forward to address them. Our challenge at this conference is to take what we know now and use it to make an impact on this universal and costly problem.

My challenge to the group is:

  • How do we identify, promote, and disseminate best organizational practices for reducing workplace stress and workplace violence?
  • What can government, industry, and labor do both separately and together to address these problems?
  • What concrete activities can the EU and US undertake jointly to alleviate this growing problem?

Performance Measures

To be good stewards of public resources and the public trust, it is important that government agencies assess, measure, and demonstrate their performance. Good intentions are not enough to ensure that agency efforts achieve results. Yet performance measurement can be a challenging exercise, especially in the area of occupational safety and health where results depend on the action of both the public and the private sectors. For research agencies, such as NIOSH, whose primary activity is the production of scientific and technological knowledge, the task becomes even more daunting. As efforts evolve to link agency performance to budget allocation, the need to developmeaningfulmeasures and indicators of performance increases. Within NIOSH, we are developing a new initiative called Research to Practice or R2P to ensure that the results of our science and prevention activities are quickly disseminated to those who can use the information for action. These efforts and our methods of communication will be timely and specifically targeted to the appropriate audiences -- be they governmental regulatory agencies, the scientific community, occupational safety and health professionals, employers and trade organizations, labor unions and workers, and others. And we will follow-up with these groups to determine if our research and recommendations are relevant, useful, and effective in preventing workplace illness and injury and enhancing the work environment.

The workgroup will, no doubt, explore the challenges inherent in developing and using performance indicators for occupational safety and health. And the most relevant and appropriate measures may differ for government, industry, and labor, as each have different responsibilities, capacities, and access to resources. But there should be a common vision of what we all want to achieve – safe and healthy workers and workplaces.

I challenge the group to think about:

  • What specific indicators for government, industry, and labor when, taken together, will present a comprehensive picture of progress and performance in workplace safety and health?

Improving Occupational Safety and Health Through Partnerships

We all know that the whole is generally greater than the sum of its parts. Government, industry, and labor have unique resources they can bring to bear on different problems. Through partnerships, we can have a greater and more sustained impact on worker health and safety. Like its sister research institutes, NIOSH too brings a special expertise to the table and we have extensive experiencing in establishing and benefiting from both research and prevention partnerships.

NIOSH research and prevention activities rely on partnerships. Partnership is also a fundamental and essential element of the National Occupational Research Agenda (NORA), which resulted in identification of 21 research priorities for the US for the decade 1996-2006. To help implement the agenda, NIOSH and partners from labor, industry, and academia work in teams to elaborate research needs, promote and foster research, share information, and leverage needed resources.

NIOSH's research partnerships have had significant results. For example, a collaboration between government, industry and labor developed an engineering control strategy to reduce worker exposure to asphalt fumes during paving operations. Agreeing to disagree about some elements of the exposure-response relationship, the partnership developed a ventilation system attached to the paver that reduces fume and heat before they can reach the worker. As a result of this partnership, all highway paving machines have adopted this control technology.

More recently, a partnership between NIOSH, a health care system, its workers, a professional nursing organization, a university, and several manufacturers resulted in the development of a comprehensive back injury prevention program. In a pre- and post-intervention effectiveness study, the results were impressive. The frequency of back injuries in six facilities operated the health system was reduced by 57 percent; injury rates were lowered by 58 percent; and workers' compensation costs decreased by 71 percent.

On a much larger, international scale, the WHO has established a Global Network of 74 Collaborating Centers in Occupational Health. NIOSH chairs the Network. These Centers work in partnership within a 2001-2005 Work Plan to identify priority health and safety problems and to develop and implementing plans to tackle the problem. The group has assembled a compendium of projects that includes more than 350 projects in 15 priority areas. The Global Network meets every two to three years to review progress and to develop joint projects. The most recent meeting was in Iguassu Falls, Brazil, and the next will be in Milan in 2006 just preceding the International Commission on Occupational Health meeting.

Though considered in a separate workgroup here at the conference, the need for and value of effective and meaningful partnerships will likely permeate all our discussions. However, we should sure come away with the answer to the following question:

  • What do we hope to achieve through this EU/US partnership in the coming two years?
  • How can we all foster meaningful and productive partnerships in our own countries?
  • As representatives of the most developed countries in the world, how can we apply our leadership, talent, resources, and partnership opportunities to help other countries in need?


In conclusion, our work here is critical. Opportunities to meet, talk, and network are always valuable in and of themselves – and I, for one, will enjoy this one immensely. But I urge us to go further. We must use this opportunity to think creatively and concretely about the outcomes we want to achieve and the products or activities that we must produce to get there. I want us to walk away with some real accomplishments and concrete plans, in addition to the sense of collaboration and camaraderie that will not doubt emerge. And I want us to consider the moral concept of noblesse oblige. Although we have many health and safety problems and challenges in our own countries, other members of the world community are in a much worse position. Let's think about how we can extend our good work to raise all boats in this complex and interconnected world.