Selecting and evaluating case studies of the economic benefits of research and services at the National Institute for Occupational Safety and Health: case studies on personal dust monitors for coal miners, improved ambulance design, and amputation surveillance.

Details

• Personal Author:
  Lastunen J ; Metz D ; Miller BM ; Smith TD
• Description:
  In 2017, the National Institute for Occupational Safety and Health (NIOSH) asked the RAND Corporation to develop an approach for estimating the economic benefit of its research and service activities and to illustrate its use through three exploratory case studies. Miller et al. (2017) provided such approach and illustrated its use through three exploratory case studies. This report builds upon that work by developing a process for selecting case studies for evaluation, applying that selection process to a list of ten potential case studies, and selecting three case studies from this list for detailed analysis. NIOSH identified ten potential case studies, and RAND traced the elements of these case studies from the input hazard to the potential changes in health outcomes for workers and other affected individuals. In parallel, RAND identified attributes of cases studies that NIOSH might use to identify which cases to evaluate in further detail: 1. Feasibility. There must be enough information available to anticipate the ability to establish and quantify the link between NIOSH activities and worker outcomes without extensive new data collection. 2. Impact. This is defined in terms of (a) the number of potentially affected workers, (b) the extent to which there is evidence that control measures resulting from on NIOSH's work are actually implemented, and (c) the actual or anticipated reduction of risk resulting from the implementation of these control measures. 3. Attribution. There must be clear evidence that changes in worker safety and health occurred in response to NIOSH efforts. 4. Balance. When taken together, the cases must represent a diversity of program areas. 5. Institutional priorities. The cases must represent current areas of particular interest to NIOSH. Based on these attributes, we selected three case studies: Personal Dust Monitors for Coal Miners, Improved Ambulance Design, and Improved Amputation Surveillance. In the Personal Dust Monitors for Coal Miners case, we found NIOSH's activities, which included awarding research grants, collaborating with industry and labor in testing and developing prototypes, disseminating research findings, and conducting outreach to miners, played a major role in the development and adoption of continuous personal dust monitors (CPDMs) for coal miners. Without NIOSH's contribution, the achieved reductions in exposure to respirable coal mine dust may not have been as successful, and improvements in workplace practices based on corrective actions linked to CPDMs would have been less likely to occur. 1. We estimate the avoided medical costs and productivity losses for cases of fatal and nonfatal respiratory disease due to the reduction in exposures to respirable coal mine dust after the adoption of CPDMs ranged from $3.6 million to $8.0 million on an annualized basis over 65 years, depending on the attribution of fatal cases avoided by age 73 or 85 and whether a 3-percent or 7-percent discount rate is used. 2. We estimate the economic benefits based on willingness-to-pay estimates associated with risk reductions in fatal and nonfatal respiratory disease ranged from $10.4 million to $25.3 million per year, depending on the attribution of fatal cases avoided by age 73 or 85 and whether a 3-percent or 7-percent discount rate is used. In the Improved Ambulance Design case, NIOSH's impact on ambulance design has been the result of a steady stream of partnerships with stakeholders. NIOSH has focused on improving the design of the patient compartment and its contents, both by working directly with manufacturers and by collaboration with standard-setting organizations. NIOSH continues to play a pivotal role in these partnerships, and many of the design changes may not have happened without NIOSH's involvement. We estimate the benefits associated with three different sets of assumptions about the effectiveness of the ambulance redesign in preventing injuries or reducing injury severity: the patient compartment becoming as safe as the back seat of a standard four-door passenger vehicle, the patient compartment becoming as safe as ambulance driver position, and improvements in patient compartment safety being consistent with literature on seat belt effectiveness in similar vehicles. 1. If the ambulance redesign causes the patient compartment of ambulances to become as safe as any of the sets of assumptions we modeled, this could result in an annualized benefit that ranges from $2.5 million to $8.0 million from 2017 to 2050, depending on the modeling assumptions and whether a 3-percent or 7-percent discount rate is used. Benefits per year increase over time. 2. If the ambulance redesign causes the patient compartment of ambulances to become as safe as any of the sets of assumptions we modeled, this could result in $24 million to $74 million in avoided "value of a statistical life" losses from 2017 to 2050, depending on the modeling assumptions and whether a 3-percent or 7-percent discount rate is used. Benefits per year increase over time. 3. There are many uncertainties associated with these estimates, and the ultimate impact could vary significantly. Due to data limitations, these estimates examine only injuries associated with collisions, and do not include injuries associated with noncollision events. In the Improved Amputation Surveillance case, we found that a Michigan amputation surveillance program funded by NIOSH led to referrals that found more violations and assessed higher monetary penalties than typical inspections in the state between 2003 and 2018. While our estimates are not causal, it is likely that the surveillance program helped the Michigan Occupational Safety and Health Administration better target inspections, leading to a more efficient allocation of scarce resources such as inspection personnel. Inspections from the surveillance program found 2.60 times as many violations as other inspections and assessed approximately 2.45 times the amount of a typical inspection in monetary penalties. The Michigan program substantially influenced other state programs such as the one in Massachusetts. The program also provided better information on the extent of amputations in Michigan and in which industries and firms amputations had occurred that were not reported in other sources. 1. While our estimates are not causal, if we assume that inspections that occurred due to the Michigan amputation surveillance program would not have occurred but for the program and that resources utilized for these inspections would have been used to conduct inspections similar to the average inspection measured in our data had the program not existed, then we can provide some rough numbers of the effects of the program on these proximate outcomes. Under these assumptions the program increased the number of violations discovered by about 96 violations per year and increased total initial penalties by approximately $47,300 per year. 2. The available data do not enable us to quantify the benefit of the program on worker safety and reduction in amputations or measure the spillover effects of the program. While more data are necessary to fully quantify the benefits of surveillance programs and to establish a causal link between surveillance, inspections, and worker safety, our preliminary analysis suggests that NIOSH-supported surveillance programs likely have positive benefits to society.
• Subjects:
  Accidents, Occupational Air Pollutants, Occupational Environmental Monitoring Epidemiology Mining Occupational Health Preceptorship Safety Vehicle Emissions Ventilation Workplace

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• Keywords:
  Accident Prevention Case Studies Disease Prevention Dusts Economic Analysis Economic Impact Economics Effectiveness Research Engineering Controls Equipment Design Feasibility Assessment Hazard Communication Hazard Controls Hazard Identification Health Hazards Health Protection Information Dissemination Injuries Injury Prevention Intervention Intervention Effectiveness Medical Research Miners Monitors Occupational Hazards Occupational Safety And Health Partnership Return On Investment Risk Management ROI Safety Research Surveillance Systematic Reviews Worker Health Worker Safety

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• Publisher:
  RAND Corporation
• Document Type:
  Text
• Funding:
  Contract
• Genre:
  Final Contract Report
• Place as Subject:
  California ; District of Columbia ; OSHA Region 3 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OD - Office of the Director
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-145
• NIOSHTIC Number:
  nn:20060205
• Citation:
  Santa Monica, CA: RAND Corporation, RR-4201-NIOSH, 2019 Dec; :1-145
• Contact Point Address:
  RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138
• Federal Fiscal Year:
  2020
• Performing Organization:
  RAND Corporation
• Peer Reviewed:
  False
• Source Full Name:
  Selecting and evaluating case studies of the economic benefits of research and services at the National Institute for Occupational Safety and Health: case studies on personal dust monitors for coal miners, improved ambulance design, and amputation surveillance
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:1af6c160d04f10c714979c082fbd3f21b8a10fe6ac20055f49a292957a7ad1701344ea9b374c00a6d05efbeb9daa43eecfd8cd582a4e10e44951c1a57951f751
• Download URL:
  https://stacks.cdc.gov/view/cdc/181873/cdc_181873_DS1.pdf
• File Type:
  [PDF - 2.25 MB ]