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Total Worker Health Intervention Research Employs the Hierarchy of Controls

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The US National Institute for Occupational Safety and Health (NIOSH) has redefined occupational safety and health for the US as safety, health and well-being, which it has termed Total Worker Health® (TWH).

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It has adapted the traditional Hierarchy of Controls, a prioritization strategy validated over decades of safety interventions, to apply to TWH efforts.  A literature review identified TWH interventions and categorized them according to the controls used from the adapted Hierarchy of Controls.

Take-home messages:

  • TWH intervention tactics from each Hierarchy level have produced measurable, positive changes in the workplace
  • The majority of TWH interventions have employed control tactics or methods classified as Educate, the least preferred tactic
  • Most interventions used more than one control strategy from the Hierarchy of Controls
  • Most interventions were aimed at employees, often combined with supervisors

Learning Outcomes

Rationale for a Total Worker Health (TWH) intervention
Restatement of the hierarchy of controls by NIOSH to reflect the TWH definition
The range of TWH interventions that have had a positive impact on workplaces and workforces
Which types of controls are used most frequently in TWH interventions
How some TWH interventions used multiple controls while others used only one


W. Kent Anger
Dr. Kent Anger has a PhD in Experimental Psychology from the University of Maine and served in the Public Health Service as a Scientist Director (Neurobehavioral Toxicology research section) at NIOSH before joining Oregon Health & Science University as the Oregon Institute for Occupational Health Sciences’ Associate Director for Applied Research in 1989. He has been continuously funded since shortly after joining the Institute and has over 90 peer reviewed publications in behavioral neurotoxicology and Total Worker Health® interventions.

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