In April 1996, The National Institute for Occupational Safety and Health (NIOSH) and
its partners unveiled the National Occupational Research Agenda (NORA
TM), a framework to guide occupational safety and health
research into the next decade. NORA is a tool not only for NIOSH but for the entire
occupational safety and health community. Approximately 500 organizations and
individuals outside NIOSH provided input into the development of the Agenda. Prior
to NORA, there had been no national research agenda in the field of occupational
safety and health (nor any other field) which had captured such
broad input and consensus. This unique process resulted in remarkable agreement
about the top 21 research priorities (see below).
NORA Priority Research Areas
Disease and Injury
Allergic and Irritant Dermatitis
Asthma and Chronic Obstructive Pulmonary Disease
Fertility and Pregnancy Abnormalities
Hearing Loss
Infectious Diseases
Low Back Disorders
Musculoskeletal Disorders of the Upper Extremities
Traumatic Injuries
Work Environment and Workforce
Emerging Technologies
Indoor Environment
Mixed Exposures
Organization of Work
Special Populations at Risk
Research Tools and Approaches
Cancer Research Methods
Control Technology and Personal Protective Equipment
Exposure Assessment Methods
Health Services Research
Intervention Effectiveness Research
Risk Assessment Methods
Social and Economic Consequences of Workplace Illness and Injury
Surveillance Research Methods
|
NORA arose out of a need to address the changes in the U.S. workplace as well as the
increasingly diversified workforce. The distribution of jobs in the U.S. economy
continues to shift from manufacturing to services. Longer hours, compressed workweeks,
shiftwork, reduced job security, and part-time and temporary work are realities of the
modern workplace. The U.S. workforce will grow to an estimated 147 million by the
year 2005, with minorities representing 28 percent of the workforce and women
approximately 48 percent.
NORA also provides a means to target research in areas with the highest likelihood of
reducing the still significant toll of workplace illness and injury. Each day, an
average of 9,000 workers sustain disabling injuries on the job, 16 workers die from
a workplace injury, and 137 workers die from work-related diseases.
These injuries and deaths continue to inflict a tremendous toll in both human and
economic costs. A NIOSH-funded study published in 1997 showed that indirect
and direct costs of occupational injuries and illnesses
totaled $171 billion ($145 billion for injuries and $26 billion for diseases) in 1992.
These costs compare to $33 billion for AIDS, $67 billion for Alzheimer's Disease,
$164 billion for circulatory diseases, and $171 billion for cancer.
These numbers alone point to the need for continued occupational safety and health
research. However, research efforts in both the public and private sector face
limited fiscal resources. Through NORA and its collaborative structure the
nation is better positioned to address the toll of workplace injury, illness, and
death.
The development of NORA was only the first step in the effort between NIOSH and its
many partners to guide and promote occupational safety and health research. Since
NORA was announced, there has been a common commitment to implement the Agenda,
primarily by increasing activities and resources in the 21 priority areas.
Twenty Partnership Teams (the two musculoskeletal priority research areas are being
addressed by one team) were formed to assist in the implementation of the Agenda.
Each team consists of a team leader, NIOSH researchers, and external partners. The
20 Partnership Teams have brought together 130 NIOSH researchers and 160 external
members including representatives from academia, labor, industry, health and safety
organizations, the insurance industry, and other government organizations.
A NORA Liaison Committee and a Federal Liaison Committee also have important roles
in the implementation of NORA. Both committees provide outreach and help guide
the progress and direction of NORA implementation.
Grant Funding
NORA has been successful on many levels, including stimulating new research needed
to address the problem of workplace injury and illness. In 1998, NIOSH and three
Federal partners awarded the largest infusion of funding ever by the Federal
government for extramural occupational safety and health research (part of a
three-year, $24 million commitment). NIOSH joined with the National Heart, Lung,
and Blood Institute (NHLBI), the National Institute of Environmental Health Sciences
(NIEHS), and the National Institute of Arthritis and Musculoskeletal and Skin
Diseases (NIAMS) to award about $8 million in grants in ten NORA priority research
areas, with NIOSH awarding 38 grants related to the 1998 NORA Request for Applications
(RFA) and the partner NIH Institutes awarding 12 grants.
In 1999, NIOSH and six other Federal agencies announced two new RFAs totaling at
least $9 million in nine priority research areas. In March 1999, NIOSH, in
partnership with five other NIH Institutes, announced a new RFA to target grant
funding in eight NORA priority research areas (committing to at least
$7.5 million in grant funds). The NIH cosponsors for this FY 99 NORA grants
initiative are: the National Cancer Institute (NCI), NHLBI, the National Institute
on Aging, the National Institute on Deafness and Other Communication Disorders, and
NIEHS. In April 1999, NIOSH, the Environmental Protection Agency, and NCI announced
the availability of $1.5 million for grant applications for research that focuses on
the development of cancer risk assessment methods and practices.
NIOSH also committed additional resources in FY 99 to investigator-initiated awards
in all 21 priority areas through its regular grants process. NORA is achieving its
goals of improved partnership and increased research in the 21 priority research
areas.
NIOSH NORA Funding
Early in the NORA process, NIOSH made a commitment to redirect some of its resources
to the 21 NORA priority areas. Out of an overall FY 96 operating budget of $165.3
million, the NIOSH baseline investment in the NORA priority areas was $15.4 million
(approximately 9% of the budget). Of this, $8.7 million was devoted to intramural
research (NIOSH-conducted) and cooperative agreements (NIOSH-funded extramural
research that NIOSH initiates and participates in) and $6.7 million to research
grants (extramural investigator-initiated projects). A redirection of resources in
FY 97 nearly doubled this investment to $28.1 million.
A new $5 million special Congressional appropriation to NIOSH in FY 98 for NORA,
coupled with additional reinvestment of baseline monies into NORA priority areas,
resulted in a $46.9 million investment (about 25% of the budget) in NORA priority
areas for FY 98. In FY 99, continued Congressional support for NORA as well as
ongoing internal resource allocation has resulted in an estimated
$62.4 million of NIOSH research funds (31% of the budget) directed at NORA priority
areas.
NIOSH NORA Investment
Other Federal Funding
As part of NORA, a survey of Federal occupational safety and health research is
conducted biennially. The first survey, covering FY 96, provided a baseline
identifying a total of only $39 million spent for all occupational safety and
health research outside of NIOSH for a total Federal investment of $204 million.
The second survey, covering FY 98, welcomed five new Federal respondents. Even
with the additional respondents, the total spending in occupational safety and
health research by Federal agencies in FY 98 was only $218 million (NIOSH $187
million and other Federal agencies $31 million). The FY 96 baseline for NORA-related
research from non-NIOSH Federal sources was about $15 million. In FY 98, the
non-NIOSH Federal total spent on NORA-related research was $23.4 million.
Federal partners will continue to perform the survey biennially, with the next
survey assessing FY 2000 expenditures.
Team Accomplishments
The Partnership Teams have also had much success in collaborating with key stakeholders,
defining research needs, and leveraging resources for research. Sixteen teams have
published or are writing white papers and NIOSH and its partners have sponsored 20
major meetings related to NORA as a whole or to specific priority areas. The teams
have also developed surveys, established graduate-level training programs, participated
in continuing medical education workshops, and developed documents.
Additional successes for NORA include NORA's selection as a semifinalist for the
prestigious Innovations in American Government Award sponsored by the Ford Foundation
and administered by Harvard University's John F. Kennedy School of Government.
August 1999
The number of organizations using NORA as a model for creating research agendas or
other types of partnership and planning is also noteworthy. Examples include the
European Agency for Safety and Health at Work, the Department of Defense, the
Japanese National Institute of Industrial Health, and the Chemical Industry Institute
of Toxicology.
To obtain a copy of the
National Occupational Research Agenda (No. 96-115),
the NORA Update 1999
(No. 99-124)
or Partnership
Team products call:
1-800-35- NIOSH
(1-800-356-4674)
or visit the NORA site on the
NIOSH Home Page at:
http://www.cdc.gov/niosh/norhmpg.html
