The future of NIOSH

A recent request sparks debate on where to house the research institute

Of all the various government agencies, departments and institutes, only one focuses solely on research to prevent occupational injuries and illnesses – NIOSH. This unique role leads many stakeholders to consider NIOSH’s successful performance vital to the occupational safety and health field. “The future of NIOSH is of the utmost importance … to worker health and safety,” American Industrial Hygiene

Association President Lindsay E. Booher said in a letter sent Feb. 2 to several high-ranking legislators. In the letter, Booher solicited the congressional leaders to request a Government Accountability Office study on the pros and cons of NIOSH remaining in its current occupational structure: reporting directly to the Centers for Disease Control and Prevention.

In 2004, a flurry of stakeholders came to NIOSH’s support when CDC suggested an occupational reorganization that would place the institute under a “coordinating center” – a move many believed would diminish or downgrade NIOSH’s importance to CDC and occupational safety and health in general.

CDC decided, at that time, not to change how NIOSH operates or reports. But stakeholder fears that CDC could propose another internal move that would stifle NIOSH or cut its budget has led some to support a reorganization that would move the institute out from under CDC.

Possibilities

“I always thought it would be nice to get an opinion from GAO or someone like that,” said John Howard, former NIOSH director, who called the institute an “interesting entity.” Established by the Occupational Safety and Health Act, NIOSH’s mission was on par with the duties of the Department of Health and Human Services’ secretary, in whose department the institute resides, Howard said. Unlike OSHA, though, NIOSH does not report straight to its department secretary. Instead, NIOSH is a component of one of several operating divisions inside HHS.

“I think that has puzzled stakeholders for a long time,” Howard said, adding that it would be important to seek comment on the organizational placement of NIOSH.

If a study is conducted and concludes that NIOSH would better serve the public elsewhere structurally, where would it end up? AIHA suggests placing the institute under the umbrella of the National Institutes of Health, which is the primary federal agency for conducting research to improve the public’s safety and health. Twenty-seven institutes and centers currently are part of NIH; most are focused on a particular body part or disease.

Not everyone agrees with AIHA’s suggestion. “If NIOSH were moved [to NIH] as a standalone agency, it would be dwarfed by the others’ gigantic budgets and would get only little support from the leadership as an orphan institute lacking a particular body part or disease to its name,” warned Denny Dobbin, interim chair of the Society for Occupational and Environ­mental Health and former chair of the Association of Occupational and Environ­mental Clinics.

Instead of dumping NIOSH into NIH, Dobbin suggested merging NIOSH with another NIH institute – specifically the National Institute of Environmental Health Sciences because both groups focus on researching environmental hazards.

(NIEHS researches the general environment, NIOSH the work environment.) Another possibility would be to have NIOSH report directly to the HHS secretary. Dobbin suggested this would be ideal, but likely too impractical and politically messy given NIOSH’s comparatively diminutive size.

One suggested new home that has almost universally been rejected is the Department of Labor. Howard noted that the statute that created NIOSH and placed it under HHS likely was written to preserve the institute’s autonomy and allow it to make occupational safety and health pronouncements that would not be subject to DOL political influence.

“What we have here is a check-and-balance system that we should treasure and preserve,” Dobbin said. Addi­tionally, such a move would be legislatively complicated, as it would require an amendment to the OSH Act.

Change without changing

Of course, any sort of study on the best place for NIOSH could recommend it stay right where it is. Many of the calls for moving NIOSH out from under CDC stem from the center’s past attempts to ­– as some saw it – diminish NIOSH’s capabilities. Aaron Trippler, AIHA’s government affairs director, said those attempts may stem from CDC’s focus since Sept. 11, 2001, when it began to increase its emphasis on emergency preparedness and the possibility of biological terror attacks.

But if Congress and a new HHS secretary recognize NIOSH’s importance and provide it with adequate resources, Trippler could see NIOSH staying where it is already integrated. He said part of the reason for AIHA’s most recent solicitation of GAO for a study has been the possibility of change coming to Washington.

Will the change in administration be all that is needed to ensure change throughout other levels in government, including CDC? Much depends on the new leadership. Kansas Gov. Kathleen Sebelius (D) had been nominated as HHS secretary at press time, but the nomination had not been confirmed. NIOSH and CDC also were without respective leaders when Safety+

Health went to press. “If things work out correctly, [NIOSH] might be better to stay where it’s at,” Trippler said. “We’re not going to know anything until we get some permanent leadership over there.”

Despite talk of reorganization, new leadership may be the most integral aspect to all of this. Dobbin suggested any GAO study should focus less on where NIOSH belongs and more on how much support CDC managers have given the institute. To Howard, the most vital issue regarding NIOSH is whether or not it has the freedom to fulfill its obligations to issue alerts and inform the public on occupational safety and health issues. “To fulfill their responsibility under the OSH Act – that to me is more important than their location,” he said.