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Current Projects
RAND is currently conducting several research projects related to workplace health and safety.
Prevention
Evaluation of Effectiveness in Preventing Injuries of a 5% Premium Discount for Firms with Certified Safety Committees
Project Leaders: Hangsheng Liu, Agnes Schaefer, John Mendeloff
Although the evidence about the effectiveness of joint labor-management safety committees in preventing injuries is not clear-cut, it is plausible that they make a contribution. Pennsylvania law requires that WC insurers offer a 5% discount on premiums to firms that stipulate that they meet the criteria for a "Certified Safety Committee." Our study first examines why the take-up rate for the program has not been larger and what reasonable steps might increase it. Next, using establishment-level data, it examines whether Certification is linked to reductions in reported lost-time injuries.
Which Safety Standards Are Most Effective in Preventing Injuries
Project Leaders: Amelia Haviland, Wayne Gray, John Mendeloff, Teague Ruder
A recent study using BLS establishment level data began to examine how the effectiveness of OSHA inspections in preventing injuries varied depending upon the particular standards that were cited in the inspection. It found one type of standard that was clearly effective—citations for violations of personal protective equipment standards. This finding could have important implications for what the focus of OSHA programs as well as of private safety programs should be. But we need more evidence about the robustness of this finding. In this study using PA WC establishment data, we will replicate the earlier study and extend it to look at a larger set of standards.
Predicting Serious Workplace Injuries: How Well Can It Be Done?
Project Leaders: John Mendeloff, Matt Schonlau, Rachel Burns
Many large firms find that an increasing share of the serious injuries at their facilities occur among the employees of contractors they have hired. This concern led to a Contractor Summit in 2006, attended by representatives of many large corporations, which called for research that could provide a more valid basis for predicting safety performance among contractors. Our study is examining the predictive validity of several of the measures currently being used by firms to assess prospective contractors.
Evaluation of Workplace Safety and Injury Prevention Measures for Public Safety Employees
Project Leaders: Tom LaTourrette, Seth Seabury and David Loughran
This project will provide new information about the nature and types of disabling injuries experienced by public safety employees, examine how specific aspects of work activities and environments lead to different types of injuries, and qualitatively evaluate potential workplace interventions aimed at improving the safety and health of public safety workers. To accomplish this, we will review the relevant literature(s), collect and analyze new and existing data on injuries to public safety providers, and conduct panel discussions with public safety community experts. The study complements another ongoing project that looks at differences in the nature of and compensation for disabling workplace injuries and illnesses of public safety employees compared to other public and private employees. While the study population focuses primarily on California, the key findings will have broad applications for the entire country.
How Effective in Preventing Injuries and Illnesses are Mandates Requiring Firms to Establish Safety and Health Progams?
Project Leaders: Tom LaTourette, John Mendeloff
During the 1990s, OSHA worked to develop a proposed regulation that would have required some or all employers to implement a "safety and health program" that would require many activities (e.g., hazard surveys, accident investigations) recommend by safety experts. That regulation was never adopted, but there is discussion that it could be high on the agenda after the 2008 election. In addition, several states have adopted some version of such a rule. What does the existing evidence suggest about the effectiveness of such a requirement? What new research would help to fill the gaps in knowledge and facilitate a more informed decision? Addressing these questions is the goal of our research.
Department of Defense (DOD) Integration of Occupational and Non-occupational Health Services
Project Leaders: Gary Cecchine, Elizabeth Sloss, Christopher Nelson
The objective of this project is first to review and evaluate the structure, capacity and performance of the current programs within DoD that are related to occupational health. Second, it will recommend specific options for DoD to consider in the design of an integrated and comprehensive Employee health Program for its active duty workforce.
Improving Our Understanding of the Use, Misuse, and Non-Use of Personal Protective Equipment (PPE)
Project Leaders: John Mendeloff, Rachel Burns
The National Personal Protective Technology Laboratory at NIOSH is trying to learn more about the status of PPE use and the barriers to improved protection. This study examines OSHA inspection data to identify the particular provisions of PPE standards that are being violated and the types of establishments where these occur.
Compensation
The Full Employer Cost of Workplace Injuries
Project Leaders: Robert Reville, Seth Seabury
Injured workers suffer the brunt of the consequences of workplace injuries, from earnings losses to impacts upon their family and quality of life. However, employers can also experience significant costs from workplace injuries. Arguably, understanding the full magnitude of these costs is as important as understanding the full impact of injuries on workers. Despite this, our understanding of employer costs has not kept pace with our knowledge of the costs borne by workers. This study focuses on how the costs to employers from workplace injuries are related to programs that aid in the prompt return of injured workers. Improved return to work could benefit employers through a number of mechanisms: by reducing the temporary and permanent disability payments, by allowing them to take advantage of the firm-specific human capital of the injured workers and by reducing the potential for an adversarial relationship with the injured workers. This is an area of critical importance in California, because the recent reforms enacted programs to help promote the return of permanently disabled workers. This study will evaluate the effectiveness of these reforms and discuss their implications for employer costs.
Adjusting Disability Ratings to Reflect Diminished Future Earnings and Capacity in Compliance with SB 899
Project Leaders: Robert Reville, Seth Seabury
The passage of SB 899 in California required that the system in workers' compensation to evaluate the severity of permanent disabilities incorporate empirical data on the long-term loss of income experienced by workers with injuries to different parts of the body. However, no previous work has provided enough information on the predicted loss of earnings capacity for different types of injuries to generate a complete set of adjustments to the rating schedule. This work summarizes the average disability ratings and 3-year cumulative proportional earnings losses for 23 different categories of disability. It includes a discussion justifying the use of standard ratings (ratings before age and occupation adjustments), proportional earnings losses calculated at the individual level, and estimates of ratings and losses for three separate regions of the spine. Ongoing work examines the new data collection that is essential for assuring future compliance with the statute.
Evaluate Policies Designed to Improve Return to Work by Disabled Employees
Project Leaders: Seth Seabury, Robert Reville
This project will study how employers and workers respond to recent reforms made to the California workers' compensation system designed to promote the use of programs dedicated to returning injured workers to work, what effect these programs have had on the duration of disability, and how they have affected the adequacy and affordability of workers' compensation benefits. In the course of this analysis, we will obtain and analyze data from the state agencies on earnings and disability benefits for disabled workers at insured firms before and after the introduction of reforms, we will survey self-insured firms about workers' compensation claims and a sample of both insured and self-insured firms about their return-to-work policies, and we will compare California's policies and return to work outcomes to those of other states. This analysis will allow us not only to determine how effective the reforms have been, but also to help inform policymakers about potential new directions to improve outcomes for both employers and injured workers in California.
Injury and Disability Among Public Safety Employees in California: An Evaluation of Workers' Compensation, Disability Retirement and Safety Procedures
Project Leaders: Tom LaTourrette, Seth Seabury and David Loughran
Public safety officers have much higher incidence and cost of injuries that result in disability retirement than other public employees, raising a number of important policy questions. For instance, do workers' compensation and disability retirement benefits provided to public safety employees adequately compensate them for disabling injuries? Do public safety employees retire because of disabilities at earlier ages, and for different types of disabilities, than other public (or private) employees? Do differential patterns of disability retirement contribute to the cost of providing public safety, and to what extent? RAND will undertake a detailed data collection and analysis effort to address these and other related questions with the aim of assisting the Commission on Health and Safety and Workers' Compensation (CHSWC) and the California legislature in their effort to minimize injuries incurred by public safety employees and provide adequate workers' compensation and disability benefits to those who are injured. While the scope of public safety provision is broad, and encompasses a number of dimensions, we will focus the majority of our analysis on the three most common public safety occupations: police officers, firefighters and correctional officers.
Linking Federal and State Data to Study the Long-Term Effects of Injuries
Project Leaders: Robert Reville, Leslie Boden
It is often suspected that many workers with long-term disabilities move from state workers' compensation programs to become beneficiaries of the federal Social Security Disability Insurance system. However, there has been relatively little empirical evidence to study how much overlap there is between the two systems, and how much the incentives imbedded in either system affect the incentives of disabled workers to engage in the other. This project will provide the first linkage between these state and federal data systems, allowing researchers to follow workers as they move from one to the other. This linkage will allow better estimates of the long run consequences of the injuries, both in terms of lost wages for workers and the availability of income support.
Assuring Quality of Care for Carpal Tunnel Syndrome
Project Leader: Teryl Nuckols
Many studies have shown that the quality of the medical care provided in the U.S. is suboptimal. To date the quality of medical care has not been examined directly in workers' compensation settings, where it has unique implications. Better care appears to benefit both workers and payors by reducing disability; two studies have shown that efforts to improve care can cut disability costs by about a third. This study, jointly based at the RAND Corporation and UCLA, has developed measures that can be used to assess care related to carpal tunnel syndrome, and is now undertaking a study to assess quality of care for patients with carpal tunnel syndrome in one large California workers' compensation provider network.
Other Projects
Analytical and Operational Support for NIOSH External Program Review
Project Team: Valerie Williams, Elisa Eiseman and Eric Landree
The objective of this project is to assist the National Institute for Occupational Safety and Health (NIOSH) in preparing for its external program review by the National Academies. Like all Federal agencies, NIOSH must comply with the terms of the Government Performance and Results Act (GPRA) and undertake regular evaluations of program performance, using the Program Assessment Rating Tool (PART). To better direct Federal R&D investment decisions in particular, the Administration provides additional guidance: all Federal R&D programs must assess relevance in terms of national priorities, agency mission, fields of science and technology, and other customer needs retrospectively, prospectively, and externally. For these reasons and to better ensure the applicability of its work in preventing work-related injuries and illnesses, NIOSH has asked the National Academies to assess the relevance and impact of 15 NIOSH research programs. In assisting NIOSH with its National Academies' review, RAND examined the experience of other Federal research agencies in undertaking external program reviews, developed a framework for NIOSH's participation in its own external program reviews, and is working with NIOSH to implement and monitor the program review. The project, including the framework and its application, will serve as the prototype for future external program reviews.
Establishing Strategic Planning Processes for the Associate Director of Science Office at NIOSH
Project Team: Valerie L. Williams, Elisa Eiseman, Eric Landree and Lauren Honess-Morreale
The objective of this project is to assist the Associate Director of Science (ADS) Office at NIOSH in establishing strategic planning processes and articulating and refining central components of its strategic plan, which will include its vision, its mission, and a discrete number of short- and long-term outcome-oriented goals and measures. In conducting the project, RAND will draw on previous work in this area. RAND's approach to strategic planning is based upon the use of a "logic model template," as a structuring tool for development of strategic goals and measures. Although strategic plans are commonly thought of as addressing organizational level issues and logic models are thought of as addressing program level concerns, logic models can be used as a foundation for strategic planning. In fact, developing a logic model can be considered a form of strategic planning since the process requires the articulation of a program's intended outcomes and how the program will work to achieve those ends. RAND will work the ADS Office to prepare logic models that will be the basis for developing outcome-oriented goals and measures. These goals and measures can be used by the ADS Office for on-going monitoring and assessment of progress in achieving strategic goals.
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