Allergic and irritant dermatitis (contact dermatitis) is overwhelmingly the most important cause of occupational skin diseases, which account for 15% to 20% of all reported occupational diseases. There is virtually no occupation or industry without potential exposure to the many diverse agents that cause allergic and irritant dermatitis. Research is needed to better identify the prevalence, causes, exposure assessment methods, and early biologic markers of this ubiquitous condition.

Occupationally-related airway diseases, including asthma and chronic obstructive pulmonary disease (COPD), have emerged as having substantial public health importance. Nearly 30% of COPD and adult asthma may be attributable to occupational exposure. Occupational asthma is now the most frequent occupational respiratory disease diagnosis. More than 20 million U.S. workers are exposed to substances that can cause airway diseases. Research is needed to clarify the prevalence, risk factors, and exposure-disease relationships, to refine techniques for monitoring worker health and the job environment, and to develop effective and practical means for preventing work-related airway diseases in at-risk workers.

While more than 1,000 workplace chemicals have shown reproductive effects in animals, most have not been studied in humans. In addition, most of the 4 million other chemical mixtures in commercial use remain untested. Physical and biological agents in the workplace that may affect fertility and pregnancy outcomes are practically unstudied. The inadequacy of current knowledge coupled with the ever-growing variety of workplace exposures pose a potentially serious public health problem. Over the next 10 years, research priorities should include expanding surveillance systems, studying working populations thought to be at risk, increasing the understanding of fundamental biological processes underlying normal and abnormal reproductive function or outcomes, and enhancing methods to identify hazards before placing human populations at risk.

Disorders of reproduction include birth defects, developmental disorders, spontaneous abortion, low birth weight, preterm birth, and various other disorders affecting offspring; they also include reduced fertility, impotence, and menstrual disorders.

Occupational hearing loss may result from an acute traumatic injury, but it is far more likely to develop gradually as a result of chronic exposure to ototraumatic (damaging to the ear or hearing process) agents. Noise is the most important occupational cause of hearing loss, but solvents, metals, asphyxiants, and heat may also play a role. Exposure to noise combined with other agents can result in hearing losses greater than those resulting from exposure to noise or other agents alone. Research is needed to define further the causal contributions of these hazards (alone or in combination) and to implement and evaluate methods for early detection and hearing conservation programs.

Occupational hearing loss is the most common occupational disease in the United States: it is so common that it is often accepted as a normal consequence of employment. More than 30 million workers are exposed to hazardous noise, and an additional 9 million are at risk from other ototraumatic agents. Occupational hearing loss knows no boundaries with respect to industries. Any worker, young or old, male or female, risks hearing loss when exposed to ototraumatic agents. Once the loss is acquired, it is irreversible.

Although noise-induced occupational hearing loss is the most common occupational disease and is the second most self-reported occupational illness or injury, it has not been possible to create a sense of urgency about this problem. Efforts to prevent occupational hearing loss have been hindered because the problem is insidious and occurs without pain or obvious physical abnormalities in affected workers.

Problems created by occupational hearing loss include the following: (1) reduced quality of life because of social isolation and unrelenting tinnitus (ringing in the ears), (2) impaired communication with family members, the public, and coworkers, (3) diminished ability to monitor the work environment (warning signals, equipment sounds, etc.), (4) lost productivity and increased accidents resulting from impaired communication and isolation, and (5) expenses for workers’ compensation and hearing aids.

Because no national surveillance or injury-reporting system exists, no generalizable data are available regarding the economic impact of occupational hearing loss.

Occupational health problems occur at work or because of the kind of work you do. These problems can include

• Cuts, broken bones, sprains, and strains
• Loss of limbs
• Repetitive motion disorders
• Hearing problems caused by exposure to noise
• Vision problems
• Illness caused by breathing, touching, or swallowing unsafe substances
• Illness caused by exposure to radiation
• Exposure to germs in health care settings

Good job safety and prevention practices can reduce your risk of these problems. Try to stay fit, reduce stress, set up your work area properly, and use the right equipment and gear.

Health care workers are at risk of tuberculosis (TB), hepatitis B and C viruses, and the human immunodeficiency virus (HIV). Social service workers, corrections personnel, and other occupational groups who work regularly with populations having increased rates of TB may also face increased risk. Laboratory workers are at risk of exposure to infectious diseases when working with infective material. Research is needed to determine the extent of occupational transmission of these infectious diseases, to understand the barriers to the use of safe work practices and vaccines, and to develop and evaluate new control methods.

Low back musculoskeletal disorders are common and costly. Although the causes of low back disorders are complex, substantial scientific evidence identifies some work activities and awkward postures as significantly contributing to the problem. In the United States, back disorders account for 27 percent of all nonfatal occupational injuries and illnesses involving days away from work. Prevention activities should be undertaken based on current knowledge, but important new research efforts are needed to assure that work-related low back disorders are successfully prevented and treated. For some occupations and tasks, there is a pressing need for more information about safe levels of exposure and for further validation of promising intervention approaches such as mechanical lifting devices for nursing aides.

Musculoskeletal disorders of the upper extremities (such as carpal tunnel syndrome and rotator cuff tendinitis) due to work factors are common and occur in nearly all sectors of our economy. More than $2 billion in workers’ compensation costs are spent annually on these work-related problems. Workers’ compensation costs undoubtedly underestimate the actual magnitude of these disorders. Current scientific research has provided important insights into the etiology and prevention of these disorders, but important questions remain unsolved. Research needs include better methods of exposure characterization and greater understanding of basic pathophysiologic mechanisms.

Musculoskeletal disorders of the neck and upper extremities due to work factors affect employees in every type of workplace and include such diverse workers as food processors, automobile and electronics assemblers, carpenters, office data entry workers, grocery store cashiers, and garment workers. The highest rates of these disorders occur in the industries with a substantial amount of repetitive, forceful work. Musculoskeletal disorders affect the soft tissues of the neck, shoulder, elbow, hand, wrist, and fingers. These include the nerves (e.g., carpal tunnel syndrome), tendons (e.g., tenosynovitis, peritendinitis, epicondylitis), and muscles (e.g., tension neck syndrome).

Injury exacts a huge toll in U.S. workplaces–on an average day, 16 workers are killed and over 17,000 workers are injured. The associated economic costs are high–about $121 billion per year. Research should focus on leading causes and high-risk groups. Priorities are deaths caused by motor vehicles, machines, violence, and falls, as well as traumatic injuries caused by falls and contact with machines, materials, equipment, and tools. High-risk groups include construction workers, loggers, miners, farmers, farm workers, adolescents, and older workers. Multiple factors and risks contribute to traumatic injuries, including the characteristics of workers, workplace/process design, work organization, economics and other social factors. Research needs are thus broad, and the development of interventions involve many disciplines and organizations.