Supporters may push for NIOSH break from CDC

Reorganization still unsettling for NIOSH

Supporters of the National Institute for Occupational Safety and Health (NIOSH) are continuing their push to protect its independence and stature. Although Congress effectively halted a reorganization of NIOSH that would have affected NIOSH’s status within the Centers for Disease Control and Prevention (CDC), NIOSH supporters remain concerned about its future and may ask Congress to consider whether NIOSH should be moved, perhaps under the National Institutes of Health.

The CDC reorganization would have placed NIOSH within the Center for Environmental and Occupational Health and Injury Prevention. Report language in the fiscal year 2005 spending bill directs CDC "to make no changes to NIOSH’s current operating procedures and organizational structure and ensure that no funds or personnel will be transferred from NIOSH to other components of CDC by means other than traditional reprogramming of funds." The report language is nonbinding, and the spending bill only applies until Oct. 1, 2005.

CDC director Julie L. Gerberding, MD, MPH, will continue to honor that directive, according to spokeswoman Kathy Harben. "The congressional language was very clear. We have complied with it, and we will continue to do so," Harben says.

To further signal its support for NIOSH, Congress approved $287.7 million for the institute, an increase over the administration’s budget request.

"This is one of the few occasions where all the stakeholders agree on something," says Frank A. White, vice president of ORC Worldwide, a Washington, DC-based firm that specializes in occupational safety and health consulting for large corporations. NIOSH has built support over the past five to seven years as it worked to address the needs of business, labor, and academia, White says. "They’ve really done a good job of having a balanced, thoughtful, useful research agenda," he says. "Industry sees that this kind of reorganization has the potential to chip away at NIOSH’s independence, and NIOSH’s ability to work effectively and, at the end of the day, NIOSH’s ability to carry out its statutory mission."

The strong endorsements of NIOSH carry political weight. "That [congressional action] indicates there is very strong bipartisan support for NIOSH within the Congress," says Sharon Morris, assistant chair for community outreach in the Depart-ment of Environmental and Occupational Health Sciences at the University of Washington in Seattle. Morris has served as a legislative officer for NIOSH and on its board of scientific counselors.

"I have never in all of those years seen such widespread, bipartisan, labor and management, and academic support for NIOSH," she says. "It seems a shame to me that NIOSH can’t take advantage of that and move forward and do what it was mandated to do by Congress."

Last year, Gerberding announced the Futures Initiative, a reorganization that she said would position the agency to face the challenges of the 21st century: preparedness against infectious, environmental, and terrorist threats and health promotion and prevention of disease, injury, and disability. In the plan, NIOSH became part of the Coordinating Center for Environmental Health, Injury Prevention and Occupational Health, which includes the National Center for Environmental Health/Agency for Toxic Substances and Disease Registry and the National Center for Injury Prevention and Control. Gerberding touted the new synergy of these centers.

"The agency needed to be better connected on overarching issues," explains Harben.

But for NIOSH supporters, the change meant a loss of status and visibility. NIOSH was created in 1970 by the Occupational Safety and Health Act to be the research counterpart to the Occupational Safety and Health Administration (OSHA), and despite its position as a part of CDC, it maintained a measure of independence. But with the reorganization, the director of NIOSH would report to the Coordinating Center’s director, not to Gerberding.

The NIOSH perspective is unique and could get lost in the larger CDC mission, worries Aaron Trippler, director of governmental affairs for the American Industrial Hygiene Association in Fairfax, VA. "Since 9-11, we believe the focus and responsibility of CDC has increased tremendously, but that responsibility is more focused on public health," he says. "NIOSH is the only agency in the federal government that is actually doing research on occupational health. With CDC spending more of its resources on public health, we’re concerned that NIOSH would lose its focus."

For example, NIOSH supporters have noted that the coordinating center does not include the word "safety," a common part of the nomenclature for organizations in the occupational safety and health arena. The new CDC calendar has no photos relating to occupational safety and health and excludes Workers Memorial Day, they say.

On a more pragmatic note, they worry about the millions of dollars NIOSH contributes to the infrastructure of CDC. NIOSH’s primary sites are in Cincinnati; Morgantown, WV; and Pittsburgh; and it is based in Washington, DC, while the CDC is based in Atlanta.

Gerberding tried to ease those concerns. After an August meeting with stakeholders, she added the word "occupational" to the agency’s primary goal of protection against "emerging infectious, environmental, and terrorist threats."

She stressed that the NIOSH headquarters would remain in Washington, DC, and that it would continue to "brand its products."

Gerberding said the CDC’s organizational chart would include workers and employers as "customers and partners." And the NIOSH director would continue to have direct access to OSHA, the Department of Labor, and the Mine Safety and Health Administration.

Through a separate management initiative of the secretary of Health and Human Services, 14 NIOSH budget analysts now report to the financial management office in CDC. But no other positions have been altered, Harben says. NIOSH director John Howard will report directly to Gerberding, as directed by Congress.

NIOSH supporters remain wary. They say they will ask Congress to convene oversight hearings on NIOSH and the CDC reorganization, and perhaps will ask for a General Accounting Office report on the question of whether NIOSH should be moved. "Now may be the time to say, "Let’s take a look at this,’" says Trippler.

NIOSH belongs in CDC, as other CDC centers conduct research that relates to the wellness and health promotion among employees, Harben says. "NIOSH’s role, which is protecting the health and safety of workers, is very much a part of CDC’s mission of protecting the health and safety of all Americans," she says.