Bernard J. Healey, PhD, is director of the Graduate Program in Health Care Administration, King's College, Wilkes-Barre, Pennsylvania, and Professor of Health Care Administration. Formerly, he was a public health epidemiologist for the Commonwealth of Pennsylvania.Kenneth T. Walker, CSP, is president of Endless Mountains Safety Consulting, Inc., Tunkhannock, Pennsylvania and adjunct professor at the University of Scranton. Previously, he was Industrial Hygiene, Safety, Emergency Response, and Technical Equipment Safety Manager for Proctor and Gamble Corporation. In 2009 he was elected a regional director for the American Society of Safety Engineers.

• Figures, Tables, and Exhibits xiIntroduction xvAcknowledgments xixThe Authors xxiThe Contributors xxiiiPart One Public Health Prevention Focus 11 History and Importance of Public Health 3A Brief History of U.S. Public Health 4Healthy People 2010 8Responsibilities of Public Health 11Public Health Accomplishments 11Emphasis on Prevention Not Control 14Public Health and Occupational Health 16Summary 25Key Terms 25Questions for Discussion 252 Epidemiology of Occupational Safety and Health 27Introduction to Epidemiology 28Surveillance Systems 31Epidemiology Studies 33Health Hazard Evaluations 35Public Health Systems in the Workplace 37Chronic Disease Epidemiology in the Workplace 38Summary 39Key Terms 39Questions for Discussion 39Part Two Occupational Safety and Health 413 History and Importance of Occupational Safety and Health 43Health, Disease, and Prevention 48The Role for Public Health 51Summary 54Key Terms 55Questions for Discussion 554 Occupational Injuries 57Epidemiology of Injuries 58The Case for an Epidemiological Approach 59Epidemiology of Accidents 66Epidemiology of Violence 68Surveillance Systems for Occupational Injuries 69Surveillance Results 70Injury Prevention Programs 73Future Challenges 77Summary 78Key Terms 80Questions for Discussion 805 Compliance versus Prevention 81OSHA Standards Development 84The Inspection Process 88Compliance or Prevention 90Prevention of Cumulative Problems 93Summary 93Key Terms 93Questions for Discussion 93Part Three Public Health Issues in Occupational Safety and Health 956 Toxicology 97Application to Occupational Epidemiology 98Subdisciplines in Toxicology 99Classification of Toxic Agents 100Environmental Tobacco Smoke 103Risk Assessment 104Toxicology Case Studies 105Toxin Regulation and Research 105Summary 108Key Terms 109Questions for Discussion 1097 Stress 111Stress Basics 112Workplace Characteristics and Stress 116Organizational Response to Stress 117When to Get Help 122Summary 122Key Terms 122Questions for Discussion 1238 The Impaired Employee 125Drug Use Frequency and Demographics 127Epidemiology of Addiction 129Substances Often Abused 134Drug-Free Workplaces and EAPs 136Summary 140Key Terms 140Questions for Discussion 1419 Wellness Programs 143Chronic Diseases in the Workplace 145The Value of Wellness Programs 146Addressing Obesity and Nutrition 147Addressing Physical Inactivity 151Addressing Tobacco Use 153Developing Comprehensive Health Programs 155The Role for Public Health 157Summary 159Key Terms 160Questions for Discussion 16010 Emergency Response Planning 161Definitions 162Emergency Management Planning Steps 162Terrorism and Bioterrorism 164Workplace Preparedness for Terrorism 167CDC’s Strategic Workplace Plan 168Applying Epidemiology to Preparedness 168Applying an Information Model to Preparedness 174Involving OSHA and NIOSH in Planning 175Summary 176Key Terms 177Questions for Discussion 17711 Ergonomics 179Two Approaches: Broad and Narrow 181Ergonomists’ Roles and Experience 187Few Absolute Limits 188Cumulative Trauma Disorders 189The Industrial Athlete 195Summary 198Key Terms 198Questions for Discussion 19812 Communicable Diseases 199Epidemiology of Communicable Diseases 200Foodborne and Waterborne Diseases 202Tuberculosis 203Hepatitis 204HIV and AIDS 207Influenza 208Emerging Infections 209Summary 213Key Terms 213Questions for Discussion 21413 Vision and Hearing Issues 215Protecting Vision in the Workplace 216Protecting Hearing in the Workplace 223Summary 231Key Terms 232Questions for Discussion 23214 Occupational Health Disparities 233Disparate Populations 234How Do Health Disparities Persist? 251Future Trends in Health Disparities 256Summary 257Key Terms 258Questions for Discussion 258Part Four Evaluation and Leadership Issues in Prevention 25915 Economic Impacts of Prevention 261Premature Mortality 262Employer Health Insurance Costs 262The Purposes of Economic Evaluation 264The Burden of Injury and Illness 264Types of Economic Analysis 266Target Areas for Evaluation 268Summary 276Key Terms 277Questions for Discussion 27716 Impacts of Leadership and Culture 279Using Vision and Management Skills 282Using Power Effectively 284Exercising Transformational Leadership 286Changing the Process of Work 287Motivating Employees 287Building a Culture 288Empowering Workers 290Improving Team Effectiveness 291Summary 292Key Terms 292Questions for Discussion 292References 293Index 313

Bernard J. Healey, PhD, is director of the Graduate Program in Health Care Administration, King's College, Wilkes-Barre, Pennsylvania, and Professor of Health Care Administration. Formerly, he was a public health epidemiologist for the Commonwealth of Pennsylvania.Kenneth T. Walker, CSP, is president of Endless Mountains Safety Consulting, Inc., Tunkhannock, Pennsylvania and adjunct professor at the University of Scranton. Previously, he was Industrial Hygiene, Safety, Emergency Response, and Technical Equipment Safety Manager for Proctor and Gamble Corporation. In 2009 he was elected a regional director for the American Society of Safety Engineers.

• Figures, Tables, and Exhibits xiIntroduction xvAcknowledgments xixThe Authors xxiThe Contributors xxiiiPart One Public Health Prevention Focus 11 History and Importance of Public Health 3A Brief History of U.S. Public Health 4Healthy People 2010 8Responsibilities of Public Health 11Public Health Accomplishments 11Emphasis on Prevention Not Control 14Public Health and Occupational Health 16Summary 25Key Terms 25Questions for Discussion 252 Epidemiology of Occupational Safety and Health 27Introduction to Epidemiology 28Surveillance Systems 31Epidemiology Studies 33Health Hazard Evaluations 35Public Health Systems in the Workplace 37Chronic Disease Epidemiology in the Workplace 38Summary 39Key Terms 39Questions for Discussion 39Part Two Occupational Safety and Health 413 History and Importance of Occupational Safety and Health 43Health, Disease, and Prevention 48The Role for Public Health 51Summary 54Key Terms 55Questions for Discussion 554 Occupational Injuries 57Epidemiology of Injuries 58The Case for an Epidemiological Approach 59Epidemiology of Accidents 66Epidemiology of Violence 68Surveillance Systems for Occupational Injuries 69Surveillance Results 70Injury Prevention Programs 73Future Challenges 77Summary 78Key Terms 80Questions for Discussion 805 Compliance versus Prevention 81OSHA Standards Development 84The Inspection Process 88Compliance or Prevention 90Prevention of Cumulative Problems 93Summary 93Key Terms 93Questions for Discussion 93Part Three Public Health Issues in Occupational Safety and Health 956 Toxicology 97Application to Occupational Epidemiology 98Subdisciplines in Toxicology 99Classification of Toxic Agents 100Environmental Tobacco Smoke 103Risk Assessment 104Toxicology Case Studies 105Toxin Regulation and Research 105Summary 108Key Terms 109Questions for Discussion 1097 Stress 111Stress Basics 112Workplace Characteristics and Stress 116Organizational Response to Stress 117When to Get Help 122Summary 122Key Terms 122Questions for Discussion 1238 The Impaired Employee 125Drug Use Frequency and Demographics 127Epidemiology of Addiction 129Substances Often Abused 134Drug-Free Workplaces and EAPs 136Summary 140Key Terms 140Questions for Discussion 1419 Wellness Programs 143Chronic Diseases in the Workplace 145The Value of Wellness Programs 146Addressing Obesity and Nutrition 147Addressing Physical Inactivity 151Addressing Tobacco Use 153Developing Comprehensive Health Programs 155The Role for Public Health 157Summary 159Key Terms 160Questions for Discussion 16010 Emergency Response Planning 161Definitions 162Emergency Management Planning Steps 162Terrorism and Bioterrorism 164Workplace Preparedness for Terrorism 167CDC’s Strategic Workplace Plan 168Applying Epidemiology to Preparedness 168Applying an Information Model to Preparedness 174Involving OSHA and NIOSH in Planning 175Summary 176Key Terms 177Questions for Discussion 17711 Ergonomics 179Two Approaches: Broad and Narrow 181Ergonomists’ Roles and Experience 187Few Absolute Limits 188Cumulative Trauma Disorders 189The Industrial Athlete 195Summary 198Key Terms 198Questions for Discussion 19812 Communicable Diseases 199Epidemiology of Communicable Diseases 200Foodborne and Waterborne Diseases 202Tuberculosis 203Hepatitis 204HIV and AIDS 207Influenza 208Emerging Infections 209Summary 213Key Terms 213Questions for Discussion 21413 Vision and Hearing Issues 215Protecting Vision in the Workplace 216Protecting Hearing in the Workplace 223Summary 231Key Terms 232Questions for Discussion 23214 Occupational Health Disparities 233Disparate Populations 234How Do Health Disparities Persist? 251Future Trends in Health Disparities 256Summary 257Key Terms 258Questions for Discussion 258Part Four Evaluation and Leadership Issues in Prevention 25915 Economic Impacts of Prevention 261Premature Mortality 262Employer Health Insurance Costs 262The Purposes of Economic Evaluation 264The Burden of Injury and Illness 264Types of Economic Analysis 266Target Areas for Evaluation 268Summary 276Key Terms 277Questions for Discussion 27716 Impacts of Leadership and Culture 279Using Vision and Management Skills 282Using Power Effectively 284Exercising Transformational Leadership 286Changing the Process of Work 287Motivating Employees 287Building a Culture 288Empowering Workers 290Improving Team Effectiveness 291Summary 292Key Terms 292Questions for Discussion 292References 293Index 313

Bernard J. Healey, PhD, is director of the Graduate Program in Health Care Administration, King's College, Wilkes-Barre, Pennsylvania, and Professor of Health Care Administration. Formerly, he was a public health epidemiologist for the Commonwealth of Pennsylvania.Kenneth T. Walker, CSP, is president of Endless Mountains Safety Consulting, Inc., Tunkhannock, Pennsylvania and adjunct professor at the University of Scranton. Previously, he was Industrial Hygiene, Safety, Emergency Response, and Technical Equipment Safety Manager for Proctor and Gamble Corporation. In 2009 he was elected a regional director for the American Society of Safety Engineers.

• Figures, Tables, and Exhibits xiIntroduction xvAcknowledgments xixThe Authors xxiThe Contributors xxiiiPart One Public Health Prevention Focus 11 History and Importance of Public Health 3A Brief History of U.S. Public Health 4Healthy People 2010 8Responsibilities of Public Health 11Public Health Accomplishments 11Emphasis on Prevention Not Control 14Public Health and Occupational Health 16Summary 25Key Terms 25Questions for Discussion 252 Epidemiology of Occupational Safety and Health 27Introduction to Epidemiology 28Surveillance Systems 31Epidemiology Studies 33Health Hazard Evaluations 35Public Health Systems in the Workplace 37Chronic Disease Epidemiology in the Workplace 38Summary 39Key Terms 39Questions for Discussion 39Part Two Occupational Safety and Health 413 History and Importance of Occupational Safety and Health 43Health, Disease, and Prevention 48The Role for Public Health 51Summary 54Key Terms 55Questions for Discussion 554 Occupational Injuries 57Epidemiology of Injuries 58The Case for an Epidemiological Approach 59Epidemiology of Accidents 66Epidemiology of Violence 68Surveillance Systems for Occupational Injuries 69Surveillance Results 70Injury Prevention Programs 73Future Challenges 77Summary 78Key Terms 80Questions for Discussion 805 Compliance versus Prevention 81OSHA Standards Development 84The Inspection Process 88Compliance or Prevention 90Prevention of Cumulative Problems 93Summary 93Key Terms 93Questions for Discussion 93Part Three Public Health Issues in Occupational Safety and Health 956 Toxicology 97Application to Occupational Epidemiology 98Subdisciplines in Toxicology 99Classification of Toxic Agents 100Environmental Tobacco Smoke 103Risk Assessment 104Toxicology Case Studies 105Toxin Regulation and Research 105Summary 108Key Terms 109Questions for Discussion 1097 Stress 111Stress Basics 112Workplace Characteristics and Stress 116Organizational Response to Stress 117When to Get Help 122Summary 122Key Terms 122Questions for Discussion 1238 The Impaired Employee 125Drug Use Frequency and Demographics 127Epidemiology of Addiction 129Substances Often Abused 134Drug-Free Workplaces and EAPs 136Summary 140Key Terms 140Questions for Discussion 1419 Wellness Programs 143Chronic Diseases in the Workplace 145The Value of Wellness Programs 146Addressing Obesity and Nutrition 147Addressing Physical Inactivity 151Addressing Tobacco Use 153Developing Comprehensive Health Programs 155The Role for Public Health 157Summary 159Key Terms 160Questions for Discussion 16010 Emergency Response Planning 161Definitions 162Emergency Management Planning Steps 162Terrorism and Bioterrorism 164Workplace Preparedness for Terrorism 167CDC’s Strategic Workplace Plan 168Applying Epidemiology to Preparedness 168Applying an Information Model to Preparedness 174Involving OSHA and NIOSH in Planning 175Summary 176Key Terms 177Questions for Discussion 17711 Ergonomics 179Two Approaches: Broad and Narrow 181Ergonomists’ Roles and Experience 187Few Absolute Limits 188Cumulative Trauma Disorders 189The Industrial Athlete 195Summary 198Key Terms 198Questions for Discussion 19812 Communicable Diseases 199Epidemiology of Communicable Diseases 200Foodborne and Waterborne Diseases 202Tuberculosis 203Hepatitis 204HIV and AIDS 207Influenza 208Emerging Infections 209Summary 213Key Terms 213Questions for Discussion 21413 Vision and Hearing Issues 215Protecting Vision in the Workplace 216Protecting Hearing in the Workplace 223Summary 231Key Terms 232Questions for Discussion 23214 Occupational Health Disparities 233Disparate Populations 234How Do Health Disparities Persist? 251Future Trends in Health Disparities 256Summary 257Key Terms 258Questions for Discussion 258Part Four Evaluation and Leadership Issues in Prevention 25915 Economic Impacts of Prevention 261Premature Mortality 262Employer Health Insurance Costs 262The Purposes of Economic Evaluation 264The Burden of Injury and Illness 264Types of Economic Analysis 266Target Areas for Evaluation 268Summary 276Key Terms 277Questions for Discussion 27716 Impacts of Leadership and Culture 279Using Vision and Management Skills 282Using Power Effectively 284Exercising Transformational Leadership 286Changing the Process of Work 287Motivating Employees 287Building a Culture 288Empowering Workers 290Improving Team Effectiveness 291Summary 292Key Terms 292Questions for Discussion 292References 293Index 313