What Now for NIOSH?

The departure of its sixth director, Dr. John Howard, in mid-July hits the safety and health community hard.

Long vacancies are normal for the position of NIOSH director. Only six directors have headed the agency since its creation, and with Dr. John Howard having handed over the post in mid-July to an acting director, Christine Branche, Ph.D., a vacancy of at least six months seems likely this time. The directorship was vacant more than a year between Howard and his predecessor, Dr. Linda Rosenstock, who now serves as dean of the UCLA School of Public Health.

Howard asked for a second six-year term. He has ideal credentials and expertise for the job: M.D., MPH, J.D., LL.M., and past experience as the head of Cal/OSHA, one of the most progressive State Plans in the country. Although he is staying on for "a short time" to advise CDC Director Julie Louise Gerberding, his work leading NIOSH ended July 14. NIOSH is part of CDC, which in turn is part of the U.S. Department of Health and Human Services (HHS).

"Of all the directors that've ever been there, there's never been one that's been better respected and better received than this one, and that was from all stakeholders," said Aaron K. Trippler, government affairs director for the American Industrial Hygiene Association.

Trippler said the decision not to reappoint Howard represents a lost opportunity the Bush administration could have used to prove it cares about workplace health and safety. "I don't know of anybody that opposed him," Trippler said. "Maybe for one of the first times ever, you had labor and employers and the major associations all united. . . . They let the opportunity pass."

Calling NIOSH "an important resource for our 32,000 occupational safety, health, and environmental professional members," American Society of Safety Engineers President Warren Brown, CSP, ARM, CSHM, said, "We were deeply disappointed that the good work of a highly competent federal administrator who brought great distinction to this administration in the eyes of the entire occupational safety and health community could not be allowed to continue. John Howard's command of issues affecting occupational safety and health worldwide is unmatched. He led NIOSH to develop and communicate key research that our members, their employers, and the public use on a daily basis.

"Our own intent is to see that, whatever administration follows in the new year, a similarly meaningful federal occupational safety and health leadership opportunity for John Howard will be offered, and that he accept it," Brown said.

The newsletter Inside OSHA reported in early July that a vice president of the U.S. Chamber of Commerce recommended reappointment in a letter sent to HHS Secretary Mike Leavitt on June 24. The AFL-CIO sent a similar letter June 12, according to the newsletter's report. The AIHA and ASSE presidents and members of the associations sent letters. Even New York Gov. David A. Paterson wrote July 2 to President Bush urging him to reappoint Howard, saying in his letter that Howard "has played a pivotal role in the coordination of 9/11 programs for Ground Zero workers in the aftermath of the terrorist attacks on the World Trade Center. Since 2002, when Dr. Howard was appointed to his current position, he has brought an unmatched expertise, skill and care to his job," the governor added.

"It's very disturbing and, because it doesn't make sense, it feels disingenuous," Sarah Felknor, Dr.PH, director of the University of Texas School of Public Health's Southwest Center for Occupational and Environmental Health and chair of the NIOSH Board of Scientific Counselors, said of the decision not to reappoint Howard. She said Howard had taken NIOSH far from where it had been "in terms of making it current and keeping it current."

"John did a fabulous job. I think he was one of the best directors I've ever known," said Scott Schneider, a member of the Board of Scientific Counselors and also OSH director for the Laborers' Health and Safety Fund of North America. "It wasn't like he went and said, 'Would you write a letter for me.' People just did it because they wanted to and they realized what a good job he was doing."

Schneider said Howard "reinvigorated" the Board of Scientific Counselors, forming workgroups of members and charging them with reviewing NIOSH staff's responses to a series of National Academies reports evaluating how well NIOSH's research programs contribute to workplace health and safety. The series began with a June 2007 evaluation of NIOSH's hearing loss research. "I know it was a lot of work for the [NIOSH] staff, but it was really valuable," Schneider said, explaining that the National Academies' independent, authoritative evaluation of NIOSH's programs would help NIOSH serve its stakeholders better and buttress its funding requests.

Felknor said the National Academies reviews are scientific, independent, credible critiques of core NIOSH programs and were typical of Howard's approach.

One board workgroup submitted a report this year about NIOSH's communications. Schneider, who chaired this workgroup, said the report noted that NIOSH has focused a lot of its communications efforts on publishing technical material, which he said might not be the best strategy to improve conditions in U.S. workplaces. But the agency also has launched a science blog and shares information on Wikipedia, he noted.

These initiatives probably will continue after Howard leaves, said Schneider, who said he personally was "disappointed but not surprised" by the decision not to reappoint.

No Explanation Given
Stakeholders were left to speculate about who made the decision and why. One theory is that Gerberding denied Howard a second term because the safety and health community had fought and defeated (with the help of Congress) her May 2004 plan to end NIOSH's independent status as she reorganized CDC. The plan would have placed NIOSH and three other agencies within the Coordinating Center for Environmental Health, Injury Prevention and Occupational Health. (NIOSH remains a separate entity, and the words "Occupational Health" are not yet part of that center's name.)

AIHA's Trippler said there may be a connection between the failed shift of NIOSH and the Howard decision. "I hope this does not signal a new move by CDC to reorganize NIOSH and move it back to Atlanta," he said. If resentment over the defeated reorganization is behind the decision, Felknor said that makes no sense for two reasons: Because NIOSH was created by a federal statute, it may be impossible to reorganize it without changing that law; also, the safety and health community as a whole and former NIOSH directors rose up against Gerberding's plan, so Howard alone should not pay the price for its fall.

"I'm saddened and distressed about his leaving and don't know what this bodes for the institute and the stakeholder groups. We'll all just have to be vigilant," Felknor said. The next meeting of the Board of Scientific Counselors is in early December 2008.

"It was a little bit of a surprise that the director of CDC would go that far, but the friction between CDC and NIOSH is no secret," said another board member, Associate Professor Joel M. Haight, Ph.D., of Pennsylvania State University. He said he appreciated Howard's strong support for the NIOSH Research to Practice (r2p) initiative. "He was very aggressive on that, and that was a big gap in the past. John has made some very strong efforts to bridge that gap," Haight said. The r2p initiative pushes NIOSH's researchers and scientists to focus on solving real problems in the field. "Why else would you do research?" Haight asked. "The safety world is an applied world, and you've got to make things that are useful now. He has been a big, big supporter and has pushed that whole idea."

Haight noted two related initiatives Howard backed: Safety by Design, through which NIOSH is helping PPE manufacturers design electronics and software technology into personal protective equipment and systems, and Prevention through Design, which brought NIOSH together with multiple partner organizations via workshops and a "PtD in Motion" newsletter. PtD is intended to highlight the value of designing out hazards or risks.

CDC's July 3, 2008, statement announcing the start of its search for Howard's replacement does not say why he wasn't retained, and a "Changes in NIOSH" email Gerberding sent that day to CDC employees gives no reason. "I can't elaborate more on that statement," Tom Skinner, a spokesman for Gerberding's office, said July 9. Asked whether the decision may be reconsidered as some members of Congress -- New York representatives, in particular -- requested, Skinner answered, "I would just say that I'm not aware of any plans to reconsider and that the search for a new director is moving forward."

The acting director, Branche, joined NIOSH as an associate director in 2007 but has been working at CDC for two decades, Gerberding said in her email to the employees. According to this email, Branche was CDC's Goal Team Leader in the Office of Strategy and Innovation when she moved to NIOSH. She joined CDC in 1988 with the Division of Injury Control in what was formerly the National Center for Environmental Health and Injury Control. She became director of the Unintentional Injury Prevention Division of the National Center for Injury Prevention and Control in 1996. In addition to a Ph.D., she has an M.S.P.H. in epidemiology from the University of North Carolina School of Public Health and a B.A. in biology from the University of Rochester.

July 3, 2008, 'All Hands' Email from John Howard to NIOSH personnel:

The time has come for me to move on from my job as NIOSH Director. My six years at NIOSH have been some of the best years of my professional life. The best part of my job was working with you to achieve NIOSH’s mission to generate new knowledge in the field of occupational safety and health and transfer that knowledge into practice. A bonus was the excitement I felt everyday representing NIOSH’s work to employers, workers, safety and health practitioners, associations, unions, professional societies, academics, print and electronic media, and to the general public. The past 72 months working with you has been a privilege I shall cherish for the rest of my life. The recent outpouring of support for me, even though made in reference to my reappointment, was, I believe, support for what we have accomplished together at NIOSH. I know this to be true because all I did these past six years was to offer a few ideas for how NIOSH could improve the relevance, quality and impact of its work. Yet, it was not me who made actual accomplishments out of any of those ideas -- it was you. In taking my leave, I do so with a heavy heart, but please know that I wish for each of you much success and satisfaction in both your personal life as well as in your professional life. Finally, I thank you for all your many kindnesses to me over the past six years.

Have a safe and happy Fourth of July!

John Howard

This article originally appeared in the August 2008 issue of Occupational Health & Safety.

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