It is a challenge to identify an area other than occupational injuries that has such a tremendous impact on public health, and yet has had such a limited foundation of sound science to guide prevention. Although workplace safety issues have received attention for more than a century, it is only relatively recently that we have applied a scientific approach to occupational injury prevention, and begun to make progress in building that foundation.Over the years, the direction of occupational injury research has been influenced by the application of the public health approach and by various, collective planning eVorts. This article discusses the public health approach to occupational injury research, and reviews some of the past strategic planning eVorts to highlight where we have gone and where we want to be.In the 1930s and 1940s, the public health community began to realize that injuries, including those that occur at work, could be addressed using the same conceptual frameworks and analytic tools that were being used successfully against infectious and chronic disease. As early as 1937, Godfrey was calling for the application of the public health approach to injury research and prevention.1 Half a century ago, in 1949, John Gordon wrote that injuries are "equally susceptible" to the public health approach as the communicable and chronic diseases of humans.2 He said "accidents as a health problem of populations conform to the same biologic laws as do disease processes and regularly evidence a comparable behavior".
2The public health process identifies and addresses health problems, such as traumatic injuries to workers.3 It consists of several clear steps, beginning with surveillance. Data collection and analysis enable us to pinpoint, prioritize, and monitor illness and injury incidence and develop hypotheses for further research. Analytic injury research enables us to identify, quantify, and prioritize risk and causal factors. Such analyses allow us to identify existing, or develop new, strategies for prevention and control and test their preventive eVectiveness and cost eVectiveness. Then, armed with information about the relative eVectiveness of potential preventive strategies, we can disseminate and transfer that information and technology to the workers at risk, and to those whose decisions can aVect that risk. Finally, after implementation of preventive strategies, we can evaluate the results of those strategies. In theory, the public health process is a straightforward, logical approach to preventing injury. In practice, it has rarely been used to its full extent, following each step from problem identification to implementation and evaluation in the workplace.There are, however, barriers to the full application of the public health process to occupational injuries. These include the need for diverse disciplines to collaborate in research, which means understanding each other's methods and terminology, and learning how to work together; the scarcity of public health educational programs that specifically...