Understanding occupational safety and health surveillance: expert consensus on components, attributes and example measures for an evaluation framework

Background Occupational safety and health (OSH) surveillance systems track work-related fatalities, injuries and illnesses as well as the presence of workplace hazards and exposures to inform prevention efforts. Periodic evaluation is critical to the improvement of these systems to meet the demand for more timely, complete, accurate and efficient data processing and analysis. Despite the existence of general guidance for public health surveillance evaluation, no tailored guidance exists for evaluating OSH surveillance systems to date. This study utilized the Delphi technique to collect consensus among experts in the United States on surveillance elements (components, attributes and measures) to inform the development of a tailored evaluation framework. Methods A Delphi study approach with three survey rounds invited an expert panel to rate and comment on potential OSH surveillance evaluation framework elements, resulting in an optimal list of elements through the panel’s consensus. Additionally, experts completed a review of OSH surveillance systems they worked with and answered questions regarding the development of an evaluation framework. Descriptive statistics of the ratings were compiled for the Delphi process. Major themes from experts’ comments were further identified using content analysis to inform contextual information underlying their choices. Results Fifty-four potential experts across the United States were contacted to participate in the Delphi study. Ten experts began the first survey round with eight then seven experts continuing in the subsequent rounds, respectively. A total of 64 surveillance components, 31 attributes, and 116 example measures were selected into the final list through panel consensus, with 134 (63.5%) reaching high consensus. Major themes regarding current OSH surveillance focused on resources and feasibility, data collection, flexibility, and the inter-relatedness among elements. Conclusions A Delphi process identified tailored OSH surveillance elements and major themes regarding OSH surveillance. The identified elements can serve as a preliminary guide for evaluating OSH surveillance systems. A more detailed evaluation framework is under development to incorporate these elements into a standard yet flexible approach to OSH surveillance evaluation.