Cuts to NIOSH, OSHA threaten decades of worker-safety progress

Editor's Note

The dismantling of the National Institute for Occupational Safety and Health (NIOSH) jeopardizes worker safety nationwide and risks reversing decades of progress, New England Journal of Medicine October 4 reports.

In April, sweeping federal workforce reductions eliminated more than 80% of NIOSH staff, closing laboratories and freezing core programs. Although some staff were reinstated after a court order, the article reports that NIOSH faces a proposed budget cut from $363 million in fiscal year 2025 to just $73 million in 2026. This drop would reduce per-worker expenditures on occupational health research to less than 50 cents annually, far below other high-income nations.

The authors emphasized NIOSH is the nation’s primary research engine for workplace safety, underpinning Occupational Safety and Health Administration (OSHA) regulations and guidance. Beyond certifying protective equipment and monitoring chemical, biologic, and heat exposures, NIOSH investigates emerging hazards such as opioid exposure among first responders and musculoskeletal injuries among healthcare staff. It also leads training through 18 education and research centers (ERCs) and 12 agricultural health centers. Collectively, these programs have trained more than 20,000 professionals since 1977 and fund nearly all US occupational and environmental medicine residencies. Eliminating this support could effectively end the specialty and worsen shortages of nurses, physicians, and industrial hygienists trained to address occupational injuries and illnesses.

NIOSH research has historically informed lifesaving regulations, such as OSHA’s limits on silica exposure in mining. During the COVID-19 pandemic, NIOSH provided respirator reuse protocols and frontline safety guidelines, and internationally, other countries relied on its expertise. The article warns that weakening the agency will slow OSHA’s ability to respond to emerging risks, leaving standards vulnerable to legal challenge.

The economic stakes are also significant. Occupational hazards cause about 5,500 deaths and 3.2 million nonfatal injuries and illnesses each year, costing employers up to $348 billion. NIOSH initiatives, operating at just 0.3% of the Department of Health and Human Services budget, have historically generated billions in savings annually.

The authors cautioned folding NIOSH into a new regulatory agency would politicize science and erode impartial research. They argued diminishing NIOSH’s capacity will disproportionately harm low-wage, immigrant, and marginalized workers while driving up workers’ compensation costs and preventable workplace deaths. Preserving the agency, they concluded, is critical for protecting the health and safety of the nation’s 160 million workers.