If a stranger passed out on the sidewalk in front of you, how likely would you be to administer mouth-to-mouth?

In our age of no-touch faucets in public bathrooms and special disinfectant wipes for grocery store carts, you wouldn’t be alone if you say you might hesitate.

Happily, two new studies conclude that when it comes to CPR, pressing rhythmically on the chest with your hands is enough to save a life.

No mouth-to-mouth required.

The American Heart Association, which has been promoting hands-only CPR for two years, hopes that bystanders will feel less apprehensive and more likely to act if faced with an emergency.

Studies indicate that fear of doing something wrong, more so than catching something, makes many would-be-heroes freeze. And people may have has good reason to fear doing something wrong when practicing traditional mouth-to-mouth CPR.

The traditional method is a bit complicated, and one study showed that those who did attempt it often didn’t do it very well. For starters, the victim’s head has to be tilted back, the airway cleared, the nose pinched and the mouth completely covered with the rescuer’s.

There are many opportunities for air to escape, and some experts believe that some bystanders perform mouth-to-mouth so poorly that the interruption reduces blood flow.

Yet the aim of CPR is to do some of the mechanical work of the heart by forcing at least some blood and oxygen to the brain and other vital organs, which is why chest compressions work.

The only cases in which mouth-to-mouth seems to make a difference is when the victim is a child, or in cases of adults who have stopped breathing because of choking, drowning or other respiratory problems.

OSHA recently solidified leadership for the agency and has provided a clearer picture of the regulatory horizon.

NIOSH Update: Aging Workers at Higher Risk of Death, Severe Injury, Conference Report Suggests Ways to Keep Workers Healthy and Productive

Policy Shifts on Work Environment, Health Promotion, Continued Research Needed to Maintain Healthy U.S. Workforce

A report of conference presentations and discussions among participants from the National Academies of Science, universities and research institutions, and representatives of professional associations, industry and labor, recommends attention to workplace environments to maintain “work ability” as workers age, along with legislative fixes and research to fill in knowledge gaps for keeping workers healthy and productive.

According to researchers using U.S. Bureau of Labor Statistics (BLS) data, older workers are more severely injured and die with greater frequency from work-related injuries than younger workers. Older workers also have longer recovery periods than younger workers. These findings raise health care delivery and economic issues for the nation, as more workers are choosing to delay retirement due to collapsed 401(k) plans and savings. BLS uses workers age 55 and older in its calculations, although the rates rise sharply for those workers over age 65. Other agencies and organizations define the term as age 50 or 55 and up. The Department of Labor uses age 40 as a starting point for “older worker.”

“The issue of healthy aging is critically important as the U.S. economy is revitalized. As we go forward in time, the demand for workers will grow but fewer workers will be entering the workforce and a larger proportion of the workforce will be older. This is a simple reality of demographics,” said National Institute for Occupational Safety and Health (NIOSH) Director John Howard, M.D. “Having a healthy, productive workforce will help sustain economic growth in the decades ahead. We must take steps now to help all workers stay safe and healthy at work as they age. We must also take steps to address the special needs of older workers who, more and more, will be staying on the job past traditional retirement age.”

The conference, held Feb. 17-18, 2009, at the National Labor College in Silver Spring, Md., paid particular attention to workers in physically demanding jobs, such as construction and health care. Health care cost-containment has meant longer work hours and increased stress among health care workers, which has led to a shortage of nurses. Thirty-nine percent of RNs were 45 years or older in 2002.

Construction workers already suffer the highest number of fatalities in any U.S. industry.  But the death rate among construction workers 55 years and older was nearly 80% higher than that of construction workers under 35 in 2007. And like the rest of the workforce, the average age of a construction worker is rising; it was 40.4 in 2008, which is 4.4 years older than in 1985. The average retirement age among construction workers is 61.

“Our nation loses an average of four construction workers every workday to a job-related incident – and that’s been consistent for more than a decade,” said Pete Stafford, executive director of CPWR – The Center for Construction Research and Training, one of the conference’s co-sponsors. “As we start to rebuild our nation’s crumbling infrastructure and venture into green jobs, we want to make sure jobsites do not become a source of pain and death for older workers who have so much to contribute, especially in mentoring younger workers.”

Howard believes the conference confirms and expands on a 2004 report from the National Academies of Science that recognized the deteriorating conditions facing an aging workforce, to the detriment of workers, their families, and businesses. “Health and Safety Needs of Older Workers” made clear recommendations to increase research efforts toward preventing work-related injury, illness and fatality among aging workers.   These recommendations have yet to be adopted.

“The discussions and recommendations from the conference point to steps that can be taken to address needs identified in the 2004 report  that were never acted upon,” said Jordan Barab, acting Assistant Secretary of Labor for  the Occupational Safety and Health Administration (OSHA). “As those discussions make clear, a sustainable workforce will be a critical component of a secure and prosperous 21st century economy. The work we do now is an investment in a stronger workforce for tomorrow.”

The Healthy Aging for Workers conference was funded through grants from NIOSH and CPWR. The Association of Occupational and Environmental Clinics and the Society for Occupational and Environmental Health were conference sponsors. Additional co-sponsors were AARP, OSHA, the American Public Health Association, the Veterans Administration, and the University of Maryland Work and Health Research Center.

The full conference report and presentations from national and international researchers on occupational health and safety issues can be found on the Society for Occupational and Environmental Health’s Web site.

The WorkLife Initiative is the NIOSH response to the 2004 Steps to a Healthier US Workforce Symposium. That Symposium, organized by NIOSH with over 20 co-sponsors and 50 supporters, reviewed the science, economics, and current practices coordinating health protection and health promotion to improve the health of workers. Symposium participants called on NIOSH to continue to show leadership in promoting research, policy, and practice in these areas.

The first major NIOSH action in the Initiative was to issue a RFA to establish Centers of Excellence. The awards for the two new Centers for Excellence to Promote a Healthier Workforce were announced in late 2006. Each Center will receive $1 million for five years through a cooperative agreement to establish trans-disciplinary research, education, and translation programs to facilitate the integration of health protection and promotion in the workplace. The grant recipients are Dr. Laura Punnett for the Center for the Promotion of Health in the New England Workplace, at the University of Massachusetts at Lowell and Dr. James Merchant for the Healthier Workforce Center for Excellence at the University of Iowa. The Center at the University of Massachusetts Lowell will evaluate several models for integrating health promotion with occupational ergonomic and mental health interventions with a strong emphasis on worker involvement. The University of Iowa Center will investigate the effects of different integrated health protection and health promotion programs tailored to meet the needs of three different work environments. NIOSH will work with these Centers and our other partners to improve the worklife of workers through implementation of this important Worklife Initiative.