COLLABORATIVE PROGRAM FOR THE IDENTIFICATION AND PREVENTION OF WORK-RELATED
MUSCULOSKELETAL DISORDERS
Release Date: March 15, 2000
RFA: OH-00-003
National Institute for Occupational Safety and Health
Letter of Intent Receipt Date: April 12, 2000
Application Receipt Date: May 15, 2000
PURPOSE
The Centers for Disease Control and Prevention (CDC) announces the
availability of fiscal year (FY) 2000 funds for cooperative agreement
(U01) applications from single institutions or consortia of
institutions who are capable of, and interested in, participating in a
Musculoskeletal Disorders Consortium (MSDC). The goal of the MSDC is
to conduct a prospective cohort study to quantify the risk for upper
limb and low back MSDs at varying levels of exposure to physical job
stressors (repetitive, forceful exertion, awkward postures, vibration,
manual handling, etc.). This research will involve multiple work sites
from the service and manufacturing industries with job tasks that
represent a range of exposures to physical job stressors that can
result in carpal tunnel syndrome (CTS), hand-wrist tendinitis, medial
and lateral epicondylitis, hand-arm vibration syndrome (HAVS), and low
back pain.
HEALTHY PEOPLE 2010
CDC is committed to achieving the health promotion and disease
prevention objectives of Healthy People 2010, a national activity to
reduce morbidity and mortality and improve the quality of life. This
announcement is related to the focus area of occupational safety and
health. For information on the conference on Healthy People 2010,
visit the internet site: http://www.health.gov/healthypeople.
ELIGIBILITY REQUIREMENTS
Applications may be submitted by public and private nonprofit and for-
profit organizations and by governments and their agencies, that is,
universities, colleges, research institutions, hospitals, other public
and private nonprofit and for-profit organizations, State and local
governments or their bona fide agents, including small, minority and/or
women-owned businesses. Applications from minority and women
investigators are encouraged.
MECHANISM OF SUPPORT
The administrative and funding instrument to be used for this program
will be a cooperative agreement (U01), an assistance mechanism, in
which substantial NIOSH scientific and/or programmatic involvement with
the awardee is anticipated during performance of the activity. Under
the cooperative agreement, the NIOSH purpose is to support and/or
stimulate the recipient"s activity by involvement in and otherwise
working jointly with the award recipient in a partner role. Details of
the responsibilities, relationships and governance of the study to be
funded under cooperative agreement(s) are discussed later in this
document under the section Terms and Conditions of Award.
The total project period for an application submitted in response to
this present RFA may not exceed five (5) years. The anticipated award
date is September 1, 2000. The award and level of support depends on
receipt of applications of high scientific merit.
For this RFA, an applicant may only submit applications that are
limited in scope to one of the three topics for this RFA. On the face
page of the application, line two, the applicant must indicate the
research area of the 1) upper limb MSDs (CTS, hand-wrist tendinitis,
epicondylitis) at varying levels of hand activity, exertion, and other
physical stressors in job tasks, 2) HAVS in relation to use of
vibrating tools, and 3) low back pain in relation to physical demands
of lifting and manual handling tasks. If an applicant wishes to apply
for more than one research area, you must submit a separate and
independent application. Applications which address more than one of
the RFA topics will be returned as non-responsive.
AVAILABILITY OF FUNDS
Approximately $900,000 is available in FY 2000 to fund three awards.
The maximum amount that maybe requested is $350,000 total cost (direct
and facilities and administrative (F&A) costs) per year.
Continuation awards within an approved project period will be made on
the basis of satisfactory progress as evidenced by required reports and
the availability of funds.
Use of Funds
Recipient should allocate funds for travel for two project staff to
attend annual meeting held during each project year.
RESEARCH OBJECTIVES
Background
Work-related Musculoskeletal Disorders (MSDs) remain a large and costly
disease to our society even though there have been many advances in
understanding the ergonomics of work. In 1996, a total of 600,390
work-related musculoskeletal injury cases resulting in work absence or
restriction were reported to be caused by overexertion and repetitive
motion by the Bureau of Labor Statistics (BLS). Because the BLS
annual survey does not cover approximately one-third of workers, this
figure significantly underestimates the overall incidence of MSDs in
the American workforce. Of all MSD cases, sixty-nine percent were low
back or distal upper limb disorders. The magnitude of the problem in
today’s workforce is confirmed by workers compensation data. For
instance, in Washington State between 1990 and 1997, 27% of all
workers compensation claims and 46% of the cost of all claims resulted
from non-traumatic musculoskeletal disorders of the neck, upper
extremity or back. The results from this research program will provide
practitioners in occupational health critical data that will facilitate
their identification of job tasks that represent low, moderate and high
risk for MSDs, and that will provide a knowledge base for effective job
design changes or interventions. Because of the limitations of cross-
sectional and retrospective studies, it widely agreed that a
prospective study design is the best approach for this problem.
An integral part of this initiative is the establishment of a
Musculoskeletal Disorders Consortium (MSDC). For this program, it is
important that data elements which will be shared between awardees are
managed in a uniform and compatible format. In addition, because much
of the shared data elements are centered on job tasks and workers, a
critical role of the MSDC will be to assure that job tasks are studied
using uniform exposure assessment methods and that workers undergo
standard health tests to identify MSDs. In order to accomplish that
goal, the MSDC will establish a Coordination Committee (CC), comprised
of one voting representative from each member of the consortium, to
serve as the main governing board for the conduct of this research
program. In addition, the CC will serve as an advisory body for the
common or shared protocols to be used in the studies. NIOSH staff will
serve as non-voting members of the CC.
Through the MSDC, it is anticipated that an outcome of this research
program will be better defined exposure-response relationships between
job physical stressors and musculoskeletal disorders across industries.
These data, when complete, will be used to test and expand existing
guidelines for limiting exposure to physical job stressors, and for
developing new guidelines where none exist. In addition, it is
anticipated that practitioners in occupational health will be able to
use the results from this study to more quickly and reliably
discriminate job tasks that represent low, moderate and high risk for
MSDs. With such knowledge effective job design changes or
interventions can be developed that reduce the burden of work-related
MSDs.
The MSDC will combine the expertise and resources of NIOSH research
staff with those of external collaborators. It is anticipated that
this consortium will involve up to three extramural partners that
demonstrate expertise in one or more of the following research areas:
1) upper limb MSDs (CTS, hand-wrist tendinitis, epicondylitis) at
varying levels of hand activity, exertion, and other physical stressors
in job tasks, 2) HAVS in relation to use of vibrating tools, and 3) low
back pain in relation to physical demands of lifting and manual
handling tasks. Individual investigators are encouraged to analyze and
publish data from the work sites they study as soon as they are able
to. In addition, each investigator will be responsible for providing
data to a data coordinating center in a uniform fashion. The site for
the center will be one of the awardees who is selected by CC. The
awardee selected as the data center will be allowed to request, for
consideration of funding, a small administrative supplement to support
this activity. This center will serve as the data resource for the
analysis by the consortium investigators of the pooled data from all
work sites in collaboration with the MSDC.
Objectives and Scope
The intent of this initiative is to assemble a cross-disciplinary,
multi-institutional consortium to define the relationships between
physical job stressors and upper limb and low back MSDs. To accomplish
this objective, it is envisioned that the following research areas be
examined: 1) upper limb MSDs (CTS, hand-wrist tendinitis,
epicondylitis) at varying levels of hand activity, exertion, and other
physical stressors in job tasks, 2) HAVS in relation to use of
vibrating tools, and 3) low back pain in relation to physical demands
of lifting and manual handling tasks.
There is evidence of causal relationships between job physical
stressors (repetitive or static exertion, forcefulness, awkward
postures, e.g.) and MSDs, and some quantitative information is
available on how much rates of MSDs change at varying levels of
exposure to each stressor and combination of stressors (exposure-
response relationships). Additional information would foster the
further development of effective intervention strategies. It is
projected that this consortium would consist of three interrelated
projects previously identified for three independent awards. It is
important that the applicant include in their application not only the
number of subjects to be included in the study, but also a
justification for the subject number.
USEFUL REFERENCES
National Institute for Occupational Safety and Health. National
Occupational Research Agenda. Cincinnati, OH: U.S. Department of Health
and Human Services, Public Health Service, Centers for Disease Control
and Prevention, National Institute for Occupational Safety and Health,
DHHS (NIOSH) Publication No.96-115
(http://www.cdc.gov/niosh/nora.html).
National Institute for Occupational Safety and Health. Musculoskeletal
Disorders and Workplace Factors. Department of Health and Human
Services, Public Health Service, Centers for Disease Control and
Prevention, National Institute for Occupational Safety and Health, DHHS
(NIOSH) Publication No.97-141 (http://www.cdc.gov/niosh/ergosci1.html).
APPLICANT CAPABILITIES
Applicants with established resources and facilities to recruit study
sites and to enroll workers willing to participate in the study in a
cost effective manner are encouraged.
The following should be addressed in a clear and organized manner (see
also peer review criteria section):
o Time line: a detailed time line for the proposed study must be
included in the application.
o In a separate section labeled ,Participant Notification of Study
Results, the applicant should describe plans for notifying participants
about their individual results and the overall results of the study.
Applicants should highlight unique expertise and/or unusual
opportunities as related to the purpose of this RFA. Examples include,
but are not limited to:
o Expertise in specialized areas with potential applications to the
issues/questions considered in this RFA, such as health effects
assessment of hand-arm vibration, field studies of working populations
experiencing work-related MSDs and experience utilizing the NIOSH
lifting equation,
o Access to specific work sites and working populations that are
willing to participate in studies of work-related MSDs,
o Expertise in assessing work situations and individual job tasks in
relation to the development of work-related MSDs, and/or
o Expertise in interviewing workers and negotiating with work site
management - in field settings.
COORDINATION COMMITTEE AND ANNUAL MSDC MEETINGS
Applicants should include in their budget support for themselves and
for at least one other person from their institutions integrally
involved in the project to attend an annual program meeting of all
members of the MSDC. The meeting will be of one or two days duration
and will be held at a site mutually acceptable to study collaborators.
The initial meeting will be in Washington, DC.
The applicant should also budget for attendance at four Coordination
Committee (CC) meetings of the MSDC during the first year and two in
each subsequent year. For budget preparation and project planning
purposes, it should be assumed that these meetings will be held in
Cincinnati, Ohio. However, the CC will determine later where and when
recurring CC meetings will be held. The CC chair will coordinate the
meetings to review and assess overall progress and provide the
opportunity for investigators to exchange information and discuss
research issues.
TERMS AND CONDITIONS OF AWARD
The Terms and Conditions of Award, below, will be incorporated in all
awards issued as a result of this RFA. It is critical that each
applicant include specific plans for responding to these terms. These
special Terms of Award are in addition to and not in lieu of otherwise
applicable OMB administrative guidelines, HHS Grant Administration
Regulations at 45 CFR Parts 74 and 92, and PHS Grants Policy Statement.
Under the cooperative agreement, the NIOSH purpose is to support and/or
stimulate the recipient"s activity by involvement in and otherwise
working jointly with the award recipient in a partner role, but it is
not to assume direction, prime responsibility, or a dominant role in
the activity. Consistent with this concept, the dominant role and
prime responsibility for the activity resides with the awardee(s) for
the project as a whole, although specific tasks and activities in
carrying out the studies will be shared among the awardees and the
NIOSH collaborators where appropriate, including the following.
1. Recipient Responsibilities
The recipient will coordinate project activities, scientifically and
administratively at the awardee institution and at the other sites that
may be supported by sub-contractors to this award. The applicant will
have primary authority and responsibility to define objectives and
approaches, to plan, conduct, and analyze data, and to publish
results, interpretations, and conclusions of studies conducted under
the terms and conditions of the cooperative agreement award. In
addition, the applicant is responsible for coordination of the
individual study with the CC. Recipient will
a. enroll and follow-up of the study participants and establish and
maintain mechanisms to ensure that data collection and management
procedures have necessary quality control and assure confidentiality of
data,
b. provide study participants with individual notification letters
when medical tests are performed,
c. serve as a permanent member of the CC,
d. develop and submit semiannual progress reports,
e. collaborate in the scientific reporting of findings,
f. provide program management oversight for the project, and
g. notify study participants of the overall study results.
2. NIOSH Responsibilities
NIOSH anticipates having substantial scientific programmatic
involvement during conduct of this activity, through technical
assistance, advice, and coordination.
a. serve as a scientific liaison between the awardee and other program
staff at NIOSH with experience in the occupational health issues of
MSDs and epidemiology,
b. provide expert consultation in the area of occupational
epidemiology,
c. provide technical advice on monitoring of field data collection,
developing operating guidelines, quality control procedures, and
developing policies/protocols for dealing with recurrent situations,
d. facilitate collaborative efforts to compile and disseminate program
results through presentations and publications,
e. assist in the development of human subjects protocols for the CDC
Institutional Review Board (if required) and in the preparation of OMB
(and other) clearances that may be required during the conduct of the
study,
3. Collaborative Responsibilities
The CC will serve as the main governing board for the cooperative
agreements making up the MSDC. NIOSH staff and one external scientist
at the recipient organizations representing the three project areas
will have membership on the CC.
One critical role of the CC is to ensure that the study designs and
data collection protocols are uniform and compatible across the MSDC.
The CC may, when it deems it to be necessary, invite additional, non-
voting scientific advisors to the meetings at which research priorities
and opportunities are discussed.
It is anticipated that there will be four CC meetings during the first
year and two in each subsequent year, but the actual number and
locations of the meetings will be determined by the CC itself. The
initial planning meeting will be organized by NIOSH and held in
Cincinnati soon after the award, but subsequent meetings will be
organized by the CC. The committee chair will schedule the meetings
and will be responsible for developing the meeting agenda, chairing the
meetings, and producing CC reports.
At the Planning Meeting, the CC may:
o discuss the required populations and recruitment approaches to be
used,
o discuss and set initial recruiting targets and schedules,
At the second and subsequent meetings, the CC may: 1) make
recommendations on the study protocols and data collection approaches,
2) discuss the study populations that have been/will be recruited for
the three studies, 3) identify and recommend solutions to unexpected
study problems and 4) discuss ways to efficiently coordinate and
combine common study activities.
HUMAN SUBJECTS REQUIREMENTS
If a project involves research on human subjects, assurance (in
accordance with Department of Health and Human Services Regulations, 45
CFR Part 46) of the protection of human subjects is required. In
addition to other applicable committees, Indian Health Service (IHS)
institutional review committees also must review the project if any
component of IHS will be involved with or will support the research.
If any American Indian community is involved, its tribal government
must also approve that portion of the project applicable to it. Unless
the grantee holds a Multiple Project Assurance, a Single Project
Assurance is required, as well as an assurance for each subcontractor
or cooperating institution that has immediate responsibility for human
subjects. The Office for Protection from Research Risks (OPRR) at the
National Institutes of Health (NIH) negotiates assurances for all
activities involving human subjects that are supported by the
Department of Health and Human Services.
INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS
It is the policy of the Centers for Disease Control and Prevention
(CDC) to ensure that individuals of both sexes and the various racial
and ethnic groups will be included in CDC-supported research projects
involving human subjects, whenever feasible and appropriate. Racial and
ethnic groups are those defined in OMB Directive No. 15 and include
American Indian or Alaska Native, Asian, Black or African American,
Hispanic or Latino, Native Hawaiian or Other Pacific Islander.
Applicants shall ensure that women, racial and ethnic minority
populations are appropriately represented in applications for research
involving human subjects. Where clear and compelling rationale exist
that inclusion is inappropriate or not feasible, this situation must be
explained as part of the application. This policy does not apply to
research studies when the investigator cannot control the race,
ethnicity, and/or sex of subjects. Further guidance to this policy is
contained in the Federal Register, Vol. 60, No. 179, pages 47947-47951,
and dated Friday, September 15, 1995.
LETTER OF INTENT
Prospective applicants are asked to submit, by April 12, 2000, a letter
of intent that includes a descriptive title of the proposed research,
name, address, and telephone number of the Principal Investigator,
identities of other key personnel and participating institutions, and
number and title of the RFA in response to which the application may be
submitted.
Although a letter of intent is not required, is not binding, and does
not enter into the review of subsequent applications, the information
allows NIOSH staff to estimate the potential review workload and to
avoid conflict of interest in the review.
The letter of intent is to be sent to:
Ann M. Cronin
National Institute for Occupational Safety and Health
Centers for Disease Control and Prevention
1600 Clifton Road, N.E.
Building 1, Room 3070B, MS D-40
Atlanta, GA 30333
Telephone 404-639-2277
Fax 404-639-0035
Email: axc2@cdc.gov
APPLICATION PROCEDURES
Applicants must use Form PHS 398 (rev. 4/98). Application kits are
available at most institutional offices of sponsored research and may
be obtained from the Division of Extramural Outreach and Information
Resources, National Institutes of Health, 6701 Rockledge Drive, MSC
7910, Bethesda, MD 20892-7910, telephone 301/710-0267, Email:
grantsinfo@nih.gov. Application kits are also available at:
http://grants.nih.gov/grants/forms.htm.
The RFA label available in the PHS 398 (rev. 4/98) application form
must be affixed to the bottom of the face page of the application.
Failure to use this label could result in delayed processing of the
application such that it may not reach the review committee in time for
review. In addition, the RFA title and number must be typed on line 2
of the face page of the application form and the YES box must be
marked.
The sample RFA label available at:
http://grants.nih.gov/grants/funding/phs398/label-bk.pdf has been modified to
allow for this change. Please note this is in pdf format.
Submit a signed original of the application, including the Checklist,
and three signed photocopies, in one package to:
Center for Scientific Review (CSR)
National Institutes of Health
6701 Rockledge Drive, Room 1040 - MSC 7710
Bethesda, MD 20892-7710
Bethesda, MD 20817 (for express/courier service)
At the time of submission, two additional copies of the application
must also be sent to:
Ann M. Cronin
National Institute for Occupational Safety and Health
Centers for Disease Control and Prevention
1600 Clifton Road, N.E.
Building 1, Room 3070B, MS D-40
Atlanta, GA 30333
Applications must be received by May 15, 2000. If an application is
received after that date, it will be returned to the applicant without
review. CSR and NIOSH will not accept any application in response to
this RFA that is essentially the same as one currently pending initial
review, unless the applicant withdraws the pending application. CSR
and NIOSH will not accept any application that is essentially the same
as one already reviewed. This does not preclude the submission of a
substantial revision of an application already reviewed, but such an
application must follow the guidance in the PHS Form 398 application
instructions for the preparation of revised applications, including an
introduction addressing the previous critique.
REVIEW CONSIDERATIONS
Upon receipt, applications will be reviewed for completeness by CSR and
responsiveness by NIOSH. Incomplete and/or non-responsive applications
will be returned to the applicant without further consideration. Those
applications that are complete and responsive, will undergo further
scientific merit review in accordance with the criteria stated below
for scientific/technical merit by an appropriate peer review group
convened by NIOSH.
All applications will be judged on the basis of the scientific merit of
the proposed project and the documented ability of the investigators to
meet the RESEARCH OBJECTIVES of the RFA. Although the technical merit
of the proposed protocol is important, it will not be the sole
criterion for evaluation of a study. Other considerations, such as the
importance and timeliness of the proposed study, access to the study
population, and the interdisciplinary nature of the studies, will be
part of the evaluation criteria.
As part of the initial merit review, all applications will receive a
written critique and undergo a process in which only those applications
deemed to have the highest scientific merit, generally the top half of
the applications under review, will be discussed, assigned a priority
score, and receive a second level review.
Following the scientific review, competitive applications will be
reviewed for programmatic importance by a NIOSH Secondary Review
Committee.
Peer Review Criteria
Applicants are encouraged to submit and describe their own ideas about
how best to meet the goals of the cooperative study and their specific
protocols and are expected to address issues identified under SPECIAL
CONSIDERATIONS AND REQUIREMENTS of the RFA. The review group will
assess the scientific merit of the protocols and related factors as
follows:
Significance: Does this study address an important problem in the area
of work-related musculoskeletal disorders? If the aims of the
applications are achieved, how will scientific knowledge be advanced?
What will be the effect of these studies on the concepts or methods
that drive this field?
Approach: Are the conceptual framework, design, methods, and analyses
adequately developed, well-integrated, and appropriate to the aims of
the project? Does the applicant acknowledge potential problem areas
and consider alternative tactics? Are the plans for the recruitment
and retention of subjects adequate? Is there adequate consideration of
follow up of study participants? Is the plan for assembling work sites
and participants suitable for this study? Is the time line for the
studies appropriate and well described? Are the methods for assuring
privacy and maintaining confidentiality of participant records,
including specific protections for computerized data systems adequate?
Innovation: Does the project employ novel concepts, approaches, or
methods? Are the aims original and innovative? Does the project
challenge existing paradigms or develop new methodologies or
technologies?
Investigators: Are the Principal Investigator, Co-Principal
Investigators and their teams appropriately trained and have adequate
experience to carry out this work? Is the work proposed appropriate to
the experience level of the principal investigator and his/her
collaborators?
Environment: Does the scientific environment in which the work will be
done significantly contribute to the probability of success? Do the
proposed experiments take advantage of unique features of the
scientific environment or employ useful collaborative arrangements? Is
there evidence of institutional support? Does the proposed project
utilize an existing resource or constitute a new one?
In addition to the above criteria, all applications will also be
reviewed with respect to the following:
o The reasonableness of the proposed budget and duration in relation
to the proposed research.
o The adequacy of plans to include both genders, minorities and their
subgroups, for the scientific goals of the research.
o The adequacy of the proposed protection for humans, animals or the
environment, to the extent they may be adversely affected by the
project proposed in the application.
Programmatic Review Criteria:
o Magnitude and severity of the problem the worker population.
o Likelihood of developing technical knowledge for the prevention of
occupational safety and health hazards on a national or regional basis.
AWARD CRITERIA
Applications will be considered for award based upon (a) scientific and
technical merit, (b) program importance, (c) program balance (at least
one award will be made for each area), and (d) availability of funds.
SCHEDULE
Letter of Intent Receipt Date: April 12, 2000
Application Receipt Date: May 15, 2000
Anticipated Award Date: September 1, 2000
INQUIRIES
Written and telephone inquiries concerning this RFA are encouraged.
The opportunity to clarify any issues or questions from potential
applicants is welcome.
Direct inquiries regarding programmatic issues to:
Michael J. Galvin, Jr. Ph.D.
Research Grants Program
National Institute for Occupational Safety and Health
Centers for Disease Control and Prevention
1600 Clifton Road, N.E.
Building 1, Room 3053, MS D-30
Atlanta, GA 30333
Telephone: 404/639-3343
FAX: 404/639-4616
Email: mtg3@cdc.gov
Direct inquiries regarding grants management to:
Sheryl L. Heard, Grants Management Specialist
Grants Management Branch, Procurement and Grants Office
Announcement 00044
Centers for Disease Control and Prevention
2920 Brandywine Road, Room 3000
Atlanta, Georgia 30341
Telephone: (770) 488-2723
Email address: slh3@cdc.gov
PAPERWORK REDUCTION ACT
Projects that involve the collection of information from 10 or more
individuals and funded by cooperative agreement will be subject to
review by the Office of Management and Budget (OMB) under the Paperwork
Reduction Act.
AUTHORITY AND REGULATIONS
The Catalog of Federal Domestic Assistance number is: 93.262 for the
National Institute for Occupational Safety and Health (NIOSH). This
program is authorized under the Public Health Service Act, as amended,
Section 301(a) [42 U.S.C. 241(a)], and the Occupational Safety and
Health Act of 1970, Section 20(a) [29 U.S.C. 669(a)]. The applicable
program regulation is 42 CFR Part 52.
LOBBYING RESTRICTIONS
Applicants should be aware of restrictions on the use of HHS funds for
lobbying of Federal or State legislative bodies. Under the provisions
of 31 U.S.C. Section 1352, recipients (and their sub-tier contractors)
are prohibited from using appropriated Federal funds (other than
profits from a Federal contract) for lobbying congress or any Federal
agency in connection with the award of a particular contract, grant,
cooperative agreement, or loan. This includes grants/cooperative
agreements that, in whole or in part, involve conferences for which
Federal funds cannot be used directly or indirectly to encourage
participants to lobby or to instruct participants on how to lobby.
In addition no part of CDC appropriated funds, shall be used, other
than for normal and recognized executive-legislative relationships, for
publicity or propaganda purposes, for the preparation, distribution, or
use of any kit, pamphlet, booklet, publication, radio, television, or
video presentation designed to support or defeat legislation pending
before the Congress or any State or local legislature, except in
presentation to the Congress or any State or local legislature itself.
No part of the appropriated funds shall be used to pay the salary or
expenses of any grant or contract recipient, or agent acting for such
recipient, related to any activity designed to influence legislation or
appropriations pending before the Congress or any State or local
legislature.
SMOKE-FREE WORKPLACE
The CDC strongly encourages all grant and contract recipients to
provide a smoke-free workplace and promote the non-use of all tobacco
products. In addition, Public Law 103-227, the Pro-Children Act of
1994, prohibits smoking in certain facilities (or in some cases, any
portion of a facility) in which regular or routine education, library,
day care, health care, or early childhood development services are
provided to children. This is consistent with the CDC mission to
protect and advance the physical and mental health of the American
people.
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