Public Health Importance of WA BRFSS Worker Health Module

On average, American adults spend more than half of their waking hours at work. Work is a social determinant of health, similar to educational attainment and income. Occupational disparities exist in health status, access to care, risk behaviors, and worksite wellness programs.

The Washington Behavioral Risk Factor Surveillance System (WA BRFSS) is an annual telephone survey that collects data on emerging public health issues, health conditions, and risk behaviors. The Washington State Department of Health operates WA BRFSS and collaborates with SHARP to collect information on industry and occupation, and work-related injuries.

SHARP uses WA BRFSS to enhance the Washington occupational health surveillance system. WA BRFSS is the only statewide source of worker-reported injuries or illnesses, and collects information on workers not available in other sources of occupational injury and illness data.

Uses of WA BRFSS data include:

  • Quantifying prevalence of health behaviors and chronic disease by industry and occupation.
  • Identifying health disparities by industry and occupation.
  • Targeting disease prevention and health promotion programs to at-risk workers.
  • Tracking worker-reported occupational injury and illness incidence.
  • Creating demographic and health profiles of specific populations of workers.

Journal Articles

Howard, N., & Marcum, J. (2020). Comparison of BRFSS Data Between Home-Based Care Providers and Health Care Support Workers in Clinical Environments in Washington State. Workplace Health & Safety. DOI: 10.1177/2165079919857448 

Anderson NJ, and Marcum JL (2019). Using Behavioral Risk Factor Surveillance System Data as an Occupational Health Profile: Washington State Janitors, 2011 to 2017. Journal of Occupational and Environmental Medicine. DOI: 10.1097/JOM.0000000000001652. | Research Findings.

Marcum JL, Chin B, Anderson NJ, Bonauto DK. (2017). Self-Reported Work-Related Injury or Illness — Washington, 2011–2014. Morbidity and Mortality Weekly Report DOI: http://dx.doi.org/10.15585/mmwr.mm6611a6 Research Findings.

Anderson NJ, Fan ZJ, Reeb-Whitaker CK, Bonauto DK, and Rauser E (2014). Distribution of asthma by occupation: Washington State Behavioral Risk Factor Surveillance System Data, 2006-2009. Journal of Asthma. DOI: 10.3109/02770903.2014.939282 | Research Findings.

Bonauto DK, Lu D, and Fan ZJ (2010). Obesity Prevalence by Occupation in Washington State. Preventing Chronic Disease. DOI: 10.5888/pcd11.130219 | Research Findings.

Anderson NJ, Bonauto DK, Fan ZJ, and Spector JT (2012). Distribution of Influenza-Like Illness (ILI) by Occupation in Washington State, September 2009-August 2010. PLoS ONE. DOI: 10.1371/journal.pone.0048806

Fan ZJ, Bonauto DK, Foley MP, Anderson NJ, Yragui NL, and Silverstein BA (2012). Occupation and the prevalence of current depression and frequent mental distress, WA BRFSS 2006 and 2008. American Journal of Industrial Medicine. DOI: 10.1002/ajim.22094

Fan JZ, Anderson NJ, Foley M, Rauser E, and Silverstein BA (2011). The persistent gap in health-care coverage between low- and high-income workers in Washington State: BRFSS, 2003-2007. Public Health Reports. DOI: 10.1177/00333549111260051

Bonauto DK, Fan JZ, Largo TW, Rosenman KD, Green MK, Walters JK, Flattery J, Yu L, Fang S, Davis LK, Valiante DJ, Cummings KR, and Hellsten JJ (2010). Proportion of workers who were work-injured and payment by workers' compensation systems - 10 states, 2007. CDC - Morbidity and Mortality Weekly Report. URL: http://www.ncbi.nlm.nih.gov/pubmed/20671660

Fan ZJ, Bonauto DK, Foley MP, and Silverstein BA (2006). Under reporting of work-related injury or illness to workers' compensation: Individual and industry factors. Journal of Occupational and Environmental Medicine. DOI: 10.1097/01.jom.0000226253.54138.1e

Technical Reports

McHugh A, Marcum J, Bonauto D (2016). ‘BRFSS 2012-2014: Demographic and Employment Characteristics of Cell Phone Only Respondents' Washington State Department of Labor and Industries, SHARP Technical Report


Using the Behavioral Risk Factor Surveillance System (BRFSS) for Occupational Health (2014) This presentation was given during the BRFSS Data Users webinar on August 12, 2014. The presentation summarizes work done by Washington State researchers that uses BRFSS data along with industry & occupation to examine a variety of health conditions facing workers.