Occupational Epidemiology

McAdam’s documented that the estimated number of OS&H professionals employers expect to hire is substantially higher than the number estimated to be produced from OS&H training programs. The Council of State and Territorial Epidemiologists (CSTE) has indicated that upwards of 2,200 additional epidemiologists will be needed just at the state level nationally to fill vacancies, with an estimated 135 needed in occupational and environmental health (CSTE, 2021; Arrazola et al, 2017). Addressing ongoing issues related to drug use in in the workplace, transportation and construction injuries, and unique exposures in battery manufacturing, the distillery industry, and the traditional high-risk industries of agriculture, fishing, and forestry remain a concern. The NIOSH Future of Work Initiative highlighted critical issues and priority topics related to emergency and disaster preparedness, extreme weather conditions, the growth of the “gig” industry, and technological job displacement are among top government and worker concerns in our region (Felknor et al., 2023, Schulte et al, 2022). While perhaps two-thirds of epidemiologists in state and regional positions are focused on infectious disease and recently COVID response, an increase of 56% for filling positions in the Environmental Public Health Tracking program and occupational injury surveillance are needed (CSTE, 2021) .

The Occupational Epidemiology core trains masters and doctoral students to assume professional positions in applied epidemiology, with a focus on workplace health and safety. Since 2012, the Occupational Epidemiology program at the University of Kentucky has been placing its graduates in state and federal government positions, including at NIOSH and the CDC, within industries, and at universities and research organizations, with employers who conduct research and implement programs and interventions to make the workplace safer and healthier.

Students who are admitted to the MS in epidemiology, the MPH in Public Health (epidemiology concentration) or the PhD program in Epidemiology and Biostatistics in the College of Public Health may contact the faculty or program Director about their interest in becoming an Occupational Epidemiology Core Trainee. Students’ graduate school applications, career interests, and personal interviews are used to determine acceptance into our program. Trainees are provided tuition, a monthly stipend, and health insurance if needed, from the federal training grant. Trainees are also provided financial support for their research and funding for travel to conferences and professional meetings to present their work.

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The academic home for the Occupational Epidemiology Core Training program is within the Department of Epidemiology and Environmental Health in the College of Public Health. Rich collaborations with a wide variety of industry, government, and academic partners are a strength of this academic program. Having our occupational epidemiology program associated with the resources of the Southeast Center for Agricultural Health and Injury Prevention (SCAHIP), the Kentucky Injury Prevention and Research Center (KIPRC), and the Division of Epidemiology and Health Planning at the Cabinet for Health and Family Services has been an invaluable asset. Many of our graduates have transitioned to jobs at major research universities and government agencies, like NIOSH and other divisions of the Centers for Disease Control and Prevention (CDC).

Students interested in the Occ Epi training program and who receive CARERC funding are required to be enrolled in an approved graduate degree program (MS, MPH, Ph.D.), have their application reviewed and approved by the director of the program, and plan to enroll in the required core courses. Students in the training program must minimally meet the admissions requirements of the Department of Epidemiology and Environmental Health in the College of Public Health, which includes a minimum cumulative grade point average (cGPA) of 3.25, an undergraduate degree in either a science, social science, mathematics, or health-related field. To be accepted within our Ph.D. program, the required master’s level GPA is 3.2 or above and a holistic review of their application materials. For candidates in the Ph.D. program, two courses in differential and integral calculus are also required. In addition, the prior coursework of Ph.D. students is closely reviewed about their performance in statistics, epidemiology, and other science courses. Also, candidates accepted into the program must receive the written endorsement of a faculty member in the department willing to act as the thesis or dissertation advisor. International applicants will not be accepted into the Occ Epi training program as part of the CARERC funding.

In addition to the trainee’s degree-specific course requirements, all Occupational Epidemiology Core trainees are required to complete CPH 617: Occupational and Environmental Epidemiology (3 hours). Occupational Epidemiology core trainees must also complete the three required CARERC interdisciplinary courses [(Occupational and Environmental Health II course (CPH 620), OHS seminar (CPH 716), and OHS field surveys (BAE678)] for 7 credit hours)]. These courses are approved to serve as electives for students in the masters and doctoral degree programs.

The Occupational Epidemiology Core Trainees will develop the following competencies:

1. Differentiate between environmental and occupational epidemiologic study designs and assess their relative strengths and weaknesses.
2. Evaluate the potential for confounding and interaction in epidemiologic data and understand approaches for addressing validity issues in epidemiologic research.
3. Appreciate the issues associated with sample size estimation and the precision of estimates in the design and evaluation of epidemiologic studies.
4. Perform and interpret analyses of exposures linked to health outcomes for estimation of measures of associations.
5. Be familiar with the interpretation, strengths, limitations, and assumptions associated with using various statistical methods for the analysis of epidemiologic data.
6. Evaluate literature of environmental and occupational epidemiology in a systematic and critical manner for assessing associations between exposures and health outcomes.

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Within the program, the MPH students complete a capstone, MS students complete a master’s thesis, and PhD students complete a dissertation. A portion of the trainee’s thesis or dissertation must focus on a selected occupational, environmental, or injury-focused health or safety problem. Facilities, equipment, and financial resources are available to support faculty-mentored student research. To help support trainee research, the Occupational Epidemiology Core is closely allied with the Southeast Center for Agriculture Health and Injury Prevention (SCAHIP) and the Kentucky Injury Prevention and Research Center. Training in human subjects’ research is a requirement for all students in our degree programs. Although several courses (including the Capstone course (CPH 607) and Epidemiologic Study Design (EPI 714)) provide content regarding informed consent, data protection, and confidentiality, the standardized course offered by the University IRB provides the most comprehensive training on these issues and is a requirement for our students.

Capstone (MPH Program). The capstone is the culminating experience required of all MPH graduates. Students select faculty from the core or supporting list as advisors for their capstone or research which needs to be on an occupational or environmental health topic of interest for trainees. Consultations with the members of a student’s committee are formalized through several established milestone meetings in the development of the capstone research to enhance feedback and critique of the student’s work. Successful defense of the capstone is required for the student to graduate.

Master’s Thesis (MS Program). The thesis research will need to be an original scientific project using either primary or secondary data with a population (epidemiologic) or clinical trials focus. The thesis must be developed under the direction of a Full or an Associate member of the Graduate Faculty. Completing the thesis will require the formation of a master’s thesis committee. At least 3 people shall constitute the thesis committee. One of the members must be a Full member of the Graduate School, and at least 2 of the 3 members must be faculty from the Department of Epidemiology and Environmental Health in the College of Public Health. The scope of the thesis shall demonstrate independence, mastery of research skills, and thoughtful reflection of the results in accordance with guidelines given in the CPH student handbook and the rules of the graduate school.

Dissertation (PhD Program). Ph.D. students develop a traditional dissertation following completion of their comprehensive and oral exams. Dissertations that include primary data collection are especially encouraged for doctoral students. The dissertation research will be an original scientific contribution which is integrative in the sense that either advanced biostatistical methods are applied to a population based epidemiologic study of sufficient size and appropriate design or original theoretical research is undertaken with applied research problems. Ordinarily, a dissertation document will produce at least two manuscripts of publishable quality and an integrative literature review of the research area. The scope of the project will demonstrate independence, mastery of research skills, thoughtful reflection of the results, and contribute to new knowledge in the field of investigation.

From its beginning until August of 2023, there have been 19 graduates from the occupational epidemiology training program (one MD-PhD), and 3 students are continuing in the program for the 2023/2024 academic year. Among these graduates, 7 have completed a DrPH degree in epidemiology, 3 have completed a PhD in epidemiology and biostatistics, and 9 have completed an MPH degree in epidemiology, one of which did so as part of a joint MD-MPH program. All graduates from the program have been successfully placed in positions relevant to their degrees.

Our graduates are currently working in state health departments in Kentucky, Tennessee, Virginia, at academic research universities, including the University of Washington, the University of Indiana, the University of Connecticut, and University of Kentucky, and at NIOSH and Divisions within the CDC.

Kentucky has a strong history in developing public health epidemiologists who serve our geographic region. State government in Kentucky has worked to develop a system of regional epidemiologists located throughout the state. Many of the current regional epidemiologists were trained through our program. Our placement success is one strong indication of need. Since its founding, the CARERC has provided leadership in training, continuing education, and coordination of applied research activities relevant to our region.