2.4.2. Hierarchy of Controls Applied to NIOSH *Total Worker Health*®

In 2015, the Office for TWH published the *Hierarchy of Controls Applied to NIOSH Total Worker Health*® (Figure 3)—adapted from the Hierarchy of Controls framework used in OSH—to strengthen the link between traditional OSH approaches and TWH and to further illustrate the value of this kind of approach to practitioners who are quite familiar with this means toward risk mitigation [31]. As in the traditional hierarchy, the controls and strategies are in descending order of likely effectiveness and protectiveness. The emphasis on addressing system-level or environmental determinants of health before individual-level approaches is a key tenet of the TWH approach.

**Figure 3.** Hierarchy of Controls Applied to NIOSH *Total Worker Health*®.
