Bullard-Sherwood Research to Practice (r2p) Award Winners and Honorable Mentions: Backgound, 2005
Title:NIOSH Alert: Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings
Authors: Connor TH, Reed LD, Burroughs GE, Mead KR, McDiarmid MA, Power LA, Hammond DR, MacKenzie BA
Source: Division of Applied Research and Technology
Background: A collaborative effort between two National Occupational Research Agenda (NORA) Teams, the Reproductive Health Research and the Control Technology and Personal Protective Equipment Teams, was begun in September 2000. This collaborative effort resulted in the development of the Alert and related research efforts on the protective effectiveness of chemotherapy gloves and on the selection and effectiveness of engineering controls for reducing exposures to hazardous drugs. This unique partnership effort also uncovered contaminated vials originating from some pharmaceutical manufacturers and developed an American Society for Testing and Materials (ASTM) test method for the permeation of chemotherapy drugs through protective glove materials.
Relevance: The purpose of this Alert is to increase awareness among healthcare workers and their employers of the health risks posed by working with hazardous drugs and to provide both workers and employers with measures for protecting worker health. Healthcare workers who prepare or administer hazardous drugs or who work in areas where these drugs are used may be exposed to these agents in the air or on work surfaces, contaminated clothing; medical equipment, patient excreta, and other surfaces. Studies have associated workplace exposures to hazardous drugs with health effects such as skin rashes and adverse reproductive outcomes and possibly leukemia and other cancers. To assist the health care professional in decision making, the Alert contains a list of drugs (Appendix A) that should be handled as hazardous drugs.
Title: Reducing Underground Miners' Exposure to Diesel Emissions
Authors: Schnakenberg G, Jr., Bugarski AD, Noll JD, Patts LD, Mischler SE, Timko RJ, Thimons ED, Watzman B, Wright MJ, Viars B, Ellis M
Source: Pittsburgh Research laboratory
Relevance: In 1988, NIOSH recommended that whole diesel exhaust be regarded as a potential occupational carcinogen. While the American Conference of Industrial Hygienists has recently recommended a diesel particulate matter (DPM) concentration-based threshold limit value of 50 micrograms of particulates per cubic meter, typical mine workers are exposed to levels exceeding 500 micrograms per cubic meter. Approximately 30,000 U.S. miners in underground metal and nonmetal mines are exposed to DPM. In January 2001, the U. S. Mine Safety and Health Administration (MSHA) promulgated a rule limiting the exposure of underground metal/nonmetal (M/NM) miners to diesel particulate matter. Labor and industry were concerned with the ability of current control technologies to meet the standards mandated by these regulations. To address this concern, labor and industry approached NIOSH PRL to form the M/NM Diesel Partnership. While MSHA was not a member of this partnership, it has played an active role in partnership activities. The primary objective of this partnership was to reduce the exposure of underground miners to particulate matter and gaseous emissions from diesel equipment used in underground mines to levels that both meet the standards and provide a healthful working environment for miners. The major thrust of this partnership has been the development and evaluation of DPM monitoring and control technologies for underground mines and the transfer of this technology to the U.S. mining industry and the enforcement agency.
Title: Understanding and Preventing Beryllium Sensitization and Chronic Beryllium Disease
Authors: Schuler CR, Kreiss K, Day GA, Henneberger PK, Hoover MD, Kitt M, Sparks R, Stanton ML, Stefaniak AB, Tift B, Velilla A, McCanlies EA, Weston A, Cummings K
Source: Division of Respiratory Disease Studies, Health Effects Laboratory Division
Relevance: Exposure to beryllium and its compounds results in sensitization of a portion of beryllium workers who are identified by the blood beryllium lymphocyte proliferation test used in workplace screening programs. Cross-sectional screening of current workers in the primary industry documents sensitization rates of up to 10%, and longitudinal followup of worker cohorts that include former workers documents up to 20% cumulative prevalence over 10 years. Sensitized workers are at high risk for chronic beryllium disease, a cell-mediated immunologic lung disease which can result in severe disability and even death. Cross-sectionally, 10-100% of sensitized workers have beryllium disease, depending on job title and length of time since first exposure. Additional cases commonly occur among workers who leave beryllium industry employment, implying life-long risk from occupational exposure to a persistent antigen. NIOSH researchers have estimated that as many as 134,000 US workers are currently exposed to beryllium. The total number of workers who have ever been exposed to beryllium is many times that. Current occupational exposure limits have not prevented beryllium sensitization and disease. The primary beryllium producer, Brush Wellman Inc. (BWI), requested NIOSH assistance in medical surveillance to identify how to protect its own workers and those of its clients in the absence of effective environmental hazard surveillance. This research addresses the NIOSH priority areas of surveillance research, control technology, exposure assessment methods, intervention effectiveness, and dermatologic sensitization (contact dermatitis).
Title: Standards Development for Respiratory Protection Equipment (RPE) used by Emergency Responders at a Chemical, Biological, Radiological, and Nuclear (CBRN) Terrorist Event
Authors: Szalajda J, Metzler R, Boord L, BerryAnn R, Palya F, Monahan G, Thornton T, Cloonan T, Dower J
Source: National Personal Protective Technology Laboratory
Relevance: This project is an excellent example of how to establish partnerships with stakeholders to produce products that improve worker safety and health. The standards development project addresses NIOSH research priorities for Control Technology and PPE.
When engineering and other controls do not reduce exposures below hazardous levels, workers must rely on personal protective equipment. Industries that often require workers to use such equipment include mining, fire fighting and other emergency response, health care, and agriculture. People who respond to hazardous incidents or terrorist activities need assurance that the protective equipment they use will perform to specifications and meet minimum performance standards. According to a recent study conducted jointly with the Bureau of Labor Statistics, approximately 3.3 million workers use NIOSH-certified respirators, including an emergency responder population of approximately 1,100,000 firefighters, 600,000 law enforcement personnel, and 500,000 emergency medical service responders.
In collaboration with the U.S. Army Research, Development, and Engineering Command (formerly SBCCOM) and the National Institute for Standards and Technology (NIST), NIOSH, NPPTL developed respirator standards for use by emergency responders against CBRN terrorism hazards. Partnerships with stakeholders in the process are detailed in subsequent paragraphs.
The efforts of the project team have established the first Chemical, Biological, Radiological, and Nuclear (CBRN) Respirator Protective Equipment (RPE) standards available in the world. The outcome of this work is significant. It allows the establishment of a national inventory of effective respiratory protective equipment to protect emergency responders against CBRN terrorist events. Prior to the development of these standards, this RPE protection did not exist. Unlike industrial environments where characterized hazards are controlled and RPE appropriately selected or battlefield conditions where RPE is designed to perform at a defined threat level, hazards at a terrorist event are normally unknown and uncontrolled during the initial response period. Emergency responders at a terrorist event may encounter more severe hazards than those normally encountered in either the industrial or military setting. The lack of a support structure governing proper selection, performance and use limitations for each respirator, and the inability to interchange consumable components such as respirator filter cartridges, will contribute to the confusion associated with such events. The sum of these unfortunate circumstances can lead to inadequate protection for the incident responders equipped with present RPE.
Title: NIOSH Safety Checklist Program for Schools
Authors: Palassis J, Cauley J, Ellison C, Rogers RR, Jr., Helton N, Doyle G, Becks V, Elliott P, Afanah S, Hamilton A, Weber J, Okun A, Votaw D, Ahlers H, Haring Sweeney M, Chan HS
Source: Education and Information Division
Relevance: The U.S. Bureau of Labor Statistics estimates that each year in the United States, 2.9 million students aged 15-17 worked during the school year, and 4 million during the summer. NIOSH estimates that each year, 200,000 students aged 14-17 suffer work-related injuries, 64,000 required treatments in hospital emergency rooms, and 70 died of work-related injuries. Most of these young workers are students in high schools and vocational schools. More than 100 other young workers died from farm-related injuries. Nearly 20% of these workers were hurt performing tasks prohibited by child labor laws. Young workers have more than double the mean worker injury rate. More than half of injured young workers reported that they had not received any training in how to prevent the injury they sustained. The direct and indirect costs of occupational injuries to young workers amount to $5 billion annually.
Approximately 11 million students attend the 20,000 vocational-technical schools in the United States. Many of these students learn their career in school shops that have the same physical, chemical, and biological hazards encountered in many businesses. The students need training to recognize these hazards and how to control them.
In addition to teaching basic safety and health, a great need exists for an occupational safety and health (OSH) program specific to schools that covers students, faculty, and staff. This need was expressed by numerous teachers in career-technical schools during site visits, focus group, and conferences. In response, the Education and Information Division (EID) of NIOSH developed a safety program and a resource data base in a CD-ROM format. The safety program and its data base were developed through collaboration with many NIOSH partners in schools, colleges, universities, and professional organizations. The main partnering organizations were the Association for Career and Technical Education, SkillsUSA-VICA, the National Association of State Directors for Career and Technical Education consortium, the U.S. Department of Education, the Office of Vocational and Adult Education, the American Association of Community Colleges, the American Society of Safety Engineers. EID used input from these key stakeholders to improve the program contents. Before its publication, the CD-ROM and its contents were uploaded in the NIOSH Web site for a 10-week public review and comment period. The resulting publication is entitled NIOSH Safety Checklist Program for Schools (Publication No. 2004-101) and was printed on a CD-ROM.
Title: Lockout/Tagout, Jammed, and Moving Machinery Controls
Authors: Mowrey GL, Schiffbauer WH
Source: Pittsburgh Research Laboratory
Background: Researchers at the Pittsburgh Research Laboratory (PRL) have developed a proximity warning system that can be used to warn and protect persons working close to stationary or mobile machinery. The technology, identified as the Hazardous Area Signaling and Ranging Device (HASARD) employs a low-frequency, low-powered electromagnetic field as a marker for dangerous areas, similar to an electric fence for a dog. Low-frequency electromagnetic fields, compared to other marking schemes, are quite capable of penetrating, dust, rock, water sprays and even steel. The marker is provided by generating a signal in a properly positioned loop of wire, or a small coil of wire wrapped around a ferrite bar. The resulting signal envelops the dangerous area. The workers must wear a small receiver, which detects and accurately measures the marker field. The receiver, after calibration, is an effective accurate distance measuring device. It is particularly suited to short range occupational situations, e.g., from 0 to 15 feet. Circuitry in the receiver determines the level of danger and, if appropriate, provides the worker with an alert. A wireless data link in the receiver can provide a remote alert to another worker or even shut down the machine, if desired.
The HASARD system design is covered by two patents held by PRL researchers: Patent number 5,939,986 "Mobile Machine Hazardous Working Zone Warning System," August 17, 1999, and Patent number 6,681,353. "Non-Directional Magnetic Field Based Receiver With Multiple Warning and Shutdown Capability".
Relevance: The HASARD system has the potential to significantly reduce traumatic injuries in the workplace, a NIOSH priority research area. Overall, about 16% of worker fatalities (2003, BLS) result from contact with equipment. HASARD can be applied in any workplace where potentially hazardous machinery is found.
Data from the Mine Safety and Health Administration (MSHA) shows that in 2003 there were 1,972 coal mines employing 70,241 workers. In mining an average of 13 fatalities occurred per year due to being run over or pinned by mobile mining equipment on the surface (1994-1998 Mine Safety and Health Administration (MSHA) data). A total of 24 fatalities in underground mines were associated with remote controlled continuous mining machines from 1988 to 2004. Safety can be enhanced in these situations through the introduction of the HASARD worker proximity warning system. In non-mining there were 150 fatalities/year and 6,800 serious injuries/year from workers being caught in machinery (1992-1998, BLS data). Highway and street construction workers are at risk of fatal and serious nonfatal injury while working near construction vehicles and equipment. Between 1995 and 2002, there were an average of 60 vehicle and equipment-related fatalities within work zones, where a worker on foot was stuck by a vehicle. Thirty-seven fatal and 9,000 nonfatal accidents resulted from conveyor-related activities (1995 BLS data). Forty-five fatalities occur annually with forklifts in the United States.
Title: ROPS Technology Transfer Team
Authors: Harris JR, McKenzie EA, Jr., Cantis DM, Etherton JR, Ronaghi, Powers JR, Jr., Lutz TJ, Hudson AJ, Homce GT, Edgell HD, Amendola AA
Source: Division of Safety Research
Relevance: NIOSH innovations in the design of rollover protective structures (ROPS) for agricultural equipment are undeniably relevant in achieving NORA goals to lower the fatality rate among farmers. Farmer fatalities due to tractor overturns exceeded 1490 from 1992 to 2000. Nearly all fatalities due to tractor overturn could be prevented with a rollover protective structure (ROPS) and proper usage of a seatbelt. The NIOSH Agricultural Safety and Health Centers, in conjunction with tractor dealers and manufacturers, have acknowledged the magnitude of this occupational safety and health problem by establishing a specific research focus for tractor overturn prevention within their current National Agricultural Tractor Safety Initiative. Over 4 million tractors are in service in the U.S., of which over 2 million lack the appropriate overturn/rollover protection.
The NIOSH ROPS Technology Transfer Team (RT3) is composed of two groups working synergistically to initiate commercialization of two new devices to protect tractor operators from overturn fatalities. The two groups are the automatically deploying ROPS (AutoROPS) group and the cost-effective ROPS (CROPS) group. Although not yet available for sale, the ground work for commercialization of these two new devices was firmly established in 2004.
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