At the request of the U.S. Congress, the National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention (CDC) issued a report in 1995 entitled Report to Congress on Workers' Home Contamination Study Conducted Under the Workers' Family Protection Act. This report was prepared in response to the 1992 Workers' Family Protection Act (Public Law 102-522) [29 USC* 671], which included a request to NIOSH to conduct a study to "evaluate the potential for, prevalence of, and issues related to the contamination of workers' homes with hazardous chemicals and substances . . . transported from the workplaces of such workers."* United States Code The 1995 NIOSH report chronicled the history of "take-home" exposures (i.e., exposures to substances transported from the workplace) and their associated health risks worldwide, primarily during the 20th century. The approach of this report was to describe health hazards associated with readily identifiable agents that have clear routes of exposure such as intentional transport of workplace materials, contamination of workers' clothing or external body surfaces (skin, hair), visitors or family members at the workplace, improper storage of hazardous agents, or cottage industry production. The Workers' Family Protection Task Force was chartered in 1994 to review the NIOSH report and to recommend to Congress a research strategy for Federal agencies to investigate (1) the nature and magnitude of take-home exposures, (2) their potential adverse consequences to workers' families, and (3) the effectiveness of prevention and remediation strategies. This document represents the Task Force's commentary on the NIOSH report, identifies gaps in the current knowledge about take-home exposures and related health effects, and provides a prioritized agenda for federally sponsored research. The agenda is intentionally broad in scope, leaving the details of study design and methods to be specified by research sponsors and investigators. The NIOSH report on take-home exposures covered the available literature in a thorough manner, with information largely describing conditions that occurred from the 1930s to the 1960s. Prominent examples of take-home exposures include lead, beryllium, and asbestos. Many reports represent anecdotal accounts of hazardous take-home exposures and subsequent illness among workers' family members. Systematic research on the extent of the problem is conspicuously absent, and thus the burden of disease caused by these exposures is unlikely to be quantified now or in the future. In addition, no comprehensive studies have documented the effectiveness of current workplace control programs for preventing the transport of toxic substances into homes. The Task Force also noted that the published literature contains only limited citations of two categories of take-home exposure-infectious agents and radioactive substances. From its review of the NIOSH report, the Task Force identified important gaps in knowledge that hinder a clear understanding of the magnitude of take-home exposures and their potential health consequences. Information is lacking about the types and concentrations of take-home exposures that are currently occurring in the United States, the size and demographic composition of the populations at risk for exposure, the types of illnesses associated with take-home exposures, and the adequacy of exposure control methods in the workplace and home. Among States that have reporting systems for recognized take-home exposures such as lead, reporting suffers from incompleteness and lack of standardization. With these knowledge gaps, it is not possible to estimate the magnitude of the public health threat created by take-home exposures, nor is it possible to predict the future risks that will occur from transported toxic agents. Difficulties in determining hazards will likely persist in the future as new materials are introduced into the workplace. To address deficiencies in knowledge about take-home exposures, the Task Force recommends the following prioritized research agenda, which could be funded by Federal and other government sources as well as by the private sector: Characterize the extent of home contamination with toxic workplace substances such as metals (e.g., lead and beryllium), pesticides, and dusts (e.g., asbestos). Identify populations at greatest risk of known and suspected take-home exposures. Assess the adverse health effects from take-home exposures, including both established and less well studied effects-such as the consequences of transmitting infectious agents and radioactive substances into the home. Identify previously unrecognized toxic exposures that place the health of workers' families at risk. For recognized hazards, assess the effectiveness of take-home exposure prevention and remediation methods (including decontamination procedures) and evaluate worker notification and training programs to reduce exposure. The Task Force recommends that this proposed research agenda be given full consideration by NIOSH under the Institute's National Occupational Research Agenda (NORA). The Task Force also noted that existing Federal statutes permit aggressive action but have been narrowly applied to take-home contamination. Moreover, the Workers' Family Protection Act did not anticipate revisions to the existing statutory authority of the Federal agencies that may be involved in take-home exposure issues. No revision would be needed if Federal and State agencies took advantage of their existing statutory authority to promulgate and enforce standards and regulations that are responsive to the hazardous conditions identified by the research agenda and developed by this Task Force. Revision of these statutes to authorize the prevention and remediation of take-home contamination (especially through revision of the prioritization schemes used by government agencies such as the U.S. Environmental Protection Agency [EPA]) should be considered by Congress only if the agencies find it difficult to respond effectively to the research agenda.
Workplace-studies; Toxic-materials; Heavy-metals; Agricultural-chemicals; Pesticide-residues; Pesticides-and-agricultural-chemicals; Lead-dust; Lead-compounds; Lead-poisoning; Beryllium-compounds; Beryllium-disease; Beryllium-poisoning; Heavy-metal-poisoning; Metal-dusts; Metal-compounds; Infectious-diseases