CDC logoSafer Healthier People CDC HomeCDC SearchCDC Health Topics A-Z
NIOSH - National Institute for Occupational Safety and Health

Skip navigation links Search NIOSH  |  NIOSH Home  |  NIOSH Topics  |  Site Index  |  Databases and Information Resources  |  NIOSH Products  |  Contact Us

NIOSH Program Portfolio

 

Manufacturing

NORA Manufacturing Sector Strategic Goals

9277079 - Medical Monitoring for Workers Using Isocyanates

Start Date: 10/1/1999
End Date: 9/30/2014

Principal Investigator (PI)
Name: Eileen Storey
Phone: 304-285-6382
E-mail: eps4@cdc.gov
Organization: NIOSH
Sub-Unit: DRDS
Funded By: NIOSH

Primary Goal Addressed
5.0

Secondary Goal Addressed
8.0


Attributed to Manufacturing
100%

Project Description

Short Summary

This project builds on established dialogue among worker representatives, academic occupational health personnel, and representatives of industries that produce and use diisocyanates to describe an optimal science-based program for medical screening during work with diisocyanates in manufacturing, construction, services, and other sectors. Descriptors of existing health screening data from diisocyanate workers were obtained from several partners' current screening practices and program effectiveness assessed. Protocols have been finalized and approved for a model program for medical screening during work with diisocyanates. Under a tripartite (government, industry, labor) agreement, the model program is being implemented, evaluated, and ultimately discussed at a workshop. The goal is to define an optimal science-based medical screening program, which will represent an important advance in strategies for prevention of occupational asthma due to diisocyanates and other agents.



Description

Occupational asthma (OA) is now the most frequently recognized occupational respiratory disorder, and the group of chemically reactive diisocyanate compounds, in spite of a PEL of 20 ppb, has emerged as the most commonly identified cause of OA. The objective of this project is to describe a science-based program for medical screening during work with diisocyanates by addressing three hypotheses: 1. A series of questionnaire items, combined with spirometry, can offer satisfactory operating characteristics (sensitivity and specificity) as a screening tool in detecting asthma that is confirmed on clinical follow-up, among individuals at risk of developing asthma in relation to work with diisocyanates. 2. Definable characteristics of industry-based medical monitoring programs are associated with an increased degree of participation in testing and follow-up among targeted employees with potential exposure to diisocyanates. 3. A program of medical monitoring during work with diisocyanates can feasibly achieve over 75% participation and over 75% detection of individuals who subsequently are clinically confirmed to have asthma. In addition to the knowledge and experience of the investigators in this area, a strength of the project is that the research will be done in collaboration with health care personnel performing actual medical screening for workers in industries with potential exposures to diisocyanates. Data collection will continue over at least 5 years. With the goal of describing an optimal science-based medical screening program, such a program would represent an important advance in strategies for prevention of occupational asthma due to diisocyanates and other agents.



Objectives

The goal of this project is to describe a science-based program for medical screening during work with diisocyanates. Research will be done in collaboration with health care personnel performing actual medical screening for workers in industries with potential exposures to diisocyanates. There are three objectives for this project:

To address three hypotheses: A series of questionnaire items, combined with spirometry, can offer satisfactory operating characteristics (sensitivity and specificity) as a screening tool in detecting asthma that is confirmed on clinical follow-up, among individuals at risk of developing asthma in relation to work with diisocyanates; definable characteristics of industry-based medical monitoring programs are associated with an increased degree of participation in testing and follow-up among targeted employees with potential exposure to diisocyanates; and a program of medical monitoring during work with diisocyanates can feasibly achieve over 75 percent participation and over 75 percent detection of individuals who subsequently are clinically confirmed to have asthma;

To describe a science-based program for medical screening during work with diisocyanates, expected completion by 2012; and.

To evaluate the utility of implemented model program and develop and disseminate recommendations to industry, expected completion by 2013.



Mission Relevance

Prevention of Occupational Asthma (OA) is one of the most challenging problems facing occupational health practitioners today. Occupational disease surveillance data from the U.S. (NIOSH SENSOR) and elsewhere indicates that OA is now the most frequently recognized occupational respiratory disorder, and the group of chemically reactive diisocyanate compounds, in spite of a PEL of 20 ppb, has emerged as the most commonly identified cause of OA. In 1996, NIOSH estimated 280,000 U.S. workers were exposed or potentially exposed to isocyanates, but this number is undoubtedly higher today, given industry growth and new applications. In 1999, American workers produced and used over 2.5 billion pounds of diisocyanates and this figure has been progressively increasing. In Ontario, 58% of compensated claims for OA are from workers exposed to diisocyanates. Occupational Asthma is a NORA 1 research priority and remains a key research topic for NORA 2 respiratory disease cross-sector and the manufacturing sector. Early recognition of OA and timely control of exposures have been associated with a lower risk of chronic irreversible respiratory effects, and there is evidence that medical monitoring of individuals who work with diisocyanates is an effective secondary prevention strategy. This project addresses the utility of actual medical screening practices among diisocyanate workers and attempts to identify an optimal standard of practice for medical screening during work with diisocyanate products. The medical and environmental monitoring procedures and methods identified by this project will be useful to occupational health professionals and producers and consumers of diisocyanates in protecting worker health. It is likely these methods will also be applicable in industries that use other asthma-causing substances.





This Project is intended to contribute to the following goals:



1. Authoritative Recommendations:

Recommended engineering controls, safe work practices, personnel protective equipment (PPE), exposure monitoring and medical monitoring;



2. Surveillance:

Strategic Goal 4 (09PPSURSG4) - Promote occupational safety and health surveillance conducted by employers, unions, and other non-governmental organizations.



Intermediate goal 4.1 (09PPSURIG4.1) - Identify best practices for occupational surveillance of illnesses, injuries, and hazards at the company, union, and/or industry sector level.



Intermediate goal 4.2 (09PPSURIG4.2) - Develop and evaluate methods for occupational illness, injury, and hazard surveillance at the company, union, and/or industry sector level.



3. Respiratory Disease:

Strategic Goal 1 (09PPRDRSG1) - Prevent and reduce work-related airways diseases.



Intermediate Goal (09PPRDRIG1.1): prevent and reduce the full range of work-related asthma (WRA), including work-exacerbated asthma; occupational asthma; and irritant-induced asthma.



Activity/Output Goal (09PPRDRAOG1.1.2): develop improved tools for detection of WRA by questionnaire or ambulatory spirometry.



Activity/Output Goal (09PPRDRAOG1.1.6): develop and implement demonstration projects that address the role of screening and surveillance for WRA in occupational settings.



4. Services Sector:

Strategic Goal 1 (09PPSRVSG1): By 2015, reduce serious occupational illnesses and fatal occupational traumatic injuries by 30% in the automotive repair industry with an emphasis on events that are due to vehicle and equipment related incidents.



Intermediate Goal 1.2 (09PPSRVIG1.2): Develop and test effective training materials, controls and comprehensive safety and health programs that reduce the risk of illness (includes MSD) among automotive repair workers.



5. Manufacturing Sector:

Strategic Goal 5 (09PPMNFSG5): Reduce the number of respiratory conditions and diseases due to exposures in the manufacturing sector.



Strategic Goal 8 (09PPMNFSG8): Reduce the incidence of injuries, illnesses, and fatalities within specific sub-sectors and small businesses within the manufacturing sector.



Page last updated: June 3, 2011
Page last reviewed: May 23, 2011
Content Source: National Institute for Occupational Safety and Health (NIOSH) Office of the Director

 

NIOSH Program:

Manufacturing