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eNews: Volume 21, Number 5 (September 2023)

Volume 21, Number 5 (September 2023)

From the Director’s Desk

John Howard, M.D., Director, NIOSH

The Manhattan Project and the Fusion of Worker Safety and Health

Christopher Nolan’s summer movie blockbuster Oppenheimer focuses on the eccentric yet charismatic physicist, Dr. J. Robert Oppenheimer. Dr. Oppenheimer was appointed by General Leslie Groves to direct our country’s WWII mission to build an atomic bomb. The movie stars many scientists-turned-celebrities, such as Robert Oppenheimer, Albert Einstein, Enrico Fermi, Neils Bohr, Edward Teller, and Ernest Lawrence. The movie also features the tens of thousands of Americans who played a central role in our nation’s nuclear weapons program. Those workers continue those efforts today—their efforts, not without sacrifice.

The Energy Employees Occupational Illness Compensation Program Act (EEOICPA) was enacted in 2000. This Act aids in compensating individuals (or their survivors) who developed cancer while doing their jobs at a Department of Energy (DOE) facility or an atomic weapons employer facility. The NIOSH Division of Compensation Analysis and Support is responsible for assessing work related radiation exposure for those workers who worked at these facilities. Several EEOICPA-covered facilities are highlighted in Oppenheimer, as described below:

  • The Lawrence Berkeley National Laboratory was also known as the “Rad Lab” in the film. This was where the electromagnetic enrichment process was developed to separate the more useful type of uranium, U-235, from the natural form.
  • The Los Alamos National Laboratory was the secret city where the world’s top scientists came together to work on the “Gadget.”
  • The Metallurgical Lab, known as the “Met Lab,” was the home of the laboratory under the football stadium at the University of Chicago. This was where the world’s first nuclear reactor was constructed. This technology was then used at the DOE Hanford and Oakridge X-10 labs to manufacture the plutonium needed to produce “Fat Man.”
  • The Hanford Site in Washington State was where the reactors were built once scientists had demonstrated that Pu-239 (a form of plutonium) could be produced in a nuclear reactor.
  • The Labs in Oak Ridge, Tennessee, played a major role as the site for both uranium enrichment and plutonium production plants. The Y-12 lab, one of two labs at Oak Ridge, was where workers produced the highly enriched uranium for “Little Boy.” That material was then sent to Los Alamos for fabrication into the nuclear weapon that was dropped on Hiroshima, Japan, on August 6, 1945.

Health Physics—Practice of Radiation Safety

Although radiation safety existed for many years before the Manhattan Project, focus on radiation worker health and safety intensified during this time. Partly out of the secrecy of the project, but also to protect the health of the workers handling radioactive materials, physicists and medical doctors came together to develop improved radiation safety guidelines and measurement techniques, coining the term, “health physics.”

Following the development of health physics at the Met Lab, further improvements were made at each site. This included the use of film badges to quantify external radiation doses received by personnel. Employee training also helped decrease risks when working with radioactive materials. Internal tolerance limits for inhaled and ingested plutonium were developed from information based on health effects observed from workplace exposures to radium. Direct and indirect methods were developed to quantify radioactive materials deposited and retained within the body.

Since the start of the Manhattan Project, more than 300 EEOICPA-covered DOE and atomic weapons employer facilities have contributed to the production of nuclear weapons and nuclear power. Nearly 80 years after Oppenheimer fathered the atomic bomb, these facilities continue to employ tens of thousands of workers to solve our nation’s energy, environment, and security challenges today.

NIOSH scientists have spent the past two decades evaluating and researching radiation safety practices. Today, under the EEOICPA, NIOSH health physicists use these personnel radiation exposure data from film badges and individual bioassay results (interpreted with modern biokinetic modeling software) to estimate specific radiation doses. These data help to determine the probability that an employee’s cancer was caused by their radiation exposure in the workplace.

NIOSH and its Division of Compensation Analysis and Support are proud to serve the community of America’s nuclear workforce. Under the EEOICPA, NIOSH will continue to provide scientific support for claims involving workers with cancer due to radiation exposure.

Additional information about radiation safety before and during the Manhattan Project can be found at the following links:

Research Rounds

Sharps Injury Rates Reported Among U.S. Workers

NIOSH study authors: Erika J. Kennedy, Kitty J. Hendricks, and Megan Casey

Why is this study important?
Injuries from a needle or other sharp objects, or sharps injuries, can expose workers to bloodborne pathogens, or germs, such as human immunodeficiency virus, hepatitis B, hepatitis C, and others. Although often viewed as a concern specific to healthcare workers, sharps injuries also occur among workers in other industries.

How did you do the study?
We calculated national estimates of sharps injuries and rates for U.S. workers from 2006 to 2020 based on a sample of approximately 67 U.S. hospital emergency departments. Rates are defined as the number of sharps injuries per 10,000 full-time equivalent workers (FTE). We obtained information for our study from the NIOSH National Electronic Injury Surveillance System—Occupational Supplement. This query tool provides estimates of the number of nonfatal injuries treated in emergency departments nationwide.

What did you find?
Overall, an estimated 875,900 work-related sharps injuries were treated over the 15-year period. Most sharps injuries occurred among female workers and younger workers less than 35 years old. Sharps injuries affected the finger most often, followed by the hand and lower arm.

The majority (84%) of sharps injuries occurred among healthcare workers, with an injury rate (16.7 per 10,000 FTE) more than six times the rate for all workers (2.7 per 10,000 FTE). After healthcare, sharps injuries occurred most often in four other industries:

  • Justice, public order, and safety
  • Traveler accommodation
  • Colleges, universities, and professional schools such as junior colleges
  • Pharmacies and drug stores

What are the next steps?
Research should continue to focus on how and when sharps injuries occur, especially among younger healthcare workers. In addition, standardized education about preventing sharps injuries is critical for all workers who are at risk.

Investigation of a Cluster of Rapidly Growing Mycobacteria Infections Associated with Joint Replacement Surgery in a Kentucky Hospital, 2013–2014 With 8-Year Follow-Up

Study authors: Matthew R. Groenewold, NIOSH; Andrea Flinchum, Aravind Pillai, and Stacey Konkle, Kentucky Department for Public Health; Heather Moulton-Meissner, CDC; Pritish K. Tosh, MD, Mayo Clinic; and Douglas A. Thoroughman, NIOSH, Kentucky Department for Public Health

Why is this study important?
Healthcare-associated infections from rapidly growing mycobacteria, or RGM, pose a serious risk to patients undergoing joint replacement surgery. These hardy bacteria can withstand extreme temperatures and lack of nutrients. They are present throughout the environment, including soil, water, and contaminated hospital settings. Finding and eliminating risk factors for these bacteria in hospitals is critical.

How did you do the study?
We investigated potential routes of exposure after a Kentucky hospital reported five cases of RGM infections occurring January–September 2013. We compared the five patients with infections with 20 randomly selected patients. All patients had received joint replacement surgery between October 2012 and March 2013. In addition, we evaluated the hospital’s efforts to prevent repeated RGM infections for eight years after the outbreak.

What did you find?
Overall, we found eight infections caused by two types of RGM. Five of the infections were caused by M. wolinskyi and three by M. goodii. Although we did not find a source of the infections in the hospital environment itself, a common factor was one nurse who worked in the operating room. The nurse had no symptoms but reported using an outdoor hot tub at home. We sampled the water, found that the bacteria M. wolinskyi was present. We confirmed these results with genetic sequencing and other specialized testing. As a result, the hot tub was removed from use, eliminating it as a source of RGM infections. The hospital revised its policies to prevent future infections. As of 2021, we have found no new RGM infections in the hospital.

What are the next steps?
Our findings highlight the importance of considering healthcare workers as a source of RGM transmission among joint-replacement recipients. Furthermore, they show the importance of carefully following all recommendations to prevent RGM and other infections in hospitals.

DD Cover image

A scene in the film has Oppenheimer at a chalkboard, demonstrating how four DOE facilities (R=“Rad Lab”; M=“Met Lab”; H=Hanford Site; and T=Tennessee-Oak Ridge), in addition to Los Alamos, met the needs of the Manhattan Project. Original image by ©Getty Images.

NIOSH eNews is Brought to You By:

John Howard, M.D., Director
Christina Spring, Editor in Chief

Managing Editor
Tanya Headley

Section Editor
Anne Blank, Research Rounds
Kiana Harper, Highlights & Monthly Features

Contributing Editors
Sarah Mitchell

Copy Editor
Cheryl Hamilton

Technical Support
Steve Leonard, Technical Lead
Steven Marra, Web Developer

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Respiratory Protection Week, September 5-8, 2023
Happy Respiratory Protection Week! Each year, NIOSH highlights the importance of respiratory protection in the workplace and provides resources to help workers and employers make educated decisions when selecting and wearing respirators. Millions of workers across the United States rely on respiratory protection to keep them safe on the job. This year we’re helping to fill in the gaps in respiratory protection with our new resources. To check them out, visit the Respiratory Protection Week 2023 webpage and follow us on social media using #RespiratorWeek.

Celebrate National Farm Safety and Health Week September 17–23!
NIOSH joins the Centers for Agricultural Safety and Health (Ag Centers) in recognizing National Farm Safety and Health Week! This annual event is when we highlight the importance of working together to prevent injuries and illnesses among agricultural workers. The 2023 theme is “No One Can Take Your Place.” This year’s events will focus on tractor and rural roadway safety, health and wellness, priority populations, combined spaces in agriculture, and brain health.

Out With the Old and in With the New: Updated Certified Equipment List Now Available
Check out the updated NIOSH Certified Equipment List. This NIOSH tool can be used to find NIOSH Approved® respirators. The updated version is reformatted and includes quick searches for identifying respirators of current interest. NIOSH encourages users to update their bookmarks to point to the new Certified Equipment List page.
NIOSH Approved is a certification mark of the U.S. Department of Health and Human Services (HHS) registered in the United States and several international jurisdictions.

NIOSH Senior Leadership Vacancies
NIOSH has two senior leadership positions open. Click on the links below for more information about each position and to apply. The deadline to apply has been extended to September 25 for both jobs.

Director of Division of Safety Research

Director of Health Effects Laboratory Division

Register Now for the Next NIOSH Expanding Research Partnerships Webinar!
On September 13, 11:00 a.m.–12:30 p.m. (ET), NIOSH is hosting the next Expanding Research Partnerships Series webinar. The title is “Occupational Safety and Health (OSH) Practice in the Workplace of the Future.” This installment will explore leveraging collaboration to address key challenges to occupational safety and health research, training, and practice. See the full speaker list and register.

Exploring the Expansion of Recovery Friendly Workplace Programs
NIOSH recently collaborated with the National Institute of Environmental Health Sciences Worker Training Program to learn more about recovery friendly workplace programs. Together, they published a national analysis that captured the achievements and gaps of 25 established recovery friendly workplace programs and 19 programs in the informal or beginning stages, from 31 states. Read the full report.

Preventing Occupational Hearing Loss
A new online guide to prevent occupational noise-induced hearing loss from NIOSH is now available. The guide walks employers and safety professionals step-by-step through the basics of creating a safer, quieter workplace.

New Heat Stress Training Module for Mine Workers
Heat stress is a growing problem among mine workers. NIOSH researchers developed a training module to address this issue and decrease heat-related illnesses in miners. The training will also help mine workers recognize the signs of heat-related illness and provide first aid.

Video Series Provides New Guidance for Funeral Directors
A new NIOSH video series for funeral directors is now available. The seven videos provide guidance for recording usual occupation and industry information on death certificates.

Best Practices for Clinical Care of 9/11-Related Conditions
New articles in the Clinical Essentials series describe best practices in the diagnosis and treatment of 9/11-related conditions. Authors include clinicians affiliated with the World Trade Center Health Program.

Monthly Features

Federal Register Notices

Proposed Data Collection Submitted for Public Comment and Recommendations: Health Hazard Evaluations/Technical Assistance and Emerging Problems
The notice was posted on August 1. Comments must be received by October 2.

Advisory Board on Radiation and Worker Health, National Institute for Occupational Safety and Health
The notice was posted on August 28. Comments must be received by October 5. The meeting will be held October 12.

Proposed Data Collection Submitted for Public Comment and Recommendations: Exposures, Health Effects, and Controls of Chemicals From Thermal Spray Coating
The notice was posted on August 7. Comments must be received by October 6.

Request for Public Comment on the Draft Immediately Dangerous to Life or Health (IDLH) Value Document for Hydrogen Chloride
The notice was posted on August 10. Comments must be received by October 10.

Proposed Data Collection Submitted for Public Comment and Recommendations: Fire Fighter Fatality Investigation and Prevention Program (FFFIPP) Survey
The notice was posted on August 21. Comments must be received by October 20.

Proposed Data Collection Submitted for Public Comment and Recommendations: Assessing Fatigue and Fatigue Management in U.S. Onshore Oil and Gas Extraction
The notice was posted on August 21. Comments must be received by October 20.

World Trade Center Health Program; Youth Research Cohort; Request for Information
The notice was posted on August 18. Comments must be received by October 23.

Advisory Board on Radiation and Worker Health, Subcommittee on Procedures Reviews, National Institute for Occupational Safety and Health
The notice was posted on August 28. Comments must be received by November 9. The meeting will be held November 16.

News from Our Partners

New Toolkit for Small Businesses Hiring Employees in Recovery
The Kentucky Occupational Safety and Health Surveillance Program has published a new toolkit focused on helping small businesses successfully hire people in recovery from substance use disorders. The toolkit includes information about hiring and legal considerations, sample workplace policies, and information about programs and resources for both employers and employees.

COVID-19 Frontline Healthcare Worker Study
The Occupational Health Surveillance Program at the Massachusetts Department of Public Health has released a report on the pandemic’s impact on healthcare workers. This publication reports on data collected in Fall 2020 from the Massachusetts COVID-19 Community Impact Survey

 7th International Conference on the History of Occupational and Environmental Health
Registration for the International Conference on the History of Occupational and Environmental Health Conference is now open! The event will take place in Durban, South Africa, November 15–17. This year’s focus will be on the migration of workers in various time periods and the interconnections of empires. Also highlighted will be public health in post-colonial periods and the role of trade unions and other social movements in occupational and environmental health.


Date Announced for 4th Prevention Through Design Workshop
NIOSH, in collaboration with Arizona State University, is pleased to announce the 4th Prevention through Design (PtD) Workshop. The event will be held September 21 in Boston, Massachusetts, at Liberty Mutual Headquarters. The workshop will focus on PtD regulation and proven strategies, among many other topics. Learn more about the workshop and registration.

Conferences, Meetings, Webinars, & Events

This page provides a list of publicly available occupational safety and health-related conferences, meetings, webinars, and events sponsored by NIOSH as well as other government agencies, and nongovernment agencies, such as universities, professional societies, and organizations.