Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to page options Skip directly to site content


workers, building, architect

NORA Manufacturing Sector Strategic Goals

927Z1UK - Improving Hand Washing (Lead Wipes)

Start Date: 10/1/2005
End Date: 9/30/2010

Principal Investigator (PI)
Name: Carol Stephenson
Phone: 513-533-8581
Organization: NIOSH
Sub-Unit: EID
Funded By: NIOSH

Primary Goal Addressed

Secondary Goal Addressed


Attributed to Manufacturing


Project Description

Short Summary

NIOSH-developed color-changing lead detection hand wipes provide an easy-to-use and objective exposure assessment tool to evaluate the effectiveness of hand washing practices for lead exposed workers. However, an evaluation of the impact of color-changing feedback on workers' behavior has not been done. The purpose of the laboratory-based and field-based pilot studies are to determine whether participants that receive color-changing feedback from hand wipes make improvements in hand washing practices as compared to participants that do not receive the color-changing feedback. A telephone survey will examine the types of businesses that may or may not be aware of the availability of the hand wipe technology.


Ineffective hand cleaning practices may result in unseen contamination that can be internally ingested or carried into the home to contaminate family members and the home environment. NIOSH researchers developed and patented a safe and easy-to-use color-changing hand wipe and associated procedures for testing for the presence of lead contamination on workers' hands. After hand washing, the wipes are rubbed over the hands to gather remaining lead contaminants, and subsequently sprayed with a mild aqueous acetic acid (pH 2.5) to solubilize the lead into lead ions and then with rhodizonate that turns red in the presence of the lead ions. Consequently, the wipes provide a visual indicator for the presence of lead contaminants that may remain on workers' hands after hand washing, thus indicating the need for further decontamination. The effectiveness of the wipes as a feedback and motivational tool has not been tested. Laboratory analyses of the amount of lead traces remaining on the used hand wipes will provide an objective and measurable test of the effectiveness of the hand washing practices and soaps. The participants' amount of time spent hand washing and washing techniques will be recorded and integrated into the data analyses.

This study will provide the first field test data (phase 2) on the hand decontamination performance of workers using the wipes, on worker attitudes towards this new technology and on the employer's impressions regarding the feasibility of use of this technology. In addition, both a controlled laboratory-based pilot study (phase 1) and a telephone survey pilot study (phase 3) will be conducted. The laboratory-based pilot study will evaluate both the impact of the color-changing feedback, as well as the impact of two different types of hand soap (soap specifically designed for cleaning lead contamination and a more-commonly used non-lead-specific soap) so as to account for differences in hand soap products currently used in lead-hazardous industries. The telephone survey pilot study will gather information on employer awareness of the hand wipe product and impact of the impact of the receipt of the product on workplace decontamination practices.


Goal 1: To determine whether study participants that directly receive color-changing feedback from the hand wipes make improvements in their hand washing practices as compared to study participants that do not receive this feedback (phases 1 and 2).

Goal 2: Examine worker and employer perceptions of the effectiveness and usefulness of the NIOSH-developed color-changing lead detection hand wipe method as a feedback and exposure assessment tool that helps workers in lead hazardous industries improve their hand washing practices (phase 1, 2, and 3).

Goal 3: Examine whether employers from lead-hazardous industries are aware of and use the hand wipe method as a feedback and exposure assessment tool that helps workers in lead hazardous industries improve their hand washing practices, and subsequently whether employers that are not using this product change their decontamination practices following the receipt of the product (phase 3).

Mission Relevance

While the Department of Health and Human Services recommends that adult blood lead levels (BLL) should be less than 25ug/dL, state prevalence rates for adults with BLLs at this level or higher were 13.4 per 100,000 workers for 1994-1997 (NIOSH, 2004). Industries in which these adults (n=6,540) were exposed included manufacturing (58%), construction (22%), mining (8%), wholesale/retail trades (7%), service industry (3%), and transportation/public utilities (2%) (MMWR, 2004). It is widely recognized that worker lead exposure can lead to significant health problems, including damage to the nervous system, cardiovascular disorders, infertility, and renal health problems (MMWR, 2002). As the result of occupational exposure, hazardous levels of lead contaminants may remain on clothing or the skin, but are invisible to the eye. Consequently, ineffective hand cleaning practices may result in unseen contamination that can be internally ingested or carried into the home to contaminate family members and the home environment. This project will evaluate the impact of the NIOSH-developed lead detection hand wipe technology across three settings: controlled laboratory testing, evaluations of field-based applications of the technology, and impact in the workplace that results from technology/product dissemination.

Relevance to NORA research priorities and Healthy People 2010: The project addresses Healthy People 2010 objectives 20-7 (reduce the number of persons who have elevated BLL concentrations resulting from work exposures). Consumers of the study findings: Findings from this pilot study could provide information on the usefulness of an immediate, objective and easy-to-use method for helping lead exposed workers improve their hand washing effectiveness. In addition, findings from this pilot study will be used to guide further research in workplace settings.

Sector: Construction - SG7: Reduce dermal exposure and associated occupational illnesses among construction workers.

IG7.3: Develop and validate improved laboratory, clinical, and field surveillance methodology for hazard identification, exposure characterization and risk assessment of chemicals that cause irritant and allergic contact dermatitis.

Sector: Manufacturing – SG8: Reduce the incidence of injuries, illnesses, and fatalities within small businesses (less than 100 employees) and specific subsectors within the manufacturing sector.

IG4.4: Dermal exposures.

Cross Sector: Personal Protective Technology - SG2: Reduce exposure to dermal hazards. IG2.4: Develop and utilize effective communication tools and outreach techniques to provide appropriate inputs to all PPT Cross-Sector activities and usable outputs (products and services) and outcomes (results) to provide dermal protection.