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Volume
8 Number 2 June 2010
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From the Director's Desk
--John Howard, M.D. Director, NIOSH
June eNews 2010
--Anita L. Schill, Ph.D., Associate Director for Science, NIOSH Guest
Columnist
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Exporting OSH Policy Success
[NIOSH
is proud of its role as an international partner in preventing work-related
injury, illness, and death. One such collaboration recently involved the
participation of Dr. Anita L. Schill, NIOSH’s Associate Director for
Science. I asked Dr. Schill to join me this month as guest columnist to
discuss this example of NIOSH’s interaction with colleagues abroad in
building internationally on a signal success here in the U.S. I look forward
to sharing similar accounts of other international partnerships in future
installments of this column. In the meantime, I am delighted to present Dr.
Schill. - John Howard]
The
Needlestick Safety and Prevention Act (Public Law 106-430) [2000] and the
public health policy accomplishments that paved the way for this historic
piece of legislation make one of the best occupational safety and health
(OSH) success stories. As a result of these accomplishments, occupationally
acquired hepatitis B virus has been dramatically reduced and sharps with
engineered sharps injury protection have been mandated by law. While there is
still much to be done to fully realize the protections promised to healthcare
workers by these efforts, the United States has a solid framework upon which
to build.
This is
not necessarily the case in many developing countries where risks to
healthcare workers from exposures to bloodborne pathogens may be even greater
than in the United States. Several factors that contribute to these increased
risks include higher prevalence of bloodborne pathogens in the population,
more severe disease in patients with whom healthcare workers have contact,
difficult or challenging working conditions, limited access to basic
supplies, unsafe work practices, more frequent use of injections for
treatment, and use of needles and other equipment associated with higher
risks of exposure [Lee 2009; Sagoe-Moses et al. 2001]. Although some progress
has been made toward recognition of the problem on both international and
national levels, the overall response of policymakers has been slow [Lee
2009].
In an
effort to stimulate policy development, the Malaysian Society of Infectious
Diseases and Chemotherapy and the Aesculap Academy organized a Safety in
Health Care Conference, "Why fight the symptoms if we can fight the
cause?," in Kuala Lumpur, Malaysia, April 15-16, 2010. The Conference,
endorsed by the Malaysian Ministry of Health, was the first of its kind. It
attracted 185 key decision makers from 12 additional countries, including
India, China, Indonesia, Philippines, Pakistan, and Singapore.
NIOSH is
proud to have been an invited participant in this historic event. I
represented NIOSH and spoke about the many public health and OSH policy
accomplishments in the United States that paved the way for the Needlestick
Safety and Prevention Act of 2000. Beginning in 1987 with the publication of
"Recommendations for Prevention of HIV Transmission in Health-Care
Settings" in the U.S. Centers for Disease Control and Prevention’s
(CDC) Morbidity &
Mortality Weekly Report, CDC and NIOSH provided critical policy
components [CDC 1987].
In the
late 1990s, NIOSH issued guidelines for selecting, evaluating, and using
sharps disposal containers [NIOSH 1998] and published the NIOSH Alert, Preventing Needlestick Injuries in
Health Care Settings [NIOSH 1999]. In 1999, NIOSH participated
with the Occupational Safety and Health Administration (OSHA) and the Food
and Drug Administration in a joint safety advisory about the potential risks
of injury and infection from bloodborne pathogens due to accidental breakage
of glass capillary tubes [OSHA 1999]. Based on the accumulating evidence of
adverse health effects from needlestick injuries, these efforts, along with
those of other federal agencies (most notably OSHA), supported state and
local activities and the eventual passing of national legislation.
Attendees
from the Safety in Health Care Conference in Malaysia.
The United
States story is a powerful one and captured the interest of conference
participants. While the policy development process will most certainly differ
for other countries, the United States example provides a model from which to
start local discussions. In fact, many of the participants have already begun
making plans for conferences in their own countries. In post-conference
evaluation feedback, many participants expressed their motivation to do more
at a national level to protect healthcare workers.
Healthcare
is a global industry. Medical tourism and international recruitment of
healthcare workers are integral components of the business model. For those
with OSH policy-making responsibilities, starting from scratch can be
overwhelming and sometimes even paralyzing. By exporting policy successes,
both nationally and internationally, time-to-protection is decreased and
health and safety conditions for workers are improved.
- Anita L. Schill, Ph.D.
References
Needlestick prevention and safety act, 106th Congress,
Public Law 106-430 [2000]. [http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=106_cong_public_laws&docid=f:publ430.106]
,
Lee R [2009]. Occupational transmission of bloodborne diseases to healthcare
workers in developing countries: meeting the challenges. J Hosp Infect 72:
285-291.
Sagoe-Moses C, Pearson RD, Perry J, Jagger J [2001]. Risks to health care
workers in developing countries. N Engl J Med 345(7):538-541.
CDC [1987]. Recommendations
for prevention of HIV transmission in health-care settings. MMWR
36(SU02):001.
NIOSH [1998]. Selecting,
evaluating, and using sharps disposal containers. Cincinnati, OH: U.S.
Department of Health and Human Services, Public Health Service, Centers for
Disease Control and Prevention, National Institute for Occupational Safety
and Health, DHHS (NIOSH) Publication No. 97-111.
NIOSH [1999]. Alert
preventing needlestick injuries in health care settings. Cincinnati, OH:
U.S. Department of Health and Human Services, Public Health Service, Centers
for Disease Control and Prevention, National Institute for Occupational
Safety and Health, DHHS (NIOSH) Publication No. 2000-108.
OSHA [1999]. Glass capillary tubes: joint safety advisory about potential
risks [http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_id=22695&p_table=INTERPRETATIONS].
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NIOSH
Focusing on Oil Clean-Up Workers
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NIOSH is providing technical assistance to the
Occupational Safety and Health Administration, the National Institute of
Environmental Health Sciences, other divisions of the U.S. Centers for
Disease Control and Prevention, and others responding to the Deepwater
Horizon oil spill. NIOSH is implementing a system for compiling a roster of
workers involved in the clean-up effort, with basic identifier information
for each worker, job duties and locations, training, and personal protective
equipment used. NIOSH oil spill response resources are available at http://www.cdc.gov/niosh/topics/oilspillresponse/
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New
Screening Tool to Protect Workers from Skin Allergies
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NIOSH Scientists and colleagues reported the
development of a simple, rapid, inexpensive test for chemicals that can cause
allergic contact dermatitis. The new test has potential for use as a
preliminary screening tool to determine whether chemicals used in consumer
products and at workplaces might cause skin allergies in people. The full
article is available at http://pubs.acs.org/doi/abs/10.1021/tx100003w
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Protecting Healthcare Staff From Risks Associated With
Disinfectants and Cleaners
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Disinfectants and cleaners are essential products for
preventing disease transmission in healthcare facilities, but they pose risks
for work-related eye and respiratory irritation, sensitization, asthma-like
symptoms, and respiratory distress for workers. A NIOSH study published in
the May 14 Morbidity &
Mortality Weekly Report provides the first multistate report on
work-related symptoms among healthcare staff in three states, with
recommendations for preventing illness and injury. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5918a2.htm
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Asthma and Asthma-Like Symptoms Among Soy Processing
Workers
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Workers at a soy processing plant showed a
higher-than-expected rate of asthma and asthma-like symptoms compared with
the general population, a study by NIOSH researchers found. Asthma outcomes
were significantly associated with immune reactivity to soy. The findings
strengthen the association found in past studies between workplace exposures
in soy processing and risk of occupational asthma and asthma-like effects and
suggest that a precautionary approach should be followed in controlling
exposures. The article was published online April 22 before print by the European Respiratory Journal.
http://erj.ersjournals.com/cgi/content/abstract/09031936.00151109v1
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AIHce Presentation Highlights OSHA/NIOSH Relationship
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NIOSH, UNITAR Agree to Expand Collaboration
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On April 30, NIOSH Director John Howard, M.D., and
Craig Boljkovac, manager of chemicals and waste management for the United Nations Institute for Training and Research (UNITAR),
signed an agreement to expand and formalize collaboration between the two
groups. UNITAR gains access to NIOSH resources and world-class expertise in
the area of occupational safety and health of nanotechnology, while NIOSH
utilizes UNITAR’s access to safety and health professionals in
developing countries, achieving NIOSH’s third strategic goal of
enhancing international workplace safety and health through global
collaborations.
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NIOSH Establishes Independent Panel for Coal Mine
Explosion Review
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On May 5, NIOSH announced an independent panel to
evaluate the process and outcome of the Mine Safety and Health
Administration’s internal review in the wake of the Upper Big Branch
coal mine explosion. NIOSH established the panel in response to a request by
the U.S. Department of Labor. http://www.cdc.gov/niosh/updates/upd-05-05-10.html
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Testimony Raises Awareness of Risks to Healthcare
Workers Lifting Patients
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Dr. James Collins, a senior scientist in the NIOSH
Division of Safety Research, testified as an expert witness before the Senate
Subcommittee on Employment and Workplace Safety. The hearing aimed to raise
awareness about the hazards of lifting patients for healthcare workers and
the technology available to prevent injury. More on NIOSH resources for
preventing musculoskeletal injuries in moving patients at http://www.cdc.gov/niosh/docs/2006-117/
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NIOSH Authors Receive "Paper of the Year" at
Prestigious Society of Toxicology Meeting
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A NIOSH paper, Influence
of Cytokine Gene Variations on Immunization to Childhood Vaccines,
was awarded Best Paper of the Year 2010 in the Immunotoxicology Specialty
Section of the annual Society of Toxicology Meeting in March. NIOSH authors
include Berran Yucesoy, Victor Johnson, Kara Fluharty, Michael Kashon, James
Slaven, David Weissman, Raymond Biagini, and Michael Luster, as well as Nevin
Wilson from University of Nevada and Dori Germolec from NIEHS. The article
can be found in the journal Vaccine
27(50):6991-6997.
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Public Meeting Announcement
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NIOSH will hold a second public meeting, concerning the
proposed rule regarding the Total Inward Leakage Requirements for Half Mask
Air-Purifying Particulate Respirators, on July 29, 2010 at the Marriott Inn
and Conference Center in Hyattsville, MD. The purpose of this meeting is to
allow stakeholders to make presentations to NIOSH; share results of any new
research that may be available or in process regarding the area of filtering
facepiece or other half mask respirator inward leakage measurement; and offer
any additional comments on the anticipated economic impact of the proposed
rule. This meeting will also be available via Live Meeting Conferencing. To
register for this meeting please call 412-386-5200. Additional information is
available at http://www.cdc.gov/niosh/docket/nioshdocket0137.html
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NIOSH is
seeking assistance from commercial organizations that manufacture or use the
two products listed below. NIOSH is looking to establish typical workplace
exposure concentrations for possible future toxicological studies. Please
e-mail mharper@xxxxxxx or call
304-285-6034.
- Products containing ethylene glycol 2-ethylhexyl
ether (EGEHE, CAS No.: 1559-35-9). EGEHE is used in ink-jet inks, gas
supply pipe sealant, electrodeposition coatings for catalytic
converters, lens manufacturing cleaning solutions, termite repellent,
liquid bleach, dishwashing detergents, flower preservatives, and air
fresheners.
- Products containing 1-chloro-4-(trifluoromethyl)
benzene, also known as parachlorobenzotrifluoride (PCBTF, CAS
No.:98-56&-6). PCBTF is widely used as a solvent, specifically in
automobile body coatings and parts cleaning, although it also has uses
as an intermediate in the synthesis of dyes, pharmaceuticals,
pesticides, insecticides, and herbicides.
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NIOSH Requests Comments/Review on the Following:
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AOEC Summer Internship Program— a Success!
The
Association of Occupational and Environmental Clinics, Occupational Health
Internship Program, funded in large part by NIOSH, will have 22 interns
working on 8-week projects this summer. In addition to a rewarding summer
work experience, the OHIP program can lead to greater professional
recognition for students. Two of last summer’s interns, Michigan State
University second-year medical students, Meena Hasan and Vibha Gupta,
presented the results of their summer 2009 project at the May 2010 American
Occupational Health Conference in a poster, A Survey of Lower Extremity Pain and Symptoms in NYC
Transportation Workers. Applications for the 2011 summer program
will be available in late January 2011. For additional information please go
to http://www.aoec.org/ohip/ or
contact Sarah Jacobs sjacobs@xxxxxxxxxxxxx
or Ingrid Denis idenis@xxxxxxxx.
New Occupational Hygiene Training Available
A set of
international training modules in occupational hygiene has been launched with
the support of the International Occupational Hygiene Association (IOHA) and
other national associations (http://www.ohlearning.com/).
Courses are being held in 11 countries over the coming months. The IOHA and
NIOSH are members of the WHO Global Network of Collaborating Centers. The
Network members are working together to develop tools to assist countries to
meet their commitments under the World Health Assembly Resolution 60.26, the
Global Plan of Action for Workers Health.
Award for Work on Hearing Loss Prevention in the Construction
Sector
NIOSH, in partnership with the National Hearing
Conservation Association, presented the New York City Department of
Environmental Protection and Parsons Brinckerhoff, Inc., the 2010
Safe-in-Sound Award™ in the category for Innovation in Hearing Loss
Prevention in the Construction Sector. The award was presented at the Building
Trades Employers' Association Leadership dinner on May 18. http://www.cdc.gov/niosh/updates/upd-05-7-10.html.
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Manufacturing Sector Council Fact Sheets
The NORA
Manufacturing Sector Council recently released 10 fact sheets, each based on
one of its 10 sector goals. Each fact sheet summarizes the current research
needs and opportunities for reaching that goal and invites participation in
research, intervention development, and efforts to have proven solutions
adopted widely. Contact the NORA
Coordinator with questions and suggestions. http://www.cdc.gov/niosh/nora/councils/manuf/pubprod.html.
NORA Liaison Committee Public Meeting Announced for June
The next NORA Liaison Committee meeting, Partnerships
to Advance the National Occupational Research Agenda, will be held June 16 in
Washington, D.C. Attendees can also participate online. Individuals and
national organizations learn about and contribute to the progress of NORA.
Details of the meeting have been published in the Federal Register. http://edocket.access.gpo.gov/2010/2010-12743.htm
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The National
Occupational Research Agenda (NORA) Manufacturing Sector Council is seeking
partners to lead or contribute to its goals identified in the NORA National
Manufacturing Agenda. This includes program priority areas such as contact
with objects and equipment, falls, musculoskeletal disorders, hearing loss,
cancer, health disparities, small businesses, and catastrophic incidents. For
more information, visit the NIOSH Partnership Opportunities Web site (www.cdc.gov/niosh/r2p/partner.html)
or contact Greg Lotz, Program Manager, at (513) 533-8462 or Michael Baskett,
Program Coordinator, at (513) 533-8153.
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What’s New on the NIOSH Blog?
Young Workers
What
factors put young workers at risk of injury, illness, or death on the job,
and what interventions are recommended? The May 4 NIOSH Science Blog notes
latest research findings. http://www.cdc.gov/niosh/blog/nsb050410_youth.html
Skin- Exposed
Workers, managers, and occupational safety and health
professionals need to be aware of the significance of dermal risks. Share
your thoughts or questions on dermal exposures, skin notation, use of engineering
controls, or control banding on the current NIOSH Blog. http://www.cdc.gov/niosh/blog/nsb052010_dermal.html
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New Communication Products
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Document Provides Recommendations for Protecting First
Responders
A new
NIOSH workplace solutions document, Preventing
Exposures to Bloodborne Pathogens Among Paramedics, provides
practical recommendations aimed at protecting first responders. http://www.cdc.gov/niosh/docs/wp-solutions/2010-139/pdfs/2010-139.pdf
Reducing Illnesses at Indoor Waterparks
Lifeguards
and patrons in the rapidly growing indoor waterpark industry can be exposed
to numerous disinfection byproducts and microorganisms that can cause adverse
health effects such as eye and respiratory irritation, skin rashes, and
flu-like symptoms. A new NIOSH workplace solutions document, Reducing Illnesses at Indoor
Waterparks, addresses issues that pool managers, designers, and
public health officials should consider to reduce illness at indoor water
parks. http://www.cdc.gov/niosh/docs/wp-solutions/2010-138/
More…
To see other new NIOSH communication products,
including documents and new and updated topic pages, go to the NIOSH
“What’s New” page. http://www.cdc.gov/niosh/whatsnew.html
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Upcoming Conferences & Workshops
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Migration
and Occupational Health: Shining a Light on the Problem, June 14 at 10:00 am,
Migration Policy Institute, Washington D.C.
To register go to http://my.migrationpolicy.org/p/salsa/event/common/public/?event_KEY=22630#RSVP
American
Society of Agricultural and Biological Engineers, June 20–23, Pittsburgh,
PA.
http://www.asabemeetings.org/
Respirator
Manufacturers Meeting, July 14, Pittsburgh, PA.
http://www.cdc.gov/niosh/npptl/resources/pressrel/letters/lttr-07142010.html
Nanomaterials
and Worker Health: Medical Surveillance, Exposure Registries, and
Epidemiologic Research, cohosted by NIOSH and the Mountain and Plains
Education and Research Center, July 21–23 in Keystone, CO. http://www.cdc.gov/niosh/topics/nanotech/keystone2010/
29th
International Conference on Ground Control in Mining, July 26–29,
Morgantown, WV.
http://www2.cemr.wvu.edu/~icgcm/gcconfer/gcconfmine/gc_index.html
International
Conference on the Health Status of Urban Transit Workers, Establishing an
Agenda for Research, Policy Direction and Action,
July 27-29, 2010, New York, New York http://www.twulocal100.org/
138th
Annual Meeting and Exposition of the American Public Health Association,
November 6-10, Denver, CO. http://www.apha.org/meetings/
16th
Annual National Ergonomics Conference and Exposition (ErgoExpo), November
30-December 3, Las Vegas, NV. http://www.ergoexpo.com/
A comprehensive list of upcoming conferences can be
found at http://www.cdc.gov/niosh/exhibits.html.
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UNITAR - This is the
acronym for the United Nations Institute for Training and Research, an
autonomous body within the United Nations with a mandate to enhance the
effectiveness of the UN through training and research. http://www.unitar.org
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NIOSH eNews on the Web:
www.cdc.gov/niosh/enews/
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