Bullard-Sherwood Research to Practice (r2p) Award Winners and Honorable Mentions: Backgound, 2007

Knowledge Category

Winner:

• Title: Developing a Nanoparticle Information Library
• Authors: Miller A, Hoover M, Stapleton B
• Source: Division of Safety Research
• Background: As the field of nanotechnology is growing rapidly, the number of workers exposed to new nanomaterials is rising quickly. Health and safety professionals who are concerned with worker exposure to such materials need related information and guidance. Industry stakeholders also are looking to NIOSH for related guidance. The Nanoparticle Information Library (NIL) was conceived as a tool to address the current lack of information regarding the health and safety implications of nanotechnology.

• Relevance: NIL is a publicly accessible, on-line searchable database which catalogs information regarding nanoparticles, their physical and chemical properties, and information related to their health and safety implications. It is available at http://www.cdc.gov/niosh/topics/nanotech/NIL.html. Many companies have volunteered to collaborate with NIOSH to develop methods for evaluating the impact of nanotechnology on worker health and safety. Some of these stakeholders also have contributed information to the NIL as part of an ongoing collaboration between industry, academia and NIOSH to ensure the health and safety of workers in this new occupational field. The development of the NIL is part of current NIOSH efforts to address the implications of nanotechnology as indicated by the establishment of the NIOSH Nanotechnology Research Center.

  Since launching the NIL on the World Wide Web in February 2006, the number of NIL users has risen steadily and is now nearing one thousand per month. To date, feedback from users and stakeholders has been positive. In addition, the administrators of several other notable nanotechnology health and safety databases and informational sources have offered to collaborate in developing ways to integrate NIL information into their information streams. Two such entities, the Woodrow Wilson Center for Scholars and the International Council on Nanotechnology, have collaborated with NIOSH, resulting in agreements to integrate capabilities for multi-database searching, directly from each respective Web site. Future plans include adding more nanomaterial data records and improving searching capabilities. Such upgrades are aimed at optimizing the usefulness of the database in order to increase the number of users, thereby maximizing the impact on worker health and safety.

Interventions Category

Winner:

• Title: Fire Fighter Fatality Investigation and Prevention Program
• Authors: McFall MF, Frederick LJ, Haskell WE, Stein R
• Source: Division of Safety Research
• Background: The NIOSH Fire Fighter Fatality Investigation Program (FFFIPP) works to analyze risk factors and identify trends in fire fighter line-of-duty injuries and fatalities. A goal of the program is to disseminate findings to fire service stakeholders who can take action for prevention. On average, 100 fire fighters die annually in the line-of-duty, with approximately 30% of those being killed while operating on the fireground. In addition, the National Fire Protection Association (NFPA) noted that in 2005, 4,140 (10%) of all fireground injuries (41,850) were directly associated with fire fighters operating in an environment that normally required the use of a self-contained breathing apparatus (SCBA) and a personal alert safety system (PASS). PASS devices are designed to emit an audible signal when a fire fighter is unable to move due to injury, entrapment, or incapacitation, thus allowing rescuers to locate and remove victims in a timely manner. This is especially critical in a low visibility environment. After investigating a number of line-of-duty fatality investigations, FFFIPP researchers identified a commonality in the chain of events of some fatalities involving structure fires; PASS devices failed to work properly when fire fighters had become incapacitated inside a burning structure. The failure of PASS devices can delay locating and assisting the incapacitated fire fighters. Researchers from the NIOSH National Personal Protective Technology Laboratory presented the NIOSH findings to the NFPA Technical Correlating Committee on PASS performance (NFPA 1982) in the summer of 2005. Based on and in response to this life-critical information, NFPA revised its existing standard to integrate three new testing methods (audible alarm muffle test, heat immersion/leakage test, and a high temperature functionality test) to address the performance issues raised by NIOSH.
• Relevance: On December 20, 2006, the standard was finalized, and the "grace period" for products certified under the old standard will expire June 30, 2007. The identification of this important problem was a true partnership among NIOSH, NFPA, the International Association of Fire Fighters, and the National Institute of Standards and Technology. Manufacturers of PASS devices have begun to re-design PASS component materials. This project is an example of how a NIOSH surveillance and research effort directly translated to the development of improved safety equipment performance criteria and standards, aiming to improve fire fighter safety and save lives.

Honorable Mention:

• Title: An Evaluation of a "Best Practices" Musculoskeletal Injury Prevention Program in Nursing Homes
• Authors: Collins JW, Waters TR, Wolf LD, Bell J, Evanoff B, Nelson A, Menzel N
• Source: Division of Safety Research
• Background: Frequent lifting and repositioning of patients is a physically demanding task and the leading source of injury for health care workers. Among U.S. female workers, nursing aides and orderlies suffer the highest prevalence (18.8%) and report the most annual cases of work-related back pain (n=269,000). Over 10,000 registered nurses suffer lost time work injuries due to lifting patients and 12% of nurses report they left the nursing profession because of back pain. Direct and indirect costs associated with back injuries in health care are estimated to be $20 billion annually. A critical nursing shortage, coupled with the excessively high injury rate, is straining the ability of the nursing work force to care for our nation's rapidly increasing sick and elderly. NIOSH researchers have worked with numerous partners to conduct a diverse program of laboratory and field research directed at reducing the risk of musculoskeletal disorders for healthcare workers.
• Relevance: NIOSH conducted an intervention trial aimed at evaluating a safe patient lifting program that demonstrated significant reductions in injury rates, workers' compensation costs, lost workday injury rates, and restricted workday rates, as well as showed a positive capital return on the investment in lifting equipment and worker training based on workers' compensation savings. Significant reductions in injuries were achieved for both full-time and part-time nurses in all age groups, in all experience categories, and in all study sites. NIOSH also undertook a project that compliments the intervention trial by developing and implementing a safe patient handling curriculum in schools of nursing. This project demonstrated that schools of nursing can be very effective in advocating a move from manual handling techniques to evidence-based safe patient handling and movement programs. In 2006, research findings were disseminated through peer-reviewed manuscripts, NIOSH documents, text books, and restructuring of nursing student curriculum. Specific outputs included: 1) a NIOSH document, "Safe Lifting and Movement of Nursing Home Residents," that conveyed scientific evidence in user-friendly terms to over 14,000 nursing homes; 2) development and pilot testing of a patient lifting curriculum in 26 schools of nursing, which successfully integrated the content into their basic skills courses; and, 3) a book authored collaboratively with researchers from the American Nurses Association and the Veteran's Health Administration, "Safe Patient Handling and Movement: A Practice Guide for Nurses and other Health Care Professionals." These outputs contributed to the passage of safe patient lifting laws in six states (Texas, Washington State, Ohio, Rhode Island, New York and Hawaii) and a Federal Bill that is being considered by Congress. The American Nurses Association also included NIOSH patient lifting study findings in their "Handle with Care" campaign, an industry-wide effort to prevent back and other musculoskeletal injuries among nurses.

Technology Category

Winner:

• Title: Conception, Development, and Rapid Commercialization of Two Novel Surface Wipe Detection Methods for Methamphetamine
• Authors: Esswein EJ, Snawder JE, Striley C, Kennedy E, DeBord GM
• Source: Division of Surveillance, Hazard Evaluations, and Field Studies and Division of Applied Research and Technology
• Background: The nation continues to face an epidemic of illegal, clandestine methamphetamine drug manufacturing. Seizures of illegal drug "labs" increased nationwide from 7,438 in 1999 to 12,484 in 2005, but this number drastically underestimates the true extent of the occupational and public health problem. Nationwide, tens of thousands of police, fire, and other responders are at serious risk for occupational exposures to methamphetamine residues, as well as other toxic chemicals, when entering these labs for search, seizure, and remediation. The public also faces risks when renting or buying contaminated property. Police, fire fighters, first responders and industrial hygienists, have indicated the need for real-time surface detection methods for methamphetamine, based in part from results of a 2004 investigation involving NIOSH. An interdivisional NIOSH team convened in late 2005 to discuss development of surface detection methods for methamphetamine. In 2006, two methods were developed and evaluated: a colorimetric wipe and an immunochemical surface wipe detection method.
• Relevance: Following initial successes in developing the colorimetric and immunochemical methods, an invention report was drafted and submitted. Stakeholders included the Cincinnati and Colorado State Health departments; Scientific Kit Company (SKC), Inc., a global leader in sampling technologies; National Jewish Medical and Research Center; the Denver Police Department and the North Metro Drug Task Force (Denver, Colorado); and the Tri-County Health Department, Colorado. Two fully commercialized products were licensed and released to commercial market at the American Industrial Hygiene Conference and Exposition in 2006. The NIOSH-developed technologies currently are sold under the brand names MethAlert and MethChek. Users of these technologies are the nation's first responders, industrial hygienists, and site remediation technicians. State and local health departments as well as departments of the federal government also are potential beneficiaries of these surface detection methods for methamphetamine. The American Industrial Hygiene Association's publication Synergist highlighted the methods in, "Tweakers, Snakes and Cold Medicine: Health and Safety during Illegal Drug Lab Cleanup" (Vol 17 (1), pp 32-36). SKC Inc. also created a Web site (http://www.meth-wipe.com/). In July 2006, a NIOSH e-News article also led to extensive interest in the products. The methods have proven to be cost-effective ways to immediately detect methamphetamine residues. In addition, SKC Inc. reports that real estate agents and the general public are purchasing the products, signifying that the methods are having a public health as well as an occupational health impact.