2008 Direct-Reading Exposure Assessment Methods (D.R.E.A.M.) Workshop

 

DISCLAIMER: The findings and conclusions in these proceedings are those of the authors and do not necessarily represent the official position of the National Institute for Occupational Safety and Health (NIOSH). Mention of any company or product does not constitute endorsement by NIOSH. In addition, citations to Web sites external to NIOSH do not constitute NIOSH endorsement of the sponsoring organizations or their programs or products. Furthermore, NIOSH is not responsible for the content of these Web sites.

Meeting Summary

Welcome

Christine Branche, PhD, Acting Director of NIOSH, welcomed the participants and thanked them in advance for their suggestions. Ideas from the workshop will be incorporated into NIOSH research efforts, which address a wide range of activities, including those of first responders. She thanked Christopher Coffey, PhD, and David Weissman, MD, as well as people from a number of NIOSH divisions, for organizing the workshop. She emphasized that the workshop represents important work that will be integrated into NIOSH’s efforts.

Introduction

John Howard, MD, former NIOSH Director, set the stage for the workshop, saying he had long anticipated the time when workers could conduct their own exposure assessment in real time. He hoped that all would look at the issue of direct-reading method (DRM) research including from a manufacturing and innovation standpoint by employers, workers, and non-government organizations. Dr. Howard emphasized that success in this arena requires not just technological development but also attention to the culture of the workplace and to regulatory structures. Rapid exposure assessment tools may help individuals identify potential problems on the front lines and implement risk management techniques in real time. Dr. Howard hoped the workshop would identify areas for research and development that would bear fruit for many years to come.

Overview

David Weissman, MD, Director of the Division of Respiratory Disease Studies at NIOSH and manager of the Exposure Assessment NORA cross sector program, explained that guest speakers would describe the state of the art of DRMs in various contexts. Later, participants would break into groups organized by type of exposure to identify key research needs. Each breakout group would summarize its findings during a second general session. Dr. Weissman said the deliberations of the breakout groups would drive the NIOSH research agenda.

Presentation Summaries

Radiation Detection in the 21st Century and the Impact of the Department of Homeland Security (DHS) on Radiation Detection Instrumentation
Morgan Cox, CHP

Mr. Cox described four types of radiation of concern (alpha, beta, photon, and neutron), their primary sources, and current detection technology, methods, and challenges for each. Mr. Cox sees great potential in the use of long-range alpha detection, which can measure alpha contamination from irregular surfaces, tubing, and piping. New methodologies for photon radiation detection are emerging with new detector types.

The International Atomic Energy Agency is seeking improved neutron detectors, primarily to detect illegal trafficking of nuclear materials across borders. The U.S. Army has tested the Stanley Kronenberg carbon fiber detector, which uses two coupled ion chambers to detect neutron radiation. Researcher Mario Overhoff demonstrated that coupling a scintillator with a photomultiplier tube can measure fast neutrons at low levels. To date, no commercial entity has explored development of either technique.

Mr. Cox noted that the creation of the DHS and the threat of so-called dirty bombs led to the rapid development of new standards for radiation detection and new, stringent DHS testing and evaluation protocols. The new standards sparked demand for new technology, and DHS tied some funding requirements for procurement of radiation detectors to the standards. The emphasis of DHS has been on radiation detection, not protection. The agency identified some specific needs in terms of product development, which has stimulated some technological advancements (e.g., miniaturization, improved portability). However, much more work is needed, and the DHS is seeking more experts willing to assist in development of standards.

Discussion

Mr. Cox described the American National Standards Institute (ANSI) standards N42.49 A & B, which address personal emergency radiation detectors with and without alarms. These standards were written with input from potential users (e.g., fire protection workers, law enforcement officers) and manufacturers, which highlighted some areas of tension between what users want and what manufacturers can provide.

Mr. Cox acknowledged that more research is needed to better understand the wide range of individual responses to radiation exposure. He noted that healthy, young people may be able to withstand higher doses or more exposure than others and that women appear to be more resistant to radiation exposure, although researchers do not know why. More attention to biodosimetry in radiation detection may offer some insight on the linear threshold of radiation damage.

Selection of DRMs and What They Mean to the Worker
Jon Volkwein, NIOSH

Mr. Volkwein observed that periodic assessment of hazards in the workplace is effective for stable work environments, but miners, among others, face constantly changing work environments. He summarized five key areas to address in development of DRMs: continuous monitoring, frequency of sampling, worker involvement and education, verification of exposure, and innovation. Current DRMs have great value in identifying sources of exposure but require skill to understand and interpret. Ideally, DRMs will become easier to use yet still provide accurate, unambiguous results. Workers need DRMs that don’t impede their ability to do their jobs and provide them enough information to help them manage or reduce exposure or risk.

The higher the hazard threat, the more frequently sampling may be required, which affects the cost of using the DRM. To evaluate the cost-benefit ratio of DRMs, Mr. Volkwein recommended analyzing the return on investment (e.g., using ORC Worldwide’s Return on Health, Safety, and Environmental Investments software). He reminded participants that the cost of a citation from the Occupational Safety and Health Administration (OSHA) is an indirect expense that could be avoided by use of DRMs and should be factored into research and cost-benefit analyses, as should potential savings from decreased worker compensation claims and lower health insurance premiums.

The key lesson from the implementation of personal dust monitors among miners was the importance of worker participation. Workers should be involved from the outset in the design of DRMs, and they should be educated on what the device measures, how it works, and what the measurements mean, empowering them to recognize potential hazards early and mitigate their risk. Research on noise exposure has shown that simply having access to real-time data was enough to spur workers to take measures to reduce their exposure.

In response to a question, Mr. Volkwein acknowledged that workers may be motivated to manipulate the results of DRMs so they can continue to work and earn overtime pay, for example. He said rules regarding sampling should be written to minimize the incentives to intentionally over or under-report the results. Furthermore implementation of sampling and/or monitoring rules for individuals should make clear that use of a DRM is not a substitute for engineering controls. (See disclaimer on the workshop home page.)

James Weeks, United Mine Workers of America

Mr. Weeks described the history of occupational safety efforts in mining, which underscore many of the concerns mine workers have about the development and use of DRMs. For example, when the federal government established the Mine Safety and Health Administration (MSHA), it set standards for dust respiration but gave responsibility for measuring dust levels to the mine operators. Years later, about 200 mine operators were convicted of submitting fraudulent samples to MSHA. Efforts to develop a tamper-proof sampling device were stalled by government deregulation efforts of the 1980s.

In 2000, MSHA proposed rules on employing personal dust monitors. Mine workers and operators united in their opposition to the rules and came to consensus on the following points:

• MSHA should be responsible for obtaining samples to determine compliance.
• Only one device, the personal dust monitor, should be used to monitor exposures to determine compliance (instead of allowing mines to choose from among several devices).
• Sampling information should be available to all interested parties.
• Samples should be taken over a full shift (typically 10–12 hours) and the results averaged over a typical work week (40 hours) to better represent real-life scenarios.
• MSHA should not calculate a margin of error for measurement. Instead, standards should include absolute limits, above which a citation is given.

Validation of DRMs (and How Not To Validate Them)
Matthew Magnuson, PhD, Environmental Protection Agency (EPA)

The EPA’s National Homeland Security Research Center evaluates DRMs in relation to homeland security and emergency response concerns. The goal of validation is to ensure that the product provides reliable, relevant data. Reliability can be addressed partly by setting manufacturing standards. While DHS has developed standards for radiation levels, few of those standards address detection or DRMs. Establishing performance criteria is challenging, and performance metrics must be validated.

Third-party testing is an important component of evaluating performance to ensure compatibility and comparability among detected results of DRMs from different manufacturers or used in different settings. The EPA’s Technology Testing and Evaluation Program evaluates both commercially available technology and products still in the development stage, either supplied by manufacturers or purchased by EPA. The program includes peer review, input on product design from stakeholders, and review of the project plans as well as the test results.

The EPA and others focus a great deal on the relevance of the data provided by DRMs. In the field, information from DRMs must be unambiguous and interpretable by the operator. Training that addresses using the DRM and interpreting the resulting data is key. Such training must be specific to the needs of the worker conducted in advance of using the DRM.

At present, the field of validation requires more high-level, scientifically derived assessments of performance characteristics that apply to the specific purpose for which a given DRM is designed. From a policy perspective, the field should link its standards to funding mechanisms and ensure that operator integration (e.g., training and real-world assessment) is part of the validation process. Manufacturers need a mechanism for showing how an instrument works and for seeking validation that does not compromise the confidentiality of its research and development efforts. Government policy can play a role in helping manufacturers see novel potential markets for their equipment.

Discussion

A participant said he’d like to see NIOSH take up testing and validation, as it has in the past. He added that requiring manufacturers to test and validate their products at their own expense poses significant barriers unless all manufacturers are required to validate products in the same way.

Another participant asked whether EPA has guidelines or standards on performance characteristics. Dr. Magnuson responded that testing evaluates what a product can do and users decide whether those functions suit their needs. Other EPA efforts focus on meeting target goals, for example, for environmental cleanup. However, states set their own target goals, so manufacturers are challenged to develop products that can meet several states’ standards.

Integration of Activity Through Position
Peng-Yau Wang, PhD, National Central University, Taiwan

Dr. Wang described the shortcomings of some existing techniques for monitoring worker activity and exposure, such as questionnaires, daily records, and video analysis. To improve understanding of what workers are doing at any given time and how that relates to exposure, his company, Sweetek, Inc., is developing a location tracking device that can be used indoors and coupled with sensors to provide real-time data. It uses the same technology as wireless computers, and information can be relayed instantly from the field to a computer server.

By adding small, portable, easy-to-use relay devices, the tracking device can function in confined spaces and remote areas. Data can be displayed in the field in real time. The device could have a wide range of applications. Dr. Wang’s company is incorporating it into a sleep study to assess body position in relation to sleep disorders.

Dr. Wang emphasized the importance—and the difficulty—of limiting the information collected to avoid being overwhelmed by data. Also, worker safety must be weighed against privacy concerns. Dr. Wang’s company created a protocol for ensuring that workers agree to release the data collected on them, but regulations in this area are needed.

DRMs as Tools for Industrial Hygiene Troubleshooting and Exposure Assessment
William Heitbrink, PhD, University of Iowa

Dr. Heitbrink explained some of the inherent drawbacks of current DRMs, noting that more data are needed that reflect real-world situations. While it’s difficult to rely on instruments to provide accurate data, they are useful in measuring relative concentrations (e.g., to determine high vs. low exposure). In addition, instruments are needed that can provide good resolution in a very short time to better assess exposure for a task that takes only a few seconds. Data analysis can be frustrated by autocorrelation—that is, current readings may be a function of past measurements. Furthermore, a given DRM may not take into account all the variables, such as wind direction or the decline in function of a vacuum as the collection bag gets full. In addition, instruments do not provide feedback that relates directly to the association between exposures and health outcomes. While current technology has its uses, Dr. Heitbrink said we lack statistical data of sufficient quality to improve decision making or standard setting.

Dr. Heitbrink described the use of space concentration mapping using an optical particle counter in an auto engine manufacturing plant to illustrate his concerns. While the approach helped identify areas where the manufacturer could improve air quality in the plant, most of the data collected were too variable and unreliable to use as a basis for statistical analysis.

How to Collect DRM Data Based on Use
Stephen Rappaport, PhD, University of California, Berkeley

Even current collection methods result in data that have an enormous range of variability, said Dr. Rappaport. Even a single worker’s exposure can vary markedly in relation to the type of work performed; the duration of that work; day-to-day differences in type, location, and duration of work and equipment used; and environmental changes. To determine cause and effect, analysis must sort out the influence of numerous variables, which requires a lot of data. With sufficient amounts of data, statistical models can be applied that account for both fixed and variable determinants.

Dr. Rappaport underscored the two distinct purposes for collecting exposure data: 1) to identify and control potential hazards and 2) to survey the health effects of exposure. For health surveillance that focuses on the chronic health effects of long-term exposure, researchers need longitudinal studies that evaluate the variations between individuals and their circumstances. Hazard control that focuses only on short-term exposure hazards only requires information on the amount of toxic material in a specific environment. In the United States, industries have focused on short-term hazard control. The government established compliance testing that relies almost entirely on voluntary assessments made by the employers themselves, which minimizes incentive to take frequent samples or collect large amounts of data. Given the current state of affairs, Dr. Rappaport said, it is unlikely that we will collect sufficient data to address long-term health effects of exposure.

Dr. Rappaport cited the European Union’s 2006 regulation, Registration, Evaluation, Authorization and Restriction of Chemicals (REACH), as an example of a system designed to evaluate the long-term health effects of chemical exposures. Devices exist to collect and evaluate exposure data, but the United States must better enforce its regulations so that data can be used more effectively.

Reports and Recommendations by Hazard

Each breakout group was charged with identifying five top research priorities. All of the breakout groups determined that research should seek to develop new or refined technologies that meet sector-specific DRM needs, and several addressed the question of how to encourage product development for niche markets. Other recurring themes emerged from the breakout group reports:

• Worker empowerment involves educating and training users to better understand how specific DRMs work, what the DRMs can and cannot do, and how to interpret the data from their DRMs.
• In nearly every setting, standards are needed to ensure the accuracy of DRMs and to validate their performance.
• Efforts are needed to speed the transition from research to real-world application of DRMs.
• The criteria for exposure must be re-evaluated or defined in several sectors.

Gases and Vapors
Monitors: Jay Snyder, NIOSH; Ted Zellers, PhD, University of Michigan
Rapporteur: Jason Ham, PhD, NIOSH

The breakout group identified nine research priorities. Mr. Ham explained the group’s rationale for each.

Research Priorities

1. Pursue gas chromatography miniaturization, which could be coupled with other detectors, sensor arrays, or mass spectrometry, for example, to identify one compound within a mixture.
2. Explore techniques that allow workers to measure their own exposures. To accrue more data, evaluate options that are simple, cheap, and provide high throughput. Some accuracy may be sacrificed to provide more raw data.
3. Refine existing technologies and improve their sensitivity and selectivity, e.g., for detecting toxic gases, hydrogen sulfide, and carbon monoxide.
4. Make devices multi-functional, e.g., capable of recording chemicals present, temperature, and heart rate and incorporating global positioning systems.
5. Develop self-calibrated systems, eliminating the need for gas transport.
6. Focus on “niche” DRMs, e.g., for formaldehyde, hafnium, chloramines (for the poultry industry), nicotine, and organic isocyanates. Explore how NIOSH can contribute to development of DRMs with narrow market applications and that are unlikely to be commercially successful.
7. Establish NIOSH-OSHA collaboration to transition new DRMs to compliance-acceptable status.
8. Develop DRMs for unknown chemical components in mixtures.
9. Seek methods for worker empowerment, e.g., DRMs that give feedback directly to workers, thus giving them options to modify their behavior or environment.

Discussion

Moderators clarified that, because more data are needed overall, DRMs that provide data of less-than-perfect accuracy may be acceptable. One participant suggested that NIOSH set standards for the level of accuracy that is acceptable for field readings (as opposed to laboratory research or compliance assessment). Dr. Zellers agreed, noting that OSHA does include some standards for DRMs and that OSHA will assist with validation and, potentially, marketing when promising technologies emerge.

Much discussion surrounded the concepts of worker empowerment and behavior modification. Many agreed on the value of immediate feedback to enable the worker to modify his or her environment. Some pointed out that workers need training and knowledge to adapt to or modify their work environments or work processes. One person stressed the need for DRM operators to understand fully how a given device works, what it can do, and what it can’t do.

A participant asked why existing hydrogen sulfide and carbon monoxide monitoring technologies need further refinement. An oil refinery employee responded that he regularly hears complaints about false alarms, wide ranges of measurements, interfering components, and other issues that compromise the performance of DRMs for these substances.

The breakout group recommended that manufacturers seek to add more functions to their devices to make them more useful in broader markets. While some argued that developing more complex devices moves focus away from the need for simple, inexpensive tools, Dr. Zellers pointed out that the market for DRMs for gases and vapors is so small that even manufacturers of good tools have gone out of business because the market is so limited.

Aerosols
Monitors: Martin Harper, PhD, NIOSH; Pam Susi, CPWR—Center for Construction Research and Training
Rapporteur: Terri Pearce, PhD, NIOSH

Research Priorities

1. Conduct basic research on how instruments respond to different aerosol characteristics.
2. Invent/continue development of aerosol monitors, especially agent-specific monitors (not just dust).
3. Develop consensus standards on accuracy and validation with input from manufacturers, OSHA, and other stakeholders. NIOSH should not be responsible for validating instruments.
4. Develop standards for performance and use of monitors.
5. Develop sector-specific education and guidance on use of monitors in specific environments.

Discussion

Dr. Harper clarified that NIOSH representatives work with ASTM International (formerly the American Society for Testing and Materials), ANSI, and the International Organization for Standardization (ISO) via technical committees to develop consensus standards. While there is little activity on development of DRM standards in the United States, the European Commission and ISO are developing joint standards (see the European Committee for Standardization’s draft technical report, “Guide for the Use of Direct-Reading Instruments for Aerosol Monitoring”) that were reviewed by an ISO technical committee on which NIOSH is well represented. A participant added that ASTM is developing a standard that addresses chemical vapor detectors. Kevin Ashley, PhD, of NIOSH said NIOSH is pursuing opportunities to develop standards.

Dr. Harper noted that other than monitoring nano-sized diesel particles, the breakout session did not address nanoparticles. Some European standards on nanoparticles are nearing publication.

In response to a question about whether manufacturers are pursuing agent-specific monitors, Dr. Harper echoed Dr. Zellers in saying that markets are so small that they are not seen as profitable areas for technology development.

Dr. Harper said more basic research on characteristics of aerosols will help manufacturers take into account how instruments respond to particles of different sizes. Dr. Heitbrink called for more attention to how existing instruments can be used in different facilities and settings and emphasized the importance of more sector-specific education and guidance.

Ergonomics
Monitors: Brian Lowe, NIOSH; Rob Radwin, PhD, University of Wisconsin-Madison
Rapporteur: Vern Anderson, NIOSH

Measuring and mitigating ergonomic risk factors that contribute to musculoskeletal disorders poses unique challenges. In ergonomic terms, “exposure” refers to factors such as force, motion, vibration, and temperature. The worker’s interaction with the workplace and tools and the physical demands of the work can present a hazard. Measurement techniques must be indirect, as they must predict the internal load on muscles and joints caused by the interaction. Current assessment of exposure ranges from simple techniques, such as using a worker’s job title as a surrogate on which to base exposure, to use of electromyography to measure muscle activity, accelerometry, force sensors, and video monitoring.

Research Priorities

1. Assess the specific needs of specific customers for DRMs (e.g., researchers, practitioners, workers). The relativity immaturity of the field demands that more basic research be conducted.
2. Develop technologies to measure exposure dose or improve existing technology (e.g., through miniaturization or better usability).
3. Investigate pathophysiological processes associated with exposure (e.g., biomonitoring for tissue response as an indicator of musculoskeletal outcomes).
4. Establish valid exposure assessment criteria. Currently, no exposure limits exist.
5. Translate research into practical instruments for DRMs.

Discussion

Dr. Radwin pointed out that NIOSH and others have developed some ergonomics guidelines that could be relevant for development of DRMs and may include some exposure limits. However, more research is needed. He clarified that laboratories use a number of instruments in research that have not successfully been modified into devices that could be used by workers in the field. Because developing appropriate measurements to determine musculoskeletal exposure is in itself a complex task and because the field of ergonomics is relatively young, development of DRMs for ergonomics is in its infancy.

A participant pointed to the increasing accessibility of accelerometry and added that the entertainment and gaming industries are driving biomechanical research. Another noted that he uses sensors and video motion analysis to evaluate exposure among musicians; in the process, he’s found that the results can help musicians improve their performance. Thus, improving abilities may be an incentive to push ergonomics research ahead.

Dr. Radwin emphasized that the environment or the task usually dictates what the worker must do, and the worker often does not have the option of modifying his exposure. He pointed to a back belt currently on the market that alerts the wearer when he or she is lifting incorrectly. Dr. Radwin said the alarm is simply annoying when the wearer knows that he or she has no choice but to lift incorrectly under the circumstances. While some feedback tools can be helpful for workers, he called for more focus on the design of the workplace and tools that decrease stress on workers.

A participant noted that more advanced technology is needed to integrate the multiple measures needed to assess musculoskeletal exposure. Others added that exposure assessment must take into account real-world variables, such as an individual’s size, strength, and ability and the use of personal protective equipment.

Noise
Monitors: Chuck Kardous, PhD, NIOSH; Rob Brauch, Larson Davis; John J. Earshen, Angevine Acoustical Consultants, Inc.
Rapporteur: Dave Byrne, NIOSH

A number of well developed DRMs for measuring noise exposure exist, and correlating standards have been in place for nearly 30 years. More attention is needed, however, to measuring exposure to different types of noise (continuous, intermittent, impact/impulse) in different settings. Instruments are needed to evaluate the non-auditory effects of noise exposure (e.g., cardiac stress, high blood pressure). Current instruments are required to comply with national or international standards, but no entity certifies that the instruments comply.

Research Priorities

1. Reexamine the basis for current damage risk criteria. Mr. Kardous called for seeking universal consensus on a new set of criteria.
2. Determine the relationship between DRMs, metrics, and behavior modification to understand whether workers change their behavior in response to instant feedback from a monitor.
3. Develop new sensor technology (e.g., microphones, acoustic mannequins) that can be used in more settings, such as law enforcement.
4. Establish metrics to evaluate performance and measure the economic impact of implementing a solid hearing conservation program (e.g., savings on hearing compensation claims).
5. Develop a repository of exposure and risk data to help assess damage risk criteria and develop metrics, for example. Divisions throughout NIOSH have decades’ worth of research data that could be linked together to create a rich database for analysis.

Mr. Brauch added that, like others, the field of noise exposure suffers from being a small market of limited potential profitability to manufacturers. However, advancements in the consumer electronics market benefit the field, and European markets are seeking technology that not only measures but also analyzes exposure. He also emphasized that preserving hearing has significant economic benefits; for example, it increases survivability among soldiers in the field. Employers need more education about the return on investment of addressing noise exposure.

Discussion

Participants pointed out the difficulty of assessing hearing loss with existing mechanisms, which measure the effect of exposure, not the exposure itself. Mr. Kardous stressed the need for frequent monitoring over time of the workplace to evaluate and address environmental concerns. Another participant emphasized the role of supervisors in educating workers about safe work practices, providing tools to mitigate individual risk, and using DRMs and other methods to address the work environment.

Radiation
Monitors: Jeri Anderson, PhD, NIOSH; Mark D. Hoover, PhD, NIOSH; Cynthia G. Jones, PhD, Nuclear Regulatory Commission
Rapporteur: Pam Drake, PhD, NIOSH

Dr. Hoover summarized the life-cycle approach to development of instrumentation and said that radiation detection efforts would benefit from a mechanism that combines all the relevant factors (e.g., temporal and historical issues) into an integrated display.

Research Priorities

1. Develop new technology for biological DRMs that are direct-reading, efficient, and available, using biodosimetry and bioassays, for example, which are already in use overseas.
2. Reduce size and increase speed of neutron radiation detection for all energies.
3. Establish mechanisms for independent third-party testing of instruments.
4. Develop methods and standards for detecting airborne particles (for chemical, biological, radiological, and nuclear threats) for immediate first responders.

Dr. Hoover added that standards for data collection, management, and transmission must be harmonized, including use of voice, video, and positioning data.

The breakout group identified five potential roles for NIOSH:

• Evaluate and report on real-life operator experience with instruments in various industries—both routine and emergency operations, international and domestic populations—and the possible transfer of emerging technology to the United States.
• Expand participation in the Inter-Agency Board to develop equipment standards and enhance interoperability for all chemical, biological, radiological, and nuclear threat detection approaches.
• Expand role in developing national and international standards.
• Identify gaps in safety practices nationwide. Develop training materials and guides to bridge gaps. Identify opportunities for solutions using DRMs.
• Collaborate with stakeholders on development and implementation of new DRMs.

Discussion

Dr. Jones described a 2002 oil refinery explosion that exposed workers to radiation. She explained that the U.S. testing facility was not up and running as anticipated, so her agency had to send samples overseas. She called on participants to anticipate potential needs and look to emergency responders for models of rapid response. Dr. Jones added that any training materials developed by NIOSH should include stakeholder input and incorporate public comments.

Surface Sampling & Biomonitoring
Monitors: John Snawder, NIOSH; Matthew Magnuson, PhD, EPA
Rapporteur: Debbie Sammons, NIOSH

Ms. Sammons said that NIOSH combined surface sampling and biomonitoring into one session because they can be complementary in some cases. The nature of the contamination may lead an investigator to examine an individual more closely for effects. Conversely, when biomonitoring reveals exposure but air samples do not provide information, surface sampling may identify the source of contamination. Ms. Sammons described recent advances in the field and said there is enthusiasm for the potential application of existing technologies to identify volatile organic compounds in exhaled breath.

Research Priorities

1. Develop standards to ensure that products live up to manufacturers’ claims and to identify what a given product can or cannot do in various circumstances. One organization should oversee standards development.
2. Address accreditation to further ensure manufacturers adhere to standards and ensure that accreditation mechanisms are defensible in court.
3. Establish training for users on how DRMs work, what they can and cannot do, and how to interpret results.
4. Determine the purpose of DRMs (e.g., screening, mitigation) and what constitutes and acceptable DRM for that purpose. Action levels (i.e., exposure levels that require action be taken) are needed but should be developed after standards are established.
5. Identify new biomarkers and sensors, partnering with other organizations to leverage time and funds and seeking new uses for existing technology.

Discussion

Mr. Snawder clarified that new methodologies combined with cheap and abundant computing power make it possible to take exhaled breath samples from individuals and air samples at the same time to evaluate the presence and absorption of volatile organic compounds. It is now easier to gather much more data and to process those data to assess exposure. A participant suggested looking at other biomonitoring techniques as well.

Mr. Snawder cautioned against developing standards without providing sufficient training and guidance that address how to interpret data gathered by DRMs and how to address the findings. Workers are more likely to embrace DRMs when they receive education that empowers them to understand and address their own exposures. Participants called for more guidance specifically on what the results of surface sampling indicate, what should be done in response to those results, and what is appropriate for sampling. Some participants mentioned existing standards for surface sampling. Both ISO and the American Industrial Hygiene Association have accreditation standards for laboratories; both organizations also have mechanisms in place that could be used to develop standards for DRMs. Dr. Ashley said that NIOSH is seeking help from other organizations and experts to begin addressing action levels.

Closing

Dr. Coffey thanked all those involved and said the proceedings of the meeting would be posted for further review. He anticipated that the proceedings would include a feedback mechanism to garner more input on the research priorities. Dr. Coffey emphasized that the meeting represents the first step in a process that will inform the NIOSH agenda.