NIOSH eNews

From the Director’s Desk

John Howard, M.D.
Director, NIOSH
October eNews 2012

New Rule Establishes Standards for Evaluation of Digital Chest Radiographs

Since its creation, NIOSH has been responsible by law for administering a program that offers chest radiographs, or x-rays, to provide underground coal miners with medical monitoring for coal workers’ pneumoconiosis, or "black lung," the term by which this serious but preventable occupational lung disease is probably better known among the general public. The NIOSH Coal Workers’ Health Surveillance Program (CWHSP) evaluates miners’ chest radiographs for the presence and severity of changes in the lung associated with coal workers’ pneumoconiosis. The program uses a standardized classification system developed by the International Labour Office (ILO).

Until recently, the ILO system could only be applied to traditional film radiographs, because it required the use of film-based radiography, the only radiography technology that existed years ago when the technical standard was developed. As a result, the system (and critically for our agency, the NIOSH program based on the system) could not be applied to the modern, digital chest images, which have largely replaced film-based radiographs at medical facilities in the United States. Digital imaging has largely replaced film methods because of its many advantages: It eliminates the need to develop film. It allows the electronic images to be stored and used economically like other computer files. It allows images to be adjusted to improve visualization of abnormalities and to compensate for problems like over-exposure of the image.

Recognizing the need to modernize the CWHSP, NIOSH embarked on a sustained effort about seven years ago to enable use of digital chest imaging in the program. An important barrier was the need to develop the highly technical guidance needed to ensure that digital imaging would provide results equivalent to film radiography under the ILO classification system. This was important because the ability to adjust the appearance of digital images could potentially affect the interpretation of specialists who read the radiograph to identify and classify abnormalities associated with coal workers’ pneumoconiosis. Because a body of information in this area did not already exist, NIOSH and partners carried out the necessary research.

Based on findings from the research, NIOSH published a guidance document on best technical approaches to applying ILO classification to digital chest images (/niosh/docs/2011-198/). Then, using these technical specifications, NIOSH proposed federal regulations last January to enable use of digital chest imaging in the CWHSP. NIOSH then drafted final regulations that were responsive to public comments. On September 13, NIOSH achieved the major milestone of publishing the final regulations enabling use of modern, digital chest images in CWHSP (http://www.regulations.gov/#!documentDetail;D=CDC-2011-0013-0018). The new regulations will become effective on October 15.

Many have benefitted from these efforts. As NIOSH worked to update its own program, it partnered with ILO and helped to update the ILO classification system. Published in late 2011, this ILO update extends applicability of the classification system to digital chest images and makes digitized standard films available for use in film classification throughout the world. Those interested in classifying digital chest images using the ILO system may want to try out NIOSH BViewer© software. It can be downloaded for free from the NIOSH Digital Chest Radiography Web page (/niosh/topics/chestradiography/digital-images.html). The Web page also has information about the NIOSH image repository, a new effort to collect digital chest images that will be useful for teaching, quality assurance, and research in image classification for pneumoconiosis.

Those interested in the Coal Workers’ Health Surveillance Program, including healthcare facilities interested in becoming participants, can find detailed information on the Program’s Web site (/niosh/topics/surveillance/ords/CoalWorkersHealthSurvProgram.html).

The Coal Workers’ Health Surveillance Program is a key component of national efforts by diverse partners to prevent a terrible but preventable occupational lung disease. The repository of x-rays on file in our laboratory in Morgantown, W.Va., comprising more than 390,000 film images stored on more than 500 shelves, represents more than 40 years of continuing health surveillance and service. I am gratified by the hard work of NIOSH’s technical staff and their partners in updating the program to ensure it remains responsive to this continuing 21st century occupational health need.

Link Up with Total Worker Health on LinkedIn

Join NIOSH’s Total Worker Health™ Group on LinkedIn. Connect with experts leading the integration of health protection and health promotion. Share your ideas and experiences and ask questions on ways to best integrate health protection and health promotion in the workplace. Stay up to date on new research and practices in Total Worker Health™. http://www.linkedin.com/groups/NIOSH-Total-Worker-Health-4473829/about

WTC Final Rule Statement

On September 12, the WTC Health Program administrator published a final rule in the Federal Register adding certain types of cancers to the list of WTC-related health conditions under the James Zadroga 9/11 Health and Compensation Act of 2010. The final rule will become effective 30 days after publication, on October 12. For additional information about the addition of cancer to the list of WTC-related health conditions visit /niosh/topics/wtc/stac/cancer.html.

Former NFL Players at Increased Risk of Death from Neurodegenerative Causes, Study Finds

A new NIOSH study found that National Football League (NFL) players may be at a higher risk of death associated with Alzheimer’s and other impairments of the brain and nervous system than the general U.S. population. These results are consistent with recent studies by other research institutions that suggest an increased risk of neurodegenerative disease among football players. Read more /niosh/updates/upd-09-07-12.html.

Free Hearing Loss Webinar

On October 30, at 3:00 EDT, join NIOSH for a free NIOSH train-the-trainer webinar on preventing work-related hearing loss. CEUs are available. For more information or to register, go to /niosh/conferences/webinar-ehlers/FreeWebinarHearingLossPreventionOct302012.pdf.

WestON Meeting - Building Western Capacity

The fifth annual Western States Occupational Network (WestON) meeting was held in September in Denver. The meeting provided a venue for state occupational safety and health professionals throughout the western U.S. to meet and share ideas for collaboration, information exchange and capacity building. Presentations, agenda and photos can be viewed at http://www.ucdenver.edu/academics/colleges/PublicHealth/research/centers/maperc/training/weston/Pages/default.aspx. The sixth WestON meeting is planned for September 26–27, 2013, in Denver. For more information on this meeting or initiatives to foster state OSH capacity in the West, please contact Yvonne Boudreau (yboudreau@cdc.gov).

Collaborating Center Newsletter Available

The September Collaborating Centre Connection newsletter is now available with updates on the work of the Global Network of WHO Collaborating Centres in Occupational Health. /niosh/ccc/CCCnewsV2N7.html

News from Our Partners

Florida Occupational Health and Safety Program

The Florida Occupational Health and Safety Program released a new report on work-related fatalities in Florida. The report can be found at http://doh.state.fl.us/Environment/medicine/occupationalhealth/fatalityreport2007.pdf

Federal Advisory Council on Occupational Safety and Health to Meet

The Federal Advisory Council on Occupational Safety and Health (FACOSH) will meet October 18 in Washington, D.C. FACOSH advises the Secretary of Labor on all matters relating to the occupational safety and health of federal employees. The meeting is open to the public. Comments and requests to speak must be submitted by October 10. See the Federal Register notice for details (http://www.gpo.gov/fdsys/pkg/FR-2012-09-19/html/2012-23106.htm).

Health Hazard Evaluation (HHE) Program Update

Psychosocial Measures for NIOSH Field Use Journal Article Available

A panel of experts in occupational health psychology was convened in October 2010 to select practical, valid psychosocial measures for use during NIOSH field investigations, particularly health hazard evaluations. Twenty-four measures representing 22 constructs were selected based on the following criteria: practicality, brevity, validity, availability of existing data, and lack of confounds between psychosocial constructs and outcomes. A summary of the panel’s procedures and results was published in the September issue of the Journal of Occupational and Environmental Medicine. Contact Doug Wiegand at hzo7@cdc.gov for more information.

New Health Hazard Evaluation Report Now Available: Assessment of Visual and Neurologic Effects Among Video Hub Employees

HHE Program investigators evaluated concerns about visual and neurological symptoms among employees who monitored television displays at a video hub office. Most employees reported multiple symptoms while at work, including headaches, eyestrain, and body aches. After measuring the distances from employees to video displays, investigators determined that looking back and forth between nearby and far objects may cause eyestrain. The video hub office was well maintained and most employees felt that management did an adequate job of letting them know what was being done to address workplace concerns. Investigators recommended that

• Employees are provided adjustable ergonomic chairs.
• Computer monitors have adjustable heights and non-glare screens.
• Management evaluates workshift scheduling.
• Employees wear personal protective equipment such as laser glasses, 3-D glasses, and earmuffs as needed.

A link to this report can be found at /niosh/hhe/whats_new.html.

New Fatality Assessment and Control Evaluation (FACE) Program Reports Now Available

Master Stonemason Dies in a 30-foot Fall from a Handmade Work Platform Attached to a Powered Industrial Truck

Some of the contributing factors that led to the death of a master stonemason were failure in the proper use and modification of a powered industrial truck, the lack of a hazard assessment, not having a fall protection plan that included training and equipment to protect the workers, not training workers to operate power industrial trucks, and not establishing accountability for safety compliance. /niosh/face/stateface/NY/07NY107.html

Carpet Installer Dies after Falling 32 Feet at a Commercial Jobsite

Some of the contributing factors that led to the death of a carpet installer were the lack of a safe and approved method to elevate, handle, and deliver materials at elevation; not ensuring guardrails on windows at elevated heights were secured; the lack of fall arrest systems when guardrails were removed; and the lack of warning signs or placards. /niosh/face/stateface/wa/09WA051.html

New Fire Fighter Fatality Investigation and Prevention Program Reports Available

Volunteer Fire Fighter Dies After Falling from Tailboard of Tanker Truck—Virginia

A 21-year-old male volunteer fire fighter died after falling from the tailboard of a fire department tanker shortly after successfully guiding the driver in backing the tanker into position to dump its load of water into a holding tank. NIOSH investigators concluded that the contributing factors included the failure of the driver to conduct a full driver walk-around before leaving the scene, inadequate communications between the driver and victim, and ice on the roadway after an unintentional discharge of water onto the roadway in freezing conditions. /niosh/fire/reports/face201206.html

Fire Fighter Suffers Heart Attack While Fighting a Structure Fire and Dies—Missouri

A 32-year-old male volunteer fire fighter died while working at the scene of a structure fire. While wearing full turnout gear, he assisted in exterior overhaul operations for about 15 minutes, before being assigned to rehabilitation. NIOSH investigators concluded that the physical stress of exterior overhaul activities triggered his heart attack and subsequent cardiac death. /niosh/fire/reports/face201217.html

Fire Marshal Suffers Cardiac Arrest and a Probable Heart Attack during a Fire Department Physical Ability Test—Utah

A 55-year-old male fire marshal suffered a sudden cardiac event during a fire department physical ability test. The test, a job-related simulation, involved completing 10 evolutions of essential fire fighter tasks in full turnout gear and self-contained breathing apparatus. The NIOSH investigator concluded that the heavy physical exertion required to complete the physical ability test in full turnout gear triggered a heart attack and/or a heart arrhythmia (asystole) that resulted in cardiogenic shock. /niosh/fire/reports/face201218.html

A Career Captain Dies and 9 Fire Fighters Injured in a Multistory Medical Building Fire—North Carolina

A 37-year-old male captain died and 9 fire fighters were injured in a 6–story medical building fire while searching for the seat of the fire. The captain ran low on air and attempted to buddy breathe with another fire fighter before being overcome by smoke. The NIOSH investigators concluded that the lack of an automatic fire suppression system, the failure to follow multistory/high-rise standard operating procedures, the failure to follow air management practices, and inadequate strategy and tactics were among the factors that contributed to the fatality. /niosh/fire/reports/face201118.html

Volunteer Fire Fighter Caught in a Rapid Fire Event During Unprotected Search, Dies After Facepiece Lens Melts—Maryland

A 43-year-old male volunteer fire fighter died after being caught in a rapid fire progression. The victim and another fire fighter were conducting a search of a third-floor apartment above the fire, when the conditions suddenly deteriorated, trapping the two fire fighters. The victim tried to exit through the rear balcony and the other fire fighter was forced to bail out a bedroom window and was injured by the fall. The NIOSH investigators concluded that the contributing factors that led to the fatality included conducting a search above the fire without a means of egress being protected by a hoseline, the incident management system was ineffective, fireground accountability was inadequate and a rapid intervention crew was not readily available to respond to the emergency. /niosh/fire/reports/face201102.html

NORA

NORA Manufacturing at the National Safety Council Congress & Expo

The NORA Manufacturing Sector Council (/niosh/nora/councils/manuf/) has been engaging potential partners to help spread the word about the National Manufacturing Agenda (/niosh/nora/comment/agendas/manuf/) and established solutions for reducing hazards. One result is a new educational track at the National Safety Council Congress & Exposition (http://www.congress.nsc.org/nsc2012/public/enter.aspx) later this month. The plan is to have an ongoing Research to Practice track that will start during this Congress. This kick-off will feature several talks about NORA research-to-practice work in the manufacturing sector, including effective hearing loss prevention programs and strategies for avoiding stress and inadequate sleep. Contact the NORA coordinator (noracoordinator@cdc.gov) for more information.

r2p Corner

NIOSH-developed HPD Well-Fit™ System leads to a Commercial Product

NIOSH signed a nonexclusive licensing agreement with Michael and Associates, Inc., (www.michaelassociates.com) to manufacture a hearing conservation system based on the NIOSH-developed Hearing Protection Device (HPD) Well-Fit™ System. HPD Well-Fit™ allows a hearing conservation professional to quickly and accurately assess the attenuation of essentially any commercially available earplug and to use these data to estimate a worker’s noise exposure. For more information on NIOSH research related to noise and hearing loss prevention, visit /niosh/topics/noise/prevention.html or contact William Murphy at WMurphy@cdc.gov. Mention of the company name or products does not constitute a NIOSH commercial endorsement.

NIOSH Collaborates with Ventanilla de Salud Advisory Council

NIOSH researcher Michael Flynn was recently named to the newly created advisory council for the Ventanilla de Salud (VDS) program. The VDS is the health promotion program of Mexico’s Department of Health and the Ministry of Foreign Affairs, which is implemented through the 50 Mexican consulates in the United States. This formal recognition of NIOSH’s ongoing collaboration with the Mexican government will ensure that occupational safety and health becomes a central component of the VDS program. For more information contact Michael Flynn at MFlynn@cdc.gov or (513) 533–8568.

What’s new on the NIOSH Science Blog? Join the Discussion Today!

• Happy N95 Day! http://blogs.cdc.gov/niosh-science-blog/2012/09/n95day/
• Lung Cancer Screening in the Occupational Setting—An Update http://blogs.cdc.gov/niosh-science-blog/2012/08/ctscan3/
• Protecting Emergency Responders http://blogs.cdc.gov/niosh-science-blog/2012/09/responderhealth/

Federal Register Notices

NIOSH Proposed Project: Exposure Assessment and Epidemiological Study of U.S. Workers Exposed to Carbon Nanotubes and Carbon Nanofibers

https://federalregister.gov/a/2012-23194
Published 9/20/12. Written comments should be received within 60 days.

NIOSH Proposed Project: Human Systems Integration Design Guidelines (MineFirst) for Improved Mine Worker Safety

https://federalregister.gov/a/2012-23191
Published 9/24/12. Written comments should be received within 60 days.

For a full listing of NIOSH official publications for rules, proposed rules, and notices, visit the NIOSH Federal Register page.

New Communication Products

Safety and Health among Hotel Cleaners, in Spanish
http://www.cdc.gov/spanish/niosh/docs/2012-151_sp/

Call for Abstracts, Proposals and Presentations

National Safety Council 2013 Texas Safety Conference & Expo
Call for presentation proposals. Submission deadline is October 5. http://tsce.nsc.org/tsce2013/public/Content.aspx?ID=1701&sortMenu=107000

ACOEM 2013 American Occupational Health Conference
Call for abstracts. Submission deadline is September 21. https://adobeformscentral.com/?f=oXs0xh0LoZF5yJXqvjjhiw

Association for Professionals in Infection Control (APIC)
Call for abstracts. Deadline for submission is December 10. https://www.conferenceabstracts.com/cfp2/login.asp?EventKey=UFNHTDSF

AAOHN 2013 National Conference
Call for abstracts. December 14, 2012 https://www.aaohn.org/component/option,com_abstracts/Itemid,462/

23^rd Annual Art and Science of Health Promotion Conference
Call for Art & Science Presentation and Activity Session proposals. Submission deadline is September 21.
Call for Peer Presentations. Submissions deadline is February 15, 2013. www.HealthPromotionConference.org

Upcoming Conferences & Workshops

Association of Occupational Health Professionals in Healthcare (AOHP)
October 3–6, Las Vegas, NV
https://www.aohp.org/Conference2012/default.asp

American Osteopathic College of Occupational & Preventive Medicine (AOCOPM)
2012 Annual Meeting
October 6–11, San Diego, CA
http://www.aocopm.org/

XXX^th International Symposium of the International Social Security Association Construction Section (ISSA-C) on Occupational Safety and Health in the Construction Industry
October 16–18, Boston, MA
http://www.issaboston2012.org/index.html

2012 National Safety Congress & Expo—Celebration of the Century
October 20–25 in Orlando, FL
http://www.congress.nsc.org/nsc2012/public/Content.aspx?ID=1130&sortMenu=106000

Pennsylvania Governor’s Occupational Safety and Health Conference (PA Gosh) October 29–30, Hershey, PA
http://pasafetyconference.com

Pittsburgh Coal Mining Institute of America and Society for Mining and Exploration Joint Meeting
October 25–26, Canonsburg, PA
http://www.smepittsburgh.org/news.htm#A9

American Public Health Association Annual Meeting
October 27–31, San Francisco, CA
http://www.apha.org/meetings/AnnualMeeting/

American Industrial Hygiene Association Fall Conference
October 27–31, San Antonio, TX
http://www.aihafallconference.org/Pages/Default.aspx

Science of Eliminating Health Disparities Summit
October 31 – November 2, National Harbor, MD
http://www.nimhd.nih.gov/summit_site/programAgenda.html

Isocyanates and Health: Past, Present, and Future
November 1–2, Bethesda, MD
http://secure.cirpd.org/isocyanates2012/content/index.cfm?service=main&page=general_information

Personal Protective Equipment Workshop
November 27–30, Hollywood, FL
www.cttso.gov

Total Worker Health Symposium
November 29-30, Coralville, IA
http://cph.uiowa.edu/media/releases/rd.asp?rlsId=953

Digital Health Communication Extravaganza 2013 (DHCX)
February 20-22, 2013, Orlando, FL
http://dhcx.hhp.ufl.edu/

23^nd Annual Art and Science of Health Promotion Conference
March 18–22, 2013, Hilton Head, South Carolina www.HealthPromotionConference.org

2013 National Safety Council Texas Safety Conference & Expo
April 7–9, 2013. Galveston, TX http://tsce.nsc.org/tsce2013/public/MainHall.aspx?ID=1646&sortMenu=101000

Association of Perioperative Nurses
March 2–7, 2013, San Diego, CA
www.aorn.org

Fire Industry Equipment Research Organization Fire PPE Symposium
March 4–6, 2013, Raleigh, NC
http://fireppesymposium.com

IAFC Wildland Urban Interface 2013
March 19–21, 2013, Reno, NV
www.iafc.org/wui

AAOHN National Conference
April 15 – 18, 2013, Las Vegas, NV.
https://www.aaohn.org/2012-national-conference/aaohn-2012-national-conference.html

Fire Department Instructors Conference
April 22–27, 2013, Indianapolis, IN
www.fdic.com

ACOEM American Occupational Health Conference
April 28-May 1, Orlando, FL
http://www.acoem.org/aohc.aspx

IAFC Fire-Rescue Med
May 4–8, 2013, Las Vegas, NV
www.iafc.org/frm

Institute for Healthcare Advancement (IHA), 12th Annual Health Literacy Conference
May 8–10, 2013, Irvine, CA
http://www.iha4health.org/default.aspx?MenuItemID=190&MenuGroup

APA Work, Stress, and Health 2013: Protecting and Promoting Total Worker Health™
May 16–19, 2013, Los Angeles, CA
http://apps.apa.org/WorkStressHealth/review1.aspx

Association for Professionals in Infection Control, 40th Annual Conference
June 8–10, 2013, Ft. Lauderdale, FL
www.apic.org/Education-and-Events/Annual-Conference-2013

New England Fire/Rescue/EMS 2013
June 19–23, 2013, Springfield, MA
http://www.newenglandfirechiefs.org/page.asp_Q_navigationid_E_1

8th International Conference on Prevention of Work-related Musculoskeletal Disorders
July 8–11, 2013, Busan, Korea
www.premus2013.org

IAFC Missouri Valley Annual Conference
July 10–12, 2013, Colorado Springs, CO
http://www.iafc.org/Divisions/DivsionEvent.cfm?itemnumber=4696

ICOH SC Joint Conference
September 23–26, 2013, São Paulo, Brazil
http://www.icohweb.org/site_new/multimedia/events/pdf/ICOH%20SC%20Joint%20Conference%202013.pdf

A comprehensive list of upcoming conferences can be found at /niosh/exhibits.html.

Did you know?

NIOSH/Cincinnati employees recently participated in a Diversity service project with Childhood Food Solutions (CFS) to help repack food into individual bags for CFS to deliver to a local school before the next long weekend when school-provided breakfasts and lunches are not available. NIOSH Cincinnati employees have volunteered twice during the last year with CFS, packing thousands of bags for distribution to children.