NIOSH eNews

From the Director’s Desk

John Howard, M.D.
Director, NIOSH

NIOSH Disaster Science Research Initiative to Enhance Responder Safety and Health

The traditional occupational safety and health programs of the twentieth century were designed, by and large, to prevent work-related injury, illness, and death in workplaces where hazards usually were recognizable and predictable. In the twenty-first century, scientists and decision-makers have had to develop additional skills and strategies to address another type of hazard: the risks that emergency responders face in the line of duty from unpredictable, uncontrolled conditions encountered in large-scale disasters.

Lessons learned to date from the September 11, 2001, terrorist attacks, anthrax mail contamination, Hurricane Katrina, the Deepwater Horizon response and cleanup, and other emergencies have informed new strategies for protecting responders. Through the emerging practice of disaster science, researchers seek to continue this progress and to engage increasingly complex challenges.

The National Institute for Occupational Safety and Health (NIOSH) has been a leader in the field of disaster science research. In partnership with other federal and state agencies, as well as with the private sector, NIOSH has made responder safety and health research a high-priority part of its research portfolio.

In January 2014, NIOSH launched the NIOSH Disaster Science Research Initiative (DSRI) to Enhance Responder Safety and Health. This initiative will concentrate on developing an approach to timely, scalable, scientifically sound responder-based research that can feasibly be implemented before, during, and after a large-scale disaster.

Disaster science as it relates to responder safety and health can present unique challenges to occupational safety and health researchers. First, a decision process to determine if a responder research study is warranted needs to be in place in advance of a disaster. Many factors need to be weighed, but it is imperative that a scientific study not interfere with actual response activities. Second, responder safety and health research studies are difficult to design and difficult to implement. Strategic thinking about which study designs and implementation plans are most feasible for responder safety and health studies is important. Third, research can be costly and scientists must assess whether studies are a worthwhile public health investment that will enhance future response efforts. The goal of disaster science research would be to produce useful, reliable results. As emergencies are by definition unpredictable, an accelerated decision-making process is necessary to determine if research should be undertaken.

Some of the potential questions under consideration by the DSRI include:

1. Considering the possible types of responses and the responders involved, what are the primary questions needing research? Where are the major gaps in our understanding of exposures and other factors influencing responder health?
2. What disaster research is NIOSH uniquely positioned to do?
3. What is the role of the academic community in responder safety and health research? What is the role of emergency preparedness and response practitioners and consultants in responder safety and health research?
4. What role should biomonitoring play in responder disaster research and how is it best implemented?
5. What are the major barriers to disaster science research to enhance responder safety and health?
6. How can an emergency responder health monitoring and surveillance system best be used to complement responder disaster research?
7. How does disaster research best fit into existing national response policies and systems?

A new NIOSH topic page (/niosh/disasterscience/) provides further information on the new NIOSH initiative, the resources that inform the initiative, and questions that will help NIOSH and its partners move the initiative forward and better integrate responder safety with other national emergency response strategies.

Please contact CAPT Margaret Kitt at ajy8@cdc.gov or CDR Lisa Delaney at lkd2@cdc.gov if you have any questions about, or are interested in participating in the DSRI.

New Video Tells Story of How Personal Flotation Devices Save Lives

NIOSH’s Alaska Pacific Office has released a new safety video highlighting the use of personal flotation devices as a critical tool in preventing deaths from rapid capsizing and man overboard events in commercial fishing. The video recounts the story of a salmon fishing crew who survived over 2 hours in the cold waters of Bristol Bay, Alaska, after their boat capsized in heavy seas. They attribute their survival to PFDs they wear as standard work gear. See the video at /niosh/docs/video/2014-115/.

NIOSH and NHCA Present 2014 Safe-in-Sound Excellence in Hearing Loss Prevention Awards™

The recipient of the 2014 Safe-in-Sound Award for Excellence is Northrop Grumman Systems Corporation, Electronic Systems Sector, from Linthicum, Maryland. An innovation award was also given to Benjamin Kanters for the Hear Tomorrow workshop at Columbia College Chicago, Chicago, Illinois. The awards were presented at the 39^th Annual National Hearing Conservation Association (NHCA) Hearing Conservation Conference on March 14, in Las Vegas, Nevada. The award recipient presentations can be seen at http://www.safeinsound.us/winners.html. Nominations for the next awards will be accepted until September 12. For further information please visit www.safeinsound.us. References to companies or products do not constitute a commercial endorsement by NIOSH.

Check Out New NIOSH Homepage

NIOSH proudly introduces the launch of the new streamlined NIOSH homepage! Check out the new animated feature banner and simplified page design at /niosh/. For the back story on the new design development, visit the NIOSH Science Blog at http://blogs.cdc.gov/niosh-science-blog/2014/03/28/webpage.

Recent Epidemiological Studies of Workplace Musculoskeletal Disorders

In the early 2000s, NIOSH funded 10 field-based studies to investigate the exposure-response relationship between job physical risk factors and work-related musculoskeletal disorders (MSDs). Findings from these studies have been compiled and published in 2014 in a special issue in the journal Human Factors. The studies show a strong link between job physical exposures and MSDs. These publications are listed on the NIOSH MSD Topic Page at /niosh/topics/ergonomics/. For more information contact Steve Hudock at sxh5@cdc.gov or Jack Lu at uzl5@cdc.gov.

Acting U.S. Surgeon General, NIOSH Alumnus, Visits Cincinnati

Rear Admiral Boris Lushniak, the acting U.S. Surgeon General, addressed colleagues and audiences in Cincinnati on March 26-27 at NIOSH and the University of Cincinnati. Lushniak is a former NIOSH health officer who was named Deputy U.S. Surgeon General in 2010 and acting U.S. Surgeon General in 2013. More information from press coverage can be found at http://www.bizjournals.com/cincinnati/news/2014/03/27/u-s-surgeon-general-prefers-cincinnati-chili-over.html?page=all .

NIOSH Congratulates

Cincinnati Federal Executive Board Recognizes NIOSH Researcher

Every year the Cincinnati Federal Executive Board (FEB) recognizes the hard work of public service employees. This year NIOSH researcher Scott Dotson was recognized as the winner of the Professional/Scientific Award at the FEB Recognition of Federal Excellence Awards Program. Congratulations to Scott and to all the NIOSH employees who were nominated for these awards.

Researchers Win Best Aerosol-related Paper Award

On March 24, NIOSH researchers John Snawder, Mike Breitenstein, Eric Esswein, Max Kiefer, and William Sieber were informed that their paper, “Occupational Exposures to Respirable Crystalline Silica During Hydraulic Fracturing,” published in the Journal of Occupational and Environmental Health won the American Industrial Hygiene Association’s (AIHA) Aerosol Technology Committee’s David L. Swift Award for best aerosol-related paper published in 2013. The award will be presented at AIHA’s annual conference in June. The full article is available at http://dx.doi.org/10.1080/15459624.2013.788352.

NIOSH Researcher Receives SOT Award for Best Paper

At the annual meeting of the Society of Toxicology, John Snawder of NIOSH and coauthors from the U.S. Environmental Protection Agency and the University of Cincinnati were notified that their paper titled “Application of an Updated Physiologically Based Pharmacokinetic Model for Chloroform to Evaluate CYP2E1-mediated Renal Toxicity in Rats and Mice” was awarded Best Paper of 2013 by the Society of Toxicology Risk Assessment Specialty Section. The full article is available at http://dx.doi.org/10.1093/toxsci/kfs320.

NORA

NORA Partnerships Public Meeting

The next National Occupational Research Agenda (NORA) public meeting, Partnerships to Advance the National Occupational Research Agenda, will be held April 22 as a webinar. The main topic will be a discussion of a variety of metrics NIOSH is considering for measuring its performance as a research agency. In addition, senior NIOSH leaders will discuss recent highlights. Pre-meeting materials will include summaries of recent accomplishments of NIOSH sector programs, NORA sector councils, and some NIOSH cross-sector programs. Individuals and national organizations will learn about and contribute to the progress of NORA. For more information or to register for the webinar, contact noracoordinator@cdc.gov.

Fire Fighter Fatality Investigation Program Reports

Captain Dies From Hyperthermia and Exertional Heatstroke While Performing Advanced Survival Training—Texas

On September 15–16, 2012, a 46-year-old male volunteer captain participated in a training course called Smoke Diver, which provides instruction in the advanced use of a self-contained breathing apparatus (SCBA) and advanced fire fighter survival skills. The training lasted approximately 12 hours on September 15 and approximately 10 hours on September 16, 2012. The heat index was 92.2°F on the first day and 90.3°F on the second. Rehabilitation occurred several times each day, in an unshaded area, and consisted of doffing SCBA, partially removing turnout gear, resting, and drinking fluids. NIOSH investigators conclude that the captain’s hyperthermia was caused by exertional heatstroke following heavy physical exertion in full PPE and severe environmental conditions with insufficient rehabilitation. /niosh/fire/reports/face201227.html

Volunteer Fire Captain Suffers Sudden Cardiac Death While Responding to a Call—New York

On March 8, 2013, a 60-year-old volunteer captain failed to respond to the scene of an emergency call at 1054 hours. Several hours later (1530 hours) he was found lying in his driveway wearing a jacket with his fire department logo; his personal vehicle was running and the windshield was partially cleared of snow. Neighbors witnessed the captain walking in his front yard less than a half hour before the call (1030 hours). Therefore, the captain was assumed to be responding to the emergency call when he suffered a sudden cardiac event. /niosh/fire/reports/face201321.html

Wildland Fire Fighter Suffers Sudden Cardiac Death During Campfire Patrol—New Mexico

On May 5, 2013, a 26-year-old male seasonal wildland fire fighter, along with his two crew members, conducted campfire patrol and terrain familiarization. After hiking with a wildland fire-fighting pack for about 3 miles in hilly terrain over approximately 2½ hours at 8,000 feet, he reported feeling dizzy and suddenly collapsed. Shortly after crew members removed his pack, the fire fighter became unresponsive with no pulse or respirations. One crew member began cardiopulmonary resuscitation as the other climbed a short distance to notify Dispatch by portable radio. Approximately 26 minutes later, the Life Flight helicopter landed and initiated advanced life support, but the efforts were unsuccessful. NIOSH investigators concluded that the fire fighter’s sudden cardiac death was due to his previously undiagnosed dilated cardiomyopathy and may have been precipitated by the moderate physical exertion associated with hiking in hilly terrain at elevation. /niosh/fire/reports/face201322.html

Lieutenant Suffers Sudden Cardiac Death at Motor Vehicle Crash—Ohio

On July 1, 2012, a 24-year-old male volunteer lieutenant was dispatched to a motor vehicle crash. The crashed vehicle had struck a utility pole and slid down an embankment. As crew members were extracting the driver, the lieutenant climbed a 10-foot embankment to retrieve a backboard from the ambulance when he collapsed. He was treated by the on-scene ambulance paramedic and transported to the hospital’s emergency department (ED). En route to the ED, the lieutenant suffered cardiac arrest; cardiopulmonary resuscitation (CPR) was begun. Despite CPR and advanced life support by ED personnel, the lieutenant died. Given the lieutenant’s underlying dilated cardiomyopathy, the physical stress of responding to the call and climbing the embankment may have triggered a fatal heart arrhythmia. /niosh/fire/reports/face201323.html

News from Our Partners

New York State New Occupational Health Indicator

In New York State, 45% of ever-employed adults with asthma have had something in their work environment that caused their asthma or made it worse, according to data from the Behavioral Risk Factor Surveillance System. To help other states determine the prevalence of work-related asthma in their state, the New York State Department of Health headed the development of a new occupational health indicator (OHI). The OHIs are used to measure the occupational health status of a state’s population that can be used to prioritize prevention efforts. The standardized methodology to calculate “Indicator 21: Asthma Among Adults Caused or Made Worse by Work” can be found in the newly updated OHI guidance document found at http://c.ymcdn.com/sites/www.cste.org/resource/resmgr/OccupationalHealth/2014EditionOHIGuidance.pdf. More information about the Occupational Health Indicators can be found here at http://www.cste.org/group/OHIndicators.

New Occupational Health Indicators Report in Nebraska

The Nebraska Department of Health and Human Services’ Occupational Safety and Health Surveillance Program recently published a report reviewing occupational health indicators from 2000 to 2009. The report describes trends of Nebraska indicators and highlights Nebraska’s above average rates of fatal occupational injuries and nonfatal injuries and illnesses. The report can be found at http://dhhs.ne.gov/publichealth/OccHealth/Documents/NebraskaOccupationalHealthIndicators20002009.pdf.

New Report on Iowa Occupational Pesticide Poisonings

The Iowa Department of Public Health Pesticide Poisoning Surveillance Program recently published a report of occupational pesticide poisonings in Iowa from 2008 to 2012. The report is posted online at www.idph.state.ia.us/LPP/Pesticide.aspx. Iowa had 331 reports that met the NIOSH SENSOR case definition for occupational pesticide poisoning, or an average of 66 cases per year. Sixty percent of exposures had a contributing factor of not wearing the appropriate personal protective equipment. Almost half (47%) of the cases went to emergency departments for evaluation while 39% only used Poison Control Center advice for medical treatment.

National Safety Council Celebrates 100 Years

As part of its 100-year anniversary celebration, the National Safety Council has developed a virtual special issue of the Journal of Safety Research, showcasing a sample of research that has made an impact in the safety arena since the journal’s inception in 1969. The articles were endorsed by readers, authors, the editorial board, and the editors. The National Safety Council said they are some of the most referenced and downloaded articles to date. Articles included in the special issue include successful occupational safety programs and committees, alcohol safety action projects (including raising the legal minimum drinking age), seat belt use, incentives/feedback to enhance workplace safety, speed limit, older drivers, safety climate, workplace self-protective behavior, teenage drivers, and distracted driving. To view the issue for free go to the National Safety Council 100-year anniversary issue! The issue will be available through September 2014.

OSHA Accepting Nominations for Advisory Committees

• The Occupational Safety and Health Administration (OSHA) is accepting nominations for members to serve on the National Advisory Committee on Occupational Safety and Health. Nominations may be submitted electronically at http://www.regulations.gov, by mail, or by facsimile. See the Federal Register notice for submission details. Nominations must be submitted by May 27.
• OSHA is seeking nominations for members to serve on the Whistleblower Protection Advisory Committee. Nominations may be submitted electronically at http://www.regulations.gov, by mail, or by facsimile. See the Federal Register notice for submission details. Nominations must be submitted by May 12.

Honoring the Memory of Ludlow—100 Years Later

The Mountain & Plains Education and Research Center and the Colorado School of Public Health announced that they are proud to present a series of events throughout April to honor the legacy of the Ludlow Massacre. The Ludlow Massacre remains one of the most significant events in U.S. Labor History. On April 20, 1914 at Ludlow, Colorado, representatives of the Colorado National Guard and the Colorado Fuel & Iron Company opened machine gun fire on a camp of coal miners and their families. The miners were striking for safer working conditions and better pay. Between 19 and 25 people died. To learn more about the series, visit http://tinyurl.com/maperc-ludlow.

Save the Date! Graduate Summer Institute in Environmental Health Sciences

The Department of Environmental Health Sciences at Johns Hopkins School of Public Health will be hosting a 2-week summer institute from June 9–21. Courses are designed for practicing public health professionals with responsibilities for health, safety, and environmental matters in government agencies, nongovernment organizations, and industry, and for students who are interested in learning more about environmental health sciences concepts. For more information go to http://www.jhsph.edu/departments/environmental-health-sciences/summer-institute/.

Rear Admiral Joseph Servidio, assistant commandant for prevention policy, U.S. Coast Guard, and Dr. John Howard, NIOSH director, sign the agreement.

r2p Corner

New Agreement Between the United States Coast Guard and NIOSH

Recently, the United States Coast Guard and NIOSH signed an amendment to extend efforts initiated under a partnership agreement. The amendment will continue to formalize the partnership between the organizations, ensuring the sharing of information and the collaboration to develop interventions to prevent injuries and fatalities to commercial fishermen and other workers in the marine environment. For more information, contact Jennifer Lincoln at (907) 271-2383 or JLincoln@cdc.gov.

Health Hazard Evaluation (HHE) Program Update

Evaluation of Coccidioides Exposures and Coccidioidomycosis Infections Among Prison Employees

The HHE Program was asked to determine the incidence of coccidioidomycosis among prison employees and assess ways to reduce potential employee exposures. In June 2013, investigators evaluated employee exposures to the fungus Coccidioides at two state prisons. Both prisons were in areas where Coccidioides naturally occurs. NIOSH investigators looked at work and occupational health policies and practices; reviewed state surveillance, medical, and work information for the coccidioidomycosis cases among employees; privately interviewed employees; and looked at the ventilation systems in some buildings. Over a 4½-year period, the state’s records showed 103 employees with a confirmed case of coccidioidomycosis. We do not know if these cases were due to an exposure at work or outside of work. Employees are likely exposed to Coccidioides in the outdoor and indoor work environment, as well as outside of work. HHE Program investigators recommended:

• Wetting soil before disturbing it and continuously wetting it while digging to keep dust levels down.
• Keeping doors and windows closed as much as possible
• Providing employees with education and training on coccidioidomycosis and ways to minimize exposure.

A link to this final report is available at /niosh/hhe/whats_new.html.

Evaluation of Musculoskeletal Disorders and Traumatic Injuries Among Employees at a Poultry Processing Plant

The HHE Program was asked by managers of a poultry processing facility to identify the potential for increases in musculoskeletal and upper extremity trauma due to a planned evisceration line speed increase. The request was required by the United States Department of Agriculture Food Safety Inspection Service to obtain an evisceration line speed waiver as part of the facility’s participation in the Salmonella Initiative Program. NIOSH investigators evaluated musculoskeletal disorders and traumatic injuries among employees before (baseline) and after (follow-up) an increase in evisceration line speed. After the baseline evaluation, two evisceration lines were combined into one; this resulted in a similar number of birds processed by most employees daily. At baseline, 41% of participants were performing jobs above the ACGIH TLV for hand activity and force, and 42% had evidence of carpal tunnel syndrome. The prevalence of hand or wrist symptoms (pain, burning, numbness, or tingling) was similar at baseline and follow-up. HHE Program investigators recommended:

• Implementing the 2013 OSHA guidelines for poultry processing and recommendations from poultry industry groups.
• Redesigning job tasks so that levels of hand activity and force are below the ACGIH TLV.
• Enhancing onsite reporting, screening, and medical assessment to improve early intervention of musculoskeletal disorders and traumatic injuries.

A link to this final report is available at /niosh/hhe/whats_new.html.

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

Federal Register Notices of Public Meetings and Public Comment

Personal Flotation Devices (PFDs) and Commercial Fishermen: Preconceptions and Evaluation in Actual Use—Reinstatement with Change

The notice was posted on March 12. Written comments should be received within 30 days. https://federalregister.gov/a/2014-05273

Respirator Protective Devices Used in Healthcare

The notice was posted on March 14. Written comments must be received by April 14. https://federalregister.gov/a/2014-05611

World Trade Center Health Programs; Amendments to the List of WTC-related Health Conditions; Cancers; Revision

Thenotice was posted on February 18. Written comments must be received by April 21. https://federalregister.gov/a/2014-03370

For a listing of NIOSH official publications for rules, proposed rules, and notices, go to www.cdc.gov/niosh/fedreg.html.

New NIOSH Communication Products

• Investigation of Purging and Airlock Contamination of Mobile Refuge Alternatives /niosh/mining/Works/coversheet1873.html
• Paul Revere: a Story of Survival in Bristol Bay Video /niosh/docs/video/2014-115/

Upcoming Conferences and Workshops

AIHCE 2014
May 31–June 5, San Antonio, TX
http://aihce2014.org/plan-for-aihce-2014/important-dates/

Safety 2014 ASSE Professional Development Conference & Exposition
June 8–11, Orlando, FL
http://safety2014.org/

2014 NFPA Conference and Expo
June 9–12, Las Vegas, NV
http://www.nfpa.org/training/nfpa-conference-and-expo

7th International Conference on Environmental Science and Technology 2014
June 9–13, Houston, TX
http://www.AASci.org/conference/env/2014

23rd Annual Social Marketing Conference
June 20–21, Clearwater, FL
http://health.usf.edu/publichealth/csm/scc.htm

International Society for Agricultural Safety and Health 2014 Annual Conference: Cultivating Ag Safety and Health
June 22–26, Omaha, NE
http://www.isash.org/

8^th Annual National Conference on Health Communication, Marketing and Media
August 19–21, Atlanta, GA
http://www.nphic.org/

1^stInternational Conference Work and Spirituality
September 9–11, Lausanne, Switzerland
www.travail-spiritualite.org/en

2014 National Safety Council Congress & Expo
September 13–19, San Diego, CA
http://www.congress.nsc.org/nsc2014/public/enter.aspx

National Symposium to Advance Total Worker Health^TM
October 6–8, Bethesda, MD
/niosh/twh

24^th Annual Meeting of the International Society of Exposure Science
October 12–16, Cincinnati, OH
http://ises2014.org/index.html

62^nd International Association of Emergency Managers Annual Conference
November 14–19, San Antonio, TX
http://www.iaem.com/page.cfm?p=events/annual-conference

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

Did You Know?

A new NIOSH document recommends practices for extended use and limited reuse of NIOSH-certified N95 filtering facepiece respirators (commonly called N95 respirators). The recommendations are intended for use by professionals who manage respiratory protection programs in healthcare institutions to protect healthcare workers from job-related risks of exposure to infectious respiratory illnesses. Click on this link to learn more: Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings