GLOBAL COLLABORATIONS

Output: NIOSH International Technical Assistance

Silicosis in the Americas

Silica is a chemical compound found in both crystalline and amorphous (non-crystalline) forms. The most common crystalline form, quartz, is common to the earth’s crust and is a component of nearly every mineral deposit [Greskevitch et al. 1992]. Quartz-containing dust may be generated in any process which involves movement of earth (e.g., mining, farming, construction). Crystalline silica is also contained in a diverse number of widely-used products, including many construction products (e.g., brick, concrete, asphalt), paints, glazes, coatings, cement roofing tiles, glass, cosmetics, plastics, and cleaning products. Crystalline silica-containing dust may be generated while using or working with these products (e.g., sawing, cutting, grinding, crushing, drilling, carving, polishing, bagging, mixing, dumping, abrasive blasting). Due to the widespread natural occurrence and the wide uses of the materials and products containing silica, workers in a large variety of industries and occupations may be exposed to respirable crystalline silica. When workers breathe in this dust, it can result in silicosis, a serious but preventable lung disease. Occupational exposure to respirable crystalline silica is also associated with lung cancer, pulmonary tuberculosis and airway diseases, and may be related to development of autoimmune disorders, chronic renal disease, and other adverse health effects.

Crystalline silica exposure and its adverse health effects are still a critical problem in both developed and developing countries. China recorded more than 500,000 cases of silicosis from 1991- 1995. In Brazil, more than 4,500 workers with silicosis have been cumulatively reported in the state of Minas Gerais. In India alone, millions of workers are at risk. In 1995, the World Health Organization (WHO) and the International Labor Organization (ILO) began a campaign to eliminate silicosis from the world by 2030. In 2005, WHO and its regional office, the Pan American Health Organization (PAHO), ILO, and the Chilean Health Ministry (MOH) requested that NIOSH provide technical assistance to build adequate capacity to eliminate silicosis in the Americas. In response to this request, a program called the “Americas Silicosis Initiative” was initiated in partnership with WHO, PAHO, ILO and countries in South America. It is the first regional approach to addressing this problem and includes:

• Training trainers in Chile, Brazil, and Peru in methods of dust control
• Developing simple guidance for employers to put controls in place (e.g., control banding)
• Visiting small quarries, stone crushing and stone craft worksites to develop customized simple guidance sheets
• Training of physicians from Chile, Brazil, and Peru in radiographic reading
• Developing regional silica reference laboratories in Chile and Peru
• Developing a respirator program suitable for small employers

NIOSH’s technical assistance to partners in Brazil, Chile, and Peru enables these countries to develop their capacity to implement National Plans to eliminate silicosis. This partnership is a model for other countries and is helping to meet the ILO/WHO goal to eliminate silicosis by 2030. Substantial work was accomplished in Chile and is currently underway in Brazil, Peru, and Columbia.

Healthcare Workers and Needlestick Injuries

Health care workers are the foundation of all healthcare systems, but it is these same individuals who face several physical, chemical, biological, ergonomic, and psychosocial occupational hazards in every shift they work. These threats include the hepatitis B virus (HBV), the hepatitis C virus (HCV) and the Human Immunodeficiency Virus (HIV), among many others. Recognizing that the workplace danger of diseases experienced by healthcare workers needs to be addressed urgently, the United States National Institute of Occupational Safety and Health (NIOSH) supported the World Health Organization (WHO) in developing and evaluating a project aimed at preventing transmission of blood borne pathogens. Beginning in South Africa, Tanzania and Vietnam, the project created a tool kit “ Protecting Healthcare Workers: Preventing Needlestick Injuries Toolkit ”.

In 2005, NIOSH, the Pan American Health Organization (PAHO), and WHO began adapting the toolkit to Latin America with its translation into Spanish and the implementation of a pilot program in Venezuela. Results have been excellent:

1. the toolkit in Spanish “Prevención de lesiones por pinchazo de aguja" is available from at least three websites
   • Biblioteca virtual de desarrollo sostenible y salud ambiental
   • Organización Mundial de la Salud
2. the project has expanded to 6 states in Venezuela; and
3. partners in Venezuela, are interested in assisting other countries in the implementation of this project as NIOSH and partner agencies work to reproduce this success in other nations.

Currently, the project has already started implementation in Peru jointly with a national campaign to immunize healthcare workers, and agencies are working to expand on the success of this program to include several South American and East Arabian countries.

This project involves strengthening educational institutions and technology transfer to government agencies. It includes a national planning meeting with state and national government officials and a three day “Training-of-Trainers” workshop for frontline workers and leaders from pilot hospitals and state officials. Through this model the program pursues the goals to:

• Prepare leaders in healthcare to provide programming on occupational health and prevention of exposure to occupational blood borne infections.
• Evaluate and make recommendations for national policies to protect healthcare workers from occupational transmission of bloodborne pathogens.
• Work with partners to address the many other workplace risks of healthcare workers.

Global Road Safety at Work

Road traffic crashes are a leading cause of workplace death, injury, and disability around the world. Workers, employers, families, and society all suffer the consequences of workplace crashes through physical and emotional suffering, lost earnings and productivity, medical, and liability costs.

The United Nations General Assembly Resolution A/62/244 on “Improving Global Road Safety", adopted unanimously in March 2008, includes encouragement for "organizations in both private and public sectors with vehicle fleets to develop and implement policies and practices that will reduce crash risks for vehicle occupants and other road users". For the first time, a United Nations resolution includes specific language that notes the importance of fleet operations to worker safety and public safety.

NIOSH and partners initiated the “Global Road Safety at Work” project, to demonstrate the injury reduction and economic benefit of workplace initiatives to prevent road traffic injuries among workers in the U.S. and other countries around the world.

NIOSH and co-sponsors hosted the International Conference on Road Safety at Work, 16-18 February 2009, Washington, DC. This event brought together business and labor representatives, policy makers, and the research community to address road traffic injury prevention at work. The conference summarized current international knowledge about road safety in the workplace and serve as a forum for discussion of initiatives to promote road safety for workers around the globe. For further information about the conference, please contact Jane Hingston or visit the

The project includes the "Road Safety at Work" online library , which houses over 200 materials from around the world that provide guidance for workers, employers, and policy makers to increase worker safety on roads. Materials in the online library include: statistical data, benchmarking data, training materials, case studies, and policy documents and Sources for these materials include government and international organizations, academic institutions, unions, non-governmental organizations, and private corporations. This online library is globally accessible and free of charge. The “Road Safety at Work” online library is in continuing development; NIOSH and partners welcome your materials. To contribute resources, please contact Stephanie Pratt.

Mining Technical Assistance and Research Collaborations

As a result of research accomplishments by the NIOSH Mining Program, collaborations with the worldwide mining engineering and scientific community have been undertaken involving mining expertise, capabilities, and facilities. View the descriptions of the collaborative activities [PDF - 641 KB] between NIOSH mining researchers and various organizations around the world since 1996.

View a collection of the NIOSH mining research abstracts [PDF - 1,327 KB] with Chinese translations.