Volume 7 Number 10 February 2010

NIOSH eNews Web page To subscribe, click here

From the Director's Desk

An Exposé on Exposomes

Free Respirator Training Videos Available

New NIOSH Internet Site Highlights Regulatory

Agenda

NIOSH Experts Comment on the H1N1

Pandemic

NIOSH Research on Flavorings Highlighted in

News Segment

NIOSH Offers Resources for Emergency

Responders

Capt. Cheryl Estill Finalist for Federal Engineer

of the Year

NIOSH Researchers Talk Nanotechnology

Abroad

Global Happenings

Two New Health Hazard Evaluation Reports

Now Available

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News from Our Partners

Evaluating the Use of Respiratory

Protection for H1N1 Among

Healthcare Workers

r2p Corner

NIOSH Collaborates with Industry

to Protect Workers Using

Hydraulic Stump Cutters

Workplace Safety and Health

Training Positively Impacts

Workers

Call for Abstracts

Take Caution When Using

Disinfectants

NIOSH Science Blog Look for Us!

American Society of Safety

Engineers, Technical Report

What’s New on the NIOSH Blog?

New Communication

Upcoming Conferences

& Workshops

Occupational Medicine

Residency Matching Service

Products

Major NIOSH Finding Featured in

Emerging Infectious Diseases

Journal

Word of the Month

Exposome

From the Director's Desk

--John Howard, M.D. Director, NIOSH

February eNews 2010

An Exposé on Exposomes

Success in mapping the human genome has fostered the complementary concept of mapping the

"exposome." This is an interesting frontier for risk assessment, one that NIOSH will examine closely as one

of our emerging issues for the 21st century.

The concept of the exposome can be defined as the measure of all the exposures that an individual may

experience over a lifetime in his or her environment, whether those exposures may affect the person's health,

and if so, in what ways. Clearly, this is a compelling topic for those of us who are in the business of

preventing illnesses that are caused or exacerbated by exposures in the workplace.

Articulated in 2005 by Dr. Christopher Wild, currently the director of the International Agency for Research on

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Cancer, the exposome also takes into account how the impact of exposures on health are further modified by

factors such as lifestyle, physical condition, and genetics. The exposome relies on the use of all exposure

assessment tools.

Understanding the contribution of environmental factors to disease susceptibility in terms of exposure and

biological response has also been called "exposure biology" and is an integral part of exposure assessment.

Exposure begins prenatally and includes insults-that is, injuries, irritations, or traumas-from environmental

and occupational sources.

Past occupational health studies have focused on a specific exposure or multiple exposures and the

relationship to a disease. Some confounders were investigated as well. Today, many studies incorporate the

interaction between genetic and environmental factors. It should be noted that the exposome also includes

the study of exposures in the environment that improve or enhance health or the opportunity to attain health

in greater measure.

The occupational exposome is extremely important and in some cases unique from other environmental

exposures. Today's occupational exposures are radically different than those of even 30 years ago.

Prevention of disease should be the critical outcome from the exposome. Ironically, the measure of success

will be that nothing happens-in other words, disease is prevented.

Some obvious challenges may limit progress in this field of study. The exposome is highly variable and

dynamic as it evolves throughout the lifetime of an individual. Ultimately, the impact of a specific

environmental exposure, regardless of its origin, may be different at the individual level for different people.

Past and even present exposures are difficult or impossible to quantify. Relating an occupational disease to

an exposure that occurred in the past can be challenging.

NIOSH has identified some specific areas that can help meet these challenges:

1. Develop more sensitive exposure assessment methods and tools. Development of new methods,

exposure assessment strategies, and other tools would improve our ability to measure occupational

exposures.

2. Develop and characterize biomarkers. The development and characterization of biomarkers is

another avenue to improve measurement of exposure, effect of exposure, and susceptibility for

determination of disease relationships. Identification of legacy biomarkers (a biomarker that would

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quantify past exposures or effects from past exposures) would be important for evaluating the

exposome and the relationship to occupational disease.

3. Develop improved statistical tools and data sharing. Development of improved statistical tools

can help evaluate the relationship of disease to the many facets of exposure. Increased data sharing

will allow for increased statistical power and a more thorough analysis of all exposures. Also needed

for use in defining the exposome are improved bioinformatics tools, pattern matching techniques, and

artificial neural network models.

4. Develop gene expression matrices. A major contribution to this area could be made through the

development of gene expression matrices resulting from occupational, environmental, dietary, lifestyle, and other exposures. This is an area in which NIOSH has already begun to generate information

for the validation of biomarkers and suites of biomarkers for exposure assessment purposes.

5. Develop standardized criteria for designing studies and reporting results. Development of a

standardized manner for the collection and storage of data that incorporates information on

epidemiology, genetics, and occupational/industrial hygiene will allow for more holistic exposure

assessment. In addition, a standardized manner for the collection and publishing of exposure

assessment measurements should be explored in order to make the information more accessible for

data mining. Such a standardized approach for the collection, analysis, and dissemination of

microarray data has been developed for genomics; these guidelines specify the minimum information

about a microarray experiment (MIAME) necessary to interpret the results and to reproduce the

experiment.

NIOSH's focus in the exposome lies in occupational exposures and resulting work-related diseases. I

anticipate that our contributions in exposure assessment, occupational epidemiology, development of

sensitive occupational methods, development and characterization of biomarkers, exposure sampling

strategies, and exposure databases will advance further the field of occupational exposomics. In turn, if

successful, these developments will lead to improved occupational health as occupational exposures are

identified and mitigated.

I invite your attention to Dr. Wild's groundbreaking thesis at http://cebp.aacrjournals.org/content/14/8/1847.full

and invite you to watch for a NIOSH topic page on the exposome, which we expect to post shortly on the

Web. Later this month, on February 25-26 in Washington, D.C., the National Academies will convene a

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national workshop to examine the exposome and the opportunities for applying the concept to improve

human health. I am honored to be included as a participant in one of the panel discussions. Further

information is available at http://dels.nas.edu/envirohealth/exposome.shtml. I look forward to seeing you there

and to hearing your ideas on possible next steps forward for NIOSH and our partners. My thanks to Dr. Gayle

DeBord, associate director for science in NIOSH's Division of Applied Research and Technology, for her

assistance in preparing this month's column.

Free Respirator Training Videos Available

NIOSH and OSHA have produced two 5-minute videos on respirator training: The Difference Between

Respirators and Surgical Masks and Respirator Safety, which includes instructions on donning (putting on)

and doffing (taking off) and user seal checks. These videos are available in both English and Spanish and are

available for download at http://www.osha.gov/SLTC/respiratoryprotection/index.html.

New NIOSH Internet Site Highlights Regulatory Agenda

NIOSH has released a new Web page (http://www.cdc.gov/niosh/regulatory.html) designed to make it easier

for stakeholders to find, read, and track NIOSH's proposed regulations and regulatory changes. The new Web

page lists and links to the proposed regulations and regulatory changes that NIOSH has posted on the

federal government's Unified Regulatory Agenda (as required by EO 12866 Section 4(b)

http://www.reginfo.gov/public/jsp/Utilities/EO_Redirect.jsp.

NIOSH Experts Comment on the H1N1 Pandemic

Les Boord and Roland Berry Ann, director and deputy director respectively of NIOSH's National Personal

Protective Technology Laboratory (NPPTL), participated in a podcast sponsored by EHS Today magazine

that examines occupational health issues related to the H1N1 pandemic. Specifically, the NIOSH officials

discussed N95 respirators and CDC's H1N1 guidelines for healthcare workers. Tune in to the podcast at

http://ehstoday.com/podcasts/experts-comment-h1n1-pandemic-0110/.

NIOSH Research on Flavorings Highlighted in News Segment

An investigative news segment February 4 on WBNS-TV, Columbus, Ohio, highlights NIOSH's

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groundbreaking research on the hazard of occupational lung disease linked with job-related respiratory

exposures to butter flavoring. News video and transcript at

http://www.10tv.com/live/content/teninvestigates/stories/2010/02/04/story-food-flavoring-popcorn.html?

sid=102.

NIOSH Offers Resources for Emergency Responders

As emergency responders are deployed to find survivors, save lives, and speed relief aid to earthquakedevastated Haiti, it is imperative to protect them from work-related injury and illness in the line of duty. NIOSH

highlights its emergency response resources for search and rescue teams, fire fighters, and other responders

at http://www.cdc.gov/niosh/topics/emres/.

Capt. Cheryl Estill Finalist for Federal Engineer of the Year

Cheryl F. Estill, a NIOSH engineer who holds the rank of Captain in the U.S. Public Health Service, has been

selected by the National Society of Professional Engineers as one of the ten finalists for the 2010 Federal

Engineer of the Year Award for outstanding service to our country. This award is the only one of its kind to

solely recognize outstanding engineers employed in the federal government. The 2010 Federal Engineer of

the Year will be announced at National Press Club on February 18.

NIOSH Researchers Talk Nanotechnology Abroad

NIOSH researchers Drs. Chuck Geraci and Vladimir Murashov were invited speakers at the Japan NIOSH

(JNIOSH) Workshop and Open Seminar for Occupational Safety and Health Promotion in January. The

meeting focused on the international trends in nanoparticle occupational safety and health. Dr. Geraci

presented a summary of the US NIOSH Nanotechnology Research Program and Dr. Murashov summarized

key policy and regulatory activities in the US and Europe. NIOSH has an active Memorandum of

Understanding with JNIOSH and the group identified several areas for more deliberate collaboration.

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Drs.Geraci and Murashov and other workshop participants.

Global Happenings

WHO Meeting Presentations Available

Presentations from the 8th Meeting of the Global Network of WHO Collaborating Centers in Occupational

Health and the Joint CIS-CC Meeting are now posted on the NIOSH Web page at

http://www.cdc.gov/niosh/programs/global/collaborations.html.

Former NIOSH Researcher Discusses Blogs on Microfinance Institutions as an Opportunity to Reach

Millions of Workers

Former NIOSH Industrial Hygienist Dr. Richard Rinehart provides a guest post on the Social Performance

Indicators Blog called "Defining Social Responsibility to the Community: Occupational Safety and Health."

Dr. Rinehart presents examples of occupational safety and health threats commonly faced by

microentrepreneurs in the developing world. "What role," he asks, "might the microfinance industry play in

mitigating the negative impact of these risks on clients and the community at large?"

http://www.spblog.org/2009/12/defining-social-responsibility-to-the-community-occupational-safety-and-health-

.html

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The full proceedings of the First International Conference on Road Safety at Work held in

Washington DC in 2009 are now available online.

http://www.cdc.gov/niosh/programs/twu/global

Two New Health Hazard Evaluation Reports Now Available

The Health Hazard Evaluation (HHE) Program evaluated exposures to hazardous metals,

including lead and cadmium, during electronics recycling efforts at four prisons.

Investigators recommended that these facilities be in full compliance with Occupational

Safety and Health Administration standards, including record keeping requirements,

communication requirements, compliance plans, and medical surveillance. HHE Program investigators also

recommended that preplacement examinations for cadmium exposure be identical to periodic examinations

so that baseline health status can be obtained prior to exposure. Investigators additionally recommended that

a detailed job hazard analysis be conducted prior to beginning any new operation or before making changes

to existing operations. http://www2a.cdc.gov/hhe/select.asp?PjtName=47185&bFlag=3

The HHE Program evaluated a possible excess in cancer incidence among current and former employees in

the criminal investigation section of a police department. The investigation determined that the cancers likely

were not work-related. Investigators recommended measures to address potential chemical exposures. They

recommended that air filters in the local exhaust ventilation and heating, ventilation, and air conditioning

systems be replaced routinely and that the amount of outdoor air supplied to occupied areas of the building

be increased. Exhaust ventilation should also be added in rooms that house chemicals or emit nuisance

odors. HHE Program investigators recommended that the super glue fuming chambers be replaced with units

that minimize airborne ethyl cyanoacrylate exposures. Investigators also recommended that employees learn

about cancer and get recommended cancer screenings. http://www2a.cdc.gov/hhe/select.asp?

PjtName=47155&bFlag=3

News from Our Partners

Evaluating the Use of Respiratory Protection for H1N1 Among Healthcare Workers

This flu season, the California Department of Public Health (CDPH) OccupationalHealth Branch is

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collaborating with NIOSH on a survey of respiratory protection policies, procedures, and work practices in

California acute care hospitals. The CDPH is also administering a Web-based survey about respiratory

protection knowledge and practices to healthcare workers throughout California. This project will assess best

practices and gaps in implementing U.S. Centers for Disease Control and Prevention (CDC) guidance

(http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm) and the recent California Aerosol Transmissible

Diseases standard. For more information please contact Dr. Barbara Materna at

barbara.materna@cdph.ca.gov.

Take Caution When Using Disinfectants

The use of disinfectants has increased because of the concern about exposure to infectious agents, such as

the 2009 H1N1 influenza virus. A patient seen recently at the Michigan State University Clinic, one of the

clinics in the Association of Occupational and Environmental Clinics, complained of respiratory symptoms

that had developed at work after exposure to a spray disinfectant. Aerosol cans of disinfectant had been

distributed by supervisors and, when people coughed at work, disinfectant was inappropriately sprayed in the

air instead of surfaces, according to the clinic. A summary of the allergenic/irritant effects of disinfectants can

be found at www.oem.msu.edu/userfiles/file/News/v20n2.pdf.

American Society of Safety Engineers, Technical Report

The American Society of Safety Engineers has developed a technical report, Guidelines for Addressing

Occupational Risks in Design and Redesign Processes (https://www.asse.org/shoponline/products/trz790-

001-2009.php). This report provides guidance on including prevention through design concepts and processes

as a specifically identified element in a safety and health management system so that decisions pertaining to

occupational risks are incorporated into the design and redesign processes, including consideration of the life

cycle of facilities, materials, and equipment.

Occupational Medicine Residency Matching Service

The Association of Occupational and Environmental Clinics provides an occupational medicine (OM)

residency "matching service" for potential candidates looking for an open OM training slot. Candidates

usually are those who have developed an interest in OM training but may have applied too late for the

December acceptance deadline of many programs. If you are a potential OM resident or know of someone

who is interested in pursuing a career in OM, please send a copy of your current CV and a cover letter to

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kkirkland@aoec.org.

r2p Corner

NIOSH Technologies Featured in Federal Laboratory Consortium Calendar

Two NIOSH technologies were highlighted in the Southeast 2010 Federal Laboratory Consortium

calendar to demonstrate outstanding research and technology transfer efforts. The first technology, a cyclone

bioaerosol sampler, is currently being used by public and private research institutions in the United States

and internationally to examine potential air hazards. To receive a copy of the calendar or for more information

contact Kathleen Goedel at KGoedel@cdc.gov.

NIOSH Science Blog

What’s New on the NIOSH Blog?

NIOSH is seeking your input on occupational health and safety training, particularly the feasibility of adding

additional rigor to research designs through the use of randomized controlled trials or other methodologies

using comparison groups, novel methods for evaluating "transfer of training" into the workplace, and methods

that facilitate the measurement of "return on investment" of training to organizations.

https://blogs.cdc.gov/niosh-science-blog/2010/01/29/training/

New Communication Products

Major NIOSH Finding Featured in Emerging Infectious Diseases Journal

NIOSH scientists published a major finding in the U.S. Centers for Disease Control and Prevention's (CDC)

journal Emerging Infectious Diseases on the relationship between silicosis and pulmonary mycosis. Silicosis

is a work-related disease caused by exposure to respirable silica dust. Pulmonary mycosis is a serious,

irreversible but preventable disease caused by fungal infection. Scientists linked the two and found that some

workers may be at risk for job-related co-exposure to silica dust and fungi.

http://www.cdc.gov/eid/content/16/2/318.htm

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Workplace Safety and Health Training Positively Impacts Workers

Occupational health and safety (OHS) training is an important part of managing workplace hazards and risks.

A Systematic Review of the Effectiveness of Training & Education for the Protection of Workers reports on a

study conducted by the Institute for Work and Health and NIOSH to determine whether OHS training and

education programs have a beneficial effect on workers and firms. To read the full report go to

http://www.cdc.gov/niosh/topics/Training/sys_review_education_training_2010.html or go to the NIOSH

Science Blog to provide comments: https://blogs.cdc.gov/niosh-science-blog/2010/01/29/training/.

More...

To see other new NIOSH communication products, including documents and new and updated topic pages,

go to the NIOSH “What’s New” page. http://www.cdc.gov/niosh/whatsnew/

Call for Abstracts

American Public Health Association 2010 annual meeting, November 6-10, Denver, Colorado. Deadline for

submission is February 5. http://www.apha.org/meetings/sessions/HowtobecomeaPresenter.htm

International Occupational Hygiene Association (IOHA 2010). Call for abstracts deadline extended to March

1. Call for posters deadline extended to March 15. http://www.ioha2010.org/.

Look for Us!

The NIOSH exhibit will be at the Construction Safety Conference and Exposition, February 16-17, in

Rosemont, Illinois, at booth #409. http://www.buildsafe.org

Upcoming Conferences & Workshops

NIOSH Announces Personal Protective Technology Stakeholder Meeting

The NIOSH Personal Protective Technology Program will hold a stakeholder meeting on March 2-3 at the

Hyatt Regency Pittsburgh Airport. John Howard, M.D., director of NIOSH, will be the luncheon keynote

speaker on March 2. Meeting participation is also available via Microsoft Live Meeting for those who cannot

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attend. http://www.cdc.gov/niosh/npptl/resources/pressrel/letters/lttr-03022010.html

National Action Summit for Latino Worker Health and Safety - Registration Now Open!

NIOSH is cosponsoring the National Action Summit for Latino Worker Health and Safety, sponsored by the

Occupational Safety and Health Administration, on April 14-15 in Houston, Texas.

http://www.osha.gov/latinosummit/index.html

Nanomaterials and Worker Health

NIOSH and the Mountain and Plains Education and Research Center will hold a conference, Nanomaterials

and Worker Health: Medical Surveillance, Exposure Registries, and Epidemiologic Research, July 21-23 in

Keystone, Colorado. http://www.cdc.gov/niosh/topics/nanotech/keystone2010/

History of Occupational and Environmental Health Conference

4th International Conference on the History of Occupational and Environmental Health, June 19-22 in San

Francisco, California. https://www.cme.ucsf.edu/cme/CourseDetail.aspx?coursenumber=MMJ10014.

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

Word of the Month

Exposome -The measure of all the exposures that an individual may experience over a lifetime in his or her

environment, whether those exposures may affect the person's health, and if so, in what ways.

NIOSH eNews on the Web: www.cdc.gov/niosh/enews/

NIOSH eNews is Brought to You By:

Director John Howard, M.D.

Editor in Chief Max Lum

Story Editor Tanya Headley

Copy Editor Cathy Rotunda

Public Affairs Officer Fred Blosser

Technical Lead Glenn Doyle

Technical Support Kevin Whaley

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