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NIOSH eNews – September 2013


Volume 11 Number 5 September 2013


From the Director’s Desk

John Howard, M.D.
Director, NIOSH

The WTC Health Program: Expanding Care More Than A Decade After 9/11

This month we commemorate the twelfth anniversary of the September 11th terrorist attacks in New York, the Pentagon, and Shanksville, Pennsylvania. Though the attacks occurred over a decade ago, many responders and survivors continue to experience physical and mental health symptoms as a result of their experience. Affected individuals may not recognize that a chronic cough, difficulty sleeping, certain cancers, or frequent heartburn could be a 9/11-related condition. The World Trade Center (WTC) Health Program can help.

The WTC Health Program is a unique NIOSH program that provides high-quality medical monitoring and treatment services for 9/11 responders and survivors. Almost 65,000 people are enrolled in the Program and are eligible to receive healthcare at one of seven Clinical Centers of Excellence in New York or through the Nationwide Provider Network. Providers with the WTC Health Program are experts in recognizing and treating physical and mental health conditions caused by the September 11th terrorist attacks.

Our goal is to ensure that everyone who is qualified for the Program enrolls and receives the care they deserve. In the last year NIOSH has made important strides toward this goal. As the administrator of the WTC Health Program, I am proud of our achievements:

  • Responders from the Pentagon and Shanksville, Pennsylvania, areas are now eligible to enroll in the WTC Health Program. We are actively recruiting Pentagon and Shanksville responders through public meetings, letters, and presentations to local responder organizations.
  • The WTC Health Program added over 50 cancers to the list of covered conditions, greatly expanding medical services to current and future members.
  • The WTC Health Program has expanded national benefits to survivors by creating the Nationwide Provider Network. A previous version of this program was available only to responders. Now all members who reside outside the New York City metropolitan area may receive monitoring and treatment benefits near where they live.
  • In April 2013, the WTC Health Program announced new criteria for breast cancer coverage. Eligible responders and survivors may be certified for the treatment of breast can­cer if they’ve experienced nighttime sleep disruption from response or clean-up activities or PCB exposure resulting from the 9/11 terrorist attacks.
  • The WTC Health Program website has been redesigned to better serve the needs of current and future members, while also providing easily accessible information to the public about health effects related to 9/11 exposures.

We strongly believe that the WTC Health Program is an important healthcare service, and we are fortunate to have the support of community and union partners to help ensure that all eligible responders and survivors know about the benefits they deserve. Our partners have increased local and national outreach to groups such as those that provided mental health services on 9/11 and the preceding months; retirees, high school students, and college students in lower Manhattan; and eligible firefighters across the country. Our outreach partners have secured donated ad space in major national magazines, connected underserved populations with Program benefits, and held meetings with affected populations. These partners work closely with our Clinical Centers of Excellence to conduct outreach to residents, students, families, firefighters, police officers, construction workers, trade unions, and other local organizations.

Expanded benefits, robust partnerships, and increased recruitment efforts are critical to the success of the WTC Health Program. NIOSH remains committed to continuing these efforts, as we provide high-quality care to all of our members.

If you have any questions about the WTC Health Program, please call us at 1-888-982-4748 or email us at

New Online Course Available to Help Nurses Prevent Workplace Violence

A new free on-line course aims to train nurses on recognizing and preventing workplace violence. NIOSH worked with healthcare stakeholders—nursing and labor organizations, academic groups, other government agencies, and Vida Health Communications, Inc.—to develop the course. The multimedia training incorporates lesson text, videos depicting workplace violence incidents, testimonials from real nurses, and lesson quizzes. Nurses can also receive continuing education credits for completing the online course. The course is available on the NIOSH website at /niosh/topics/violence/training_nurses.html.

Online Emergency Responder Training Now Available

It’s finally here! The Emergency Responder Health Monitoring and Surveillance online training course is now available. This course provides a recommended health monitoring and surveillance framework, referred to as the Emergency Responder Health Monitoring and Surveillance (ERHMS) system, which includes specific recommendations and tools for all phases of a response, including the pre-deployment, deployment, and post-deployment phases. The training is available through the NIOSH ERHMS page /niosh/topics/erhms/ or the CDC Training page at

2013 Drive Safely Work Week Toolkit Available for Free Download

October 7–11 is Drive Safely Work Week (DSWW). The theme of the 2013 campaign is “Gear up for safe driving: Mind ·Body ·Vehicle.” DSWW is developed by the Network of Employers for Traffic Safety (NETS), a public-private partnership that promotes road safety on and off the job. The DSWW toolkit provides easy-to-use Web-based resources for employers, including downloadable graphics and activities tailored for each day of the campaign week. Download at no cost via the NETS Web site (

NIOSH Announces Upper Limb Musculoskeletal Disorders Web Page

NIOSH has released a new topic page on Upper Limb Musculoskeletal Disorders. The page features peer-reviewed publications that were completed by NIOSH researchers and other members of the MSD Consortium (Washington State Dept. of Labor & Industry, University of California/Berkeley/San Francisco, Washington University/St. Louis, University of Wisconsin, University of Iowa, University of Connecticut, and University of Utah). /niosh/topics/upperlimb

N95 Day Set for Thursday, 9/5

N95 Day is right around the corner, this Thursday, September 5. This observance is meant to bring recognition to the importance of respiratory protection in the workplace and familiarize users with the educational resources available. In recognition of N95 Day, NIOSH will feature a NIOSH Science Blog on the topic, a video featuring the NIOSH N95 certification laboratory, and lots of Twitter action (follow @NIOSH and @NPPTL). There will also be a webinar focusing on the myths versus the facts of N95 use. Registration for the webinar is now full, but it will be posted on the webpage (/niosh/npptl).

HHE Annual Report Now Available

The Health Hazard Evaluation Program has released its 2012 Annual Report! To view a pdf of this document go to /niosh/hhe/pdfs/HHE_2012_Annual_Report.pdf. If you would like to request a paper copy, send an email with your name and address to

Networking to Advance Nanotechology Health, Safety Knowledge

Anna Shvedova, Ph.D., NIOSH research physiologist and member of NIOSH’s Nanotechnology Research Center, served on the Scientific Committee and gave one of the keynote presentations at the 2nd Applied Nanotechnology & Nanotoxicology (ANNT) meeting, August 15-19 in Russia. This meeting serves to strengthen international cooperation on occupational and environmental health and safety research, one of the key objectives of the nanotechnology sub-working group of the U.S.-Russia Bilateral Presidential Commission’s Science and Technology Innovation Working Group. A third meeting is scheduled to take place in 2015 in Kazan, Russia.

Call for Nominations 2014 Safe-in-Sound Excellence in Hearing Loss Prevention Awards™

Nominations are now being accepted for the 2014 Safe-in-Sound Excellence in Hearing Loss Prevention Awards.™ The awards are given by NIOSH in partnership with the National Hearing Conservation Association to recognize excellence in hearing loss prevention. The deadline for self-nominations is September 6, 2013. Additional information is available at

Health Insurance Marketplace Educational Materials

The U.S. Department of Health and Human Services has launched its Health Insurance Marketplace education effort, along with the re-launch of a new consumer-focused website and a 24-hour consumer call center to help Americans prepare for open enrollment under the Affordable Care Act. The HHS news release can be viewed at For a whole host of materials, including widgets, brochures, infographics, presentations, fact sheets, and more, go to The consumer website is located at

USA Today article notes NIOSH role in safe work for youths in Ag

NIOSH’s role in conducting research and surveillance to monitor trends in the employment of youths in agricultural jobs, and its work with the farming community in reducing risks of injury and illness for youths in agriculture, were noted in a feature article in USA TODAY on August 30 about youths and, agricultural jobs.

Positive results from Telenovela project discussed in new journal article

Using culturally appropriate mediums can be an effective way of reaching and educating workers and other audiences about preventing injuries from work-related falls, a peer-reviewed article by researchers from the University of California, the University of Georgia, and NIOSH finds. The article, published on August 29 in the online SAGE open journals, discusses an innovative project led by NIOSH and CPWR-The Center for Construction Research and Training, in which a work-site safety message was woven into the storyline of a nationally televised Telenovela, or Spanish-language TV drama.


Monthly Features

NIOSH Congratulates…

Dr. Susan Moore, Director of Division of Mining Science

Dr. Susan Moore has been named the director of the Division of Mining Science and Technology in the NIOSH Office of Mining Safety and Health Research (OMSHR). Dr. Moore has been with OMSHR since 2006, serving as researcher, executive management intern to the associate director for mining, branch chief, and most recently acting division director for DMST. As a researcher, she has authored 59 publications—26 peer-reviewed publications, 32 conference proceedings, and 1 U.S. government patent. Dr. Moore received her B.S. in Mechanical Engineering from the University of Kentucky and a Ph.D. in Bioengineering from the University of Pittsburgh. Susan’s record is one of bringing measurable value to mineworkers, OMSHR, and NIOSH.

CDC and ATSDR Honor Award Winners

Congratulations to the winners of the 61st Annual CDC and ATSDR Honor Awards, which were presented on August 20. Jacob Carr, mining engineer in the NIOSH Office of Mine Safety and Health Research, was recognized for his leadership qualities and engineering expertise in mining machine safety research. In the NIOSH Division of Respiratory Disease Studies, the Respiratory Disease Hazard Evaluation and Technical Assistance Team of the division’s Field Studies Branch was recognized for its multidisciplinary identification of emerging occupational lung diseases and the means to prevent them. The awards recognize exemplary public service by employees of the U.S. Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry.


R2P Highlighted at the National Safety Council Congress & Expo

The NORA Manufacturing Sector Council (/nora/sectors/manuf/#council) and the National Safety Council will co-sponsor the second annual Research to Practice educational track at the National Safety Council Congress & Exposition this month in Chicago ( Topics include a roadmap for the transfer of knowledge into highly effective practices for improving worker well-being and operational excellence, a review of mats and insoles to promote safe standing, an approach to improving employee return to work, and a workshop with several of the new and affordable hearing protection fit-testing technologies now in the market (including the NIOSH-developed Hearing Protection Device Well-Fit™ System, For more information, visit the conference site or contact the NORA coordinator (

Fire Fighter Fatality Investigation Program Reports

Fire Apparatus Operator Found Unresponsive in Bunk Room after a Ladder Training Drill—Virginia
Fire Apparatus Operator Found Unresponsive in Bunk Room after a Ladder Training Drill—Virginia On March 19, 2012, a 54-year-old male career fire apparatus operator participated in a training drill that required climbing a 100-foot aerial ladder in full turnout gear and self-contained breathing apparatus, which he easily completed in about 2–3 minutes. Upon returning to the base of the ladder, he did not report any unusual symptoms and showed no signs of distress. Approximately 1 hour and 45 minutes later he was found unresponsive and pulseless on the floor near his bunk. Station members immediately began emergency medical care and he was transported to the local hospital’s emergency department where he was pronounced dead. NIOSH investigators conclude that the victim most likely died of a fatal arrhythmia and recommended that all fire departments should phase in a mandatory comprehensive wellness and fitness program for fire fighters. /niosh/fire/reports/face201309.html

News from Our Partners

2013 International Conference on Fall Prevention and Protection (ICFPP)

NIOSH will co-sponsor the International Conference on Fall Prevention and Protection to be held on October 23–25 in Tokyo, Japan. The conference is organized by the Japan National Institute of Occupational Safety and Health. This meeting will bring together interested stakeholders to provide an update on emerging technologies for fall protection, innovative research concepts for fall injury control, and advancing a global research agenda on fall prevention.

Identifying the Presence of Drugs among Injured Motor Vehicle Drivers

The Kentucky Injury Prevention and Research Center (KIPRC) recently reported linking automobile crash data with emergency department and inpatient hospitalization data to assess the association between the data sets in identifying the presence of drugs among injured motor vehicle drivers. Of the 72,529 linked crash/emergency department visits, the data identified more injured drivers with drug involvement compared with emergency department data (only 163 cases overlapped). Of the 20,860 total linked crash/inpatient hospitalization cases, inpatient hospitalization data identified more cases of drug involvement among injured drivers than the crash data (only 207 overlapped). KIPRC concluded that surveillance data from multiple public health data sets is necessary to identify the presence of drugs in injured drivers involved in motor vehicle crashes. The use of a single surveillance data set alone may significantly underreport the number of drugged drivers who were injured in a motor vehicle collision. For more information, contact Terry Bunn, Ph.D., at

New report from the New Hampshire Occupational Health Surveillance Program

The New Hampshire Occupational Health Surveillance Program collaborated with the Northern New England Poison Center to publish a recent report, Poisoned at Work: An Evaluation of New Hampshire Poison Center Data for Occupational Exposures from 2005 to 2011. The report highlights the importance of poison center data to describe the distribution and trends of occupational poisoning exposures among New Hampshire’s employed population. Findings will be used to assist in developing targeted prevention strategies designed to reduce work-related exposures to harmful substances at work, the report said. The report can be found at

Construction/Outdoor Workers at Risk for Valley Fever

The California Department of Public Health has a new web page on Valley Fever, featuring prevention materials for employers and workers. Workers who disturb soil containing the Coccidioides fungus and work in dusty outdoor areas are at risk for Valley Fever. Valley Fever fungus is found in some areas of the southwestern United States. The states with the highest incidence of reported illness are Arizona and California. About 8 of every 100 people hospitalized with Valley Fever die from the infection annually. Yet workplace health and safety plans often do not mention Valley Fever, despite the fact that the illness can be disabling or fatal. Workers can be protected against this disease by the use of dust control measures and appropriate personal protective equipment.

Vitamin B Warning from the U.S. Food and Drug Administration

Recently, the U.S. Food and Drug Administration (FDA) warned consumers that they should not use or purchase Healthy Life Chemistry by Purity First B-50, marketed as a vitamin B dietary supplement. A preliminary FDA laboratory analysis indicated that the product contains two potentially harmful anabolic steroids. The discovery of the contamination began with a series of patients at the North Shore University Hospital in Manhasset. Doctors initially suspected possible environmental contamination and patients were referred to Dr. Ken Spaeth, director of the Occupational and Environmental Medicine Center at the North Shore-Long Island Jewish Health System. “People come in and part of what you’re trying to do is be a detective and figure out what the problem is,” Spaeth said. His questions led to all having consumed the B-50 vitamins and not having a common environmental source. Follow-up by the FDA led to the warning to consumers. Dr. Spaeth is a member of the Association of Occupational and Environmental Clinics. For more information contact Katherine Kirkland at

Building Industrial Hygiene Capacity in Colombia

Recently, the Universidad el Bosque, Colombia, requested NIOSH assistance to present a course on qualitative and quantitative exposure assessment strategies, and statistical analysis of exposure data in its Continuing Education program, July 25–29, 2013. The aim of this collaboration with NIOSH was to build industrial hygiene capacity in Colombia and in the region. The 32-hour course, taught by NIOSH researchers Aaron Sussell, Diana Ceballos, Catherine Beaucham, and Martha Waters, was filled beyond planned capacity due to the high demand. The Universidad El Bosque has plans to replicate the course in Colombia in the future. For more information, contact Dr. María Teresa Espinosa, MD, at or for inquires in the U.S. about the course, contact Catherine Beaucham at

Health Hazard Evaluation (HHE) Program Update

HHE logoExposures to Lead and Other Metals at an Aircraft Repair and Flight School Facility

The HHE Program evaluated concerns about lead exposure at an aircraft repair and flight school facility. Single-engine aircraft at the facility use leaded aviation fuel, which generates lead-containing particulates as a combustion byproduct. Lead was detected in blood samples collected from all personnel. The hangar area had the highest surface concentrations of lead; lead was also found on the steering wheel of an employee’s car. All airborne concentrations of lead and other elements measured over a shift were low. Airborne lead concentrations approached the occupational exposure limit for a short-term exposure when spark plugs were sandblasted. Lead dust was found on toys and a baby walker in the work area. HHE Program investigators recommended

  • developing a respiratory protection program and requiring employees to use a respirator when sandblasting spark plugs.
  • using wet cleaning methods to clean the hangar.
  • providing employees with disposable shoe covers and on-site laundering for work clothes to reduce the potential for take-home lead contamination.
  • not allowing children in work areas.

Evaluation of Instructor and Range Officer Exposure to Emissions from Copper-Based Frangible Ammunition at a Military Firing Range

HHE Program investigators evaluated exposures to weapons emissions during qualification sessions inside a partially enclosed firing range. The range uses copper-based ammunition, which breaks into pieces on impact. Instructors reported symptoms similar to those reported by instructors in previous surveys at the facility, such as headache, metallic tastes, sore throat, and respiratory symptoms. These symptoms were consistent with the types of exposures measured in the range. Investigators determined that the ventilation system was not designed to remove air contaminants. Air contaminant concentrations did not exceed occupational exposure limits. Investigators found that levels of very small particles inside the range increased during firing events. HHE Program investigators recommended

  • modifying the ventilation system to exhaust air contaminants out of the range.
  • rotating range duties to minimize time spent inside the range during firing events.

Evaluation of Ventilation Controls for Tuberculosis Prevention at a Hospital.

The HHE Program evaluated ventilation controls at a hospital as a result of latent tuberculosis infections being identified among hospital staff. All of the airborne infection isolation rooms and anterooms were exhausted directly to the outside as recommended. All but one of the isolation rooms that investigators measured provided at least six air changes per hour, and all but one isolation room provided a negative pressure greater than or equal to 0.01 inches of water gauge. HHE Program investigators recommended

  • following the Centers for Disease Control and Prevention recommendations for airflow rates in isolation rooms and anterooms.
  • maintaining a sufficient number of isolation rooms to house patients with known or suspected active tuberculosis disease.
  • placing portable air cleaners with high-efficiency particulate air filtration and ultraviolet germicidal irradiation in patient rooms to achieve good air mixing.

Link to these final reports are available at /niosh/hhe/whats_new.html.

r2p Corner

AIHA Proficiency Analytical Testing Programs Continues Partnership with NIOSH

Recently, the American Industrial Hygiene Association (AIHA) PAT LLC and NIOSH signed an agreement to continue their commitment to protecting worker health until December 31, 2016. AIHA PAT LLC has data that can assist NIOSH with making recommendations relating to respirable crystalline silica, such as with sampling and analytical procedures for the assessment of workers’ exposure. With the agreement in place, this data has now been transferred to NIOSH for evaluation. Please note that while AIHA has a memorandum of understanding with NIOSH, the recent transfer of the AIHA laboratory quality programs to separate limited liability companies meant that additional agreements were necessary with these entities. For more information, contact Martin Harper at (304) 285-5823 or

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

Federal Register Notices of Public Meetings and Public Comment

NIOSH Personal Protective Technology Program—Framework Document for the Healthcare Worker Personal Protective Equipment Action Plan
Written comments must be received by September 13.

Survey of Nanomaterial Risk Management Practices
Written comments must be received by September 15.

NIOSH Traumatic Injury Research and Prevention Program and Strategic Goals; Draft Document Availability
Written comments must be received by September 16.

NIOSH Public Meetings

Personal Protective Equipment Conformity Assessment/Inward Leakage Performance Requirements NIOSH will sponsor two public meetings on September 17. The first meeting will run from 8:00 AM until 12:00 PM and will discuss personal protective equipment conformity assessment. The second meeting will run from 1:00 PM to 5:00 PM and will discuss respirator inward leakage performance requirements. Both meetings will be held at the NIOSH Pittsburgh site. Remote participation will also be available. Registration is required for participation via either option. Visitors who are non-U.S. citizens must complete additional paperwork by August 16 to enter a federal facility. /niosh/npptl/resources/pressrel/letters/lttr-09172013.html

Respirator Manufacturing Meeting NIOSH will host a respirator manufacturing meeting on September 18. This meeting will be held at the NIOSH Pittsburgh site. The agenda is currently under development and will be posted to the NPPTL website when available. Registration is required and visitors who are non-U.S. citizens must complete additional paperwork by August 16 to enter a federal facility. /niosh/npptl/resources/pressrel/letters/Manufacturers/lttr-09182013.html

For a listing of NIOSH official publications for rules, proposed rules, and notices, go to

New NIOSH Communication Products

The following NIOSH communication products are now available in Spanish:

The following NIOSH communication product is available in Spanish:

Call for Abstracts and Presentations

AIHce 2014
Call for professional development courses. The deadline for submission is September 1.
Call for technical presentations. The deadline for submission is September 13.

2014 NFPA Conference & Expo
Call for session proposals. The deadline for submission is September 16.

2014 Global Health & Innovation Conference
Call for abstracts. The deadline for submission is September 30.
Please note that presentations submitted by August 31 will be given preference for oral presentations at the conference.

AIHA 2013
Call for abstracts for poster presentations. Deadline for submissions is October 15.

Association of periOperative Registered Nurses
Call for Poster Abstracts. The deadline for submission is October 18.

National Safety Council Texas Safety Conference & Expo
Call for presentations. Deadline for submission is October 25.

Upcoming Conferences and Workshops

World Safety Organization
September 9–11, San Diego, CA

Association of Occupational Health Professionals in Healthcare
September 11–14, Orlando, FL

National Personal Protective Technology Laboratory (NPPTL): Public meeting
September 17, Pittsburgh, PA

National Tactical Officers Association
September 22–27, Kansas City, MO

ICOH SC Joint Conference
September 23–26, São Paulo, Brazil

2013 North American Agricultural Safety Summit: Raising Safety
September 25–27, Minneapolis, MN

AIHA Fall Conference 2013:Your Source for Scientific, Management & Technical Knowledge
September 28–October 2, Miami, FL

2013 NSC Congress & Expo
September 28–October 4, Chicago, IL

Health, Workplace, Environment: Cultivating Connections
October 17, Storrs, CT

International Association of Chiefs of Police
October 19–23, Philadelphia, PA

2013 International Conference on Fall Prevention and Protection (ICFPP)
October 23-25, Tokyo, Japan

61st Annual International Association of Emergency Managers)
October 25–30, Reno, NV

87th Annual Pennsylvania Governor’s Occupational Safety and Health Conference
October 28–29, Hershey, PA

AIHA 2013 Asia Pacific OH+EHS Conference + Exhibition
October 29–31, Singapore

National Safety Council Texas Safety Conference & Expo
March 30–April 1, 2014, Galveston, Texas.

AIHCE 2014
May 31–June 5, 2014, San Antonio, TX

Did You Know?

September is National Preparedness Month. Throughout September there will be activities across the country to promote emergency preparedness. Learn more about these activities at You can also access NIOSH Emergency Preparedness and Response Resources at /niosh/topics/emergency

Please send your comments and suggestions to us by visiting /niosh/contact/.

This newsletter is published monthly via email by the National Institute for Occupational Safety and Health to inform members of the public health community as well as interested members of the general public of Institute related news, new publications, and updates on existing programs and initiatives.