[Federal Register Volume 63, Number 24 (Thursday, February 5, 1998)]
[Notices]
[Pages 5952-5957]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-2824]
[[Page 5952]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
National Institute for Occupational Safety and Health; Draft
Document ``Review of NIOSH Report to Congress on Workers' Home
Contamination Study Conducted Under the Workers' Family Protection Act
(29 U.S.C. 671a)''
AGENCY: National Institute for Occupational Safety and Health (NIOSH),
Centers for Disease Control and Prevention (CDC), Department of Health
and Human Services (DHHS).
ACTION: Request for comments.
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SUMMARY: NIOSH is seeking public comments on the draft document
``Review of NIOSH Report to Congress on Workers' Home Contamination
Study conducted under the Workers' Family Protection Act (29 U.S.C.
671a)'', provided in this announcement. The Workers' Family Protection
Task Force was chartered in 1994 to review the NIOSH Report and to make
recommendations to Congress for a research agenda that federal agencies
might implement to investigate the types and magnitude of workplace-
transported (``take-home'') exposures and their potential adverse
consequences among workers' family members. This document represents
the Task Force's commentary on the NIOSH Report, identifies gaps in
current knowledge of take-home exposures and related health effects,
and presents a prioritized agenda for federally-sponsored research. In
particular, comments are being sought regarding additional data needs
not identified by the Task Force and comments on the recommended
investigative strategy proposed by the Task Force for use in meeting
data gaps.
DATES: Written comments to this notice should be submitted to Diane
Miller, NIOSH Docket Office, 4676 Columbia Parkway, Mailstop C-34,
Cincinnati, Ohio 45226. Comments must be received on or before April 6,
1998. Comments may also be submitted by email to: dmm2@cdc.gov as
WordPerfect 5.0, 5.1/5.2, 6.0/6.1, or ASCII files.
FOR FURTHER INFORMATION CONTACT: Technical information may be obtained
from Elizabeth Whelan, 4676 Columbia Parkway, Mailstop R-15,
Cincinnati, Ohio 45226, telephone 513-841-4437.
SUPPLEMENTARY INFORMATION: The following is the complete text of the
draft document for public comment ``Review of NIOSH Report to Congress
on Workers' Home Contamination Study conducted under the Workers'
Family Protection Act (29 U.S.C. 671a)'' and the NIOSH response to the
Task Force report.
SUMMARY: At the request of the U.S. Congress, the Centers for Disease
Control and Prevention's National Institute for Occupational Safety and
Health (NIOSH) issued a report in 1995 entitled: ``Report to Congress
on Workers' Home Contamination Study Conducted Under the Workers'
Family Protection Act.'' This Report was prepared in response to the
1992 Workers' Family Protection Act (Pub. L. 102-522, 29 U.S.C. 671)
which included a request to NIOSH to conduct a study to ``evaluate the
potential for, prevalence of, and issues related to the contamination
of workers' homes with hazardous chemicals and substances * * *
transported from the workplaces of such workers.''
The NIOSH Report chronicled the history of workplace-transported
exposures and associated health risks worldwide, primarily during the
20th century. The approach taken by NIOSH was to describe health
hazards associated with readily identifiable agents that have
unambiguous routes of exposure, that is, intentional transport of
workplace materials, contamination of workers' clothing or external
body surfaces (skin, hair), family members visiting the workplace,
improper storage of hazardous agents, and as a result of cottage
industries.
The Workers' Family Protection Task Force was chartered in 1994 to
review the NIOSH Report and to make recommendations to Congress for a
research agenda that federal agencies might implement to investigate
the types and magnitude of workplace-transported (``take-home'')
exposures and their potential adverse consequences among workers'
family members. This document represents the Task Force's commentary on
the NIOSH Report, identifies gaps in current knowledge of take-home
exposures and related health effects, and presents a prioritized agenda
for federally-sponsored research.
The Task Force noted that the NIOSH Report covered a wide range of
literature, largely describing conditions that occurred during the
1930s-1960s. Prominent examples of take-home hazards from the workplace
included poisoning from lead and beryllium, and exposure to asbestos.
The Task Force noted that the Report appeared to cover available
literature in a thorough manner. However, much of the literature
represents anecdotal accounts of hazardous take-home exposures and
subsequent illness in workers' family members. No comprehensive studies
have documented the effectiveness of current workplace control programs
for preventing the transport of toxic substances into homes. In
addition, there is a conspicuous absence of systematic research
regarding the extent of the problem and therefore no quantification of
the burden of disease caused by these exposures or the burden that is
likely to occur in future years. The Task Force also noted an
inadequate discussion of two categories of exposure, infectious agents
transmitted in biological fluids and radioactive substances.
The Task Force noted the presence of important gaps in knowledge
that hinder a clear understanding of the magnitude of take-home
exposures and potentially associated health consequences. For example,
information is lacking on the types and levels of take-home exposures
that are currently occurring in the U.S., the size and demographic
composition of the populations at risk for exposure, types of illnesses
associated with take-home exposures, and adequacy of exposure control
methods in the workplace and in the home. Some states have reporting
systems for recognized potential take-home toxicants such as lead.
However, even in such surveillance systems, reporting suffers from
incompleteness and lack of standardization. With these knowledge gaps,
it is currently not possible to estimate the magnitude of the public
health threat created by take-home exposures, nor is it possible to
predict the future risks that will occur from transported toxic agents.
Difficulties in determining potential hazards will likely increase in
the future as new materials are introduced into the workplace.
To address deficiencies in knowledge on take-home exposures, the
Task Force recommends the following prioritized Research Agenda for
which funding could be provided from federal and other governmental
sources and, in some cases, from the private sector:
Characterization of the extent of home contamination with
recognized workplace toxicants, including, but not restricted to: toxic
metals (e.g., lead, beryllium), pesticides, and dusts (e.g., asbestos);
Identification of populations at greatest risk of exposure
to known and suspected take-home toxicants;
Assessment of adverse health effects potentially related
to take-home exposures, including considerations of previously
established adverse effects and newer or less well-studied
associations, such as the consequences
[[Page 5953]]
of transmitting infectious agents and radioactive substances into the
home;
Identification of previously unrecognized toxic exposures
that potentially place workers' family members at risk for health
impairment; and
Assessment of the effectiveness of take-home exposure
prevention and remediation methods, including decontamination
procedures.
The Task Force recommends that this proposed Research Agenda be
given full consideration by NIOSH under the Institute's National
Occupational Research Agenda (NORA). The Task Force also noted that
existing federal statutes apply to take-home contamination in a narrow
manner, either because of substance-specific language or restrictive
enforcement priorities. Moreover, the Workers' Family Protection Act
(WFP Act) did not anticipate revisions to the existing statutory
authority of the federal agencies that may be involved in take-home
contamination issues. None will be needed if federal and State agencies
take advantage of their existing statutory authority to promulgate and
enforce standards and regulations that are responsive to the hazardous
conditions identified by the Research Agenda developed by this Task
Force. Revision of these statutes to authorize the prevention and
remediation of take-home contamination, especially through revision of
the prioritization schemes used by governmental agencies, such as the
Environmental Protection Agency, should be considered by Congress only
if the agencies find it difficult to respond effectively to the
Research Agenda.
Introduction
At the request of the U.S. Congress, the Centers for Disease
Control and Prevention's National Institute for Occupational Safety and
Health issued a report in 1995 entitled: ``Report to Congress on
Workers' Home Contamination Study Conducted Under the Workers' Family
Protection Act.'' This report (henceforth referred to as the ``NIOSH
Report'') was prepared in response to the 1992 Workers' Family
Protection Act (Public Law 102-522, 29 U.S.C. 671) which included a
request to NIOSH to conduct a study to ``evaluate the potential for,
prevalence of, and issues related to the contamination of workers'
homes with hazardous chemicals and substances * * * transported from
the workplaces of such workers.''
The NIOSH Report chronicled the history of workplace-transported
exposures and associated health risks worldwide, primarily during the
20th century. The approach taken by NIOSH was to describe health
hazards associated with readily identifiable agents that have
unambiguous routes of exposure, that is, intentional transport of
workplace materials, contamination of workers' clothing or external
body surfaces (skin, hair), family members visiting the workplace,
improper storage of hazardous agents, and as a result of cottage
industries. Prominent toxic exposures included beryllium, asbestos,
lead, and pesticides for which clear evidence of exposure-related
sequelae had been established. Reports of exposures and risks from
other agents, such as asthmagens, estrogenic substances, and infectious
agents, were generally more sporadic in the literature and thus
received less attention. Methods to control exposures at the workplace
and in the home were also summarized and linked to specific agents.
The Workers' Family Protection Task Force was chartered in 1994 to
review the NIOSH Report and to make recommendations to Congress for a
research strategy that federal agencies might implement to investigate
the types and magnitude of workplace-transported (``take-home'')
exposures and their potential adverse consequences among workers'
family members.
Purpose
This document represents the Task Force's commentary on the NIOSH
Report, identifies gaps in current knowledge of take-home exposures and
related health effects, and presents a prioritized agenda for
federally-sponsored research. Development of a Research Agenda to
address exposure and health hazards potentially posed by take-home
exposures was the Task Force's principal objective. A final section of
this report is devoted to legal and policy considerations. This section
was included by the Task Force to assist the Secretary of Labor in
fulfilling the requirements specified under subsection (d) of the
Workers' Family Protection Act, notably to assess the information
developed under subsection (c) of the Act in determining additional
enforcement and regulatory needs.
Commentary on the NIOSH Report
The NIOSH Report contains a substantial amount of information
culled from the available literature, primarily published reports in
medical and industrial hygiene journals. Additional reports of take-
home incidents were solicited from federal and State health, labor, and
environmental agencies. As the authors of the Report acknowledge, there
are substantial limitations in the available literature. An important
limitation is that U.S. reporting systems for sentinel exposures and
health outcomes are limited to lead and pesticides. Moreover, the
Report notes that community clinicians may not recognize diseases that
result from take-home exposures because they fail to obtain relevant
information on family members' occupations. Systematically-obtained
data on exposure types and levels for most agents are lacking, even for
lead and pesticides which have been the subject of considerable focus.
Additionally, the Report acknowledged that much of the literature
summarized pertains to exposure conditions that occurred during the
1930s-1960s, and, therefore, may have limited relevance to contemporary
home and work environments. The Task Force agrees that these
limitations exist.
In general, the Task Force found the Report to be a comprehensive
review of episodes of toxicity for the agents that fit the criterion of
having a clearly recognizable transported exposure route. However, the
scope of the problem of take-home exposures seems to be too narrowly
defined in some instances. For example, the nuclear industry has
documented cases of various radionuclides carried home on workers
clothing, shoes, or on other items (e.g., tools) that are brought home
from the workplace. The Task Force concluded that there was an
inadequate discussion of potential take-home hazards from radioactive
substances. Furthermore, the Report does not consider the broader range
of exposures to infectious agents that might be transmitted from
workers to their family members by means other than from the presence
of pathogens on skin or clothing. The Task Force recognizes that this
restrictive definition of infectious agent transmission was prescribed
by Congress. Nonetheless, the majority of infectious disease risk to
workers' family members is likely to result from other routes of
exposure. Of specific concern is the possibility of transmission of
infectious diseases to family members of health care workers. Potential
risks for reproductive system damage and developmental disorders as a
consequence of take-home exposures also did not receive adequate
consideration.
Assessing the extent of take-home exposures requires the
identification and analysis of contamination transport pathways, and
methods of measuring the toxic chemicals of interest. A review of the
published literature, as
[[Page 5954]]
summarized in the NIOSH Report, does not provide specific information
describing these pathways or their analysis. Many of the citations are
anecdotal, based on outdated industrial practices, or are summaries of
foreign experiences that may not be directly applicable to the United
States.
Gaps in Knowledge
An understanding of the potential burden of impaired health
experienced by workers' family members due to take-home exposures has
been limited by significant knowledge gaps in: the types, sources, and
magnitude of take-home exposures; the size and characteristics of at-
risk populations; the types and severity of potentially associated
health effects; and the adequacy of exposure control methods. The
following section summarizes the Task Force's conclusions on knowledge
gaps and recommended approaches for reducing these gaps.
Types and Levels of Exposure
Little systematic research has permitted quantification of
previously recognized and emerging take-home exposures. Moreover,
identification of new, unanticipated hazards is impeded by limitations
of existing research methodology. Past episodes of documented health
hazards suggest the importance of determining the extent of take-home
exposures from recognized toxic agents, such as lead or beryllium.
However, no reliable and feasible methods exist to determine how many
homes and families are potentially exposed to established toxicants and
what exposure levels might exist.
The difficulties of assessing the extent of exposure to previously
unrecognized toxicants are even more daunting. Although it might be
argued that contemporary workplace hygienic practices should offer
adequate protection against excessive take-home exposures in large,
well-organized businesses, small businesses often lack financial
resources for exposure reduction programs. A further complication is
that it is virtually impossible to predict which workplace agents may
in the future pose threats to workers' family members' health. The
problem of agent identification and quantification undoubtedly has been
compounded in recent years as newer materials have been introduced into
the workplace. This trend is likely to continue for the foreseeable
future.
Identifying sources of exposures (i.e., workplace or ambient
environment) is another difficulty that must be addressed in
characterizing exposure pathways.
It will clearly not be possible to institute a nationwide
surveillance system for all known and suspected take-home toxicants.
Instead, focused approaches can be devised that provide sufficient
information to support health-related research or exposure remediation
interventions. One recommended approach is to institute regional, and
where feasible, national exposure sentinel monitoring systems for
agents that have a likely potential for home transport and can be
measured reliably. Precedent is provided by the Beryllium National
Registry. Such a system would require prioritizing agents on the basis
of known toxicity and ease of recognition, and targeting surveillance
in areas where workplace exposures are relatively common. Take-home
pesticide exposures in rural areas may be a useful prototype because
there exist methods for in-home exposure measurement and exposure
pathway analyses.
Determining exposures to agents that are not obvious take-home
hazards might require input from community health practitioners who
should be encouraged to obtain more and better information on the
occupational history of family members, at least for current
employment. Periodic collection and analysis of data relating disease
occurrence to family members' occupations might reveal previously
unrecognized associations that warrant further examination.
There are also important knowledge gaps related to defining the
populations at risk for take-home toxic exposures, and, ultimately,
health hazards. The potentially exposed population includes all
household members of workers capable of transporting contaminants into
the home, residents of farms, and residents of homes that function as
cottage industry workplaces. Exposed household members frequently are
children, the elderly, pregnant women, and the ill or disabled. Family
members exposed to take-home agents may in some instances have an
increased level of vulnerability compared to individuals exposed in an
occupational setting. Household members may differ from workers
physiologically (e.g., age and health status), behaviorally (e.g.,
hand-to-mouth and pica behaviors of young children), and educationally
(e.g., worker awareness and use of personal protective equipment). For
example, children absorb, distribute, and metabolize some toxicants
differently than adults. The elderly also exhibit physiologic
differences that may alter susceptibility to toxic substances. Elderly
persons who have experienced long-term exposures may also have
accumulated substantial body burdens before take-home exposures occur.
Additionally, the vulnerability of some workers' household members may
be affected by low socioeconomic status, which may lead to problems
with access to health care, pre-existing diseases, and compromised
nutritional status. Limited access to health care is an important issue
because workers of lower socioeconomic status may be more likely to
hold jobs in which they are exposed to high levels of toxic substances
because of inadequate workplace controls; elevated exposure levels may
combine with limited access to health care to increase the risk of
adverse health effects among workers and their families.
To characterize the exposed population accurately it will be
necessary to generate estimates of the number of workers who encounter
specific hazardous substances on the job. Descriptions of household
sizes, types, and locations will also be needed. These data are not
currently available, but may be crudely estimated for some major agents
(e.g., asbestos, lead) from national databases and census reports.
However, even these estimates are limited by a lack of specific,
quantitative information concerning workplace exposure levels and modes
of toxicant transport from the workplace to homes. An additional
complication will be introduced as the age distribution and living
conditions of the exposed population changes. For example, as the U.S.
population ages and health care costs escalate, extended families
living in the same home may become more common, and the home may become
an increasingly frequent site for health care delivery to chronically
ill family members. These changes in the profile of the population-at-
risk make it difficult to predict the future magnitude of the problem
of home contamination.
Distinguishing Primary Occupational Health Effects From Secondary Take-
Home Exposure Effects
Workers' household members may exhibit different health effects
from those seen in workers, thus making detection difficult and
potentially obscuring the link to the workplace. Lead, for example, can
impair the child development at low levels of body burden, and exposure
to estrogenic compounds has been reported to cause hormone-related
effects, such as abnormal breast enlargement in children. Other
chemicals brought home from the workplace may cause similar toxic
effects. Although there are documented instances of these effects
following take-home exposures, the
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extent of the problem remains unknown. Additionally, adverse
reproductive effects have been associated with exposures to several
toxic exposures in worker groups, but effects experienced by family
members, including pregnant wives of workers, have not been well
characterized. Epidemiologic studies of worker families may be useful
in this regard. Improved data sources, such as the inclusion of both
parents' occupations on birth certificates, should be considered.
Government-mandated standards for levels of workplace exposure are
based on protection of adult workers. Guidelines for worker exposures
are not intended to protect individuals who may be more vulnerable due
to compromised health or age factors. Thus, workers who themselves may
not be affected adversely by work exposures may still transport agents
to the home that are capable of affecting others in their household.
The characteristics of the home environment dictate that some family
members may experience take-home toxic exposures throughout the day,
especially for persistent agents that can be readily disbursed in the
home environment (e.g., lead). Continuous exposures to these
substances, even at low levels, may pose health risks to family
members.
Most Important Health Effects
The literature summarized in the NIOSH Report to Congress indicates
that the clearest instances of health hazards related to take-home
exposures are those where the pathways of exposure are established and
the health effects are both severe and specific to the exposure. The
most obvious examples are asbestos- and beryllium-associated lung
diseases and lead poisoning. Knowledge of health effects is based
largely on case reports rather than population-based studies;
consequently, the true spectrum of health outcomes is essentially
unknown. Most of the research literature does not address how take-home
exposures contribute to diseases with complex or multi-factorial
origins (e.g., cancers or birth defects). Other conditions, such as
asthma, skin diseases, and neurological dysfunction, are difficult to
relate to take-home exposures because of their generally non-specific
etiologies.
The health effects of historically important take-home toxicants,
such as lead, pose a continuing threat, but remain difficult to monitor
because there is no system for evaluating the extent of the problem.
For example, as workplace lead standards are lowered it may be
anticipated that take-home exposure concentrations would be diminished
concomitantly. However, data from population surveys (e.g., NHANES) of
blood lead levels cannot reveal the past contribution of take-home
occupational exposures to currently occurring health effects due to the
overwhelming influence of ambient exposures on body burden.
Potential Future Threats to Health From Take-Home Exposures
Severe episodes of toxicity from known hazards, such as lead or
pesticide poisoning, will undoubtedly occur in the future with
unpredictable frequency. The contributions of less well-established
take-home exposures are much less predictable and deserve more
scrutiny. Diseases that are clearly increasing in incidence and
prevalence, such as childhood asthma, are logical candidates for future
study. Health effects of fundamental importance to reproductive
function also require further examination, especially given the
established association between certain occupational exposures and
altered endocrine function.
The wording of the Workers' Family Protection Act limits take-home
exposures to agents that are transmitted either from the workers'
clothing or external body surfaces. Thus, chemicals or infectious
agents harbored in blood or other internal body compartments were
considered outside the purview of the NIOSH review. Although this
restriction simplifies the scope of exposure control and remediation
strategies, possible health risks of considerable public health
importance may be excluded from consideration. Blood-borne infections,
occupationally acquired by health care workers and subsequently
transmitted to family members, is a clear example of such take-home
transmission.
Exposure Remediation
Remedial measures to protect workers' families should focus
primarily on identifying and preventing the transport of potentially
hazardous substances from the workplace. NIOSH's National Occupational
Research Agenda (April 1996) lists control technology and personal
protective equipment as one of 21 research priorities that can lead to
improved worker safety and health. It states that ``recognized safety
and health hazards can be managed by a variety of engineering,
administrative, and worker protection techniques.'' These same
techniques can be applied to prevent the contamination of workers'
homes with hazardous substances transported from workplaces.
Decontamination procedures should be viewed as necessary only when
preventive measures were not taken or were inadequate.
There is little research documenting the overall degree of exposure
and the extent to which health effects occur because workers
inadvertently carry home hazardous substances from work on their
clothes, body, or tools; health effects related to some substances,
however, are well recognized because of their uniqueness and clear
associations with workplace exposures. For these hazardous substances,
a modest investment of resources could prevent transport of the
substances to workers' homes, first and foremost by enhanced training
efforts to increase awareness of the hazards and acceptance of safe
work and material-handling procedures by employees and employers (e.g.,
changing clothes before going home, showering before going home,
separating work areas from living or eating areas, using personal
protective equipment). Also effective would be the development and
distribution of information and education programs aimed at family
members and health care professionals.
Take-home contamination can also be managed by instituting and
adhering to engineering controls, such as the proper use of equipment,
substitution of safer materials, use of equipment with improved
engineering designs when available, or using personal protective
equipment to isolate the worker from the hazard. Although various
control measures have been used to prevent the adverse health effects
of known take-home toxicants in workers' families, limited information
exists to assess or predict their effectiveness. The Task Force
recommends that, at a minimum, an investigative strategy should
include: (1) Development of surveillance programs to document the
effectiveness of control measures that are being used, including an
assessment of the feasibility and effectiveness of alternative
measures; (2) an assessment of the performance of existing protective
clothing (i.e., single-use disposable and clothing that can be
laundered) as barriers for chemical, biological, thermal, and physical
hazards; (3) an assessment of the use and acceptance of protective
clothing by workers; (4) research on, and development of, new types of
materials for protective clothing and gloves, including evaluation of
their performance characteristics; and (5) measures to ensure that
protective clothing is designed to fit the growing numbers of minority
and female workers, and that such clothing is made available to them.
[[Page 5956]]
For many occupations, control measures have not been developed
because there is a lack of awareness of the potential health effects of
take-home toxicants and the extent to which they occur at home. As
these hazards become apparent, the Task Force recommends that
sufficient technical and financial resources be applied to evaluate the
effectiveness of proposed control measures.
The effectiveness of most decontamination procedures has not been
adequately assessed, and is dependent on the hazardous substance(s)
involved, the manner in which remediation procedures are followed, and
the entity that requires decontamination (e.g., person, clothing,
surface). Because the primary source of home contamination is via the
worker's clothing, items that come in contact with the worker's
garments such as automobile seats, carpeting, furniture, and other
porous materials, are most likely to require decontamination.
Decontaminating reusable garments using home laundry procedures can
create problems with contaminated effluent, as well as incomplete
decontamination due to the lack of sophisticated laundry techniques and
poor use of cleaning temperatures, mechanical action, and appropriate
cleaning agents. Furthermore, laundering garments worn by health care
workers in locations other than commercial laundries has the potential
to contaminate homes with infectious agents transported from the
workplace. In these situations, and where there is worker exposure to
non-water soluble contaminants (such as asbestos), disposable, single-
use garments is an option.
Proposed Research Agenda
In proposing a Research Agenda to address potential health hazards
resulting from take-home exposures, the Task Force formulated the
following questions: (1) What evidence is there that historically-
recognized toxic exposures continue to pose health threats to workers'
family members; (2) what are the previously unrecognized hazardous
exposures; (3) what adverse health effects among workers' family
members can be attributed to take-home exposures; and, (4) are exposure
control methods effective? The Task Force commented that any scientific
determination of the past and ongoing occurrence of impaired health
associated with take-home exposures requires coordinated research among
professionals with expertise in occupational and environmental exposure
assessment, epidemiology, biostatistics, clinical occupational and
environmental medicine, and toxicology.
The Task Force recommends that federal and other governmental
agencies sponsor research into the types, levels, and determinants
(i.e., sources) of take-home exposures, potential adverse consequences
experienced by workers' family members, and exposure remediation and
control technology. The Task Force notes that the Research Agenda is
not intended to be a mutually exclusive list of individual research
programs; rather, the Agenda items are interdependent and should
engender research efforts that address more than one of these programs
concurrently. The research priorities are listed below:
Characterization of the extent of home contamination with
recognized workplace toxicants, including, but not restricted to: toxic
metals (e.g., lead, beryllium), pesticides, and dusts (e.g., asbestos);
Identification of populations at greatest risk of exposure
to known and suspected take-home toxicants;
Assessment of adverse health effects potentially related
to take-home exposures, including considerations of previously
established adverse effects and newer or less well-studied
associations, such as the consequences of transmitting infectious
agents and radioactive substances into the home;
Identification of previously unrecognized toxic exposures
that potentially place workers' family members at risk for health
impairment; and,
Assessment of the effectiveness of take-home exposure
prevention and remediation methods, including decontamination
procedures.
In proposing this research agenda, the Task Force intentionally
avoided prescribing specific topics for and methods of investigation.
This was due largely to the absence of adequate contemporary
information that would indicate which exposures currently present the
greatest hazards to family members. This dearth of information is, in
fact, what motivated the research agenda recommendations for
characterizing exposure conditions. The Task Force felt that
responsibility for defining specific topics and scope of research
protocols should reside with federal and other governmental agencies,
and with private sector research sponsors, who issue requests for
research proposals and make research grant awards. Additionally, the
Task Force concluded that research on exposure and health assessments
related to take-home exposures deserves full consideration by NIOSH
under the Institute's National Occupational Research Agenda (NORA).
Legal and Policy Considerations
Existing federal statutes have been applied to take-home
contamination in a narrow manner, either because of substance-specific
statutory language or restrictive enforcement priorities. For example,
the toxic-waste remediation efforts of EPA and ATSDR emphasize large-
scale contamination events, usually involving neighborhoods or entire
communities. Under the Workers' Family Protection Act, these agencies
must emphasize assessment of isolated incidents in which only one or a
few workers bring home toxic substances from their workplaces. These
incidents, are important to identifying the toxic substances most often
involved in take-home contamination, determining the means by which
contaminants are effectively removed from the workplace to the home,
and estimating the extent to which such contamination represents a much
larger problem in a particular workplace or industrial sector. The
research approach implemented by ATSDR to document these incidents, as
well as the Sentinel Event Notification System for Occupational Risks
(SENSOR) developed by the National Institute for Occupational Safety
and Health, could be adopted by other federal and State agencies
involved in take-home contamination research. The data resulting from
this research could then be used by federal and State agencies,
including OSHA, to promulgate regulations and standards to prevent
take-home contamination. In this regard, attention must be paid to the
regulatory authority of the Department of Energy/Nuclear Regulatory
Commission, Department of Transportation, and the Coast Guard over
specialized industries; the involvement of these agencies in strategy
implementation is critical to the protection of the families of workers
regulated by these agencies.
Of the non-OSHA federal statutes, only the Asbestos Hazard
Emergency Response Act of 1986 explicitly addresses take-home
contamination. The remaining statutes, however, contain provisions that
could be used to prevent and remediate take-home contamination if the
agencies that implement these statutes elect to emphasize this issue in
the standards and regulations they promulgate. The Workers' Family
Protection Act did not anticipate revisions to the existing statutory
authority of the federal agencies that may be involved in take-home
contamination issues, and none will be needed if these agencies take
[[Page 5957]]
advantage of their existing statutory authority to promulgate and
enforce standards and regulations that are responsive to the hazardous
conditions identified by the Research Agenda developed by this Task
Force. Agency responsiveness to the Agenda, however, depends largely on
the means by which participation, coordination, and accountability
among the agencies are effected. Revision of agency statutes to
authorize specifically the prevention and remediation of take-home
contamination, especially through revision of the factors used to
establish the prioritization schemes used by EPA and ATSDR, should be
considered by Congress only if the agencies find it difficult to
respond effectively to the Research Agenda.
Response From the National Institute for Occupational Safety and Health
(NIOSH)
NIOSH supports the research agenda proposed by the Workers' Family
Protection Task Force in this report. The recommended research
priorities fit within the framework of the National Occupational
Research Agenda (NORA) and particularly its priority area ``Special
Populations at Risk.'' This plan, developed by NIOSH and more than 500
public and private partners and stakeholders, includes priorities for
addressing allergic and irritant dermatitis; asthma and chronic
obstructive pulmonary disease; fertility and pregnancy abnormalities;
infectious diseases; control technology and personal protective
equipment; and many other areas highlighted by the Task Force for
consideration. NIOSH supports the recommendations of the Task Force and
welcomes public comment on the proposed research agenda.
Dated: January 30, 1998.
Linda Rosenstock,
Director, National Institute for Occupational Safety and Health
(NIOSH), Centers for Disease Control and Prevention (CDC).
[FR Doc. 98-2824 Filed 2-4-98; 8:45 am]
BILLING CODE 4163-19-P
