Current Issues in Addressing Medical Surveillance, Exposure Registration, and Epidemiologic Research for Nanomaterial Workers

The responsible development of nanotechnology requires that precautions be taken to protect nanomaterial workers from potential hazards.  Primary preventive approaches have been recommended by the National Institute for Occupational Safety and Health (NIOSH) and several international organizations.  To assure that such approaches are working and in keeping with good occupational health practice, medical screening and surveillance should be considered for all nanomaterial workers.  It is critical that the application and content of such programs be updated as new hazard and risk information is obtained.  This presentation will identify the current guidelines for medical screening and surveillance.  There is also a need to assess the risk of potentially adverse health effects in nanomaterial workers.  This will not be straightforward since the workers are not in large centralized companies but rather spread across a range of facilities in various sectors and their exposures will include a variety of potential occupational exposures in addition to nanomaterials.  Finding and characterizing potential cohorts for study will require attention to the heterogeneity of exposure.  Market characterization will be needed and may serve as the basis for developing exposure registries as a foundation to epidemiologic research.  One approach that combines medical screening and surveillance, exposure registration, and epidemiologic research has been described in a model entitled “The Nanomaterial Workers Health Study.”  This would be a study of approximately 5,000 workers from various companies with various nanomaterial exposures.  This group would be part of an exposure registry and serve as a pool in which research on potential health effects would be assessed using cross-sectional and prospective designs.  Various biomarkers would be evaluated as early indicators of adverse effects.  Critical in moving ahead in all of these areas is government, industry, and labor collaboration.