1
|
Rose A, Uebel KE, Rae WI. Interventionalists' perceptions on a culture of radiation protection. SA J Radiol 2018; 22:1285. [PMID: 31754493 PMCID: PMC6837825 DOI: 10.4102/sajr.v22i1.1285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 11/21/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Occupational exposure to ionising radiation poses potential health risks to radiation workers unless adequate protection is in place. The catheterisation laboratory is a highly contextualised workplace with a distinctive organisational and workplace culture. OBJECTIVE This study was conducted to understand the culture of radiation protection (CRP). METHODS This study was a qualitative study and data were collected through 30 in-depth and 6 group interviews with 54 purposively selected South African interventionalists (interventional radiologists and cardiologists). The participants included a diversity of interventionalists who varied in sex, geographic location and years of experience with fluoroscopy. The transcribed data were analysed thematically using a deductive and inductive approach. RESULTS 'Culture of radiation protection' emerged as a complex theme that intersected with other themes: 'knowledge and awareness of radiation', 'radiation safety practice', 'personal protective equipment (PPE) utilisation' and 'education and training'. CONCLUSION Establishing and sustaining a CRP provides an opportunity to mitigate the potentially detrimental health effects of occupational radiation exposure. Education and training are pivotal to establishing a CRP. The time to establish a culture of radiation in the catheterisation laboratory is now.
Collapse
Affiliation(s)
- André Rose
- Department of Community Health, University of the Free State, South Africa
| | - Kerry E. Uebel
- Department of Internal Medicine, University of the Free State, South Africa
| | - William I. Rae
- Department of Medical Physics, University of the Free State, South Africa
| |
Collapse
|
2
|
Guseva Canu I, Schulte PA, Riediker M, Fatkhutdinova L, Bergamaschi E. Methodological, political and legal issues in the assessment of the effects of nanotechnology on human health. J Epidemiol Community Health 2017; 72:148-153. [PMID: 29203525 DOI: 10.1136/jech-2016-208668] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/01/2017] [Accepted: 11/03/2017] [Indexed: 11/04/2022]
Abstract
Engineered nanomaterials (ENMs) raise questions among the scientific community and public health authorities about their potential risks to human health. Studying a prospective cohort of workers exposed to ENMs would be considered the gold standard for identifying potential health effects of nanotechnology and confirming the 'no effect' levels derived from cellular and animal models. However, because only small, cross-sectional studies have been conducted in the past 5 years, questions remain about the health risks of ENMs. This essay addresses the scientific, methodological, political and regulatory issues that make epidemiological research in nanotechnology-exposed communities particularly complex. Scientific challenges include the array of physicochemical parameters and ENM production conditions, the lack of universally accepted definitions of ENMs and nanotechnology workers, and the lack of information about modes of action, target organs and likely dose-response functions of ENMs. Standardisation of data collection and harmonisation of research protocols are needed to eliminate misclassification of exposures and health effects. Forming ENM worker cohorts from a combination of smaller cohorts and overcoming selection bias are also challenges. National or international registries for monitoring the exposures and health of ENM workers would be helpful for epidemiological studies, but the creation of such a registry and ENM worker cohorts will require political support and dedicated funding at the national and international levels. Public authorities and health agencies should consider carrying out an ENM awareness campaign to educate and engage all stakeholders and concerned communities in discussion of such a project.
Collapse
Affiliation(s)
- Irina Guseva Canu
- Institute for Work and Health (IST), University of Lausanne, University of Geneva, Suisse, Switzerland
| | - Paul A Schulte
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Michael Riediker
- Institute for Work and Health (IST), University of Lausanne, University of Geneva, Suisse, Switzerland.,IOM (Institute of Occupational Medicine) Singapore, Singapore, Singapore.,School of Material Science and Engineering, Nanyang Technological University, Singapore, Singapore
| | | | - Enrico Bergamaschi
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| |
Collapse
|
3
|
Gulumian M, Verbeek J, Andraos C, Sanabria N, de Jager P. Systematic Review of Screening and Surveillance Programs to Protect Workers from Nanomaterials. PLoS One 2016; 11:e0166071. [PMID: 27829014 PMCID: PMC5102462 DOI: 10.1371/journal.pone.0166071] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 10/21/2016] [Indexed: 12/25/2022] Open
Abstract
Background Screening and surveillance approaches for workers exposed to nanomaterials could aid in early detection of health effects, provide data for epidemiological studies and inform action to decrease exposure. The aim of this review is to identify such screening and surveillance approaches, in order to extract available data regarding (i) the studies that have successfully been implemented in present day, (ii) identification of the most common and/or toxic nano-related health hazards for workers and (iii) possible exposure surveillance markers. This review contributes to the current understanding of the risk associated with nanomaterials by determining the knowledge gap and making recommendations based on current findings. Methods A systematic review was conducted. PubMed and Embase were searched to identify articles reporting on any surveillance-related study that described both exposure to nanomaterials and the health indicators that were measured. Four reviewers worked in pairs to independently assess the eligibility of studies and risk of bias before extraction of data. Studies were categorised according to the type of study and the medical surveillance performed, which included the type of nanomaterial, any exposure details provided, as well as health indicators and biomarkers tested. Results Initially 92 studies were identified, from which 84 full texts were assessed for eligibility. Seven studies met all the inclusion criteria, i.e. those performed in Taiwan, Korea, Czech Republic and the US. Of these, six compared health indicators between exposed and unexposed workers and one study described a surveillance program. All studies were at a high risk of bias. Workers were exposed to a mix of nanomaterials in three studies, carbon-based nanomaterials in two studies, nano-silver in one study and nano-titanium oxide in the other study. Two studies did not find a difference in biomarkers between exposed and unexposed workers. In addition, differences in early effects on pulmonary function or neurobehavioral tests were not observed. One study found an increased prevalence of allergic dermatitis and “sneezing” in the exposed group. Conclusions This review of recently published data on surveillance studies proves that there is a gap in the current knowledge, where most of the surveillance-related studies reported do not follow a set format that provides the required information on ENM characterisation, the type of exposure and the measured indicators/biomarkers. Hence, there is very low quality evidence that screening and surveillance might detect adverse health effects associated with workplace exposure. This systematic review is relevant because it proves that, although surveillance programs have been initiated and preliminary results are being published, the current studies are actually not answering the important questions or solving the overall problem regarding what the potential health hazards are among workers either handling or potentially exposed to ENMs. The recommendations, thus proposed, are based on an obvious need for (i) exposure registries, where longitudinal follow-up studies should inform surveillance, (ii) known exposure measurements or summary indices for ENMs as a reference (iii) validation of candidate biomarkers and (iv) studies that compare the effects of these surveillance approaches to usual care, e.g. those commonly followed for bulk-size hazardous materials.
Collapse
Affiliation(s)
- Mary Gulumian
- Department of Toxicology and Biochemistry, National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa
- * E-mail:
| | - Jos Verbeek
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Charlene Andraos
- Department of Toxicology and Biochemistry, National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa
| | - Natasha Sanabria
- Department of Toxicology and Biochemistry, National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa
| | - Pieter de Jager
- Department of Epidemiology and Surveillance, National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
4
|
Schulte PA, Roth G, Hodson LL, Murashov V, Hoover MD, Zumwalde R, Kuempel ED, Geraci CL, Stefaniak AB, Castranova V, Howard J. Taking stock of the occupational safety and health challenges of nanotechnology: 2000-2015. JOURNAL OF NANOPARTICLE RESEARCH : AN INTERDISCIPLINARY FORUM FOR NANOSCALE SCIENCE AND TECHNOLOGY 2016; 18:159. [PMID: 27594804 PMCID: PMC5007006 DOI: 10.1007/s11051-016-3459-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Engineered nanomaterials significantly entered commerce at the beginning of the 21st century. Concerns about serious potential health effects of nanomaterials were widespread. Now, approximately 15 years later, it is worthwhile to take stock of research and efforts to protect nanomaterial workers from potential risks of adverse health effects. This article provides and examines timelines for major functional areas (toxicology, metrology, exposure assessment, engineering controls and personal protective equipment, risk assessment, risk management, medical surveillance, and epidemiology) to identify significant contributions to worker safety and health. The occupational safety and health field has responded effectively to identify gaps in knowledge and practice, but further research is warranted and is described. There is now a greater, if imperfect, understanding of the mechanisms underlying nanoparticle toxicology, hazards to workers, and appropriate controls for nanomaterials, but unified analytical standards and exposure characterization methods are still lacking. The development of control-banding and similar strategies has compensated for incomplete data on exposure and risk, but it is unknown how widely such approaches are being adopted. Although the importance of epidemiologic studies and medical surveillance is recognized, implementation has been slowed by logistical issues. Responsible development of nanotechnology requires protection of workers at all stages of the technological life cycle. In each of the functional areas assessed, progress has been made, but more is required.
Collapse
Affiliation(s)
- P. A. Schulte
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - G. Roth
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - L. L. Hodson
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - V. Murashov
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - M. D. Hoover
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - R. Zumwalde
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - E. D. Kuempel
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - C. L. Geraci
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - A. B. Stefaniak
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - V. Castranova
- School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - J. Howard
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| |
Collapse
|
5
|
Liao HY, Chung YT, Lai CH, Wang SL, Chiang HC, Li LA, Tsou TC, Li WF, Lee HL, Wu WT, Lin MH, Hsu JH, Ho JJ, Chen CJ, Shih TS, Lin CC, Liou SH. Six-month follow-up study of health markers of nanomaterials among workers handling engineered nanomaterials. Nanotoxicology 2013; 8 Suppl 1:100-10. [DOI: 10.3109/17435390.2013.858793] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Hui-Yi Liao
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan,
| | - Yu-Teh Chung
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan,
| | - Ching-Huang Lai
- Department of Public Health, National Defense Medical Center, Taipei, Taiwan,
| | - Shu-Li Wang
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan,
- Institute of Environmental Health, College of Public Health, China Medical University and Hospital, Taichung, Taiwan,
| | - Hung-Che Chiang
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan,
| | - Lih-Ann Li
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan,
| | - Tsui-Chun Tsou
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan,
| | - Wan-Fen Li
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan,
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, WA, USA,
| | - Hui-Ling Lee
- Department of Chemistry, Fu Jen Catholic University, Taipei, Taiwan, and
| | - Wei-Te Wu
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan,
| | - Ming-Hsiu Lin
- Institute of Occupational Safety and Health, Council of Labor Affairs, Taipei, Taiwan
| | - Jin-Huei Hsu
- Institute of Occupational Safety and Health, Council of Labor Affairs, Taipei, Taiwan
| | - Jiune-Jye Ho
- Institute of Occupational Safety and Health, Council of Labor Affairs, Taipei, Taiwan
| | - Chiou-Jong Chen
- Institute of Occupational Safety and Health, Council of Labor Affairs, Taipei, Taiwan
| | - Tung-Sheng Shih
- Institute of Environmental Health, College of Public Health, China Medical University and Hospital, Taichung, Taiwan,
- Institute of Occupational Safety and Health, Council of Labor Affairs, Taipei, Taiwan
| | - Chin-Chi Lin
- Institute of Occupational Safety and Health, Council of Labor Affairs, Taipei, Taiwan
| | - Saou-Hsing Liou
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan,
- Department of Public Health, National Defense Medical Center, Taipei, Taiwan,
- Institute of Environmental Health, College of Public Health, China Medical University and Hospital, Taichung, Taiwan,
| |
Collapse
|
6
|
Current world literature. Curr Opin Urol 2012; 22:254-62. [PMID: 22469752 DOI: 10.1097/mou.0b013e328352c3f8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|