Radiation Dose Reconstruction Program of the National Institute for Occupational Safety and Health: overview

Over the past 65 years, hundreds of thousands of workers have been engaged in nuclear weapons-related activities for the U.S. Department of Energy or its predecessor agencies. To date, almost 27,000 such employees (or their survivors) have filed claims under Part B of the Energy Employees Occupational Illness Compensation Program Act of 2000, which provides monetary compensation and medical benefits to energy employees who have developed certain types of cancer that have been determined, under the guidelines of the program, to have resulted from occupational radiation exposure covered under the Act. Although it is difficult to predict the number of cancer claims that will be evaluated under this program, the number could double or triple. In each case, the processing of a claim requires that the National Institute for Occupational Safety and Health reconstruct the radiation dose received by the employee followed by a determination by the U.S. Department of Labor as to whether the employee was "at least as likely as not" to have sustained the cancer as a result of his or her occupational exposure to ionizing radiation. Although some of the dose assessments are straightforward, many are extremely complex due to (1) missing, non-interpretable, or undocumented records; (2) a wide variety of external and internal exposure conditions; and/or (3) highly variable work assignments and work loads. The program objectives are to process claims in an effective, efficient, and timely manner. One of the initial challenges was to develop the necessary infrastructure to meet these objectives. Subsequent challenges included documenting that assessments are fair and scientifically consistent. Ensuring that each claimant receives the "benefit of the doubt" in any cases where the required background information and data are ambiguous or not available is also an important objective. Fortunately, there are some aspects of the processing requirements that have tended to reduce the complexity, two examples being that compensation is based on exposures that occurred during covered employment after a cancer has developed and that the required dose estimates are for individual body organs, not effective doses. Throughout the process, every effort has been made to ensure that the dose assessments have the support of the best available science.     

The Occupational Safety and Health Act. The national policy for the prevention of work-related illness

Occupational health and safety issues are increasingly important on the broader health agendas of both industrial and non-industrial communities. These issues go beyond traditional industrial hygiene into areas of environmental epidemiology and public health engineering. The policy framework for addressing such issues is the Occupational Safety and Health Act of 1970.     

Reevaluation of lung cancer risk in the acrylonitrile cohort study of the National Cancer Institute and the National Institute for Occupational Safety and Health

OBJECTIVES: The present study provides additional analyses of data obtained earlier on lung cancer risk among workers with acrylonitrile exposure. METHODS: The original authors provided the data. For total mortality and the cancer sites of a priori interest (lung, stomach, brain, breast, prostate, and the lymphatic and hematopoietic systems), standardized mortality ratios (SMR) and 95% confidence intervals (95% CI) were computed, the total United States and surrounding counties being used as standard populations. Regional rate-based SMR values were also computed between lung cancer and cumulative acrylonitrile exposure. RESULTS: Except for lung cancer, the external comparisons corroborated the earlier internal comparisons (no increased cancer mortality risk). For lung cancer, the external comparisons revealed death deficits for the unexposed workers (SMR 0.68, 95% CI 0.5-0.9) and all categories of acrylonitrile-exposed workers. The SMR obtained using external rates and the most exposed group (SMR 0.92. 95% CI 0.6-1.4) differed from the corresponding relative risk (RR) of the internal rates (RR 1.5, 95% CI 0.9-2.4). CONCLUSIONS: The analysis of the present study provides little evidence that acrylonitrile exposure increases the mortality risk of cancers of a priori interest, including lung cancer. The lung cancer findings of the external comparison differed from the earlier findings of the internal comparisons. Selection bias (as the healthy worker effect) was probably not responsible. Additional follow-up and analyses, especially of the unexposed workers with low lung cancer rates, may help elucidate the internal and external comparison differences. Results from both comparisons should be presented when the relative risks differ markedly, as both have advantages and disadvantages.     

The Farmworker Health and Safety Institute (FHSI)

ABSTRACT

In general, few people know about pesticide poisoning, understand the concept of restricted entry interval, or have received any training on how to protect themselves from pesticides. Symptoms related to pesticide poisoning are easily confused with those for other illnesses, often resulting in health care providers and farmworkers alike not always recognizing the negative health affects related to pesticide exposure. The Farmworker Health and Safety Institute has developed a training program that makes farmworkers aware of the hazards to which they are exposed to on a daily basis as well as give them skills to address these hazards. The sessions are conducted in English, Spanish, and Haitian Creole and training materials are prepared in each of the three languages. The program enables farmworkers to develop advocacy skills in order to directly address problems in the workplace and community by influencing federal and state agencies who are responsible for enforcing these regulations.     

National Institute for Occupational Safety and Prevention (ISPESL): role in occupational health and safety

The article explains the role of the Italian National Institute for Occupational Safety and Prevention (ISPESL), a public research body dealing with occupational and environmental health. Its organization, institutional roles, activities, facilities, and resources are outlined. Especially important is ISPESL's participation in national and international occupational safety and health networks. The Institute is active in epidemiologic surveillance of workers exposed to physical, chemical, and biological hazards.