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)''

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.

-----------------------------------------------------------------------

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: [email protected] 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

[[Page 5955]]

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]

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