r2p: Research To Practice at NIOSH
Research to Practice (r2p) is a new NIOSH initiative focused on the transfer and translation of research findings, technologies, and information into highly effective prevention practices and products which are adopted in the workplace.
The goal of r2p is to reduce illness and injury by increasing workplace
use of effective NIOSH and NIOSH-funded research findings. In order to
achieve this, NIOSH is continuing to work with our partners to focus research
on ways to develop effective products, translate research findings into
practice, target dissemination efforts, and evaluate and demonstrate the
effectiveness of these efforts in improving worker health and safety.
r2p in Action
Several recent NIOSH successes exemplify the types of activities the
new r2p initiative is designed to promote and enhance:
Communicating Results-Driven NIOSH ResearchNIOSH is partnering with the American Industrial Hygiene Association (AIHA) and the American Institute of Physics (AIP) to provide content for AIP's "Discoveries and Breakthroughs in Science" video news service. "Discoveries and Breakthroughs in Science" provides short news segments for local television news stations covering innovative scientific projects and programs. In particular, the segments highlight scientific advancements that have beneficial impact for health and society. Three segments showcasing NIOSH projects are available for viewing at the external links below.
NIOSH research to develop a cooling suit to reduce fire fighters' risk of heat stress http://www.aip.org/dbis/stories/2008/18017.html
NIOSH's unique mine roof simulator for understanding and addressing the forces that cause mine roof collapse http://www.aip.org/dbis/stories/2008/18014.html
NIOSH research to develop a system for monitoring fire fighters' vital signs http://www.aip.org/dbis/stories/2008/18019.html
NIOSH Fire Fighter Fatality Investigations Support Revisions to NFPA StandardsNIOSH findings and recommendations from its Fire Fighter Fatality Investigation and Prevention Program (FFIPP) have been used in the development and revision of several National Fire Protection Association (NFPA) standards. Examples follow, with specifics on how the standards were influenced by the FFFIPP.
NFPA, 1982 Personal Alert Safety System (PASS)
NIOSH investigative findings were instrumental in prompting and guiding revisions to this standard which became effective December 20, 2006, and will result in more stringent testing of devices sold after August, 2007 (http://www.nfpa.org/newsReleaseDetails.asp
NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments
NIOSH staff and investigations findings played important roles in updating NFPA 1582, the voluntary standard that establishes components of a fire department occupational medical program. The 2000 edition of NFPA 1582 considered it a reasonable approach to conduct medical screening (exercise stress) tests in asymptomatic fire fighters with no coronary artery disease risk factors beginning at age 40, and at age 35 for asymptomatic fire fighters with one or more coronary artery disease risk factors. The NIOSH reports, coupled with our participation on the NFPA committees, highlighted the discrepancy between this guidance and the recommendations of the American Heart Association, the Department of Transportation, and the Report of the U.S. Preventative Services Task Force. Subsequent versions of NFPA 1582 (2003 and 2007 editions), became consistent with other organizations both in terms of the age (males > 45 years; females > 55 years) and number of coronary risk factors (two or more) triggering the screening test and the type of screening test used (symptom limiting versus sub-maximal exercise stress tests).
This recommended practice provides guidance on establishing fire ground rehabilitation units to provide relief from extreme environmental conditions and triage fire fighters needing additional medical observation or treatment. NIOSH investigations revealed some stoic symptomatic fire fighters refusing further medical evaluation and returning to fire suppression duties. This delay in medical evaluation reduced the fire fighter’s chances of surviving a heart attack triggered by fire suppression duties. NIOSH brought this situation to the attention of the NFPA committee charged with updating NFPA 1584, scheduled for release in the fall of 2007. The revised document provides guidance to the leader of the rehabilitation section and the overall incident commander that fire fighters assigned to rehabilitation are still under the incident command system and cannot refuse an order for further medical evaluation or transport to a medical facility.
This standard recommends staffing based on the types of emergency response fire departments are likely to encounter. Mr. Richard Duffy, the Secretary of the Technical Committee that developed this standard, reported that NIOSH fatality investigation reports were used extensively in development of this standard. Many provisions of this standard are also included in a counterpart for volunteer departments, NFPA 1720.
NIOSH Collaborates with FDA to Address Hazards with Oxygen Resuscitators
NIOSH investigations of serious fire fighter injuries associated with fires in oxygen resuscitators, along with collaborative work with the Food and Drug and Administration (FDA) and the National Aeronautics and Space Administration (NASA), led to a product recall, product design changes, a new test method for product design, and a proposed FDA rule that would require oxygen regulators to meet the new test method requirements or similarly demonstrate safe design.
In 1998, the International Association of Fire Fighters (IAFF) requested that NIOSH investigate a series of incidents involving fire fighters who were injured when portable oxygen resuscitators spontaneously ignited and burned. In addition to conducting investigations of several incidents, NIOSH staff worked with the FDA, the agency that is responsible for the approval of this type of medical device, consulted with NASA given their expertise in compressed oxygen delivery systems, and contracted for the services of a forensics testing laboratory. It was quickly determined that most of the incidents involved the same model oxygen regulator, and NIOSH and FDA worked with this manufacturer who took steps to address the hazard, recalling 200,000 units from the field, offering a retrofit kit to address the ignition hazard, and changing their product design. FDA and NIOSH publicized the hazard and safety measures through a joint publication, FDA and NIOSH Public Health Advisory: Explosions and Fires in Aluminum Oxygen Regulators (http://www.fda.gov/cdrh/oxyreg.html).
NIOSH again worked with the FDA in 2005 and 2006 in an investigation requested by the Virginia Beach Fire Department into an incident in which an oxygen resuscitator ignited and burned while fire department crew members were going about their daily equipment checks. NIOSH and FDA reviewed the circumstances of the incident along with adverse incident reports made to FDA and jointly contracted for a forensic analysis of the oxygen regulator. The forensic analysis identified an ignition hazard associated with re-use of plastic gaskets. CDC/NIOSH and FDA worked together to develop and distribute a public health advisory regarding this previously under-recognized hazard, FDA AND NIOSH Public Health Notification: Oxygen Regulator Fires Resulting from Incorrect Use of CGA 870 Seals (http://www.fda.gov/cdrh/safety/042406-o2fires.html) The Virginia Beach Fire Department subsequently presented the NIOSH investigator who led this investigation with a meritorious service award, citing the investigation as an example of how government and the private sector are supposed to work hand-in-hand.
Development of Testing Method and Proposed FDA rule
To reduce the likelihood that new models of oxygen resuscitators would have ignition hazards, NIOSH sought assistance from NASA and provided funding to develop a new testing method. This new testing method, G175-03 Standard Test Method for Evaluating the Ignition Sensitivity and Fault Tolerance of Oxygen Regulators Used for Medical and Emergency Applications, became effective in 2006, American Society for Testing and Materials (http://www.astm.org/cgi-bin/SoftCart.exe
On February 27, 2007, FDA published in the Federal Register (Volume 72, No. 38) a proposed rule that will require oxygen regulators to conform with ASTM G175-03 or provide equivalent assurances of safety and effectiveness.
Personal Dust Monitor (PDM) for Assessment of Particulate Exposure
In collaboration with manufacturers, labor and industry, NIOSH developed a new personal dust monitor (PDM) for assessing coal miners’ exposure to coal dust in underground coal mines. The first advancement in more than 30 years for monitoring exposures, the PDM provides real-time exposure data during a work shift. It warns of potential over-exposures in time for mine operators to reduce exposures that might lead over time to development of coal workers’ pneumoconiosis or “black lung,” a debilitating lung disease that caused 14,000 deaths between 1991 and 2000. NIOSH plans to commercialize the device, following additional testing this year to verify its performance.
Hand Wipe Method for Detecting Lead
Through a simple color change, a NIOSH-developed hand wipe technology quickly and easily detects the presence of lead (Pb) contamination on skin and on hard surfaces in industries where lead is produced or used to a limit of identification of 15 micrograms per sample. The method was designed following a NIOSH Health Hazard Evaluation in a Pb acid battery plant that revealed high concentrations of lead on worker’s hands after washing and also on a variety of surfaces throughout the plant cafeteria. The Handwipe Disclosing Method for the Presence of Lead is patented and commercially available under the brand name Full Disclosure. While the method provides instant in the field results, the samples can also be analyzed using numerous NIOSH laboratory analytical methods. Recognition of lead exposure risks is a critical first step in preventing workplace exposures as well as limiting take-home toxics that can result in ingesting of lead during eating, drinking, or smoking. Through this novel technology, lead exposure can be reduced for more than 10,000 workers and 900,000 children in the United States. Full Disclosure was licensed in 2003 and is commercially available from SKC, Inc. - www.skcinc.com/prod/550-001.asp
A follow-up invention to Full Disclosure (also invented at NIOSH) is the Handwipe Removal Method for Toxic Metals. Hands Off! (proposed brand name) has been evaluated by NIOSH to effectively remove Pb and other toxic metals from the skin. NIOSH field studies have shown that soap and water are not completely effective are removing toxic metal contamination from skin. The Handwipe Removal Method for Toxic Metals involves a system of skin decontamination that is skin safe yet extremely effective at removing toxic elements such as Pb, nickel, cadmium and arsenic. This technology is patent-pending and currently available for commercial licensing.
Contact: Eric Esswein at email@example.com; (303) 236-5946.
Injury Prevention in the Commercial Fishing Industry
In partnership with an engineering firm, NIOSH in 2003 helped to produce a detailed, easy-to-read booklet recommending and describing engineering measures on commercial crab fishing vessels to prevent injuries in this highly hazardous industry. More than 3,000 copies of the booklet have been distributed in the U.S. and abroad. The recommendations in the booklet resulted from NIOSH’s partnerships with many stakeholders to develop practical interventions that address hazards posed by machinery, fishing equipment, and physical design and layout of fishing vessels. Contact: Jennifer Lincoln at firstname.lastname@example.org.
Kit for Detecting Mold
NIOSH developed an innovation that provides the basis for a new, commercially available do-it-yourself kit to detect the mold Stachybotrys chartarum. S. chartarum is a toxigenic mold commonly found in chronically water-damaged buildings. Determining if a building is contaminated with S. chartarum has been difficult due to the lack of a good detection device. The NIOSH-developed species-specific monoclonal antibody is being used as a diagnostic reagent in this novel technology kit. This kit provides building inspectors and industrial hygienists with a simple tool to detect the mold in less than 5 minutes. Contact: Detlef Schmechel at email@example.com.
Note: The presence of S. chartarum as detected by this kit does not imply that the toxins produced by S. chartarum are also present in the environment or that the fungus should be considered as the causative agent of adverse health effects associated with the environment. A positive result confirms the presence of the fungus and can be used to develop a focused indoor air quality and exposure analysis.
Reducing Worker Exposure to Asphalt Fumes
A unique government, industry, and labor partnership was formed to reduce worker exposure to asphalt fumes during paving operations. In a departure from the traditional occupational safety and health (OSH) approach, government researchers partnered with representatives from industry and labor to create a cooperative research effort. The research partnership included all U.S. manufacturers of highway-class asphalt paving equipment, numerous paving contractors, and the full participation of labor unions representing paving workers. This partnership was successful in developing practical, effective control systems to control asphalt fume exposures and a voluntary agreement to incorporate these controls on all newly manufactured highway pavers. Related NIOSH Publication (No. 97–105): Engineering Control Guidelines for Hot Mix Asphalt Pavers.
Historically, NIOSH has been a leader in applying research into workplace solutions that reduce injury and illness. Now we are challenged to work more efficiently and effectively with our partners, to apply r2p practices at every turn, and to evaluate their effectiveness so that our best practices keep getting better and more universal at NIOSH and among our partners. To learn more, contact: DeLon Hull at firstname.lastname@example.org.
For information on other occupational safety and health technologies available for licensing in the areas of:
The CDC Technology Transfer Office is a primary window to the business community regionally, nationally, and internationally and facilitates productive interactions with the public health, life sciences, and occupational safety and health industries. Technology transfer is wholly focused on translation of CDC’s research findings into practical application for the benefit of health and safety of the American public and the world.
Translating Research - Featured NIOSH Publications