[Federal Register Volume 63, Number 24 (Thursday, February 5, 1998)]
[Notices]
[Pages 5952-5957]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-2824]



[[Page 5952]]

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

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]
BILLING CODE 4163-19-P