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Respiratory Diseases Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health
Respiratory Diseases Research at NIOSH
Reviews of Research Programs of the National Institute for Occupational Safety and Health
Committee to Review the NIOSH Respiratory Diseases Research Program
Board on Environmental Studies and Toxicology
Division on Earth and Life Studies
NATIONAL RESEARCH COUNCIL AND INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
www.nap.edu
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Respiratory Diseases Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health
THE NATIONAL ACADEMIES PRESS
500 Fifth Street, NW Washington, DC 20001
NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This project was supported by Contract No. 211-2006-19152 between the National Academy of Sciences and the National Institute for Occupational Safety and Health. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
International Standard Book Number-13: 978-0-309-11873-6
International Standard Book Number-10: 0-309-11873-5
Cover: Photograph by Keith Weller, U.S. Department of Agriculture. The air-curtain orchard sprayer uses multiple crossflow fans to disperse pesticide to apple trees.
Additional copies of this report are available from the
National Academies Press,
500 Fifth Street, NW, Lockbox 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.edu.
Copyright 2008 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America.
Suggested citation: National Research Council and Institute of Medicine. 2008. Respiratory Disesases Research at NIOSH. Committee to Review the NIOSH Respiratory Diseases Research Program. Rpt. No. 4, Reviews of Research Programs of the National Institute for Occupational Safety and Health. Washington, D.C.: The National Academies Press.
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Respiratory Diseases Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.
www.national-academies.org
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Respiratory Diseases Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health
COMMITTEE TO REVIEW THE NIOSH RESPIRATORY DISEASES RESEARCH PROGRAM
Members
MARK UTELL (Chair),
University of Rochester, New York
JOHN BALMES,
University of California, San Francisco
PAUL BLANC,
University of California, San Francisco
ELIZABETH CHAMBERLIN,
Massey Coal Services, Chapmanville, WV
ROGENE HENDERSON,
Lovelace Respiratory Research Institute, Albuquerque, NM
DAVID MANNINO,
University of Kentucky, Lexington
JAMES MERCHANT,
University of Iowa, Iowa City
JACQUELINE NOWELL,
United Food and Commercial Workers International, Washington, DC
CHARLES POOLE,
University of North Carolina, Chapel Hill
RICHARD SCHLESINGER,
Pace University, New York, NY
NOAH SEIXAS,
University of Washington, Seattle
IRA TAGER,
University of California, Berkeley
DAVID WEGMAN,
University of Massachusetts, Lowell
Staff
K. JOHN HOLMES, Senior Program Officer
KARL E. GUSTAVSON, Senior Program Officer
DAVID J. POLICANSKY, Scholar
RUTH E. CROSSGROVE, Senior Editor
CAY BUTLER, Editor
MIRSADA KARALIC-LONCAREVIC, Manager,
Technical Information Center
JORDAN CRAGO, Senior Project Assistant
MORGAN R. MOTTO, Senior Program Assistant
RADIAH A. ROSE, Senior Editorial Assistant
Sponsor
NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH
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Preface
The National Institute for Occupational Safety and Health (NIOSH) was established by the Occupational Safety and Health Act of 1970 to “conduct … research, experiments, and demonstrations relating to occupational safety and health” and to develop “innovative methods, techniques, and approaches for dealing with [those] problems.” One component of these activities is the Respiratory Diseases Research Program, whose stated mission is “to provide national and international leadership for the prevention of work-related respiratory diseases, using a scientific approach to gather and synthesize information, create knowledge, provide recommendations, and deliver products and services to those who can effect prevention.” Work-related respiratory diseases are a serious problem of major magnitude. NIOSH indicates that deaths from work-related respiratory disease and malignancies account for about 70 percent of all occupational disease mortality.
In this report, the Committee to Review the NIOSH Respiratory Diseases Research Program evaluates NIOSH’s Respiratory Diseases Research Program (RDRP). Using a framework developed by the NRC Committee to Review the NIOSH Research Program, this committee focused primarily on the last 10 years of RDRP activities to review the relevance and impact of RDRP’s research portfolio. In its evaluation the committee also discusses and makes recommendations for upcoming research areas and challenges to be addressed by RDRP.
This report has been reviewed in draft form by persons chosen for their diverse perspectives and technical expertise in accordance with procedures approved by
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Respiratory Diseases Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health
the NRC’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards of objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following for their review of this report: Lisa Brosseau, University of Minnesota; William Bunn III, International Truck & Engine Corporation; David Christiani, Harvard School of Public Health; Ellen Eisen, Harvard School of Public Health; Terry Gordon, New York University; Joel Kaufman, University of Washington; Franklin Mirer, Hunter College of the City University of New York; Roger McCarthy, Exponent, Inc.; Gunter Oberdorster, University of Rochester School of Medicine and Dentistry; Lorann Stallones, Colorado State University; and James Weeks, Advanced Technologies and Laboratories International, Inc.
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by the review coordinator Frank Speizer, Harvard Medical School, and the review monitor, Mark Cullen, Yale University School of Medicine. Appointed by the NRC, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the committee and the institution.
The committee gratefully acknowledges the following for making presentations to the committee: Michael Attfield, Vincent Castranova, Paul Henneberger, Kathleen Kreiss, Jacek Mazurek, Paul Schulte, Lewis Wade, David Weissman, and Ainsley Weston, National Institute for Occupational Safety and Health; Jim Cooper, Synthetic Organic Chemical Manufacturers Association; David Duebner, Brush Inc.; Amanda Edens and William Perry, Occupational Safety and Health Administration; Franklin E. Mirer, Hunter College; George Niewiadomski, Mine Safety and Health Administration; James Weeks, Advanced Technologies and Laboratories International, Inc. The committee also thanks Raymond Sinclair, National Institute for Occupational Safety and Health, for serving as the liaison to the committee and for his outstanding service and professionalism.
The committee is also grateful for the assistance of the NRC staff in preparing this report. Staff members who contributed to this effort are K. John Holmes, Karl Gustavson, and David Policansky, study directors; James Reisa, director of the
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Board on Environmental Studies and Toxicology; Ruth Crossgrove and Cay Butler, editors; Mirsada Karalic-Loncarevic, research associate; and Morgan Motto, senior project assistant.
I would especially like to thank the committee for their efforts throughout the development of this report.
Mark J. Utell, Chair
Committee to Review the NIOSH Respiratory Diseases Research Program
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Contents
SUMMARY
1
1
INTRODUCTION
15
Overview of the Respiratory Diseases Research Program,
18
Study Charge and Evaluation Committee,
27
Evaluation Approach,
28
Organization of the Report,
32
2
EVALUATION OF THE RESPIRATORY DISEASES RESEARCH PROGRAM
34
RDRP Goals, Subgoals, and Resources,
35
External Factors Affecting the RDRP,
35
Surveillance, Health Hazard Evaluation and Technical Assistance Program, and Other Input Activities,
39
Introduction to Relevance and Impacts Assessment,
42
Strategic Goal 1: Prevent and Reduce Work-Related Airway Diseases,
43
Strategic Goal 2: Prevent and Reduce Interstitial Lung Diseases,
59
Strategic Goal 3: Prevent and Reduce Work-Related Infectious Respiratory Diseases,
81
Strategic Goal 4: Prevent and Reduce Work-Related Respiratory Malignancies,
97
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Strategic Goal 5: Prevent Respiratory and Other Diseases Potentially Resulting from Occupational Exposures to Nanomaterials,
109
Overall Assessment of the RDRP Relevance and Impacts,
117
3
EMERGING RESEARCH AND RESEARCH ISSUES
120
Strategic Goal 1: Prevent and Reduce Work-Related Airways Diseases,
120
Strategic Goal 2: Prevent and Reduce Work-Related Interstitial Lung Diseases,
122
Strategic Goal 3: Prevent and Reduce Work-Related Infectious Respiratory Diseases,
125
Strategic Goal 4: Prevent and Reduce Work-Related Respiratory Malignancies,
127
Strategic Goal 5: Prevent Respiratory and Other Diseases Potentially Resulting from Occupational Exposures to Nanomaterials,
128
Cross-Cutting Issues: Continuing and Emerging Issues Cutting Across Multiple Program Goals,
129
4
RECOMMENDATIONS
132
Strategic Goal 1: Prevent and Reduce Work-Related Airway Diseases,
132
Strategic Goal 2: Prevent and Reduce Work-Related Interstitial Lung Diseases,
139
Strategic Goal 3: Prevent and Reduce Work-Related Infectious Respiratory Diseases,
141
Strategic Goal 4: Prevent and Reduce Work-Related Respiratory Malignancies,
143
Strategic Goal 5: Prevent Respiratory and Other Diseases Potentially Resulting from Occupational Exposures to Nanomaterials,
144
Cross-Cutting Issues,
145
Broader Programmatic Goals,
149
REFERENCES
150
APPENDIXES
A Framework for the Review of Research Programs of the National Institute for Occupational Safety and Health
173
B Stakeholder Responses: Online Survey
217
C Bibliographic Information for the Committee to Review the NIOSH Respiratory Diseases Research Program
223
D Biographic Information on the Committee to Review the NIOSH Respiratory Diseases Research Program
226
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Tables, Figures, and Boxes
TABLES
1-1
Timeline of Administrative Developments Related to NIOSH Respiratory Diseases Research,
19
1-2
NORA Priority Research Areas,
21
1-3
Example of NORA’s Matrix Approach to Coordinating Research,
21
1-4
NORA2 Structure,
22
1-5
NIOSH RDRP Funding by Fiscal Year, 1996-2005,
25
1-6
NIH versus NIOSH Extramural Funding,
26
2-1
Strategic Goals and Subgoals of the NIOSH RDRP, as of February 2007,
36
2-2
NIOSH RDRP Budget and Staffing by Research Goals,
37
2-3
NIOSH Divisions, Laboratories, and Offices Involved in the RDRP,
39
2-4
Summary of Infectious Diseases Program Outputs and Outcomes,
82
A-1
NORA High-priority Research Areas by Category,
181
A-2
Examples of NIOSH Program Research and Transfer Activities,
198
A-3
Examples of a Variety of Scientific Information Outputs,
201
A-4
Evaluation Committee Worksheet to Assess Research Programs and Subprograms,
209
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C-1
List of Documents and Other Items Submitted by the NIOSH RDRP to the National Academies Evaluation Committee between October 10, 2006 and May 17, 2007,
224
FIGURES
1-1
NIOSH organization chart, as of October 2006,
16
1-2
RDRP projects throughout NIOSH,
23
1-3
Flow chart for the evaluation of the NIOSH research program,
29
1-4
Logic model for the RDRP,
32
2-1
Proportional Allocation of RDRP Intramural Funds by Goal by Fiscal Year,
38
2-2
Reductions in respirable dust concentrations derived from MSHA compliance data, and prevalence of CWP among participants in the Coal Workers’ Health Surveillance Program, 1970-2005,
67
A-1
The NIOSH operational plan presented as a logic model,
182
A-2
Flow chart for the evaluation of the NIOSH research program,
186
BOXES
S-1
Scoring Criteria for NIOSH Program Reviews from Framework Document,
5
S-2
Summary of Recommendations,
13
1-1
Criteria for Rating Relevance,
30
1-2
Criteria for Rating Impact,
31
1-3
Logic Model Terms and Examples,
33
2-1
Scoring Criteria for NIOSH Program Reviews from Framework Document,
118
4-1
Summary of Recommendations,
134
B-1
Letter with Questionnaire,
218
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Abbreviations and Acronyms
AIHA American Industrial Hygiene Association
ALFORD Appalachian Laboratory for Occupational Respiratory Diseases
ALOSH Appalachian Laboratory for Occupational Safety and Health
AMT 3-amino-5-mercapto-1,2,4,-triazole
AOEC Association of Occupational and Environmental Clinics
APR Air Purifying Respirators
ASTM American Society for Testing and Materials
ATS American Thoracic Society
ATSDR Agency for Toxic Substances and Disease Registry
BDS Biological Detection Systems
BEST Board on Environmental Studies and Toxicology
BLS Bureau of Labor Statistics
BRDPI Biomedical Research and Development Price Index
BRFSS Behavior Risk Factor Surveillance Survey
BSC Board of Scientific Counselors
CBD Chronic Beryllium Disease
CBR Chemical, Biological, and Radiological
CBRN Chemical, Biological, Radiological, and Nuclear
CDC Centers for Disease Control and Prevention
COPD Chronic Obstructive Pulmonary Disease
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CPWR Center to Protect Workers’ Rights
CWP Coal Workers’ Pneumoconiosis
CSTE Council of State and Territorial Epidemiologists
DART Division of Applied Research and Technology
DBBS Division of Biological and Behavioral Science
DELS Division of on Earth and Life Sciences
DHHS Department of Health and Human Services
DOD Department of Defense
DOE Department of Energy
DOI Department of the Interior
DPSE Division of Physical Sciences and Engineering
DRDS Division of Respiratory Disease Studies
DSHEFS Division of Surveillance, Hazard Evaluations and Field Studies
DSR Division of Safety Research
EC Evaluation Committee
EID Education and Information Division
EPA Environmental Protection Agency
FBI Federal Bureau of Investigation
FC Framework Committee
FDA Food and Drug Administration
FDNY Fire Department of New York
FEMA Federal Emergency Management Agency
FEV1 Forced Expiratory Volume in One Second
FTE Full-Time Equivalent
FVC Forced Vital Capacity
HELD Health Effects Laboratory Division
HEPA High-Efficiency Particulate Aerosol
HETA HHE and Technical Assistance
HHE Health Hazard Evaluation
HMW High Molecular Weight
IARC International Agency for Research on Cancer
ILO International Labour Office
ILSI International Life Sciences Institute
IOM Institute of Medicine
ISO International Standards Organization
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JEM Job-Exposure Matrix
LMW Low Molecular Weight
MDI Methylene Diisocyanate
MESA Mine Enforcement and Safety Administration
MINER Mine Improvement and New Emergency Response
MMWR Morbidity and Mortality Weekly Report
MOU Memorandum of Understanding
MSHA Mine Safety and Health Administration
NA National Academies
NAS National Academy of Sciences
NACOSH National Advisory Committee on Occupational Safety and Health
NCEH National Center for Environmental Health
NCHS National Center for Health Statistics
NCI National Cancer Institute
NCID National Center for Infectious Diseases
NFPA National Fire Protection Association
NHANES National Health and Nutrition Examination Survey
NHIS National Health Interview Survey
NHLBI National Heart, Lung, and Blood Institute
NIEHS National Institute of Environmental Health Sciences
NIH National Institutes of Health
NIOSH National Institute for Occupational Safety and Health
NMAM NIOSH Manual of Analytical Methods
NNI National Nanotechnology Initiative
NOHSM National Occupational Health Survey of Mining
NORA National Occupational Research Agenda
NORMS National Occupational Respiratory Mortality System
NPPTL National Personal Protective Technology Laboratory
NRC National Research Council
NSCWP National Study of Coal Workers’ Pneumoconiosis
NSET Nanoscale Science, Engineering and Technology Subcommittee
NSSPM National Surveillance System of Pneumoconiosis Mortality
NSTC National Science and Technology Council
NTP National Toxicology Program
NTRC Nanotechnology Research Center
OHC Office of Health Communications
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OMB Office of Management and Budget
ORA Office of Regulatory Analysis
ORDS Occupational Respiratory Disease Surveillance
OSHA Occupational Safety and Health Administration
PAPR Powered Air Purifying Respirator
PART Program Assessment Rating Tool
PCR Polymerase Chain Reaction
PEL Permissible Exposure Limit
PHS Public Health Service
PPE Personal Protective Equipment
PRL Pittsburgh Research Laboratory
RCF Refractory Ceramic Fibers
RDRP Respiratory Diseases Research Program
REL Recommended Exposure Limit
SARS Severe Acute Respiratory Syndrome
SENSOR Sentinel Event Notification System for Occupational Risks
SPIROLA Spirometry Longitudinal Data Analysis
SRL Spokane Research Laboratory
TB Tuberculosis
TC Total Carbon
TDI Toluene Diisocyanate
TIL Total Inward Leakage
UMWA United Mine Workers of America
USPS United States Postal Service
UVGI Ultraviolet Germicidal Irradiation
VA Veterans’ Administration
VOC Volatile Organic Compound
WHO World Health Organization
WoRLD Work-Related Lung Disease
WRA Work-Related Asthma
