Occupational Exposure to Carbon Nanotubes and Nanofibers

Periodic Evaluations••Evaluations should be conducted at regular intervals and at other times (e.g., postincident)as deemed appropriate by the responsible health-care professional basedon data gathered in the initial evaluation, ongoing work history, changes in symptomssuch as new, worsening, or persistent respiratory symptoms, and when processchanges occur in the workplace (e.g., a change in how CNT or CNF are manufacturedor used or an unintentional “spill”). Evaluations should include the following:ȣȣȣȣȣȣAn occupational and medical history update, including a respiratory symptomupdate, and focused physical examination—performed annually.Spirometry—testing less frequently than every 3 years is not recommended[OSHA NIOSH 2011]; andConsideration of specific medical tests (e.g., chest X-ray).Written reports of medical findings••The health-care professional should give each worker a written report containingthe following:ȣȣȣȣThe individual worker’s medical examination results.Medical opinions and/or recommendations concerning any relationshipsbetween the individual worker’s medical conditions and occupational exposures,any special instructions on the individual’s exposures and/or use of personalprotective equipment, and any further evaluation or treatment.••For each examined employee, the health-care professional should give the employer awritten report specifying the following:ȣȣȣȣȣȣAny work or exposure restrictions based on the results of medical evaluations.Any recommendations concerning use of personal protective equipment.A medical opinion about whether any of the worker’s medical conditions is likelyto have been caused or aggravated by occupational exposures.••Findings from the medical evaluations having no bearing on the worker’s abilityto work with CNT or CNF should not be included in any reports to employers.Confidentiality of the worker’s medical records should be enforced in accordancewith all applicable regulations and guidelines.1.1.4 Worker EducationWorkers should be provided information sufficient to allow them to understand the natureof potential workplace exposures, potential health risks, routes of exposure, and instructionsfor reporting health symptoms. Workers should also be provided with informationabout the purposes of medical screening, the health benefits of the program, and the proceduresinvolved.1.1.5 Periodic Evaluation of Data and Screening Program• • Standardized medical screening data should be periodically aggregated and evaluatedto identify worker health patterns that may be linked to work activities and practicesNIOSH CIB 65 • Carbon Nanotubes and Nanofibersxv