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The presentation was intended for the EMI SIG Annual Meeting Subcommittee on Technical Analysis and Response Support in August 2020 and included strategies and policies regarding essential workers and returning to work.
The contamination legacy of industrialization, militarization, and nuclear arms race poses current or future risks to populations and the environment. Responsible parties and regulators make decisions regarding which sites to clean up, how, how much, and when. This study aimed to provide an information needs template to evaluate and reduce risks to human health when considering whether to initiate or delay remediation. This investigation focused on four aspects of timing and prioritization: 1) management, planning and implementation, 2) source terms, pathways, and exposures, 3) risks and receptors, and 4) external drivers. Within each type, issues were identified and described. Management class included personnel, health and safety data, funding, equipment, and structural integrity. Source term included contaminant sources, pathways, initiating events, and barriers to exposure. Risk included types and exposures to workers and general public. External drivers included regulatory framework, stakeholders, Congressional mandates, and economic and social contexts. Risk may increase over time as contamination spreads, enters aquifers, and reaches receptors, and may decline as radionuclides decay, and plumes dissipate. The overall objective was to provide a template of information that is useful to managers and regulators, and might be used by the public to understand the risks and benefits of re-prioritization cleanup.
NASA's Occupational Health Program Manager briefed attendees on current Agency initiatives and projects affecting Center Occupational Health personnel. Plans, insight, and expectations for the coming year will be discussed.
Reports of the health effects of handling cytotoxic drugs and compliance with guidelines for handling these agents are briefly reviewed, and studies using analytical and biological methods of detecting exposure are evaluated. There is little conclusive evidence of detrimental health effects from occupational exposure to cytotoxic drugs. Work practices have improved since the issuance of guidelines for handling these drugs, but compliance with the recommended practices is still inadequate. Of 64 reports published since 1979 on studies of workers' exposure to these drugs, 53 involved studies of changes in cellular or molecular endpoints (biological markers) and 12 described chemical analyses of drugs or their metabolites in urine (2 involved both, and 2 reported the same study). The primary biological markers used were urine mutagenicity, sister chromatid exchange, and chromosomal aberrations; other studies involved formation of micronuclei and measurements of urinary thioethers. The studies had small sample sizes, and the methods were qualitative, nonspecific, subject to many confounders, and possibly not sensitive enough to detect most occupational exposures. Since none of the currently available biological and analytical methods is sufficiently reliable or reproducible for routine monitoring of exposure in the workplace, further studies using these methods are not recommended; efforts should focus instead on wide-spread implementation of improved practices for handling cytotoxic drugs.
The authors examine the application of interpersonal human factors training on operating room (OR) personnel. Mortality studies of OR deaths and critical incident studies of anesthesia are examined to determine the role of human error in OR incidents. Theoretical models of system vulnerability to accidents are presented with emphasis on a systems approach to OR performance. Input, process, and outcome factors are discussed in detail.
The nuclear fuel cycle presents formidable 10 30+ multiscale challenges for high-efficiency spectroscopic sensing of alpha-neutron-fission radiation signatures amidst extreme gamma-beta radiation backgrounds at various stages of the cycle; it involves diverse arenas ranging from continuous/pulsed power production, security/safeguards, spent fuel, environmental remediation, and personnel health-dosimetry. This paper discusses the novel tensioned metastable fluid detector (TMFD) sensor technology. It discusses the results of studies demonstrating extreme (10 4 Sv/h) gamma-beta field blind high intrinsic efficiencies (80–100%) for neutron-alpha-fission radiation spectrometric detection. Example studies discussed in this paper include Neutron detection with spectroscopy; H*10 neutron radiation dosimetry upwards from ultra-low10 −2 µSv/h levels; Air and/or liquid-borne trace (10 –3 Bq/mL) quantity, 1 keV energy resolved alpha/fission spectroscopy for Rn/Po/U/Pu/Am environmental isotope assays at 106:1 (β:α) ratios; Directional-position enabled extended standoff tracking of neutron emitting (shielded/unshielded) special nuclear materials while stationary or moving at highway speeds; and, U.S. Department of Energy nuclear complex wide nuclear waste reprocessing, criticality safety, health physics, and environmental applications.
The NASA policy on environmental health uses medical and environmental concepts to: (1) Determine the health status of employees; (2) prevent illness and promote good health among employees; and (3) identify and control factors that affect the health of personnel and quality of environment. Evaluation and control of physical, chemical, radiological and biological factors surrounding personnel and which represent physiological and psychological stresses and impairment are considered.
The Space Technology Applied to Rural Papago Advanced Health Care (STARPAHC) demonstrated the value and potential of telemedicine using physician's assistants for providing quality health care delivery to people in a remote area. Generally, the program's achievements were to: (1) establish the feasibility of the STARPAHC concept in the delivery of health care; (2) gain information for developing health care systems for future manned spacecraft; (3) determine the constraints and capabilities involved in the interaction between physicians and non-physician health care personnel; (4) determine effectiveness of the STARPAHC technique; and (5) define the additional developments that are needed and/or most valuable to improving telemedicine and its exportable potential.
The purpose of this research was to obtain basic data on ethnic foods by studying dietary patterns and multicultural foods, and to determine nutritional status of multicultural space explorers by evaluating dietary, clinical, biochemical, and socioeconomic factors. The study will plan a significant role in providing nutritional research for space explorers of different ethnic backgrounds. It will provide scientific background information by bringing together cross cultural dietary and nutritional from different ethnic groups. Results will also help the health care personnel including physicians, dietitians, and nutritionists to better understand and assist patients from other cultures illness. Also, the results will provide data which will help in the development of future food plans for long duration flights involving manned exploration to Mars and lunar base colonies.
The Hummer Associates Exposure Control Plan is designed to reduce significant occupational exposure to bloodborne pathogens and infectious materials for Hummer Associates health care personnel. Under universal precautions, all patients and all body fluids are considered potentially infectious for bloodborne pathogens. Medical personnel need not be at increased risk if universal precautions are correctly understood and followed. This program covers all employees who could reasonably anticipate contact with blood or other potentially infectious materials during the performance of their job responsibilities. Although HIV and hepatitis B are mentioned most often, this program applies to all bloodborne diseases. The two main components needed to implement this program are universal precautions and engineering/work practice controls. This program covers all employees who may have occupational exposure to blood or other potentially infectious materials. Other aspects of this program are discussed.
Prolonged rest in bed has been utilized by physicians and other health-care workers to immobilize and confine patients for rehabilitation and restoration of health since time immemorial. The sitting or horizontal position is sought by the body to relieve the strain of the upright or vertical postures, for example during syncopal situations, bone fractures, muscle injuries, fatigue, and probably also to reduce energy expenditure. Most health-care personnel are aware that adaptive responses occurring during bed rest proceed concomitantly with the healing process; signs and symptoms associated with the former should be differentiated from those of the latter. Not all illnesses and infirmities benefit from prolonged bed rest. Considerations in prescribing bed rest for patients-including duration, body position, mode and duration of exercise, light-dark cycles, temperature, and humidity-have not been investigated adequately. More recently, adaptive physiological responses have been measured in normal, healthy subjects in the horizontal or slightly head-down postures during prolonged bed rest as analogs for the adaptive responses of astronauts exposed to the microgravity environment of outer and bed-rest research.
No abstract available
The six domains that must be addressed in managing fatigue in operational settings are identified, and examples of how the aviation industry is dealing with the problems in each domain are given. Challenges facing healthcare providers in managing fatigue are also discussed.
The lack of scientific basis in the so-called periodic health examinations on military personnel inclusive of the Executive Health Program is outlined. This latter program can well represent a management tool of the company involved in addition to being a status symbol. A multiphasic screening technique is proposed in conjunction with an automated medical history questionnaire for preventive occupational medicine methodology. The need to collate early sickness consultation or clinic visit histories with screening techniques is emphasized.
Physician-monitored central control facility communicating with remote site facilities staffed by paramedical personnel for public health care, based on aerospace experience
Department 00635, Performance Assurance, assessments reveal risks and opportunities for improvement Labs-wide. This assessment was conducted to identify opportunities for improving the Department 00635 Assessment Program. This evaluation was conducted to identify opportunities for improving the Center 00600 assessment process by reviewing the quality of assessments completed by Environment Safety and Health (ES&H) personnel in fiscal year (FY) 2018. Approximately 20 percent of the Center 00600 assessments completed in FY18 were reviewed. One assessment was selected from each Center 00600 department contingent on availability in the Assurance Information System (AIS).
The LANL Meteorological (Met) Program has been subject to several external reviews over the past 19 years. The DOE Meteorological Coordinating Council (DMCC) conducted an initial Met Program Site Assist Visit (SAV) in August 2006 (DMCC 2006). A follow-up SAV in August 2015 assessed progress (DMCC 2015), and in June 2023, the DOE Meteorological Subcommittee (DMSC), successor to the DMCC, conducted a second follow-up SAV (DMSC 2023), in which the Met Program was evaluated relative to the following 8 high-level questions: • What is the state of the meteorological services provided to its customers? • What is the quality of meteorological data provided to its customers and is it adequate and available to meet all customer needs? • What is the quality of atmospheric transport and diffusion modeling provided to its customers and is it applicable to complex wind flow patterns at LANL? • Are the current and future meteorological service customers being serviced appropriately? • Are there adequate human resources to meet present and future program customer needs and are they being appropriately leveraged? • Are existing instrumentation, facilities, and systems adequate to meet present and future customer needs? • Are LANL meteorological services conducted in an efficient, cost-effective manner? • Is meteorological data used to ensure safety & health of LANL personnel? More specific evaluations were performed relative to 23 performance objectives extracted from the ANSI/ANS-3.11- 2024 national standard and 14 separate performance objectives associated with consequence assessment and atmospheric transport and diffusion modeling in the consequence assessment element of DOE G 151.1-1B. In 2023, the DMSC SAV Team also reviewed the status of each of the 18 remaining recommendations from its 2015 SAV. Based on this review, DMSC stated in its Exit Briefing that the LANL meteorological program has gotten much stronger and more robust since 2015 and now represents one of the better managed programs within the DOE complex.
A toxicity profile is provided, of 187 toxic substances procured by NASA Lewis Research Center during a 3 1/2 year period, including 27 known or suspected carcinogens. The goal of the program is to assure that the center's health and safety personnel are aware of the procurement and use of toxic substances and to alert and inform the users of these materials as to the toxic characteristics and the control measures needed to ensure their safe use. The program also provides a continuing record of the toxic substances procured, who procured them, what other toxic substances the user has obtained in the past, and where similar materials have been used elsewhere at the center.