163198 Medical Surveillance for Nanomaterials

Wednesday, November 7, 2007: 2:45 PM

Michael Kosnett, MD, MPH , University of Colorado at Denver and Health Sciences Center, Denver, CO
Lee S. Newman, MD, MA , Colorado School of Public Health, Mountain and Plains Education and Research Center, Aurora, CO
Scientific uncertainties regarding the potential adverse health effects associated with occupational exposure to nanomaterials pose a challenge to the design and implementation of workplace medical surveillance. Preliminary reports in experimental animals suggest that compared to larger sized particles, nano-sized particles of the same compounds or elements may have different toxicokinetic and toxicodynamic profiles. In particular, current permissible exposure levels for airborne exposures based on gravimetric (i.e. mass/vol) dose-response relationships for large size particles may offer inadequate protection from nanoparticles. Animal bioassays suggest that inhaled nanoparticles may have the potential to induce pulmonary granulomas and fibrotic changes. Other research, both experimental and epidemiological, suggests that ultra-fine particulate, if not nanoparticulate, may be associated with an increased risk of cardiovascular morbidity and mortality. These health endpoints, if related to nanoparticulate exposure in the workplace, may be amenable to secondary prevention by medical surveillance. We will discuss methods of radiological imaging, pulmonary function testing, measurement of biochemical and immunochemical biomarkers of pulmonary and vascular inflammation, noninvasive assessment of cardiac function, and web-enabled methods of exposure and clinical data aggregation and analysis that might be candidate components of medical surveillance for these conditions. Prospective cohort studies on working populations with carefully defined exposures to nanomaterials will be needed to establish the sensitivity, specificity, and positive predictive value of these approaches. At this point in time, conduct of workplace medical surveillance for members of the nanotechnology workforce within the framework of voluntary clinical research is appropriate, ethical, and feasible.

Learning Objectives:
1. Understand the toxicokinetic features of nanomaterials that influence dose-response relationships 2. Learn potential components of a medical surveillance program for individuals exposed to nanomaterials 3. Appreciate the value of web-enabled methods of medical surveillance

Keywords: Toxicants, Occupational Surveillance

Presenting author's disclosure statement:

Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Occupational HealthLink, Inc. Information technology Consultant

Any company-sponsored training? No
Any institutionally-contracted trials related to this submission? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.