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A Road Map Toward a Globally Harmonized Approach for Occupational Health Surveillance and Epidemiology in Nanomaterial Workers

Riediker, Michael; Schubauer-Berigan, Mary K. PhD; Brouwer, Derk H. PhD; Nelissen, Inge PhD; Koppen, Gudrun PhD; Frijns, Evelien MSc; Clark, Katherine A. DrPH; Hoeck, Juergen PhD; Liou, Saou-Hsing MD, PhD; Ho, Sweet Far MBBS, MSc; Bergamaschi, Enrico MD, PhD; Gibson, Rosemary DPhil

Journal of Occupational and Environmental Medicine: October 2012 - Volume 54 - Issue 10 - p 1214–1223
doi: 10.1097/JOM.0b013e31826e27f1
Original Articles

Objective: Few epidemiological studies have addressed the health of workers exposed to novel manufactured nanomaterials. The small current workforce will necessitate pooling international cohorts.

Method: A road map was defined for a globally harmonized framework for the careful choice of materials, exposure characterization, identification of study populations, definition of health endpoints, evaluation of appropriateness of study designs, data collection and analysis, and interpretation of the results.

Results: We propose a road map to reach global consensus on these issues. The proposed strategy should ensure that the costs of action are not disproportionate to the potential benefits and that the approach is pragmatic and practical.

Conclusions: We should aim to go beyond the collection of health complaints, illness statistics, or even counts of deaths; the manifestation of such clear endpoints would indicate a failure of preventive measures.

From the IST Institut universitaire romand de Santé au Travail [Institute for Work and Health] (Drs Riediker and Clark), Université de Lausanne + Genève, Lausanne, Switzerland; National Institute for Occupational Safety and Health (Dr Schubauer-Berigan), Cincinnati, Ohio; TNO (Dr Brouwer), Research group Quality & Safety, Zeist, the Netherlands; VITO NV Flemish Institute for Technological Research (Drs Nelissen, and Koppen and Ms Frijns), Mol, Belgium; TEMAS AG (Dr Hoeck), Arbon, Switzerland; National Health Research Institutes (Dr Liou), Zhunan Town, Miaoli County, Taiwan; Occupational Safety and Health Division (Dr Ho), Ministry of Manpower, Singapore; Laboratory of Industrial Toxicology (Dr Bergamaschi), University of Parma Medical School, Parma, Italy; and Health & Safety Laboratory (Dr Gibson), Buxton, the United Kingdom.

Address correspondence to: Michael Riediker,, Institute for Work and Health, Bugnon 21, CH-1011 Lausanne, Switzerland (

This work was funded by grant NMP4-CA-2008-218539 from the European Commission to NanoImpactNet-–the European network on the health and environmental impact of nanomaterials, and the contributing authors' institutions.

The contents including any opinions, findings, and conclusions in this article are those of the authors and do not necessarily represent or reflect the opinion, policy, or the views of the National Institute for Occupational Safety and Health, the Institute for Work and Health, the Dutch TNO Quality of Life, the Flemish Institute for Technological Research (VITO NV), TEMAS AG, the Taiwanese National Health Research Institutes, the Singapore Ministry of Manpower, the University of Parma, or the UK's Health and Safety Executive.

©2012The American College of Occupational and Environmental Medicine