title: Considerations on occupational medical surveillance in employees handling nanoparticles.
abstract: OBJECTIVE
  The use of engineered nanoparticles not only offers new technical perspectives but also raises questions regarding possible health aspects for producers and users. Nanoparticles may, just by virtue of their size, exert biological effects unrelated to the chemicals they are composed of. These considerations, and results from experimental animal studies suggesting that engineered nanomaterials may pose a health hazard to employees, all underscore the need for preventive measures. In this context, the need for, the feasibility, and the appropriateness of targeted occupational medical surveillance are currently subject to debate.
  
  
  METHODS
  We compared established concepts for the development of occupational medical surveillance programs to existing knowledge on exposures in workplaces and on health effects of nanomaterials.
  
  
  RESULTS
  A variety of potential effect parameters have been proposed for medical surveillance of exposed personnel, such as heart rate variability, blood-clotting parameters, pro-inflammatory cytokines, etc. None of these parameters are specific, most are not validated as individual health risk indicators, and some require sophisticated equipment not routinely available. Against this background, BASF currently puts specific weight on risk assessment and exposure control in workplaces. Particle emissions are primarily avoided by manufacturing in closed systems or using effective extraction systems. Appropriate personal protective equipment has been defined for such operations where an exposure potential cannot be excluded.
  
  
  CONCLUSIONS
  While there is presently no evidence-based foundation for "nano-specific" occupational medical screening, one can perform general medical screening with methods targeted at some of the health outcomes under discussion. The results of such examinations can provide a basis for future epidemiologic studies. Therefore, the establishment of exposure registries to enable the conduct of large-scale multi-centric prospective epidemiologic studies is recommended.
authors.affiliation: Occupational Medicine and Health Protection Department, BASF Aktiengesellschaft, 67056, Ludwigshafen, Germany. michael.nasterlack@basf.com
authors.forename: Michael
authors.initials: M
authors.lastname: Nasterlack
authors.forename: Andreas
authors.initials: A
authors.lastname: Zober
authors.forename: Christoph
authors.initials: C
authors.lastname: Oberlinner
mesh_terms: D004784:Environmental Monitoring; D006801:Humans; D053758:Nanoparticles / Q000009:adverse effects*; D016273:Occupational Exposure / Q000517:prevention & control*; D016272:Occupational Health; D016730:Program Development; D012106:Research; D018570:Risk Assessment; D017132:Workplace