title: Can Control Banding be Useful for the Safe Handling of Nanomaterials? A Systematic Review.
abstract: OBJECTIVE
  Control banding (CB) is a risk management strategy that has been used to identify and recommend exposure control measures to potentially hazardous substances for which toxicological information is limited. The application of CB and level of expertise required for implementation and management can differ depending on knowledge of the hazard potential, the likelihood of exposure, and the ability to verify the effectiveness of exposure control measures. A number of different strategies have been proposed for using CB in workplaces where exposure to engineered nanomaterials (ENMs) can occur. However, it is unclear if the use of CB can effectively reduce worker exposure to nanomaterials. A systematic review of studies was conducted to answer the question "can control banding be useful to ensure adequate controls for the safe handling of nanomaterials."
  
  
  METHODS
  A variety of databases were searched to identify relevant studies pertaining to CB. Database search terms included 'control', 'hazard', 'exposure' and 'risk' banding as well as the use of these terms in the context of nanotechnology or nanomaterials. Other potentially relevant studies were identified during the review of articles obtained in the systematic review process. Identification of studies and the extraction of data were independently conducted by the reviewers. Quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS). The quality of the evidence was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE).
  
  
  RESULTS
  A total of 235 records were identified in the database search in which 70 records were determined to be eligible for full-text review. Only two studies were identified that met the inclusion criteria. These studies evaluated the application of the CB Nanotool in workplaces where ENMs were being handled. A total of 32 different nanomaterial handling activities were evaluated in these studies by comparing the recommended exposure controls using CB to existing exposure controls previously recommended by an industrial hygienist. It was determined that the selection of exposure controls using CB were consistent with those recommended by an industrial hygienist for 19 out of 32 (59.4%) job activities. A higher level of exposure control was recommended for nine out of 32 (28.1%) job activities using CB while four out of 32 (12.5%) job activities had in place exposure controls that were more stringent than those recommended using CB. After evaluation using GRADE, evidence indicated that the use of CB Nanotool can recommend exposure controls for many ENM job activities that would be consistent with those recommended by an experienced industrial hygienist.
  
  
  CONCLUSIONS
  The use of CB for reducing exposures to ENMs has the potential to be an effective risk management strategy when information is limited on the health risk to the nanomaterial and/or there is an absence of an occupational exposure limit (OEL). However, there remains a lack of evidence to conclude that the use of CB can provide adequate exposure control in all work environments. Additional validation work is needed to provide more data to support the use of CB for the safe handling of ENMs.
authors.affiliation: Nanotechnology Research Center, National Institute for Occupational Safety and Health.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Eastlake
authors.affiliation: RCS Corporation.
authors.forename: Ralph
authors.initials: R
authors.lastname: Zumwalde
authors.affiliation: Nanotechnology Research Center, National Institute for Occupational Safety and Health.
authors.forename: Charles
authors.initials: C
authors.lastname: Geraci
keywords: Control Banding; Nanomaterials; Nanotechnology; Systematic Review