improved occupational safety and health among the U.S. workforce. This potential has been demonstrated by previous RDRP WRA activities. The evaluation committee is concerned, however, that the new second National Occupational Research Agenda (NORA2) industrial-sector-based priority-setting approach may lead to a decreased emphasis on needed asthma-focused research.


Recommendation: The RDRP should systematically evaluate whether WRA activities are being weakened under the new NORA2 approach.


Other specific recommendations to enhance the relevance and impact of the RDRP’s WRA research activities are organized by the subgoals as delineated by NIOSH.


Subgoal: Preventing and reducing natural rubber latex asthma and allergy among health care workers.

Recommendation: The RDRP’s efforts to prevent latex allergy and asthma have been highly successful. RDRP investigators have documented that the prevalence of latex sensitization fell as a result of the intervention effort that began with the 1996 NIOSH Alert. The evaluation committee recommends that the RDRP assess how its successful work on latex and asthma can be extended to other high-molecular-weight sensitizers that cause occupational asthma and occupational rhinitis.


Subgoal: Preventing and reducing WRA in the isocyanate production industry.

Recommendation: Previous RDRP work on diisocyanates directly addressed the most common low-molecular-weight sensitizing cause of asthma in the developed world and led to important knowledge that has been transferred to prevent disease. The committee recommends that the RDRP assess how its research on diisocyanates and asthma can be extended to other low-molecular-weight sensitizers that cause occupational asthma, especially in terms of mechanisms of disease.


Subgoal: Preventing and reducing WRA related to nonindustrial indoor environmental quality.

Recommendation: While the indoor environmental quality work of the RDRP is judged to be relevant to occupational health and safety in the general sense, it is not always clearly related to WRA. The committee recommends that the RDRP reexamine whether its indoor air-quality-related research is sufficiently relevant to work-aggravated asthma. Moreover, the RDRP should reevaluate the relative commitment of resources to indoor air-quality investigations, as the health effects are often not airway in nature (that is, systemic or neurologic complaints).



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