Occupational Disease and Nanoparticles

Posted on by John Howard, MD, Charles L. Geraci, PhD, CIH, and Paul Schulte, PhD

NIOSH research has shown that some nanoparticles, including certain types of carbon nanotubes and metal oxides, can be toxic to the heart and lung in mice and rats in laboratory experiments. Other research has demonstrated various other adverse effects of nanoparticles. Through its Approaches to Safe Nanotechnology, NIOSH recommends that specific precautions be taken to protect workers who might be exposed to any level of nanoparticles or nanoparticle-containing materials. A big question left unanswered is, can nanoparticles cause the same types of disease in humans?

In the September issue of the European Respiratory Journal, the first medical case series of workers with serious disease that the study authors associate with exposure to nano-sized particles has been published.

Investigators Y. Song, X. Li, and X Du of the Chaoyang Hospital of the Capital University of Medical Sciences in Beijing, China, report on a series of seven previously healthy young women who developed serious heart and lung disease after working at a print plant exposed to a chemical “paste” mixture containing undefined “nanoparticles” of approximately 30 nanometers in diameter. There is no doubt about the severity of the heart and lung disease in these workers. One worker died in the hospital 16 days post-surgery and another died of respiratory failure 21 months after symptom onset. The question is, did their exposure to nanoparticles cause or contribute to their disease? Unfortunately, the study cannot scientifically answer that question for us because of a lack of exposure data.

We are told that workers manually scooped coating material and placed it in a machine that automatically air-sprayed the material onto polystyrene boards. The boards were then heated to 100 degrees centigrade to cure the air-sprayed material on the polystyrene boards. The room in which the women worked was small and unventilated for a significant amount of the 5 to 13 months of their exposure. On occasion, they wore “cotton gauze masks.” Workers developed face and arm itching due to “flocculi produced during air spraying.” The paste was analyzed by gas chromatography/mass spectroscopy (GC/MS) and found to contain butanoic acid, butyl ester, N-butyl ether, acetic acid, toluene, di-tert-butyl peroxide, 1-butanol, acetic acid ethenyl ester, isopropyl alcohol, and ethylene dioxide. Electron microscopic examination of both the paste and dust residue found at the intake of the exhaust used to remove smoke from heating the boards revealed the presence of nanoparticles of approximately 30 nanometers in diameter. No information was provided on the chemical composition of the nanoparticles or their relative abundance in the samples.

Sufficient exposure information necessary to draw a causal association between exposure to nano-sized particles in the paste/dust and lung and heart disease in the workers is missing and there may be alternative explanations for what the study authors have described medically.

What was the concentration of nanoparticles in the paste/dust? What was the chemical composition of the nanoparticles found? Were the particles found in the paste/dust identical to the particles found in lung tissue and fluid? Since the exposure was to a complex chemical mixture, could other exposures in the workplace have caused the heart and lung disease? For instance, formation of thermodegradation fume products are known to cause significant occupational disease (Johnston, et al., 2000). Paint spraying operations have been shown to be harmful many years before nano-sizing of chemicals developed as a technology (Camus & Nemery, 1998). Excluding all other potential exposure mechanisms as causes of occupational disease seen in these workers is just as necessary as it was for the study authors to exclude all other known medical causes to explain the workers’ heart and lung disease.

The study authors do acknowledge the limitations of their case series in terms of a lack of exposure information, yet they state that “more studies on the […] prevention of the nano material-related disease are needed.” Despite the certainty inherent in their use of the term “nano material-related disease,” the study authors have not provided us with scientific evidence nanoparticles were or were not the cause of the tragic medical consequences in these seven workers.

In the meantime, NIOSH continues to recommend that in the face of continuing uncertainty about the risks to worker health associated with exposure to nanoparticles and chemical intermediates containing various concentrations of nanosized particles, a proactive, prudent approach to working with nanomaterials is necessary. Visit the NIOSH nanotechnology topic page for more information on the occupational safety and health implications and applications of nanotechnology.

Dr. Howard is a distinguished consultant in the Public Health Law Program at the Centers for Disease Control and Prevention and served as Director of NIOSH from 2002-2008.

Dr. Geraci is a Supervisory Physical Scientist in the NIOSH Education and Information Division and is the Coordinator of the Nanotechnology Research Center.

Dr. Schulte is the Director of NIOSH’s Education and Information Division and Manager of the Nanotechnology Research Center.


  1. Song Y. Li X, Du X. Exposure to nanoparticles is related to pleural effusion, pulmonary fibrosis and granuloma. Eur Respir J 2009;43:559-567.
  2. NIOSH. Approaches to Safe Nanotechnology: Managing the Health and Safety Concerns Associated with Engineered Nanomaterials.
  3. Camus, Ph., Nemery, B. A novel cause for bronchoilitis obliterans organizing pneumonia: exposure to paint aerosols in textile workshops. Eur. Respir. J. 1998, 11, 259-262.
  4. Johnston, C.J., Finkelstein, J.N., Mercer, P., Corson, N., Gelein, R., Oberdorster, G. Pulmonary Effects Induced by Ultrafine PTFE Particles, Tox. Appl. Phar. 2000, 168, 208-215.

Posted 8/24/09 at 4:15 pm

Posted on by John Howard, MD, Charles L. Geraci, PhD, CIH, and Paul Schulte, PhDTags

10 comments on “Occupational Disease and Nanoparticles”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    Nice to see that NIOSH was right on top of this development (as usual). In my humble opinion, the paper should have never been published and the peer reviewers and ERJ should have their tickets pulled for this one. The press coverage of this paper has been horrific and unjustified. Please keep up the good work.

    NIOSH has the statutory responsibility to recommend standards to OSHA. It’s long past time for NIOSH to propose a REL and start the argument about whether it’s protective enough. Engineers need an exposure index to guide design of control measures.

    The heavyweight nanoparticles are titanium dioxide (a good candidate for the mystery material here), carbon nanotubes and diesel particulate matter. There’s considerable laboratory data on the first two and considerable human data on the third.

    NIOSH supporters can’t only blame inaction on OSHA for failing to set PEL’s.

    indeed nanoparticles are a worry in todays society and i feel that major companies should take more precautions to protect their faithfull and temp workers a like and should ensure regular risk assesments

    Health evaluation of nanoparticles should be seriously studied, especially for their increasing application. And what’s more, state of art technologies and sound method are needed for this evaluation.

    The authors of this post were correct to point out the chemicals that were determined to be present. It is my feeling that some of the “effects of nanomaterials” are really caused by residuals or byproducts from the manufacturing processes. It is hard to start health evaluations of nanoparticles when they are produced in a wide variety of ways and are often ill-defined, poorly characterized, and not well understood how they change in different situations and environments.

    The paper describes the process that resulted in exposure as fabricating tooling for printing from materials purchased from vendors. It would seem likely that similar operations are occurring in other plants. If we think of the article as a sentinel event report, a next step would be to investigate similar operations to see if illness is occurring, perhaps in a milder form from lower exposures. If opportunities exist to investigate other uses of these materials it could help establish whether this is an isolated problem or an indicator of a more wide-spread problem, just NIOSH investigations of diacetyl from reports of popcorn lung led to a better understanding of the risks of that material. I disagree with the characterization of the publication of this report as unjustified. The authors and editors had a responsibility to publish this to give others the opportunity to prevent similar illness.

    Why is anyone concerned? It will probably take years before the population realizes why they’re dropping like flies from a variety of illness all stemming from what we put in their vaccines, food, clothes, medicines, etc. Priorities, how can we make money first.

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