IMMUNE, DERMAL AND INFECTIOUS DISEASES

Immune Diseases

Inputs: NIOSH Strategic Goals

Impaired immune function can result in uncontrolled inflammation or increased susceptibility to diseases. Allergic conditions are exaggerated immune responses to substances often found in the workplace. Areas of interest to be explored will include: health risks due to employment in mold-contaminated workplaces; allergic rhinitis and sinusitis from occupational allergen exposures; the impact of occupational exposures to chemicals on normal immune function; and the identification of allergens in the workplace imposing significant health risks to workers in various sectors and industries.

Exposures to chemical substances that may induce immune abnormalities including immune suppression and autoimmunity are important hazards in certain work environments. Immunological evaluation of exposure to these chemicals/substances is needed due to the potential risk for the development of clinical disease.

NIOSH Program Portfolio Approach

NIOSH has been organizing research, guidance, information, and service efforts into specific programs that can be readily communicated and strategically governed and evaluated. Ten Sector Programs represent industrial sectors, and twenty-four Cross-sector Programs organized around adverse health outcomes, statutory programs and global efforts.

The Sector Programs intersect with Cross-Sector Programs in a matrix-like fashion. For example, an Agriculture, Forestry and Fishing Program goal of reducing farm-related deaths and injuries due to tractor rollovers and trucks would likely be a shared goal with the Transportation Program and if appropriate would be adopted by both programs. This approach provides an added advantage and will allow multiple Programs to work towards accomplishment of intersecting goals.

Each of the 34 programs in the NIOSH Program Portfolio has a Manager and Coordinator. Each of the 10 NIOSH Sector Programs facilitates the work of a NORA Sector Council to engage external stakeholders in the process of developing sector goals for the nation and methods to measure the short-term, intermediate and long-term outcomes arising from those goals. The NORA goals for the nation will be considered when choosing NIOSH sector program goals. Cross Sector programs have internal Steering Committees that develop program goals and monitor outcome measures.

These planning efforts will position NIOSH to align with the most current governmental approaches for evaluating program effectiveness, i.e., the Program Assessment Rating Tool (or PART). PART is a mechanism to hold governmental agencies accountable for accomplishing results. As part of our comprehensive approach to performance measurement, NIOSH has engaged the National Academies to independently evaluate our sector and cross-programs for relevance and impact.

Strategic Goal for Intramural Research

Strategic Goal: Contribute to the reduction of immune abnormalities associated with workplace exposures.

Intermediate Goal 1: Contribute to the advancement of knowledge regarding the impact of occupational exposures to chemicals or biological agents on normal immune function.

Approaches:

• Develop improved techniques for the detection of occupational allergens based on the analysis of clinical, environmental, and aerosol samples. Successful completion of these investigations should lead to the development of effective prevention strategies for occupational allergies and asthma.
• Expansion of the immunological database for human exposure to workplace chemicals. This information would help improve risk assessment strategies, classify the mechanisms of action and the immune parameters affected by exposures to certain classes of chemicals, and determine if the chemical-exposed population with altered immune function has a greater risk for the development of clinical disease.
• Evaluate the immunotoxicity caused by exposure to certain occupational chemicals or allergens.
• Hazard identification of occupational chemicals/allergens.
• Develop new methods for assessment of chemical adjuvancy and better characterization of the associated pathophysiological disorders.
• Develop a model of allergic skin sensitization that defines mechanism of chemical sensitization. The generated data can be used to strengthen in silico hazard predictive models and allow for substitution or modification of allergenic chemicals and drugs.

Intermediate Goal 2: Contribute to understanding and elimination of the health risks due to employment in mold-contaminated workplaces.

Approaches:

• Accurate and precise monitoring techniques for fungal exposure will be developed.
• Standardized approaches to characterize health effects associated with fungal exposure will be established.
• Personal exposure to fungi in occupational settings will be measured through the identification of the most prominent allergens.
• Immunoassays will be developed that will provide a standardized approach to characterize adverse health effects associated with fungal aerosols and ultimately contribute to better patient management.

Intermediate Goal 3: Contribute to the identification and advancement of knowledge regarding occupational allergens causing allergic rhinitis, asthma, or other significant health effects for workers in various sectors and industries.

Approaches:

• Develop a fully characterized model of occupational asthma, including the contribution of inflammatory cells, antibodies, cytokines, and specific allergic mediators, to study potential biomarkers of the disease and possible disease intervention.
• Characterize the cellular and genetic events involved in occupational asthma and the role of allergic mechanisms in an attempt to develop novel intervention and therapeutic strategies that help improve the accuracy of risk assessment by providing safer exposure levels.

Intermediate Goal 4: To reduce airborne transmission on infectious agents.

Approaches:

• To improve methods for sampling, detection, and quantification of infectious agents on surfaces and in air.
• Provide scientific data to clarify the mechanisms of human influenza transmission in healthcare facilities.
• To better understand which medical procedures results in potentially infectious aerosols including a survey of the target procedures to characterize the size and number of particles produced.
• Provide scientific data to evaluate the efficacy of PPE against infectious cough-generated aerosols.

Intermediate Goal 5: To evaluate health effects related to indoor air quality and identify potential pollutants that contribute to the occupational phenomenon known as sick building syndrome.

Approaches:

• Develop a model to identify potential indoor air pollutants.
• Evaluate the health effects associated with exposure to oxygenated reaction products found in the indoor air environment.
• Investigate the potential of structurally related indoor air chemicals to induce similar types of exposure-related health effects through the same biological mode of action

Priority Strategic Goal for Extramural Research Related to Immune Diseases

The NIOSH Immune and Dermal Program selected the immune diseases goal as particularly suited for extramural research during fiscal years 2014-16:

• Strategic Goal: Contribute to the reduction of immune abnormalities associated with workplace exposures.

Those seeking NIOSH grants to conduct studies related to immune diseases can view the current funding opportunities .

NIOSH is interested in your opinions about the relevance and value of strategic goals for the Immune and Dermal Program. We encourage you to consider partnering with us on issues of interest to you and your organization.