Form Approved
OMB No. 0920-XXXX
Exp. Date xx/xx/xxxx
	
	
	
The RAND Corporation, a non-profit policy research institute, is conducting this survey to collect information about how research findings, guidance documents, and other information developed by the Centers for Disease Control and Prevention National Institute for Occupational Safety and Health (CDC/NIOSH) is being used by engineered nanomaterials-related industries and how that information is influencing occupational safety and health.
	
The information gathered from this survey will be used to by NIOSH to enhance its understanding of how its efforts related to engineered nanomaterials is influencing occupational safety and health across a range of nanomaterial-related businesses.
	
The survey is voluntary and should take no longer than twenty minutes to complete. The information we collect will be summarized in an internal document that will be made available to NIOSH. We will not identify you or your company in any documents or reports we write to deliver to our sponsor without your prior approval.
	
If you have questions about this survey, please do not hesitate to contact Eric Landree at 703-413-1100 ext. 5708 or landree@rand.org.
	
	
	
	
		This
		survey should be completed by the person in your company who is the
		most knowledgeable about the safety and health programs at this
		location. This may be the environmental safety and health manager
		or a senior manager at this location. 
		 LOCATION:
		ADD LOCATION If
		there is someone else in your company who would be a more
		knowledgeable respondent for this survey, please forward this
		survey to that individual. If more than one individual is needed to
		complete the survey, we ask that you work together to provide as
		much information as possible. 
		
		
		
	
	
	
	 
		Public reporting burden of
		this collection of information is estimated to average 20 minutes
		per response, including the time for reviewing instructions,
		searching existing data sources, gathering and maintaining the data
		needed, and completing and reviewing the collection of information.
		An agency may not conduct or sponsor, and a person is not required
		to respond to a collection of information unless it displays a
		currently valid OMB control number. Send comments regarding this
		burden estimate or any other aspect of this collection of
		information, including suggestions for reducing this burden to
		CDC/ATSDR Information Collection Review Office, 1600 Clifton Road
		NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (xxxx-xxxx). 
		
	
1. Does your company develop, manufacture, use, handle, distribute, analyze, or provide services related to engineered nanomaterials?
For the purpose of this survey, the term “engineered nanomaterials” refers to a variety of purposefully engineered materials and structures that have at least one dimension that is order of 100 nanometers or less.
If you are not sure whether the material is an engineered nanomaterial, you may need to consult with others (e.g., product manager, process engineer, purchasing agent, supplier or review product information (e.g., Safety Data Sheets).
(Check one.)
 Yes
 No  GO TO QUESTION 32, PAGE 10
 Don’t Know GO TO QUESTION 32, PAGE 10
2. Please indicate the commercial sector(s) where the engineered nanomaterials or the engineered nanomaterials-enabled products or services that your company provides are intended to be used.
(Check all that apply.)
Manufacturing the following products, specifically:
 Textiles or Apparel
 Wood, Paper, and/or Printing Products
 Petroleum or Coal Products (e.g., asphalt, petroleum refineries, lubricants, grease)
 Chemicals (e.g., petrochemical, dye and pigment, resin, paints, coatings, pesticides, fertilizer)
 Pharmaceuticals or Medicine (e.g., nanomaterial enabled medicines or therapeutics)
 Toiletry, Soap, or Cleaning Compounds (e.g., lotions, cosmetics, sunscreen, polishing)
 Plastics or Rubber Products (e.g., plastic containers, pipes, polymers)
 Nonmetallic Mineral Products (e.g., cement, concrete, clays, including carbon nanotubes and graphene)
 Metal or Fabricated Metal Products (e.g., nanoscale metals, forging, stamping, metal tools, metal parts)
 Manufacturing Machinery (e.g., for agriculture, construction, semiconductors, chemicals, metalworking)
 Electronic Products, Electrical, Electro-optical or Electromedical Equipment, and Components (e.g., batteries, semiconductors, integrated circuits, electronic sensors)
 Transportation Equipment (e.g., cars, trucks, boats, planes)
 Medical Equipment or Supplies (e.g., non-electrical equipment, such as surgical equipment)
 Agriculture, Forestry, Fishing, or Hunting (e.g., farming, crop production, animal production)
 Mining, Quarrying, or Oil and Gas Extraction
 Utilities (e.g., electric power [including solar], natural gas, water and sewage systems)
 Professional, Scientific, or Technical Services (e.g., R&D physical, engineering, life sciences, biotechnology)
 Waste Management and Remediation Services (e.g., land, site or building remediation)
 Other, please specify:
_________________________________________________________________________________
_________________________________________________________________________________
3. Your organization or company may have multiple locations. Please report the data only for the location or locations (i.e. worksite, building, facility, plant, etc.) for which you have knowledge of safety and health programs. Throughout the survey we will refer to these sites as “your location(s).”
	
	
What is the total number of individuals (employees and contractors) who work at your location(s)?
(Check one.)
 1-10
 11-50
 51-250
 251-500
 501-1,000
 1,001-5,000
 More than 5,000
	
	
4. How many individuals have any contact with engineered nanomaterials at your location(s)? Include both employees and contractors with either regular or occasional contact with engineered nanomaterials.
Regular Contact – Include employees that regularly handle or use engineered nanomaterials as a matter of routine during the course of their average work day.
Occasional Contact – Include employees that may have infrequent, short contact with engineered nanomaterials over the course of an average work day (i.e., an employee that moves through a space where engineered nanomaterials are being handled or used such as maintenance or janitorial staff).
(Check one.)
 None
 1-10
 11-50
 51-250
 251-500
 501-1,000
 1,001-5,000
 More than 5,000
5. Which of the following describes how your company handles or relates to engineered nanomaterials at this location(s)?
(Check all that apply.)
 Develop engineered nanomaterials
 Manufacture engineered nanomaterials
 Incorporate engineered nanomaterials into our products
 Develop applications or products that use engineered nanomaterials
 Repackage/distribute engineered nanomaterials
 Conduct laboratory scale-up of engineered nanomaterials
 Perform nanomaterials characterization
 Provide services using products containing engineered nanomaterials
 Conduct site visits to determine exposure to engineered nanomaterials
 Produce instruments for manufacturing, characterizing, and detection of engineered nanomaterials
 Dispose engineered nanomaterials
 Other, please specify:
__________________________________
__________________________________
	
6. In what physical forms are engineered nanomaterials handled at your location(s)?
(Check all that apply.)
 Solid, freely mobile (e.g., dry powder)
 Contained in an aerosol
 Suspended in a liquid (e.g. water, solvent)
 Suspended in a matrix (e.g. polymer, paste)
 Solid, embedded, bound, or fixed in a material or product
 Other, please specify:
__________________________________
__________________________________
	
7. On a typical day, what is the approximate quantity of engineered nanomaterials handled at your location(s)?
(Check one.)
 Less than a kilogram (2.2 pounds)
 More than a kilogram (2.2 pounds)
	
	
8. What are the different types of engineered nanomaterials at your location(s)?
(Check all that apply.)
 Nanoparticles, specifically:
 Silver nanoparticle
 Gold nanoparticle
 Other metallic nanoparticles, please specify:
__________________________________
__________________________________
 Titanium dioxide nanoparticle
 Zinc oxide nanoparticles
 Other metal-oxide nanoparticles, please specify:
__________________________________
__________________________________
 Ceramic nanoparticles, please specify:
__________________________________
__________________________________
 Quantum dots (i.e., semiconductor nanoparticles)
 Nanotubes, nanofibers, nanorods, or nanowires, specifically:
 Single-walled carbon nanotubes
 Multi-walled carbon nanotubes
 Carbon nanofibers
 Boron nitride nanofibers
 Semiconductor nanotubes or nanofibers
 Semiconductor nanorods or nanowires
 Other metallic nanorods or nanowires, please specify:
__________________________________
__________________________________
 Nanosheets, specifically:
 Graphene
 Boron-nitride nanosheets
 Other nanosheets, please specify:
__________________________________
__________________________________
 Nanofibrils cellulous
 Nanocystaline cellulous
 Nanoclays
 Dendrimer
 Polymers
 Other, please specify:
__________________________________
__________________________________
 Don’t know
9. Some government, non-profit, or for-profit organizations offer site visits or site consultations consisting of teams of experts that evaluate and provide recommendations regarding occupation safety and health practices.
Since 2005 has any of your location(s) hosted such a site visit or site consultation?
(Check one.)
 Yes
 No  GO TO QUESTION 13, PAGE 5
 Don’t Know  GO TO QUESTION 13, PAGE 5
	
10. Who conducted the site visit(s) or site consultation(s) at your location(s)?
(Check all that apply.)
 Centers for Disease Control and Prevention (CDC)/NIOSH
 Other government organization
 Private company/consultant
 Academic institutions
 Other, please specify:
__________________________________
__________________________________
	
11. Did the site visit(s) or site consultation(s) include feedback or recommendations for handling of engineered nanomaterials?
(Check one.)
 Yes
 No  GO TO QUESTION 13, PAGE 5
 Don’t Know  GO TO QUESTION 13, PAGE 5
	
12. Were any of the feedback or recommendations for handling of engineered nanomaterials from the site visit(s) or site consultation(s) implemented?
(Check one.)
 Yes, all of them
 Yes, some of them
 No
	
	
13. Which of the following resources have you used to acquire information about handling or safety and health practices regarding engineered nanomaterials?
(Check all that apply.)
 Government publications/materials (Check all that apply.)
 NIOSH “Approaches to Safe Nanotechnology”
 NIOSH “General Safe Practices for Working with Engineered Nanomaterials in Research Laboratories”
 NIOSH “Current Strategies for Engineering Controls in Nanomaterial Production and Downstream Handling Processes”
 NIOSH “Occupational Exposure to Carbon Nanotubes and Nanofibers”
 NIOSH “Occupational Exposure to Titanium Dioxide”
 A professional development course or webinar taught by NIOSH instructors
 EPA “Control of Nanoscale Materials under the Toxic Substances Control Act”
 EPA disposal regulations
 OSHA Fact Sheet “Working Safely with Nanomaterials”
 NIST “New NIST Reference Material Provides a Silver Lining for NanoEHS Research“, 2015
 Federal, state, or local government publications, please specify:
_________________________________________________________________________________
_________________________________________________________________________________
 Industry, scientific, or professional meetings, conferences, or tradeshows, please specify:
_________________________________________________________________________________
_________________________________________________________________________________
 Scientific articles, professional or industry publications, please specify:
_________________________________________________________________________________
_________________________________________________________________________________
 International publications (e.g. Safe Work Australia), please specify:
_________________________________________________________________________________
_________________________________________________________________________________
 Websites, blogs, and Internet search engines (e.g. Google, Bing)
 Informal discussions with professional contacts or peers
 Materials or publications developed by your company
 Product manufacturer information (e.g: Safety Data Sheets (SDS) or Pre-manufacturing Notices (PMN))
 Other, please specify:
_________________________________________________________________________________
_________________________________________________________________________________
14. How has the information you acquired from any source about engineered nanomaterials been used?
(Check all that apply.)
 Inform safety and health practices
 Inform company policies for handling of engineered nanomaterials
 Incorporated into training materials
 Incorporate into product information (e.g., SDS)
 Modifications to products
 Modifications to processes
 Other, please specify:
_________________________________________________________________________________
_________________________________________________________________________________
15. Does your location(s) implement a safety and health program for your employees?
These programs have a variety of names, including Accident Prevention Program, Injury and Illness Prevention Program, Comprehensive Safety and Health Program and, for laboratories, Chemical Hygiene Plan (CHP).
(Check one.)
 Yes
 No
16. Which of the following safety and health practices are used at your location(s)? For each that you identify, indicate whether there is separate or specific guidance for its application to engineered nanomaterials.
If the safety and health programs vary by location, please report on the most typical for the locations for which you are knowledgeable, for example those at your largest location or the most common.
| 
					 | Safety and health practices used at your location(s)? (Check one.) | IF YES IN COLUMN 1: Separate or specific guidance for engineered nanomaterials? (Check one.) | 
| 
					 | ||
| HAZARD IDENTIFICATION AND EVALUATION: | ||
| Determination of routes of exposure |  Yes   No |  Yes  No | 
| Identification of processes or job tasks where workers may be exposed |  Yes   No |  Yes  No | 
| Evaluation of new processes/procedures for hazards |  Yes   No |  Yes  No | 
| Review of purchase orders for possible hazardous materials |  Yes   No |  Yes  No | 
| PROTECTION: | ||
| Use of exposure controls (elimination, substitution, engineering, administrative, Personal Protective Equipment [PPE]) |  Yes   No |  Yes  No | 
| Assessment of effectiveness of exposure controls |  Yes   No |  Yes  No | 
| Assessment of need for PPE |  Yes   No |  Yes  No | 
| Maintenance of engineering controls (e.g., dust collection systems) |  Yes   No |  Yes  No | 
| Spill cleanup procedures |  Yes   No |  Yes  No | 
| Waste management/disposal procedures |  Yes   No |  Yes  No | 
| SCREENING OR MONITORING: | ||
| Medical screening and surveillance |  Yes   No |  Yes  No | 
| Exposure monitoring |  Yes   No |  Yes  No | 
| ADMINISTRATIVE OR PROCEDURAL: | ||
| Systematic review and update of safe use procedures |  Yes   No |  Yes  No | 
| Method for reporting hazards, illnesses, and injuries |  Yes   No |  Yes  No | 
| Development of internal company exposure guidelines |  Yes   No |  Yes  No | 
| OTHER: | ||
| 
					 Other, please specify: _________________________________ 
 |  Yes   No |  Yes  No | 
17. In cases where you do not have specific safety and health practices or guidelines for engineered nano-material, what surrogate hazards or substances do you use to inform your safety and health practices or guidelines?
(Check all that apply.)
 Nuclear hazards
 Asbestos
 Biohazards
 General chemical hazard, please specify: ___________________________________
 Other, please specify: ___________________________________
 No, we do not use other hazards or substance as a model for engineered nanomaterials
18. Which of the following engineering controls are used to reduce or prevent worker exposure to any potential chemical or material hazards at your location(s)? For those engineering controls you identify, please indicate if any are required when working with engineered nanomaterials.
| 
					 | Used to reduce any potential chemical or material hazard? (Check one.) | IF YES IN COLUMN 1: Required when working with engineered nanomaterials? (Check one.) | 
| 
					 | ||
| Separate HVAC system |  Yes   No |  Yes  No | 
| Pressure differentials |  Yes   No |  Yes  No | 
| Designed or separate work areas (e.g., control room) |  Yes   No |  Yes  No | 
| Closed system piping |  Yes   No |  Yes  No | 
| Cleanroom |  Yes   No |  Yes  No | 
| Laboratory fume hood |  Yes   No |  Yes  No | 
| Laminar low flow ventilated enclosure |  Yes   No |  Yes  No | 
| Biosafety cabinet (BSC) |  Yes   No |  Yes  No | 
| Glove box |  Yes   No |  Yes  No | 
| Local exhaust ventilation (other than fume hood, BSC or glovebox) |  Yes   No |  Yes  No | 
| High-efficiency particulate air (HEPA) filtration |  Yes   No |  Yes  No | 
| Ultra-low particulate air (ULPA) filtration |  Yes   No |  Yes  No | 
| Working with nanomaterial in a slurry or suspension |  Yes   No |  Yes  No | 
| Other, please specify): __________________________________ 
 |  Yes   No |  Yes  No | 
19. Which of the following personal protective equipment (PPE) is used by individuals working with engineered nanomaterials at your location(s)?
(Check all that apply.)
 No PPE is used
 Coveralls or lab coats (check all that apply)
 Woven
 Nonwoven
 Gloves
 Eye/face protection
 Shoe covers
 Hair bonnets
 Respirators (check all that apply)
 Disposable filtering facepiece
 Elastomeric half-facepiece respirator
 Elastomeric full-facepiece respirator
 Powered loose fitting facepiece
 Powered tight fitting facepiece
 Other type of respirator, please specify:
__________________________________
 Other type of PPE, please specify:
__________________________________
__________________________________
20. Does your workforce receive any informal or formal training on the safe use or handling of engineered nanomaterials?
(Check one.)
 Yes
 No  GO TO QUESTION 23, PAGE 9
 Don’t Know  GO TO QUESTION 23, PAGE 9
	
21. How is this training provided?
(Check all that apply.)
 Formal training from internal training staff and resources
 Informal training from colleagues and peers
 External or consultant training resources
 Other, please specify:
__________________________________
__________________________________
	
	
	
	
	
	
	
	
	
	
	
	
	
	
22. Who at your location(s) receives training on the following practices regarding the safe use or handling of engineered nanomaterials? Include full-time staff, part-time staff, contractors working onsite, and/or temporary staff. Employees are categorized by the level of possible contact with engineered nanomaterials.
Regular Contact – Include employees that regularly handle or use engineered nanomaterials as a matter of routine during the course of their average work day.
Occasional Contact – Include employees that may have infrequent, short contact with engineered nanomaterials over the course of an average work day (i.e., an employee that moves through a space where engineered nanomaterials are being handled or used such as maintenance or janitorial staff).
No contact –Employees that do not have any type of contact with engineered nanomaterials
| 
					 | Regular Contact | Occasional Contact | No Contact | Training not provided | 
| 
					 | (Check all that apply.) | |||
| Types of engineered nanomaterials and general engineered nanomaterial awareness |  |  |  |  | 
| Where to locate information about the safety and health practices regarding engineered nanomaterials |  |  |  |  | 
| Routes of exposure to engineered nanomaterials |  |  |  |  | 
| Use or maintenance of exposure controls (elimination, substitution, engineering, administrative, PPE) for engineered nanomaterials |  |  |  |  | 
| Use or maintenance of respirators for engineered nanomaterials |  |  |  |  | 
| Procedures for spill cleanup, waste management, or disposal procedures of engineered nanomaterials |  |  |  |  | 
| Method for reporting hazards, illnesses and injuries related to engineered nanomaterials |  |  |  |  | 
23. Is worker awareness or knowledge of engineered nanomaterials assessed at your location(s)?
(Check one.)
 Yes
 No  GO TO QUESTION 25
 Don’t Know  GO TO QUESTION 25
	
	
24. How is it assessed?
(Check all that apply.)
 Periodic surveys
 Random inspections
 Other, please specify:
__________________________________
__________________________________
	
	
25. What type of process emission or exposure monitoring is conducted at your location(s)?
(Check all that apply.)
 Monitoring is not
conducted  GO TO QUESTION 27
 Filter-based air sampling for mass
 Filter-based air sampling for electron microscopy
 Direct reading particle counters
 Wipe sampling
 Dermal sampling
 Other, please specify:
__________________________________
__________________________________
	
26. When is process emission or exposure monitoring conducted?
(Check all that apply.)
 Initial process start-up
 Changes in process or control(s)
 During upset conditions (i.e., response conditions, in response to a spill or similar unanticipated event)
 Periodically (e.g., annually)
 Other, please specify:
__________________________________
__________________________________
	
27. Does your company produce documents related to engineered nanomaterials?
(Check one.)
 Yes
 No  GO TO QUESTION 29
 Don’t Know  GO TO QUESTION 29
	
	
28. What types of documents are produced?
(Check all that apply.)
 Journal articles
 Scientific publications
 Articles for trade magazines
 Comments on public policies that are intended to be disseminated (either within or outside of your company)
 Comments or input on NIOSH documents
 Comments or input to industry or materials standards
 Comments or input to professional, scientific or trade associations
 Blogs
 Safety Data Sheets
 Instructions for how to use your products or guidance for measuring engineered nanomaterials
 Information provided to your customers along with your products or services
 Information from your company’s standard operating procedures or practices for the handling or use of engineered nanomaterials
 Other, please specify:
__________________________________
__________________________________
	
29. Does your company have an occupational safety and health office, department, or individual?
(Check one.)
 Yes
 No
 Don’t Know
	
	
30. How many occupational safety and health (OS&H) professionals are employed at your location(s)?
An OS&H professional is someone who has a degree in OS&H or certification from a nationally recognized accrediting body and who devotes a significant portion of their work time to OS&H responsibilities. Be sure to count yourself if applicable.
 
	(Write in the number of OS&H professionals.)
 Don’t Know
	
	
31. How long have you worked in a location with engineered nanomaterials?
(Enter number of years.)
 
	
Years
	
	
32. What is your current position at your company?
Please specify:
__________________________________
__________________________________
33. Do you have any certification in occupational safety and health (OS&H)? For example, Certified Industrial Hygienist (CIH), Certified Safety Professional (CSP), or Chemical Hazardous Material Manager (CHHM).
(Check one.)
 Yes, please specify:
__________________________________
__________________________________
 No
	
34. Are your responsibilities regarding occupational safety and health your:
(Check one.)
 Full-time responsibility
 Part-time responsibility
 Other duty as assigned (i.e., responsibilities are done with other responsibilities)
 None of the above
 Other, please specify:
__________________________________
__________________________________
	
	
	
	
35. Is there any other information on occupational safety and health regarding engineered nanomaterials you wish you had?
(Check one.)
 No
 Yes, please specify:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
	
Please return the completed survey in the enclosed pre-paid envelope to:
	
Dr. Eric Landree
RAND Corporation
1200 South Hayes Street
Arlington, VA 22202
	
THANK YOU!
	 
		
	
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| Author | Bradley, Melissa | 
| File Modified | 0000-00-00 | 
| File Created | 2021-01-22 |