This post is part of a series on presentations delivered at AIHce EXP 2019.

In an AIHce EXP 2019 session dedicated to protecting workers with implanted medical devices through exposure assessment, industrial hygienists dispelled myths, discussed case studies, and made recommendations to keep workers with implants safe and on the job.

Implanted medical devices are designed to replace, support, or enhance a missing or damaged biological structure. Use of these devices, which include heart pacemakers, implantable cardioverter defibrillators (ICDs), coronary stents, artificial hips and knees, artificial spinal discs, and metal screws, pins, plates, and rods used to repair traumatic fractures, is on the rise. But these medical miracles may also interfere with the electromagnetic fields that can be generated by a wide variety of equipment, both inside and outside of the work environment.

Stephen Hemperly, CIH, CSP, CSLS, FAIHA, presented on using exposure assessment of nonionizing radiation (NIR) sources to protect workers with implanted medical devices. “Someone who wears an implanted device will encounter, not only in the workplace but in their daily life, various equipment that could potentially interfere with their device,” explained Hemperly. “The wearer is going to experience symptoms, such as vertigo or dizziness, that tell them things aren't quite right. They can remove themselves from the situation, and then usually the pacemaker or other cardiac implanted device will return to its normal function.”

Hemperly pointed out that the risk of electromagnetic interference (EMI) causing harm to those with medical implants can be managed using information provided by the medical device manufacturers, healthcare providers, and industrial hygienists. He also recommended that employers inventory and monitor EMF sources with the potential to produce significant field strength. Employers can also ensure worker safety by implementing control measures, such as restricting access to personnel with medical electronic or metallic implants, posting warning signs, marking off restricted areas, and labeling potentially hazardous equipment.

Hemperly also explained the need for industrial hygienists and allied professionals to work directly with at-risk workers and their healthcare providers. “We want to extend our life and maintain the quality of our life, and that's all very legitimate,” he said. “But at the same time, we are going to have electromagnetic fields out there that can interfere with the operation of these devices. We need to be aware of that.”

Another presenter, Mona Shum, MSc, CIH, answered the question of whether workers can return to their jobs after getting an implanted medical device. “I think there would be some circumstances, maybe linemen where they are next to high voltage, that might not be able to do their job anymore,” she said. “But I feel we can accommodate these workers.”

Shum dispelled the myth that exposure to EMI for pacemaker patients means certain death. “A lot of people have a misunderstanding that if there is any electromagnetic interference, then people will drop dead. But that's not the case. Educating people on that is important as well,” explained Shum. “Old devices sometimes had more electromagnetic interference. Nowadays, less so.”

Shum presented a case study assessing two medical device wearers, one who worked at a pulp and paper mill, and another who worked at a chlorine plant, in which both were able to return to work after their implant. Shum’s team recommended educating for workers with medical devices and distancing them from hazardous equipment.

Finally, Shum recommended that IHs and employers reevaluate their strategy for dealing with modified workers based on any changes to implanted devices or workplace equipment. “If they got new equipment, or if, for example, the plant starts to work at a higher power capacity, they should reevaluate,” Shum said. Referring to one of the subjects of the case study mentioned above, she added, “they brought us [the IHs] back a year later; we reevaluated, and ensured again that the worker was fine to be working in all those areas.”

For more information on modified workers and how to protect them, check out the article “Protecting Modified Worker Health: Biohacking and the Workplace” in the digital Synergist.