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DIGITAL EXTRA
KAY BECHTOLD is assistant editor of The Synergist
She can be reached at kbechtold@aiha.org or (703) 846-0737.
Editor’s note: The individuals featured in this series were selected from responses to a survey that AIHA conducted in 2014. For background, see "The IH Hero Gap" in the January 2015 issue. Meet Donna Doganiero, the industrial hygienist who leads the team responsible for ensuring the health and safety of U.S. Army personnel worldwide, including soldiers who are deployed and in training. As portfolio director of occupational health sciences in the Army Public Health Center, Doganiero oversees industrial hygiene, ergonomics, ionizing and non-ionizing radiation, and health hazard assessment during the development of Army materiel—military equipment and supplies. Her job keeps her busy, but she has found time over the years to devote to AIHA and the advancement of the IH and occupational health and safety professions. Doganiero served on the AIHA Board of Directors through the late ’90s and early 2000s and was AIHA president in 2004–2005. While working to protect Army staff across the globe, Doganiero used her time on the Board to expand AIHA’s focus to the world beyond the U.S. During her year as president, AIHA made its initial outreach to China and began to build relationships with occupational health organizations in the Far East. In 2004, Doganiero traveled to Beijing for AIHA’s first meeting with representatives of the Chinese Occupational Safety and Health Association (COSHA), and returned with a signed memorandum of understanding to exchange information that opened a steady line of communication between the two organizations. AIHA’s international outreach to China has continued to grow and will reach a new milestone this September, when the first-ever China-U.S. Occupational Health Symposia will be held in Shanghai. “[Working internationally] makes us stronger as a profession,” Doganiero says. “It enables us to bring our capabilities and knowledge to other countries that are developing their safety and occupational health programs. As we work with these individuals in other countries, we also learn from them.” REACHING OUT TO CHINA Prior to Doganiero’s term as AIHA president, the association hadn’t done much in the way of international outreach, but the Board had decided in the mid-’90s to prioritize China and India for forthcoming international outreach efforts. Doganiero recalls that while she was on the Board, the International Affairs Committee was in its infancy and there had been some effort to work with the health and safety organizations in Romania. At that time, AIHA communicated with counterparts in Australia, the U.K., and other English-speaking countries, but hadn’t yet extended its outreach to Asia or elsewhere. One of Doganiero’s focus areas during her year as president was to turn AIHA’s mostly U.S.-centric focus more global. “I came after two really great past presidents: Tom Grumbles and Gayla McCluskey,” she says. “I wanted to continue some of their initiatives, including encouraging AIHA to look beyond our borders.” With the help of AIHA member Nick Yin, Doganiero and AIHA Executive Director Peter O’Neil connected with COSHA officials and representatives of the Chinese equivalent of NIOSH. During their first visit to China, Doganiero and O’Neil participated in a conference where Doganiero gave a presentation on the integration of industrial hygiene and occupational health. Doganiero describes the first meetings with Chinese officials as similar to a dance, with much polite conversation. She was successful in reaching an agreement with the president of COSHA, the first step in AIHA’s relationship with the individuals working to advance occupational health and safety in China. “We could not have done it without Nick Yin,” Doganiero says, explaining how Yin was instrumental in setting up many of the meetings in his role as their guide and translator. That same year, she awarded Yin the President’s Award for his efforts in facilitating AIHA’s initial interaction with the occupational safety and health elements in China. Doganiero recalls with amusement their first meetings with their Chinese counterparts. “We would walk into a meeting and the immediate assumption was that Peter was the president of AIHA,” she says. “[The Chinese representatives] would reach out to shake his hand, and Peter had to say, ‘Oh, no, it’s not me—it’s her.’ I guess it was typical of the time.” It wasn’t the first time Doganiero had to overcome others’ assumptions of her as a female leader and professional.
An Effective Versatilist AIHA Past President’s Leadership Spans Army, Association
BY KAY BECHTOLD, ASSISTANT EDITOR, THE SYNERGIST
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BECOMING A LEADER
Doganiero began working for the Army in 1981 as a junior industrial hygienist with the Industrial Hygiene Field Services Program of what was then called the U.S. Army Environmental Hygiene Agency at Aberdeen Proving Ground, Md. Over the next several years, she was promoted to senior industrial hygienist and then to program manager of Industrial Hygiene Special Services. Always up for a challenge, Doganiero impressed Army leadership with her capabilities, and in May 1993 she became the first civilian and the first woman to attain a director-level position within her organization, even though the job had been designated for a military staff member. Not all of the staff accepted her as a leader, and whether it was because she was a civilian or a female was hard to say. She worked hard in her new role, and was grateful for the support of mentors who knew she was capable and helped her through rough times. “I can remember walking into meetings and it getting awfully quiet when I walked in the room,” Doganiero says. “But that was then, and you don’t dwell on it. Our organization has come a long way as far as valuing and evaluating people based upon what they bring to the table. I don’t think anyone looks at me now and thinks, ‘She’s a female director.’ I’m just a director.” Doganiero is more concerned with other challenges in her leadership role, the biggest of which is information overload. In making decisions based on the wealth of IH and OHS information being published, she has to ensure that she stays current on the latest knowledge. “We’re all challenged with information overload,” she says. “Our focus has expanded in that we’re looking at so many more elements related to the worker and looking at the worker more holistically. There are a lot of pieces to mentally put together.” Another struggle she shares with other industrial hygienists is defining the value of the profession and the value of what she and her team bring to the table. Doganiero emphasizes the importance of being able to articulate this value in the terminology of the audience being addressed. “We’re trying to train our professionals to understand how to show value, how to speak to the different audiences about value,” she says. “We need to get this capability incorporated into graduate school programs as we teach the new IHs that we’re bringing in to the profession.” Doganiero is hard at work trying to develop the junior IHs within her organization, and she knows the clock is ticking. As the profession as a whole faces the forthcoming retirement of a generation of practitioners, so does the Army Public Health Center, where Doganiero says there are several individuals who have more experience than she does working for the Army as IHs. “We have lots of historical information, and we’re all getting close to that retirement age,” she says. “How are we going to ensure continuity of support and make sure that there is a knowledge transfer?” She and her team are working to develop their junior staff through mentoring and by making sure that they document information for future use. But Doganiero admits it’s a challenge to keep up with the task in such a rapidly paced environment. Her efforts are also hindered by limited funding and a restrictive conference attendance policy for government employees. She explains that she and her team have been making the best of the resources they have, and that a large portion of their training is now electronic, through webinars and virtual conferences. But Doganiero believes online training misses a key element. “We are really lacking the ability for our junior professionals to start interacting and developing professional contacts outside the immediate workplace here,” she says. “There is a certain value when you go to a training where you’re meeting people who are not from your group. [They bring varied] perspectives into play as you’re trying to understand what is happening with your profession, where things are going both nationally and internationally, and the challenges that other professionals are facing.” UNIQUE CHALLENGES All workplaces have their own unique challenges, and Doganiero’s is no different. Her organization must continually address new hazards for military personnel as they introduce new chemicals, processes, and pieces of Army materiel, which covers everything from a new garment that a soldier will wear to a new weapons system. Doganiero and her team are involved with all materiel development in a product stewardship sense, from early on in the design phase to manufacture to use of each piece of materiel. For example, the Army Public Health Center has been part of the development process for insensitive munitions explosives, a type of high-explosive compositions that were developed to improve the safety of munitions for soldiers. Doganiero explains that two components of insensitive munitions do not have exposure limits, so the Army Public Health Center used its toxicology capability to propose new exposure limits and develop sampling methodologies. They are working with Toxicology Excellence for Risk Assessment (TERA) to validate the proposed exposure limits and develop Workplace Environmental Exposure Levels® (WEELs) for the components in question. The Army Public Health Center must also adapt based on where soldiers are being deployed. Doganiero explains that new concerns have risen since soldiers have been deployed for longer periods of time, including stress and suicide risk. Potential concussions, blast aftermath, traumatic brain injuries, and vibration are among other concerns she and her team have for soldiers in the deployed environment. “We’re addressing many more issues than we did in the past because we’re going to places that we have never gone to and fought in before,” she says. Her organization faced an especially difficult test when they were called in as one of the first teams to respond to the Pentagon following the terrorist attacks on Sept. 11, 2001. “9/11 was very sobering for us,” she says. “We were there to work with other teams of professionals to assess what was going on and how we were going to get the building back up and running again.” Prior to 9/11, Doganiero says that her organization was more concentrated on assessing exposures in a workplace. Their experience responding to the Pentagon led them to change and upgrade their emergency response capability, and work to enhance their detection capabilities and field equipment. Doganiero notes that her organization has become more involved with response to biological threats and expanded understanding of chemical, radiological, and explosive concerns. Her team has also been working with organizations that are taking a close look at personal protective equipment for emergency response workers. The Department of the Army honored Doganiero with the Commander’s Award for Civilian Service for services provided to the Pentagon in response to the terrorist attacks.
 
LASTING ACHIEVEMENTS
Doganiero’s career with the Army now spans more than three decades, and she’s seen the Army Environmental Hygiene Agency reorganize into the Army Center for Health Promotion and Preventive Medicine, and then the Army Public Health Command. The organization recently became the Army Public Health Center, which she likens to a corporate body for IH and occupational health sciences within the Department of the Army. Doganiero went from being a field industrial hygienist to taking on management and leadership roles while working for the Army, and she’s not going anywhere until she retires. “Working for the Army has been a very rewarding career,” she says. “I’ve had great opportunities to learn, to advance my personal relationships, and to be involved with AIHA and the Academy at the time. I’ve been very fortunate to have worked for an organization that recognizes that being involved with a professional organization can help a person grow professionally and personally.” Doganiero has been repeatedly acknowledged by her peers as a leader in the industrial hygiene profession. In his 2006 Cummings Award Lecture, the late Steven P. Levine listed her as one of the “established leaders of the next generation of industrial hygienists,” noting her strength as an “effective versatilist” in her role in the Department of the Army. AIHA presented Doganiero with the Alice Hamilton Award in 2009, recognizing her as an outstanding woman who has made a definitive, lasting achievement in the field of occupational and environmental hygiene. One of her nominators described her leadership in occupational health as “closely [mirroring] that of Alice Hamilton as a woman in a field clearly dominated by men who has succeeded by both earning their respect and influencing their decisions.”
Donna M. Doganiero, CIH
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What Kind of Near-miss Was Ebola? As I write this in mid-October 2014, Americans are still getting used to the new and scary risk of Ebola. Ebola fears led to a number of airline passengers being yanked off planes because they exhibited flu-like symptoms and had some connection, however remote, to Africa. So far they’ve all tested negative for Ebola. If that remains true, the number of such disruptions will soon decline precipitously. 
Are these events warnings that we should continue to take seriously, “casting a wide net” to reduce the odds of missing an actual Ebola case onboard? Or are they false alarms that we should learn to stop worrying about? Most experts, officials, and journalists say they’re false alarms. But that answer will change in hindsight if a traveler from West Africa ever infects some fellow passengers with Ebola.
Ebola also offers an object lesson in learned overconfidence. The discovery that two nurses were infected with the virus while treating an Ebola sufferer at a Dallas hospital raised many questions. Did the nurses breach PPE protocols? Were the protocols insufficiently protective in the first place? Is it realistic to expect healthcare workers to be 100 percent meticulous in following such protocols? 
One relevant fact: every nurse has considerable experience with breaches of infection control protocols that didn’t end in infection. And all too often the lesson learned isn’t that “We need to be more meticulous.” It is that “Infection control is pretty forgiving. Even when we mess up, it doesn’t usually do any harm.” Then along comes a much less forgiving pathogen, Ebola, and learned overconfidence becomes life-threatening.
Peter Sandman