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	<title>2020 Science &#187; FDA</title>
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	<description>Providing a clear perspective on developing science and technology responsibly</description>
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		<title>A nanotechnology regulation hat trick from the US federal government</title>
		<link>http://2020science.org/2011/06/10/a-nanotechnology-regulation-hat-trick-from-the-us-federal-government/</link>
		<comments>http://2020science.org/2011/06/10/a-nanotechnology-regulation-hat-trick-from-the-us-federal-government/#comments</comments>
		<pubDate>Fri, 10 Jun 2011 19:09:21 +0000</pubDate>
		<dc:creator>Andrew Maynard</dc:creator>
				<category><![CDATA[Andrew Maynard]]></category>
		<category><![CDATA[Emerging Technology]]></category>
		<category><![CDATA[Nanotechnology]]></category>
		<category><![CDATA[Oversight]]></category>
		<category><![CDATA[Regulation]]></category>
		<category><![CDATA[Risk Science]]></category>
		<category><![CDATA[Technology Innovation]]></category>
		<category><![CDATA[EPA]]></category>
		<category><![CDATA[FDA]]></category>
		<category><![CDATA[OMB]]></category>
		<category><![CDATA[OSTP]]></category>
		<category><![CDATA[White House]]></category>

		<guid isPermaLink="false">http://2020science.org/?p=4243</guid>
		<description><![CDATA[It must be Nanotechnology Regulation week in Washington DC.  Yesterday, two federal agencies and the White House released documents that grapple with the effective regulation of products that depend on engineered nanomaterials. In a joint memorandum, the Office of Science and Technology Policy, the Office of Management and Budget and the Office of the United [...]]]></description>
			<content:encoded><![CDATA[<p></p><p style="text-align: justify;"><span class="drop_cap">I</span>t must be <em>Nanotechnology Regulation</em> week in Washington DC.  Yesterday, two federal agencies and the White House released documents that grapple with the effective regulation of products that depend on engineered nanomaterials.</p>
<p style="text-align: justify;">In a joint memorandum, the Office of Science and Technology Policy, the Office of Management and Budget and the Office of the United States Trade Representative laid out <a href="http://www.whitehouse.gov/blog/2011/06/09/responsible-realization-nanotechnologys-full-potential">Policy Principles for the U.S. Decision Making Concerning Regulations and Oversight of Applications of Nanotechnology and Nanomaterials</a>.</p>
<p style="text-align: justify;">On the same day, the US Environmental Protection Agency posted a prepublication notice on <a href="http://yosemite.epa.gov/opa/admpress.nsf/0/05ff063e9205eb3c852578aa005aa0f8?OpenDocument">Policies Concerning Products Containing Nanoscale Materials</a>.</p>
<p style="text-align: justify;">And to cap it all, the US Food and Drug Administration released <a href="http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm258377.htm">Draft Guidance for Industry on Considering Whether an FDA-Regulated Product Involves the Application of Nanotechnology</a>.</p>
<p style="text-align: justify;">A busy week for nanotechnology regulation!</p>
<h3>White House Memo on Nanotechnology Regulation Policy Principles</h3>
<p style="text-align: justify;">The White House memorandum is the latest document to come out of the Emerging Technologies Interagency Policy Coordination Committee &#8211; <a href="http://www.whitehouse.gov/blog/2010/05/15/emerging-technologies-ipc-has-inaugural-meeting">ETIPC</a> for short.  In part, it is a response to the 2010 review of the National Nanotechnology Initiative by the President&#8217;s Council of Advisors on Science and Technology, and in particular the concern expressed by <a href="http://www.whitehouse.gov/sites/default/files/microsites/ostp/pcast-nano-report.pdf">PCAST</a> that</p>
<blockquote style="text-align: justify;"><p>&#8220;In the absence of sound science on the safe use of nanomaterials and of technologies and products containing them, the chance of unintentionally harming people and the environment increases.  At the same time, uncertainty and speculation about potential risks threaten to undermine consumer and business confidence.&#8221;</p></blockquote>
<p style="text-align: justify;">Correspondingly, this is a memorandum that is heavily focused on science-driven regulation, and the avoidance of knee-jerk responses to speculative concerns.</p>
<p style="text-align: justify;">Reading through it, a number of themes emerge, including:</p>
<ul style="text-align: justify;">
<li>Existing regulatory frameworks provide a firm foundation for the oversight of nanomaterials, but there is a need to respond to new scientific evidence on potential risks, and to consider administrative and legal modifications to the regulatory landscape should the need arise.</li>
<li>Regulatory action on nanomaterials should be based on scientific evidence of risk, and not on definitions of materials that do not necessarily reflect the evidence-based likelihood of a material causing harm.</li>
<li>There should be no prior judgement on whether nanomaterials are intrinsically benign or harmful, in the absence of supporting scientific evidence.</li>
<li>Transparency and communication are important to ensuring effective evidence-based regulation.</li>
</ul>
<p style="text-align: justify;">Overall, this is a strong set of policy principles that lays the groundwork for developing regulation that is grounded in science and not swayed by speculative whims, and yet is responsive and adaptive to emerging challenges.  Gratifyingly, the memorandum begins to touch on some of the concerns <a href="http://2020science.org/2011/04/15/why-we-don’t-need-a-regulatory-definition-for-nanomaterials/">I have expressed previously</a> about approaches to nanomaterial regulation that seem not to be evidence-based.  There is a reasonable chance that they will help move away from the dogma that engineered nanomaterials should be regulated separately because they are new, to a more nuanced and evidence-based approach to ensuring the safe use of increasingly sophisticated materials.  Where it perhaps lacks is in recognizing the importance of other factors in addition to science in crafting effective regulation, and in handling uncertainty in decision making.  But it is undoubtedly a move in the right direction.  The principles are listed at the end of this post.</p>
<h3>EPA Draft Pesticides and Nanomaterials Policies</h3>
<p style="text-align: justify;">The second piece in this triumvirate is a prepublication version of a document from EPA that should appear in the Federal Register next week, titled <a href="http://yosemite.epa.gov/opa/admpress.nsf/0/05ff063e9205eb3c852578aa005aa0f8?OpenDocument">&#8220;Pesticides; Policies Concerning Products Containing nanoscale Materials; Opportunities for Public Comment.&#8221;</a></p>
<p style="text-align: justify;">As the title makes very clear, this is a statement from the EPA that is setting out draft policies for dealing with nanomaterials in pesticide products &#8211; materials such as nanoscale silver particles &#8211; and asking for public comment.  This is the latest iteration in a process that has been going on for some time to address the use of nanoscale silver as an antimicrobial agent, together with other antimicrobial, fungicidal and pesticide uses of nanomaterials.</p>
<p style="text-align: justify;">The crux of the proposed policy is a requirement for manufacturers to let EPA know when a pesticide product contains an engineered nanomaterial &#8211; irrespective of whether it is an active or passive ingredient in the product. EPA acknowledges that the presence of a nanoscale material in a product does not necessarily indicate the possibility that it will exhibit new or unusual risks &#8211; but the agency intends to use this information as a trigger for a more thorough evaluation of products that might raise concerns.</p>
<p style="text-align: justify;">This is a long and somewhat convoluted document, that spends some time outlining what the agency considers is an engineered nanomaterial, and reviewing nanomaterial hazard data.</p>
<p style="text-align: justify;">Reading the document, EPA still seems somewhat tangled up with definitions of engineered nanomaterials. After outlining conventional attributes associated with engineered nanomaterials, including structures between ~1 &#8211; 100 nm and unique or novel properties, the document states</p>
<blockquote style="text-align: justify;"><p>&#8220;These elements do not readily work in a regulatory context because of the high degree of subjectivity involved with interpreting such phrases as &#8220;unique or novel properties&#8221; or &#8220;manufactured or engineered to take advantage of these properties&#8221; Moreover the contribution of these subjective elements to risk has not been established.&#8221;</p></blockquote>
<p style="text-align: justify;">This aligns with where my own thinking has been moving in recent years.  Yet following this statement, the document reverts back to considering nanoparticles between 1 &#8211; 100 nm as the archetypal nanomaterial, and intimates &#8220;novel&#8221; properties such as &#8220;larger surface area per unit volume and/or quantum effects&#8221; as raising new risk concerns.</p>
<p style="text-align: justify;">I also found the background information on potential hazards somewhat lopsided, as a litany of studies were cited that indicate a number of potential hazards associated with a range of materials, but without clear information on how this might translate to plausible and quantifiable risk.</p>
<p style="text-align: justify;">At the end of the day, I found this to be a mixed bag of a document &#8211; some useful information and some evidence of new thinking, but all surrounded by a rather unfocused assessment.   However, it is a draft that has been put out for public comment, which means that there is an opportunity here to tighten it up considerably in the final version.</p>
<p style="text-align: justify;">I must also add that I was impressed by the final section on Questions for Comment &#8211; here you will find a list of highly relevant questions that are the clearest indication in the document that EPA understands many of the critical issues here, and is genuinely looking for expert input to address them.</p>
<p style="text-align: justify;">Interestingly though, the EPA document does not reference the White House <a href="http://www.whitehouse.gov/blog/2011/06/09/responsible-realization-nanotechnologys-full-potential">memorandum on Policy Principles</a> published at the same time &#8211; unlike my third and final document in this set from FDA.</p>
<h3>FDA Draft Guidance for Industry on Products and Nanotechnology</h3>
<p style="text-align: justify;">The FDA <a href="http://www.fda.gov/RegulatoryInformation/Guidances/ucm257698.htm">Guidance for Industry: Considering Whether an FDA-Regulated Product Involves the Application of Nanotechnology</a> is a very different kettle of fish to the EPA document.  It is overtly responsive to the White House memo; it demonstrates a deep understanding of the issues surrounding nanotechnology and regulation; and it is mercifully concise.</p>
<p style="text-align: justify;">To be fair, the scope of the draft guidance is limited to helping manufacturers understand how the agency is approaching nanotechnology-enabled products under their purview.  But this is something it does well.</p>
<p style="text-align: justify;">One of the more significant aspects of the guidance is the discussion on regulatory definitions of nanomaterials.  Following a line of reasoning established some years ago, the agency focuses on material properties rather than rigid definitions:</p>
<blockquote style="text-align: justify;"><p>&#8220;FDA has not to date established regulatory definitions of &#8220;nanotechnology,&#8221; &#8220;nanoscale&#8221; or related terms&#8230; Based on FDA&#8217;s current scientific and technical understanding of nanomaterials and their characteristics, FDA believes that evaluations of safety, effectiveness or public health impact of such products should consider the unique properties and behaviors that nanomaterials may exhibit&#8221;</p></blockquote>
<p style="text-align: justify;">Of course, this still begs the question &#8220;what is a nanomaterial in FDA&#8217;s eyes?&#8221;  The agency answer by stating:</p>
<blockquote>
<p style="text-align: justify;">At this time, when considering whether an FDA-regulated product contains nanomaterials or otherwise involves the application of nanotechnology, FDA will ask:</p>
</blockquote>
<blockquote style="text-align: justify;">
<ol>
<li>Whether an engineered material or end product has at least one dimension in the nanoscale range (approximately 1 nm to 100 nm); or</li>
<li>Whether an engineered material or end product exhibits properties or phenomena, including physical or chemical properties or biological effects, that are attributable to its dimension(s), even if these dimensions fall outside the nanoscale range, up to one micrometer.</li>
</ol>
</blockquote>
<p style="text-align: justify;">The guidance goes on to state</p>
<blockquote style="text-align: justify;"><p>&#8220;These considerations apply not only to new products, but also may apply when manufacturing changes alter the dimensions, properties, or effects of an FDA-regulated product or any of its components.  Additionally, they are subject to change in the future as new information becomes available, and to refinement in future product-specific guidance documents.&#8221;</p></blockquote>
<p style="text-align: justify;">FDA is clearly aiming for responsive and adaptive regulation here.</p>
<p style="text-align: justify;">Reading the first of the two criteria above and the associated justification in the guidance, I can&#8217;t help feeling that FDA is still trying to justify responding to sub-100 nm scale materials based on assumptions of risk rather than evidence.  But the second criteria is important, because it opens the door to considering physical form and structure as a factor in determining potential risk <em>irrespective of scale</em> &#8211; as long as a material can come into intimate biological contact with a person.  This is a significant move, as it supports evidence-based decision-making on materials and products under FDA&#8217;s jurisdiction, irrespective of what technological label is applied to them.</p>
<p style="text-align: justify;">That said, there remains some confusion as to how this criteria will be applied, and the reasoning behind it. Clearly, there is an aim here to capture supra-100 nm materials that nevertheless exhibit biological behavior associated with a nanometer-scale structure &#8211; including agglomerates, coated materials and hierarchical structures.  Yet the criteria is also said to have been selected to &#8220;exclude macro-scaled materials that may have properties attributable to their dimension(s) but are not likely relevant to nanotechnology&#8221;.  This statement seems to hark back to an assumption that &#8220;nanotechnology&#8221; is something that needs to be regulated, rather than focusing on materials and products that run the risk of slipping through the regulatory net &#8211; no matter what they are called.</p>
<p style="text-align: justify;">But like the EPA document, the FDA guidance is still in draft form, and open to public comment.  And so is still very much a work in progress.</p>
<p style="text-align: justify;">Overall, all three of these documents seem to be heading in the right direction if evidence-based, responsive and responsible regulations are the end goal.  There is still a way to go for both FDA and EPA before regulatory policy escapes being mesmerized by &#8220;nanotechnology&#8221;. But with strong science-driven policy principles emerging from the White House, the odds of this occurring are looking decidedly more healthy.</p>
<p style="text-align: justify;">_____________</p>
<h3 style="text-align: justify;"><em><strong>While House Policy Principles for the U.S. decision-Making Concerning Regulation and Oversight of Applications of nanotechnology and Nanomaterials: </strong></em></h3>
<blockquote style="text-align: justify;"><p><em>In addressing issues raised by nanomaterials, agencies will adhere to the Principles for Regulation and Oversight of Emerging Technologies. Specifically, to the extent permitted by law, Federal agencies will:</em></p>
<ul>
<li><em>To ensure scientific integrity, base their decisions on the best available scientific evidence, separating purely scientific judgments from judgments of policy to the extent feasible;</em></li>
<li><em>Seek and develop adequate information with respect to the potential effects of nanomaterials on human health and the environment and take into account new knowledge when it becomes available;</em></li>
<li><em>To the extent feasible and subject to valid constraints (involving, for example, national security and confidential business information), develop relevant information in an open and transparent manner, with ample opportunities for stakeholder involvement and public participation;</em></li>
<li><em>Actively communicate information to the public regarding the potential benefits and risks associated with specific uses ofnanomate rials;</em></li>
<li><em>Base their decisions on an awareness of the potential benefits and the potential costs of such regulation and oversight, including recognition of the role of limited information and risk in decision making;</em></li>
<li><em>To the extent practicable, provide sufficient flexibility in their oversight and regulation to accommodate new evidence and learning on nanomaterials;</em></li>
<li><em>Consistent with current statutes and regulations, strive to reach an appropriate level of consistency in risk assessment and risk management across the Federal Government, using standard oversight approaches to assess risks and benefits and manage risks, considering safety, health and environmental impacts, and exposure mitigation;</em></li>
<li><em>Mandate risk management actions appropriate to, and commensurate with, the degree of risk identified in an assessment.</em></li>
<li><em>Seek to coordinate with one another, with state authorities, and with stakeholders to address the breadth of issues, including health and safety, economic, environmental, and ethical issues (where applicable) associated with nanomaterials; and</em></li>
<li style="text-align: justify;"><em>Encourage coordinated and collaborative research across the international community and clearly communicate the regulatory approaches and understanding of the United States to other nations.</em></li>
</ul>
</blockquote>
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		<title>Nanotechnology in context – Size matter</title>
		<link>http://2020science.org/2007/11/01/nanotechnology-in-context-%e2%80%93-size-matter/</link>
		<comments>http://2020science.org/2007/11/01/nanotechnology-in-context-%e2%80%93-size-matter/#comments</comments>
		<pubDate>Thu, 01 Nov 2007 04:00:06 +0000</pubDate>
		<dc:creator>Andrew Maynard</dc:creator>
				<category><![CDATA[Ethics]]></category>
		<category><![CDATA[Nanotechnology]]></category>
		<category><![CDATA[Oversight]]></category>
		<category><![CDATA[FDA]]></category>

		<guid isPermaLink="false">http://2020science.wordpress.com/?p=208</guid>
		<description><![CDATA[In July 2007, a specially convened task force of the United States Food and Drug Administration (FDA) concluded that size does in fact matter (FDA 2007).  The focus of the task force was not on the importance of “largeness”, but rather on the technology of the unimaginably small—nanotechnology. Nanotechnology is the technology of manipulating matter [...]]]></description>
			<content:encoded><![CDATA[<p></p><p>In July 2007, a specially convened task force of the United States Food and Drug Administration (FDA) concluded that size does in fact matter (FDA 2007).  The focus of the task force was not on the importance of “largeness”, but rather on the technology of the unimaginably small—nanotechnology.</p>
<p>Nanotechnology is the technology of manipulating matter at near-atomic levels; typically, but not exclusively, within the size range of 1 – 100 nanometers.  Working at this scale, it becomes possible to combine materials in ways and forms unimaginable more than a few decades ago.  Imagine the contrast between eighteenth century surgery and modern microsurgery, and you begin to get an idea of what this emerging technology offers.</p>
<p>According to the FDA task force, “properties of a material relevant to the safety and (as applicable) effectiveness of FDA-regulated products might change repeatedly as size enters into or varies within the nanoscale range”. But as Professor James Moor and Professor John Wecker point out in the Spring 2007 edition of Medical Ethics [<a href="http://www.lahey.org/Pdf/Ethics/Ethics_Spring_2007.pdf" target="_blank">PDF, 805 KB</a>], nanotechnology not only raises safety and regulatory issues, but ethical questions as well (Moor and Wecker 2007).<span id="more-208"></span></p>
<p>At the heart of the buzz surrounding nanotechnology is its potential to extend what can be achieved with conventional technologies, and the tantalizing possibility of developing radical new technologies.  Nanotechnology is not so much a specific technology as a new way of doing things, or a new technological tool kit.  In the words of Moor and Wecker, “[n]anotechnology offers us the general capability of material malleability”.</p>
<p>The idea of engineering at the nanoscale conjures up images of everyday mechanical objects shrunk to the scale of molecules; nano-gears, nano-engines, even nano-machines—conventional engineering, but at a miniscule scale.  Such nano-engineering would enable us to build complex devices from handfuls of atoms, increasing the performance and utility of human-scale products.  It would also help use limited resources expediently—making products molecule by molecule, with minimal waste.  In other words, this is a vision of nanotechnology that would emulate the biological world and lead to a synthetic biology; augmenting existing natural nano-machines and “molecular assemblers” that have evolved over billions of years, with an inorganic counterpart over which we have full control.</p>
<p>Eric Drexler envisaged such a world in his book Engines of Creation: The Coming Era of Nanotechnology (Drexler 1986).  Yet, while some of these concepts may one day become a reality, the nanotechnology of today looks very different.  Returning to the idea of engineering at the nanoscale, the chemist and Nobel Laureate Richard Smalley is credited with describing nanotechnology as “the art and science of building stuff that does stuff at the nanometer scale”.  Scientists and technologists alike are drawn to nanotechnology because of the unconventional behavior exhibited by many nanoscale materials, and their ability to “do stuff” in ways conventional materials do not.  As atoms and molecules are formed into nanoscale structures, intrinsic material properties like conductivity, transparency and chemical reactivity diverge from those observed in the constituent molecules or the bulk material.</p>
<p>But engineered nanomaterials can also demonstrate unconventional behavior that is associated with extrinsic attributes like size and shape. For instance, engineering a material as discrete nanometer-diameter particles might make it easier to incorporate into products, deliver to specific areas of use, or substantially increase the surface area to mass ratio.  In these cases, the intrinsic physical and chemical properties of the engineered nanomaterial are not necessarily scale-specific, but the ways in which the material is used are.</p>
<p>The scale-specific behavior of engineered nanomaterials takes on a special significance in interactions with biological systems and processes. Biology is inherently nanoscale, and purposely-engineered nanoscale materials allow the possibility of modulating biological processes at a fundamental level. Nano-bio interactions may result from scale-specific physical and chemical properties intrinsic to some nanoscale materials.  But they may just as likely result from nanoscale materials having access to biological processes that are inaccessible to larger scale materials.</p>
<p>In this way, nanotechnology provides a high-precision tool kit for exploring and influencing living systems.  The biological utility of nanotechnology is demonstrated effectively through its use in potential cancer treatments. Researchers at Rice University for example are combining the scale-dependent photonic properties of nanometer-thick gold shells, with the size-dependent biological properties of nanoscale particles, to create composite particles capable of preferentially treating tumors.  Gold-coated nanometer-diameter silica particles are introduced into the bloodstream, from where they preferentially pass through the leaky vasculature around tumors.  Once sufficient material has accumulated around the diseased cells, irradiating the particles with a laser tuned to the gold nanoshells causes localized heating, destroying the growth while leaving healthy tissue unharmed (O&#8217;Neal, Hirsch et al. 2004).</p>
<p>Going a step further, researchers at the University of Michigan are developing multifunctional nanoparticles for treating specific cancers.  Starting with generic nanoparticles, various functional components are added: ligands that attach to specific biological targets; contrast agents to allow particles to be tracked round the body; and sensitizing agents, enabling particles to receive and respond to external signals.  With these components, nanoparticles are being developed that selectively target and destroy cancer cells, while minimally impacting the rest of the body (Koo, Fan et al. 2007).</p>
<p>From relatively simple nanotechnology applications to the possibilities of synthetic life, nanotechnology provides us with tools for developing radical new processes and products.  And with these tools come the social and ethical responsibilities to use them wisely.  Concerns have already been expressed over potential new risks to humans and the environment that nanoscale-specific material behavior present. Little is known about how nanomaterials released into the environment will be transported, transformed and accumulated, or their impact on sensitive ecosystems (Oberdörster, Oberdörster et al. 2005).  Animal studies have demonstrated that nanoscale particles can enter and be transported within bodies in ways that larger particles cannot, and research suggests some nanomaterials are more potent in organs such as the lungs than their larger scale counterparts (Oberdörster, Stone et al. 2007). There are also early indications that nanoscale materials might interfere with protein conformation, and even lead to enhanced fibrillation rates in proteins associated with amyloid diseases such as Parkinsons and Alzheimers (Linse, Cabaleiro-Lago et al. 2007).</p>
<p>Studies remain inconclusive as to what might make nanomaterials harmful and what can be done to avoid harm.  Recommendations have been made for better-focused and funded strategic research (e.g. Maynard, Aitken et al. 2006).  But the responsible use of nanotechnologies will depend on more than good risk management.  In their article, Moor and Wecker suggest that nanotechnology has the potential to raise one of the ultimate ethical and medical issues: therapy versus enhancement.  At what point do we cross the line between restorative biocompatible materials and implanted sensors (for instance), and the enhancements such technologies will offer to healthy individuals?</p>
<p>Already, there is serious discussion on how nanotechnologies might extend a person’s lifespan, or even be used to enhance an individual’s intelligence (Roco and Bainbridge 2003). But the ethical issues raised by nanotechnology go further:  Who will receive the benefits of these new technologies, and who will pay the price?  Will nanotechnologies widen social, economic and cultural divides, or close them?   What are the implications of research into emulating biological systems?  And what are the consequences of not grasping the opportunities being offered by nanotechnology?</p>
<p>Many of these issues are not unique to nanotechnology, but as Moor and Wecker intimate, the possibilities that nanotechnologies offer to do things differently throw them into sharp relief.  Nanotechnology has the potential to improve living standards around the world, and offers solutions to some of the most pressing challenges we face: renewable energy, plentiful supplies of clean water, effective treatments for cancer, to name just three.  If our aim is to improve quality of life and do good, it would be irresponsible and even unethical to deny the world what nanotechnology has to offer.  Yet this potential for good must be weighed against the very real possibilities of causing harm, widening equity imbalances and reducing autonomy.  A future without nanotechnology would be a poorer, harsher place.  But a world where nanotechnology is not developed within a clear ethical and social framework could be immeasurably worse.  Either way, we have a challenge on our hands to move forward responsibly.  When it comes to navigating through the implications of emerging technologies on our lives, size, it would seem, really does matter.</p>
<p>Drexler, E. (1986). Engines of creation: The coming era of nanotechnology. New York, Anchor Books.<br />
FDA (2007). Nanotechnology.  A report of the U.S. Food and Drug Administration Nanotechnology Task Force. Washington DC, Food and Drug Administration.<br />
Koo, Y. E. L., W. Fan, et al. (2007). &#8220;Photonic explorers based on multifunctional nanoplatforms for biosensing and photodynamic therapy.&#8221; Applied Optics 46(10): 1924-1930.<br />
Linse, S., C. Cabaleiro-Lago, et al. (2007). &#8220;Nucleation of protein fibrillation by nanoparticles.&#8221; Proc. Natl. Acad. Sci. U. S. A. doi:10.1073/pnas.0701250104.<br />
Maynard, A. D., R. J. Aitken, et al. (2006). &#8220;Safe handling of nanotechnology.&#8221; Nature 444(16): 267-269.<br />
Moor, J. H. and J. Wecker (2007). &#8220;Nanotechnology and nanoethics.&#8221; Medical Ethics 14(2): 1-2.<br />
O&#8217;Neal, D. P., L. R. Hirsch, et al. (2004). &#8220;Photo-thermal tumor ablation in mice using near infrared-absorbing nanoparticles.&#8221; Cancer Letters 209(2): 171-176.<br />
Oberdörster, G., E. Oberdörster, et al. (2005). &#8220;Nanotoxicology: An emerging discipline evolving from studies of ultrafine particles.&#8221; Environ. Health Perspect. 13 (117): 823-840.<br />
Oberdörster, G., V. Stone, et al. (2007). &#8220;Toxicology of nanoparticles: A historical perspective.&#8221; Nanotoxicology 1(1): 2 &#8211; 25.<br />
Roco, M. C. and W. S. Bainbridge, Eds. (2003). Converging technologies for improving human performance.  Nanotechnol;ogy, biotechnology, information technology and cognitive science. Norwell MA, USA, Kluwer Academic Publishers.<br />
___________________________________</p>
<p><em><span style="color:#c0c0c0;">First published in the Lahey Clinic Medical Ethics Journal, Fall 2007</span><span style="color:#c0c0c0;"> [<a href="http://www.lahey.org/Pdf/Ethics/Ethics_Fall_2007.pdf" target="_blank">PDF, 215 KB</a>]</span></em></p>
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