Showing papers in "Annals of Occupational Hygiene in 2012"

Effectiveness of three decontamination treatments against influenza virus applied to filtering facepiece respirators

Abstract: Filtering facepiece respirators (FFRs) are recommended for use as precautions against airborne pathogenic microorganisms; however, during pandemics demand for FFRs may far exceed availability. Reuse of FFRs following decontamination has been proposed but few reported studies have addressed the feasibility. Concerns regarding biocidal efficacy, respirator performance post decontamination, decontamination cost, and user safety have impeded adoption of reuse measures. This study examined the effectiveness of three energetic decontamination methods [ultraviolet germicidal irradiation (UVGI), microwave-generated steam, and moist heat] on two National Institute for Occupational Safety and Health-certified N95 FFRs (3M models 1860s and 1870) contaminated with H5N1. An aerosol settling chamber was used to apply virus-laden droplets to FFRs in a method designed to simulate respiratory deposition of droplets onto surfaces. When FFRs were examined post decontamination by viral culture, all three decontamination methods were effective, reducing virus load by > 4 log median tissue culture infective dose. Analysis of treated FFRs using a quantitative molecular amplification assay (quantitative real-time polymerase chain reaction) indicated that UVGI decontamination resulted in lower levels of detectable viral RNA than the other two methods. Filter performance was evaluated before and after decontamination using a 1% NaCl aerosol. As all FFRs displayed <5% penetration by 300-nm particles, no profound reduction in filtration performance was caused in the FFRs tested by exposure to virus and subsequent decontamination by the methods used. These findings indicate that, when properly implemented, these methods effectively decontaminate H5N1 on the two FFR models tested and do not drastically affect their filtering function; however, other considerations may influence decisions to reuse FFRs.

Occupational Exposure Assessment in Carbon Nanotube and Nanofiber Primary and Secondary Manufacturers

Abstract: UNLABELLED RESEARCH SIGNIFICANCE: Toxicological evidence suggests the potential for a wide range of health effects, which could result from exposure to carbon nanotubes (CNTs) and carbon nanofibers (CNFs). The National Institute for Occupational Safety and Health (NIOSH) has proposed a recommended exposure limit (REL) for CNTs/CNFs at the respirable size fraction. The current literature is lacking exposure information, with few studies reporting results for personal breathing zone (PBZ) samples in occupational settings. To address this gap, exposure assessments were conducted at six representative sites identified as CNT/CNF primary or secondary manufacturers. METHODS Personal and area filter-based samples were collected for both the inhalable mass concentration and the respirable mass concentration of elemental carbon (EC) as well as CNT structure count analysis by transmission electron microscopy to assess exposures. When possible, full-shift PBZ samples were collected; area samples were collected on a task-based approach. RESULTS The vast majority of samples collected in this study were below the proposed REL (7 μg m(-3)). Two of the three secondary manufacturers' surveyed found concentrations above the proposed REL. None of the samples collected at primary manufacturers were found to be above the REL. Visual and microscopy-based evidence of CNTs/CNFs were found at all sites, with the highest CNT/CNF structure counts being found in samples collected at secondary manufacturing sites. The statistical correlations between the filter-based samples for the mass concentration of EC and CNT structure counts were examined. A general trend was found with a P-value of 0.01 and a corresponding Pearson correlation coefficient of 0.44. CONCLUSIONS CNT/CNF concentrations were above the proposed NIOSH REL for PBZ samples in two secondary manufacturing facilities that use these materials for commercial applications. These samples were collected during dry powder handling processes, such as mixing and weighing, using fairly large quantities of CNTs/CNFs.

Stoffenmanager Nano Version 1.0: A Web-Based Tool for Risk Prioritization of Airborne Manufactured Nano Objects

Abstract: Stoffenmanager Nano (version 1.0) is a risk-banding tool developed for employers and employees to prioritize health risks occurring as a result of exposure to manufactured nano objects (MNOs) for a broad range of worker scenarios and to assist implementation of control measures to reduce exposure levels. In order to prioritize the health risks, the Stoffenmanager Nano combines the available hazard information of a substance with a qualitative estimate of potential for inhalation exposure. The development of the Stoffenmanager Nano started with a review of the available literature on control banding. Input parameters for the hazard assessment of MNOs were selected based on the availability of these parameters in, for instance, Safety Data Sheets or product information sheets. The conceptual exposure model described by Schneider et al. (2011) was used as the starting point for exposure banding. During the development of the Stoffenmanager Nano tool, the precautionary principle was applied to deal with the uncertainty regarding hazard and exposure assessment of MNOs. Subsequently, the model was converted into an online tool (http://nano.stoffenmanager.nl), tested, and reviewed by a number of companies. In this paper, we describe the Stoffenmanager Nano. This tool offers a practical approach for risk prioritization in exposure situations where quantitative risk assessment is currently not possible. Updates of this first version are anticipated as more data become available in the future.

Comparability of portable nanoparticle exposure monitors.

Abstract: Five different portable instrument types to monitor exposure to nanoparticles were subject to an intensive intercomparison measurement campaign. Four of them were based on electrical diffusion charging to determine the number concentration or lung deposited surface area (LDSA) concentration of airborne particles. Three out of these four also determined the mean particle size. The fifth instrument type was a handheld condensation particle counter (CPC). The instruments were challenged with three different log-normally distributed test aerosols with modal diameters between 30 and 180 nm, varying in particle concentration and morphology. The CPCs showed the highest comparability with deviations on the order of only ±5%, independent of the particle sizes, but with a strictly limited upper number concentration. The diffusion chargerbased instruments showed comparability on the order of ±30% for number concentration, LDSA concentration, and mean particle size, when the specified particle size range of the instruments matched the size range of the aerosol particles, whereas significant deviations were found when a large amount of particles exceeded the upper or lower detection limit. In one case the reported number concentration was even increased by a factor of 6.9 when the modal diameter of the test aerosol exceeded the specified upper limit of the instrument. A general dependence of the measurement accuracy of all devices on particle morphology was not detected.

Harmonization of Measurement Strategies for Exposure to Manufactured Nano-Objects; Report of a Workshop

Abstract: The present paper summarizes the outcome of the discussions at the First International Scientific Workshop on Harmonization of Strategies to Measure and Analyze Exposure to (Manufactured) Nano-objects in Workplace Air that was organized and hosted by the Netherlands Organization for Applied Scientific Research (TNO) and the Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA) (Zeist, The Netherlands, December 2010). It reflects the discussions by 25 international participants in the area of occupational (nano) exposure assessment from Europe, USA, Japan, and Korea on nano-specific issues related to the three identified topics: (i) measurement strategies; (ii) analyzing, evaluating, and reporting of exposure data; and (iii) core information for (exposure) data storage. Preliminary recommendations were achieved with respect to (i) a multimetric approach to exposure assessment, a minimal set of data to be collected, and basic data analysis and reporting as well as (ii) a minimum set of contextual information to be collected and reported. Other issues that have been identified and are of great interest include (i) the need for guidance on statistical approaches to analyze time-series data and on electron microscopy analysis and its reporting and (ii) the need for and possible structure of a (joint) database to store and merge data. To make progress in the process of harmonization, it was concluded that achieving agreement among researchers on the preliminary recommendations of the workshop is urgent. © 2011 The Author.

Control banding approaches for nanomaterials.

Abstract: Control banding (CB) has been developed as a pragmatic tool to manage the risk resulting from exposure to a wide variety of potentially hazardous substances in the absence of firm toxicological and exposure information. Currently, the CB approach is applied for emerging risks such as nanoparticles, by the development of various CB-based tools. Six of these are compared. Despite their similarity, i.e. combining hazard and exposure into control or risk bands, the structure, the applicability domains, and the assignment of the hazard and exposure bands, show differences that may affect the consistency of the resulting outcome amongst the various CB tools. The value of the currently available CB tools for nanomaterials can be enhanced by transparently elucidating these differences for user consideration during the selection of a tool for a specific scenario of application. © The Author 2012.

Cytotoxicity and genotoxicity of nanosized and microsized titanium dioxide and iron oxide particles in Syrian hamster embryo cells.

Abstract: Potential differences in the toxicological properties of nanosized and non-nanosized particles have been notably pointed out for titanium dioxide (TiO(2)) particles, which are currently widely produced and used in many industrial areas. Nanoparticles of the iron oxides magnetite (Fe(3)O(4)) and hematite (Fe(2)O(3)) also have many industrial applications but their toxicological properties are less documented than those of TiO(2). In the present study, the in vitro cytotoxicity and genotoxicity of commercially available nanosized and microsized anatase TiO(2), rutile TiO(2), Fe(3)O(4), and Fe(2)O(3) particles were compared in Syrian hamster embryo (SHE) cells. Samples were characterized for chemical composition, primary particle size, crystal phase, shape, and specific surface area. In acellular assays, TiO(2) and iron oxide particles were able to generate reactive oxygen species (ROS). At the same mass dose, all nanoparticles produced higher levels of ROS than their microsized counterparts. Measurement of particle size in the SHE culture medium showed that primary nanoparticles and microparticles are present in the form of micrometric agglomerates of highly poly-dispersed size. Uptake of primary particles and agglomerates by SHE exposed for 24 h was observed for all samples. TiO(2) samples were found to be more cytotoxic than iron oxide samples. Concerning primary size effects, anatase TiO(2), rutile TiO(2), and Fe(2)O(3) nanoparticles induced higher cytotoxicity than their microsized counterparts after 72 h of exposure. Over this treatment time, anatase TiO(2) and Fe(2)O(3) nanoparticles also produced more intracellular ROS compared to the microsized particles. However, similar levels of DNA damage were observed in the comet assay after 24 h of exposure to anatase nanoparticles and microparticles. Rutile microparticles were found to induce more DNA damage than the nanosized particles. However, no significant increase in DNA damage was detected from nanosized and microsized iron oxides. None of the samples tested showed significant induction of micronuclei formation after 24 h of exposure. In agreement with previous size-comparison studies, we suggest that in vitro cytotoxicity and genotoxicity induced by metal oxide nanoparticles are not always higher than those induced by their bulk counterparts.

Toxicity and Genotoxicity of Nano-SiO2 on Human Epithelial Intestinal HT-29 Cell Line

Abstract: Silica mesoporous nanoparticles have been recently selected for a wide range of applications from electronics to medicine due to their intrinsic properties. Among medical applications, drug delivery using SiO(2) nanoparticles by oral route is under study. Major benefits are expected including higher specificity and sensitivity together with side effect reduction. Since literature shows that very complex and unexpected interactions could occur between nanomaterials and biological systems, one critical issue is to control the nanoparticle cytotoxicity/genotoxicity for normal tissues and specially stomach and intestine when oral route is considered. The aim of the work is to study the cytotoxicity and genotoxicity of SiO(2) nanoparticles on HT29 human intestine cell line, using conventional and innovative methodologies, for measuring cell viability and proliferation, global metabolism, genotoxicity, and nanoparticles uptake. Core-dye doped SiO(2) nanoparticles of 25 and 100 nm were specifically synthesized to track nanoparticles incorporation by confocal and video microscopy. Besides conventional approaches (sulforhodamine B, flow cytometry, and γ-H2Ax foci), we have performed a real-time monitoring of cell proliferation using an impedance-based system which ensure no interference between measures and nanoparticles physicochemical characteristics. Overall, our results showed that SiO(2)-25nm and SiO(2)-100nm induced a rather limited cytotoxic and genotoxic effects on HT-29 cells after a 24 h exposure. However, regarding cell viability and genotoxicity, inverse dose-dependent relationships were observed for SiO(2)-100nm nanoparticles. In conclusion, it seems that the higher the dose of SiO(2)-100nm, the lower the cytotoxic/genotoxic effects, data that well illustrate the complexity in identifying and understanding the hazards of nanoparticles for human health.

Exposure to Inhalable, Respirable, and Ultrafine Particles in Welding Fume

Abstract: This investigation aims to explore determinants of exposure to particle size-specific welding fume. Area sampling of ultrafine particles (UFP) was performed at 33 worksites in parallel with the collection of respirable particles. Personal sampling of respirable and inhalable particles was carried out in the breathing zone of 241 welders. Median mass concentrations were 2.48 mg m(-3) for inhalable and 1.29 mg m(-3) for respirable particles when excluding 26 users of powered air-purifying respirators (PAPRs). Mass concentrations were highest when flux-cored arc welding (FCAW) with gas was applied (median of inhalable particles: 11.6 mg m(-3)). Measurements of particles were frequently below the limit of detection (LOD), especially inside PAPRs or during tungsten inert gas welding (TIG). However, TIG generated a high number of small particles, including UFP. We imputed measurements

Risk Assessment and Risk Management of Nanomaterials in the Workplace: Translating Research to Practice

Abstract: In the last decade since the rise in occupational safety and health (OSH) research focusing on nanomaterials, some progress has been made in generating the health effects and exposure data needed to perform risk assessment and develop risk management guidance. Yet, substantial research gaps remain, as do challenges in the translation of these research findings to OSH guidance and workplace practice. Risk assessment is a process that integrates the hazard, exposure, and dose-response data to characterize risk in a population (e.g. workers), in order to provide health information needed for risk management decision-making. Thus, the research priorities for risk assessment are those studies that will reduce the uncertainty in the key factors that influence the estimates. Current knowledge of OSH in nanotechnology includes the following: (i) nanomaterials can be measured using standard measurement methods (respirable mass or number concentration), (ii) workplace exposures to nanomaterials can be reduced using engineering controls and personal protective equipment, and (iii) current toxicity testing and risk assessment methods are applicable to nanomaterials. Yet, to ensure protection of workers' health, research is still needed to develop (i) sensitive and quantitative measures of workers' exposure to nanomaterials, (ii) validation methods for exposure controls, and (iii) standardized criteria to categorize hazard data, including better prediction of chronic effects. This article provides a state-of-the-art overview on translating current hazard research data and risk assessment methods for nanomaterials to the development and implementation of effective risk management guidance.

Protective Facemask Impact on Human Thermoregulation: An Overview

Abstract: The use of protective facemasks (PFMs) negatively impacts respiratory and dermal mechanisms of human thermoregulation through impairment of convection, evaporation, and radiation processes. The relatively minor reported increases in core temperature directly attributable to the wearing of PFMs suggest that associated perceptions of increased body temperature may have a significant psychological component or that regional or global brain temperature changes are involved. Modifications in PFM structure, components, and materials might allow for improved heat dissipation and enhanced compliance with use.

Exposure limits for nanoparticles: report of an international workshop on nano reference values.

Abstract: This article summarizes the outcome of the discussions at the international workshop on nano reference values (NRVs), which was organized by the Dutch trade unions and employers’ organizations and hosted by the Social Economic Council in The Hague in September 2011. It reflects the discussions of 80 international participants representing small- and medium-size enterprises (SMEs), large companies, trade unions, governmental authorities, research institutions, and non-governmental organizations (NGOs) from many European countries, USA, India, and Brazil. Issues that were discussed concerned the usefulness and acceptability of precaution-based NRVs as a substitute for health-based occupational exposure limits (OELs) and derived no-effect levels (DNELs) for manufactured nanoparticles (NPs). Topics concerned the metrics for measuring NPs, the combined exposure to manufactured nanomaterials (MNMs) and process-generated NPs, the use of the precautionary principle, the lack of information about the presence of nanomaterials, and the appropriateness of soft regulation for exposure control. The workshop concluded that the NRV, as an 8-h time-weighted average, is a comprehensible and useful instrument for risk management of professional use of MNMs with a dispersible character. The question remains whether NRVs, as advised for risk management by the Dutch employers’ organization and trade unions, should be under soft regulation or that a more binding regulation is preferable.

Assessment of occupational and public exposure to trichloramine in Swiss indoor swimming pools: a proposal for an occupational exposure limit.

Abstract: Objectives: The presence of trichloramine in the air in different indoor swimming pools has been studied in several countries. In almost all studies, the results show a possible health impact due to trichloramine among pool attendants. The main objectives of our study were to evaluate, for the first time in Switzerland, occupational and public trichloramine exposure in a representative panel of indoor pools and to propose an occupational exposure limit for trichloramine. Methods: Measurements were done in 30 indoor swimming pools located in three regions of Switzerland: Jura, Neuchatel, and Fribourg. All investigations were performed during the 2007-2008 winter season in order to assure closed windows and standard ventilation condi- tions. Trichloramine air samplings were performed at 130 cm above the floor around the pool. Analyses of free chlorine and bounded chlorine were performed on-site, and water samples were immediately sent to the laboratory for analysis of trihalomethanes, urea, and dissolved organic carbon. A health questionnaire was distributed to all the participants. Results: Our results indicate that in all the studied facilities except one, the trichloramine concentrations were below the French reference value of 0.5 mg m 23 , and only three were equal to or slightly over 0.3 mg m 23 . Overall, our results point out a very low and consistent range of trichloramine concentrations (mean concentration of trichloramine: 0.114 6 0.043 mg m 23 ). A total of 184 questionnaires were filled out by pool workers. Of the study popula- tion, 66% were men (n 5 117), 21% were smokers (9 women and 29 men), and only 7% (n 5 13) were ex-smokers. The control group was composed of 71 persons (38 men and 33 women); 22% (n 5 15) were smokers and 24% (n 5 16) ex-smokers. Conclusions: Our results demonstrate an increasing risk of irritative symptoms up to a level of 0.2-0.3 mg m 23 of trichloramine. The health data in our study, as well as the review of the literature, strongly suggest fixing the trichloramine occupational exposure limit at 0.3 mg m 23 . Severe technical standards (on flocculation, filters, water flow, and ventilation systems) and regulations on water quality (free and combined chlorine, urea, and amount of fresh water) contribute to reducing trichloramine formation and, consequently, occupational and public trichloramine exposure. In addition, to ensure good public hygiene (showering before swim- ming), correct and regular public awareness campaigns should be undertaken.

Systematic review of respiratory outbreaks associated with exposure to water-based metalworking fluids

Abstract: Introduction Potential demographic risk factors for outbreaks of respiratory disease due to water-based metalworking fluids (MWFs) were investigated through systematic review of published outbreak investigations. Methods Search terms were selected by a multidisciplinary team, assisted by an experienced library information service. Several computerized literature databases were searched for articles published between January 1990 and October 2011, relating to ill health outbreaks due to MWFs. Papers meeting the search criteria were reviewed in detail, and their references checked for additional articles. Study design and demographic details of the outbreak were extracted from the selected articles and entered into standardized evidence tables. Results Thirty-five articles relating to investigations of 27 outbreaks of respiratory ill health attributed to MWF exposure were identified. The majority of reports were case series of disease or observational cross-sectional studies of symptoms and hygiene measurements. Eight of the outbreak investigations included an element of case-control analysis. Most outbreaks were from the USA, had occurred in large car- or aeronautical-manufacturing plants, and were associated with the use of central shared sumps. Hygiene studies have not demonstrated consistent risk factors for respiratory outbreaks, in terms of the type of MWF utilized, degree of microbial contamination, or levels of personal exposure. Six studies were identified that found workers with MWF exposure during outbreaks were more likely to report respiratory or systemic symptoms than unexposed control workers. Six case-control analyses were also identified that found workers with extrinsic allergic alveolitis (EAA) were more likely to demonstrate certain immune responses to microbial contaminants and/or used MWFs than workers without EAA. Conclusion Despite a number of detailed workplace and immunological studies of asthma and alveolitis outbreaks in MWF-exposed workforces, our understanding of their aetiology remains limited.

Nanoparticle penetration through filter media and leakage through face seal interface of N95 filtering facepiece respirators.

Abstract: National Institute for Occupational Safety and Health recommends the use of particulate respirators for protection against nanoparticles (<100 nm size). Protection afforded by a filtering facepiece particulate respirator is a function of the filter efficiency and the leakage through the face-to-facepiece seal. The combination of particle penetration through filter media and particle leakage through face seal and any component interfaces is considered as total inward leakage (TIL). Although the mechanisms and extent of nanoparticle penetration through filter media have been well documented, information concerning nanoparticle leakage through face seal is lacking. A previous study in our laboratory measured filter penetration and TIL for specific size particles. The results showed higher filter penetration and TIL for 50 nm size particles, i.e. the most penetrating particle size (MPPS) than for 8 and 400 nm size particles. To better understand the significance of particle penetration through filter media and through face seal leakage, this study was expanded to measure filter penetration at sealed condition and TIL with artificially introduced leaks for 20-800 nm particles at 8-40 l minute volumes for four N95 models of filtering facepiece respirators (FFRs) using a breathing manikin. Results showed that the MPPS was ~45 nm for all four respirator models. Filter penetration for 45 nm size particles was significantly (P < 0.05) higher than the values for 400 nm size particles. A consistent increase in filter penetrations for 45 and 400 nm size particles was obtained with increasing breathing minute volumes. Artificial leakage of test aerosols (mode size ~75 nm) through increasing size holes near the sealing area of FFRs showed higher TIL values for 45 nm size particles at different minute volumes, indicating that the induced leakage allows the test aerosols, regardless of particle size, inside the FFR, while filter penetration determines the TIL for different size particles. TIL values obtained for 45 nm size particles were significantly (P < 0.05) higher than the values obtained for 400 nm size particles for all four models. Models with relatively small filter penetration values showed lower TIL values than the models with higher filter penetrations at smaller leak sizes indicating the dependence of TIL values on filter penetration. When the electrostatic charge was removed, the FFRs showed a shift in the MPPS to ~150 nm with the same test aerosols (mode size ~75 nm) at different hole sizes and breathing minute volumes, confirming the interaction between filter penetration and face seal leakage processes. The shift in the MPPS from 45 to 150 nm for the charge removed filters indicates that mechanical filters may perform better against nanoparticles than electrostatic filters rated for the same filter efficiency. The results suggest that among the different size particles that enter inside the N95 respirators, relatively high concentration of the MPPS particles in the breathing zone of respirators can be expected in workplaces with high concentration of nanoparticles. Overall, the data obtained in the study suggest that good fitting respirators with lower filter penetration values would provide better protection against nanoparticles.

Measurement of Hearing Protection Devices Performance in the Workplace during Full-Shift Working Operations

Abstract: Objectives: The effectiveness of hearing protection devices (HPDs), when used in workplace conditions, has been shown over the years to be usually lower than the labeled values obtained under well-controlled laboratory conditions. Causes for such discrepancies have been listed and discussed by many authors. This study is an attempt to understand the issues in greater details and quantify some of these factors by looking at the performance of hearing protectors as a function of time during full work shift conditions. Methods: A non-invasive field microphone in the real ear (F-MIRE)-based method has been developed for measuring the effectiveness of different HPDs as a function of time in the workplace. Details of the test procedures, the equipment used, and the post-processing operations are presented and discussed. The methodology was developed in such a way that a complete time and frequency representation are possible. The system was used on a total of 24 workers in eight different companies. Work shifts of up to 9-h long were recorded. Various types of earmuffs and one type of molded earplugs were tested. Results: Attenuation data reported as a function of time showed, for most workers tested, considerable fluctuations over entire work shift periods. Parts of these fluctuations are attributed to variations in the low-frequency content in the noise (in particular for earmuffs) as well as poor insertion and/or fitting of earplugs. Lower performances than laboratory-based ones were once again observed for most cases tested but also, important left and right ear differences were obtained for many individuals. When reported as a function of frequency, the attenuation results suggested that the few approximations used to relate the measurements to subjective real-ear-attenuation-at-threshold (REAT) data were realistic. Conclusions: The use of individualized attenuation data and performance ratings for HPDs as well as a good knowledge of the ambient noise in the workplace are key ingredients when evaluating the performance of hearing protectors in field conditions.

Associations between the Occupational Stress Index and Hypertension, Type 2 Diabetes Mellitus, and Lipid Disorders in Middle-Aged Men and Women

Abstract: Introduction: Retrospective and prospective studies show that stress at work is linked to an increased risk of hypertension, diabetes mellitus, and coronary heart disease. However, the nature of the contributory job stressors and biological mechanisms need further elucidation. Objectives: The study is aimed to determine the associations between aspects of the occupational stress index (OSI) and arterial hypertension, diabetes mellitus (DM) type 2, and lipid disorders in working middle-aged men and women. Methods: The cross-sectional study involved 989 middle-aged men and women in different occupations. The OSI was calculated by using standardized questionnaires. The total participation rate was 93%. Occupational stressors were divided into seven groups: High Demands, Strictness, Underload, Extrinsic Time Pressure, Noxious Exposure, Avoidance, and Conflict/ Uncertainty. Serum lipid levels, glucoregulation, blood pressure, and cardiovascular risk factors were measured. Results: For both women and men, the total OSI score associated significantly with DM (women: odds ratio [OR] 2.4, 95% confidence intervals [CI] 1.67–3.45; men: 1.21, 1.15–1.45), any type of dyslipidemia (women: 1.54, 1.17–2.03; men: 1.31, 1.24–1.39), and arterial hypertension (women: 1.15, 1.10–1.21; men: 1.58, 1.49–1.68). The group as a whole showed associations between total OSI and low high-density lipoprotein (HDL) cholesterol, high total cholesterol, and high triglyceride levels. Of the OSI aspects, Underload associated significantly in both men and women with arterial hypertension (women: 3.48, 1.91–6.31; men: 2.71, 1.96–3.75) and dyslipidemia (women: 3.26, 2.13–4.99; men: 2.11, 1.76–2.52). Underload was also associated with several lipid abnormalities in the group as a whole. It associated with DM in women only (4.7, 2.84–7.81). All remaining OSI aspects also associated significantly and positively with DM in women only. Conversely, in male workers, but not female workers, High Demand, Conflict/ Uncertainty, and Extrinsic Time Pressure associated significantly with arterial hypertension. Strictness and Conflict/Uncertainty associated positively with dyslipidemia in women only. Noxious Exposures associated positively with DM and arterial hypertension in women only. Conclusions: The study provides evidence for the association of work stress with metabolic disorders and hypertension. Total OSI associated significantly with DM type 2, arterial hypertension, and dyslipidemia in both genders. Different OSI aspects associated with these health issues in gender- and occupational-specific patterns. Underload, which represents lack of social communication, simple task preparation, and underestimation of working results, associated most strongly of all OSI aspects with disease in both the sexes.

Combining a Job-Exposure Matrix with Exposure Measurements to Assess Occupational Exposure to Benzene in a Population Cohort in Shanghai, China

Abstract: Background: Generic job-exposure matrices (JEMs) are often used in population-based epidemiologic studies to assess occupational risk factors when only the job and industry information of each subject is available. JEM ratings are often based on professional judgment, are usually ordinal or semi-quantitative, and often do not account for changes in exposure over time. We present an empirical Bayesian framework that combines ordinal subjective JEM ratings with benzene measurements. Our aim was to better discriminate between job, industry, and time differences in exposure levels compared to using a JEM alone. Methods: We combined 63 221 short-term area air measurements of benzene exposure (1954– 2000) collected during routine health and safety inspections in Shanghai, China, with independently developed JEM intensity ratings for each job and industry using a mixed-effects model. The fixed-effects terms included the JEM intensity ratings for job and industry (both ordinal, 0–3) and a time trend that we incorporated as a b-spline. The random-effects terms included job (n 5 33) and industry nested within job (n 5 399). We predicted the benzene concentration in two ways: (i) a calibrated JEM estimate was calculated using the fixed-effects model parameters for calendar year and JEM intensity ratings; (ii) a job-/industry-specific estimate was calculated using the fixed-effects model parameters and the best linear unbiased predictors from the random effects for job and industry using an empirical Bayes estimation procedure. Finally, we applied the predicted benzene exposures to a prospective population-based cohort of women in Shanghai, China (n 5 74 942). Results: Exposure levels were 13 times higher in 1965 than in 2000 and declined at a rate that varied from 4 to 15% per year from 1965 to 1985, followed by a small peak in the mid-1990s. The job-/industry-specific estimates had greater differences between exposure levels than the calibrated JEM estimates (97.5th percentile/2.5th percentile exposure level, BGR95B: 20.4 versus 3.0, respectively). The calibrated JEM and job-/industry-specific estimates were moderately correlated in any given year (Pearson correlation, rp 5 0.58). We classified only those jobs and

Thermal burden of N95 filtering facepiece respirators.

Abstract: Increased thermal perceptions that affect comfort are a leading reason for intolerance to wearing respiratory protective equipment. Despite their popularity and use for decades, relatively little is known about the thermal burden imposed by the use of N95 filtering facepiece respirators (FFR) at normal work rates. Twenty healthy subjects exercised at a low-moderate work rate for 1 and 2 h while wearing four models of N95 FFR (two with an exhalation valve) as core and skin temperatures were monitored wirelessly. N95 FFR use resulted in non-significant minimal increases in core temperature and uncovered facial skin (cheek) temperatures. Facial skin temperature under the FFR was significantly increased over baseline values (P < 0.001). Wearing N95 FFR for up to 2 h at a low-moderate work rate does not impose a significant thermal burden on core temperature and uncovered facial skin temperature but significantly increases the temperature of the facial skin that is covered by the FFR. Perceptions of increased body heat when wearing N95 FFR under the test conditions are likely not due to effects on core temperature but may relate more to warming of the facial skin covered by the respirator and warming of the inspired air.

Evaluation of filter media for particle number, surface area and mass penetrations.

Abstract: The National Institute for Occupational Safety and Health (NIOSH) developed a standard for respirator certification under 42 CFR Part 84, using a TSI 8130 automated filter tester with photometers. A recent study showed that photometric detection methods may not be sensitive for measuring engineered nanoparticles. Present NIOSH standards for penetration measurement are mass-based; however, the threshold limit value/permissible exposure limit for an engineered nanoparticle worker exposure is not yet clear. There is lack of standardized filter test development for engineered nanoparticles, and development of a simple nanoparticle filter test is indicated. To better understand the filter performance against engineered nanoparticles and correlations among different tests, initial penetration levels of one fiberglass and two electret filter media were measured using a series of polydisperse and monodisperse aerosol test methods at two different laboratories (University of Minnesota Particle Technology Laboratory and 3M Company). Monodisperse aerosol penetrations were measured by a TSI 8160 using NaCl particles from 20 to 300 nm. Particle penetration curves and overall penetrations were measured by scanning mobility particle sizer (SMPS), condensation particle counter (CPC), nanoparticle surface area monitor (NSAM), and TSI 8130 at two face velocities and three layer thicknesses. Results showed that reproducible, comparable filtration data were achieved between two laboratories, with proper control of test conditions and calibration procedures. For particle penetration curves, the experimental results of monodisperse testing agreed well with polydisperse SMPS measurements. The most penetrating particle sizes (MPPSs) of electret and fiberglass filter media were ~50 and 160 nm, respectively. For overall penetrations, the CPC and NSAM results of polydisperse aerosols were close to the penetration at the corresponding median particle sizes. For each filter type, power-law correlations between the penetrations measured by different instruments show that the NIOSH TSI 8130 test may be used to predict penetrations at the MPPS as well as the CPC and NSAM results with polydisperse aerosols. It is recommended to use dry air (<20% RH) as makeup air in the test system to prevent sodium chloride particle deliquescing and minimizing the challenge particle dielectric constant and to use an adequate neutralizer to fully neutralize the polydisperse challenge aerosol. For a simple nanoparticle penetration test, it is recommended to use a polydisperse aerosol challenge with a geometric mean of ~50 nm with the CPC or the NSAM as detectors.

Does Daily Exposure to Whole-Body Vibration and Mechanical Shock Relate to the Prevalence of Low Back and Neck Pain in a Rural Workforce?

Abstract: OBJECTIVES: To determine whether whole-body vibration (WBV) and mechanical shock exposure from quad bike use are associated with the prevalence of neck and low back pain (LBP) in New Zealand farmer ...

Local Exhaust Ventilation for the Control of Welding Fumes in the Construction Industry—A Literature Review

Abstract: Arc welding is a common unit operation in the construction industry, where frequent changes in location and welding position make it more difficult to control fume exposures than in industries where fixed locations are the norm. Welders may be exposed to a variety of toxic airborne contaminants including manganese (Mn) and hexavalent chromium (CrVI). Local exhaust ventilation (LEV) is a well-known engineering control for welding fumes but has not been adopted widely in the construction industry. This literature review presents data on the performance of a variety of LEV systems for welding fume control from the construction (five references), shipyard (five references), and other industries. The studies indicate that LEV can reduce fume exposures to total particulate, Mn, and CrVI to levels below currently relevant standards. Field studies suggest that 40-50% or more reduction in exposure is possible with portable or fixed LEV systems relative to natural ventilation but that correct positioning of the hood and adequate exhaust flow rates are essential. Successful implementation of extraction guns for gas metal arc welding (GMAW) and flux core arc welding has been demonstrated, indicating that a successful balance between extraction airflow and shielding gas requirements is possible. Work practices are an important part of achieving successful control of fume exposures; in particular, positioning the hood close to the arc, checking exhaust flow rates, and avoiding the plume. Further research is needed on hood size effects for controlling welding fume with portable LEV systems and identifying and overcoming barriers to LEV use in construction.

Lethal carbon monoxide poisoning in wood pellet storerooms--two cases and a review of the literature

Abstract: The installation of wood pellet heating as a cost-effective and climatically neutral source of energy for private households has increased steadily in recent years. We report two deaths that occurred within the space of about a year in wood pellet storerooms of private households in German-speaking countries and were investigated by forensic medical teams. This is the first report of fatalities in this special context as is shown in the literature review. Both victims died of carbon monoxide (CO) poisoning; one of the victims was a woman who was 4 months pregnant. Measurements at the scene detected life-threatening CO concentrations (7500 ppm, >500 ppm), which were not significantly reduced after ventilation of the storerooms as required by regulations. We carried out a series of experiments in order to confirm CO production by wood pellets. Thirty kilograms of freshly produced pellets from two different manufacturers were stored for 16 days in airtight containers at 26°C with different relative humidities. CO concentrations between 3100 and 4700 ppm were measured in all containers. There were no notable differences between the wood pellet products or storage at different humidities. Emission of CO from wood pellets has already been described, but fatal accidents have previously been reported only in association with pellet transport on cargo ships or storage in silos. It is therefore a new finding that fatal accidents may also occur in the wood pellet storerooms of private households. We show that significant CO concentrations can build up even when these rooms are ventilated in accordance with the regulations and that such levels may cause the death of healthy persons, as described in the following. As the safety recommendations from the wood pellet industry are inadequate, we consider that further fatal accidents are likely to occur and recommend urgent revision of the safety regulations.

Development of an exposure measurement database on five lung carcinogens (ExpoSYN) for quantitative retrospective occupational exposure assessment.

Abstract: BACKGROUND SYNERGY is a large pooled analysis of case-control studies on the joint effects of occupational carcinogens and smoking in the development of lung cancer. A quantitative job-exposure matrix (JEM) will be developed to assign exposures to five major lung carcinogens [asbestos, chromium, nickel, polycyclic aromatic hydrocarbons (PAH), and respirable crystalline silica (RCS)]. We assembled an exposure database, called ExpoSYN, to enable such a quantitative exposure assessment. METHODS Existing exposure databases were identified and European and Canadian research institutes were approached to identify pertinent exposure measurement data. Results of individual air measurements were entered anonymized according to a standardized protocol. RESULTS The ExpoSYN database currently includes 356 551 measurements from 19 countries. In total, 140 666 personal and 215 885 stationary data points were available. Measurements were distributed over the five agents as follows: RCS (42%), asbestos (20%), chromium (16%), nickel (15%), and PAH (7%). The measurement data cover the time period from 1951 to present. However, only a small portion of measurements (1.4%) were performed prior to 1975. The major contributing countries for personal measurements were Germany (32%), UK (22%), France (14%), and Norway and Canada (both 11%). CONCLUSIONS ExpoSYN is a unique occupational exposure database with measurements from 18 European countries and Canada covering a time period of >50 years. This database will be used to develop a country-, job-, and time period-specific quantitative JEM. This JEM will enable data-driven quantitative exposure assessment in a multinational pooled analysis of community-based lung cancer case-control studies.

Predictors of airborne exposures to polycyclic aromatic compounds and total organic matter among hot-mix asphalt paving workers and influence of work conditions and practices.

Abstract: Objectives: We evaluated personal airborne exposures to polycyclic aromatic compounds (PACs) and total organic matter (TOM) among hot-mix asphalt (HMA) paving workers. The primary objectives of this study were to identify predictors of airborne PAC exposures, identify PAC exposure sources, and characterize how work practices may affect personal airborne exposure to PACs. Methods: Four workers were recruited from each of three asphalt paving crews (12 workers) and were monitored for three consecutive days over 4 weeks for a total of 12 sampling days per worker (144 worker-days). Three sampling weeks were conducted while maintaining standard working conditions with regard to airborne exposures. The fourth week included the substitution of biodiesel for diesel oil used to clean tools and equipment. Linear mixed-effects models were used to evaluate predictors of airborne exposures including weather parameters (air temperature, wind speed, and relative humidity), worksite conditions (HMA application temperature, work rate, asphalt grade, and biodiesel use), and personal factors (minutes sampled, minutes of downtime, and smoking status). Results: Concentrations of the 33 individual PACs measured in personal air samples were generally below detection limits under all conditions with the exception of fluorene [geometric mean (GM) 5 65 ng m 23 ], naphthalene (GM 5 833 ng m 23 ), phenanthrene (GM 5 385 ng m 23 ), and pyrene (GM 5 57 ng m 23 ). The summary measures of TOM (GM 5 864 m gm 23 ) and four- to six-ring PAC (GM 5 0.13 m gm 23 ) were detected in the majority of air samples. Although task was not a predictor of airborne exposures, job site characteristics such as HMA application temperature were found to significantly (P £ 0.001) affect summary and individual PAC exposures. Based on the results of multivariate linear mixed-effects models, substituting biodiesel for diesel oil as a cleaning agent was associated with significant (P £ 0.01) reductions in TOM, four- to six-ring PACs, and naphthalene and pyrene concentrations that ranged from 31 to 56%. Using multivariate linear mixed-effects models under standard conditions, reducing the application temperature of HMA from 149C (300F) to 127C (260F) could be expected to reduce airborne exposures by 42‐82%, varying by analyte.

Factors affecting vegetable growers' exposure to fungal bioaerosols and airborne dust

Abstract: We have quantified vegetable growers’ exposure to fungal bioaerosol components including (1/3)-b-d-glucan (b-glucan), total fungal spores, and culturable fungal units. Furthermore, we have evaluated factors that might affect vegetable growers’ exposure to fungal bioaerosols and airborne dust. Investigated environments included greenhouses producing cucumbers and tomatoes, open fields producing cabbage, broccoli, and celery, and packing facilities. Measurements were performed at different times during the growth season and during execution of different work tasks. Bioaerosols were collected with personal and stationary filter samplers. Selected fungal species (Beauveria spp., Trichoderma spp., Penicillium olsonii, and Penicillium brevicompactum) were identified using different polymerase chain reaction-based methods and sequencing. We found that the factors (i) work task, (ii) crop, including growth stage of handled plant material, and (iii) open field versus greenhouse significantly affected the workers’ exposure to bioaerosols. Packing of vegetables and working in open fields caused significantly lower exposure to bioaerosols, e.g. mesophilic fungi and dust, than harvesting in greenhouses and clearing of senescent greenhouse plants. Also removing strings in cucumber greenhouses caused a lower exposure to bioaerosols than harvest of cucumbers while removal of old plants caused the highest exposure. In general, the exposure was higher in greenhouses than in open fields. The exposures to b-glucan during harvest and clearing of senescent greenhouse plants were very high (median values ranging between 50 and 1500 ng m 23 ) compared to exposures reported from other occupational environments. In conclusion, vegetable growers’ exposure to bioaerosols was related to the environment, in which they worked, the investigated work tasks, and the vegetable crop.

Organic dust toxic syndrome at a grass seed plant caused by exposure to high concentrations of bioaerosols

Abstract: We describe an outbreak of sudden health problems in workers at a Danish grass seed plant after exposure to a particularly dusty lot of grass seeds. The seeds are called problematic seeds. The association between development of organic dust toxic syndrome (ODTS) and the handling of grass seeds causing exposure was assessed in a four-step model: (i) identification of exposure source, (ii) characterization of the emission of bioaerosols from the problematic and reference seeds, (iii) personal and stationary exposure measurement at the plant and (iv) repeated health examinations. The grass seeds were identified as the exposure source; the emissions of some bioaerosol components were up to 107 times higher from the problematic seeds than from reference seeds. Cleaning of the seeds was not enough to sufficiently reduce the high emission from the problematic seeds. Emission in terms of dust was 3.4 times as high from the problematic cleaned seeds as from cleaned reference seeds. The personal exposure reached 3 × 105 endotoxin units m−3, 1 × 106 colony-forming units (cfu) of thermophilic actinomycetes m−3, 8 × 105 cfu of Aspergillus fumigatus m−3 and 9 × 106 hyphal fragments m−3. Several workers working with the problematic seeds had symptoms consistent with ODTS. The most severe symptoms were found for the workers performing the tasks causing highest exposure. Respiratory airway protection proved efficient to avoid development of ODTS. Work with reference seeds did not cause workers to develop ODTS. Exposure was during work with the problematic seeds higher than suggested occupational exposure limits but lower than in studies where researchers for some minutes have repeated a single task expected to cause ODTS. In this study, many different bioaerosol components were measured during a whole working day. We cannot know, whether it is the combination of different bioaerosol components or a single component which is responsible for the development of ODTS. In conclusion, workers developed specific health symptoms due to the high bioaerosol exposure and were diagnosed with ODTS. Exposure to high concentrations of endotoxin, actinomycetes, fungi, hyphal fragments, β-glucan, and A. fumigatus occurred when working with a dusty lot of grass seed. Suspicion should be elicited by seeds stored without being properly dried and by seeds producing more dust than usually.

Asbestos Fibre Burden in the Lungs of Patients with Mesothelioma Who Lived Near Asbestos-Cement Factories

Abstract: Background Epidemics of malignant mesothelioma are occurring among inhabitants of Casale Monferrato and Bari never employed in the local asbestos-cement (AC) factories. The mesothelioma risk increased with proximity of residence to both plants. Objectives To provide information on the intensity of environmental asbestos exposure, in the general population living around these factories, through the evaluation of the lung fibre burden in mesothelioma patients. Methods We analysed by a scanning electron microscope equipped with X-ray microanalysis wet (formalin-fixed) lung tissue samples from eight mesothelioma patients who lived in Casale Monferrato or Bari and underwent surgery. Their occupational and residential history was obtained during face-to-face interviews. Semi-quantitative and quantitative indices of cumulative environmental exposure to asbestos were computed, based on residential distance from the AC plants and duration of stay. Results The lung fibre burden ranged from 110 000 to 4 300 000 fibres per gram of dry lung (f/g) and was >1 000 000 f/g in three subjects. In four cases, only amphibole fibres were detected. Environmental exposures had ceased at least 10 years before samples were taken. No patient had other definite or probable asbestos exposures. A linear relationship was observed between the lung fibre burden and all three indices of environmental cumulative exposure to asbestos. Conclusions Environmental exposure to a mixture of asbestos fibres may lead to a high lung fibre burden of amphiboles years after exposure cessation. The epidemiological evidence of an increased mesothelioma risk for the general population of Casale Monferrato and Bari, associated with asbestos contamination of the living environment, is corroborated.

Reaerosolization of MS2 Bacteriophage from an N95 Filtering Facepiece Respirator by Simulated Coughing

Abstract: The supply of N95 filtering facepiece respirators (FFRs) may not be adequate to match demand during a pandemic outbreak. One possible strategy to maintain supplies in healthcare settings is to extend FFR use for multiple patient encounters; however, contaminated FFRs may serve as a source for the airborne transmission of virus particles. In this study, reaerosolization of virus particles from contaminated FFRs was examined using bacteriophage MS2 as a surrogate for airborne pathogenic viruses. MS2 was applied to FFRs as droplets or droplet nuclei. A simulated cough (370 l min(-1) peak flow) provided reverse airflow through the contaminated FFR. The number and size of the reaerosolized particles were measured using gelatin filters and an Andersen Cascade Impactor (ACI). Two droplet nuclei challenges produced higher percentages of reaerosolized particles (0.21 and 0.08%) than a droplet challenge (<0.0001%). Overall, the ACI-determined size distribution of the reaerosolized particles was larger than the characterized loading virus aerosol. This study demonstrates that only a small percentage of viable MS2 viruses was reaerosolized from FFRs by reverse airflow under the conditions evaluated, suggesting that the risks of exposure due to reaerosolization associated with extended use can be considered negligible for most respiratory viruses. However, risk assessments should be updated as new viruses emerge and better workplace exposure data becomes available.

The influence of ergonomic devices on mechanical load during patient handling activities in nursing homes

Abstract: OBJECTIVES: Mechanical load during patient handling activities is an important risk factor for low back pain among nursing personnel. The aims of this study were to describe required and actual use of ergonomic devices during patient handling activities and to assess the influence of these ergonomic devices on mechanical load during patient handling activities. METHODS: For each patient, based on national guidelines, it was recorded which specific ergonomic devices were required during distinct patient handling activities, defined by transferring a patient, providing personal care, repositioning patients in the bed, and putting on and taking off anti-embolism stockings. During real-time observations over ~60 h among 186 nurses on 735 separate patient handling activities in 17 nursing homes, it was established whether ergonomic devices were actually used. Mechanical load was assessed through observations of frequency and duration of a flexed or rotated trunk >30° and frequency of pushing, pulling, lifting or carrying requiring forces 230 N from start to end of each separate patient handling activity. The number of patients and nurses per ward and the ratio of nurses per patient were used as ward characteristics with potential influence on mechanical load. A mixed-effect model for repeated measurements was used to determine the influence of ergonomic devices and ward characteristics on mechanical load. RESULTS: Use of ergonomic devices was required according to national guidelines in 520 of 735 (71%) separate patient handling activities, and actual use was observed in 357 of 520 (69%) patient handling activities. A favourable ratio of nurses per patient was associated with a decreased duration of time spent in awkward back postures during handling anti-embolism stocking (43%), patient transfers (33%), and personal care of patients (24%) and also frequency of manually lifting patients (33%). Use of lifting devices was associated with a lower frequency of forces exerted (64%), adjustable bed and shower chairs with a shorter duration of awkward back postures (38%), and an anti-embolism stockings slide with a lower frequency of forces exerted (95%). CONCLUSIONS: In wards in nursing homes with a higher number of staff less awkward back postures as well as forceful lifting were observed during patient handling activities. The use of ergonomic devices was high and associated with less forceful movements and awkward back postures. Both aspects will most likely contribute to the prevention of low back pain among nurses.