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Kobos L, Anderson K, Kurth L, Liang X, Groth CP, England L, Laney AS, Virji MA. Characterization of Cleaning and Disinfection Product Use, Glove Use, and Skin Disorders by Healthcare Occupations in a Midwestern Healthcare Facility. Buildings (Basel) 2022; 12:10.3390/buildings12122216. [PMID: 38650891 PMCID: PMC11034745 DOI: 10.3390/buildings12122216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Healthcare facility staff use a wide variety of cleaning and disinfecting products during their daily operations, many of which are associated with respiratory or skin irritation or sensitization with repeated exposure. The objective of this study was to characterize the prevalence of cleaning and disinfection product use, glove use during cleaning and disinfection, and skin/allergy symptoms by occupation and identify the factors influencing glove use among the healthcare facility staff. A questionnaire was administered to the current employees at a midwestern Veterans Affairs healthcare facility that elicited information on cleaning and disinfection product use, glove use during cleaning and disinfection, skin/allergy symptoms, and other demographic characteristics, which were summarized by occupation. The central supply/environmental service workers (2% of the total survey population), nurses (26%,), nurse assistants (3%), and laboratory technicians (5%) had the highest prevalence of using cleaning or disinfecting products, specifically quaternary ammonium compounds, bleach, and alcohol. Glove use while using products was common in both patient care and non-patient care occupations. The factors associated with glove use included using bleach or quaternary ammonium compounds and using cleaning products 2-3 or 4-5 days per week. A high frequency of glove use (≥75%) was reported by workers in most occupations when using quaternary ammonium compounds or bleach. The use of alcohol, bleach, and quaternary ammonium compounds was associated with skin disorders (p < 0.05). These research findings indicate that although the workers from most occupations report a high frequency of glove use when using cleaning and disinfection products, there is room for improvement, especially among administrative, maintenance, and nursing workers. These groups may represent populations which could benefit from the implementation of workplace interventions and further training regarding the use of personal protective equipment and the potential health hazards of exposure to cleaning and disinfecting chemicals.
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Affiliation(s)
- Lisa Kobos
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - Kim Anderson
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - Laura Kurth
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - Xiaoming Liang
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - Caroline P. Groth
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV 26505, USA
| | - Lucy England
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - A. Scott Laney
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - M. Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
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Bowers LN, Stefaniak AB, Knepp AK, LeBouf RF, Martin SB, Ranpara AC, Burns DA, Virji MA. Potential for Exposure to Particles and Gases throughout Vat Photopolymerization Additive Manufacturing Processes. Buildings (Basel) 2022; 12:10.3390/buildings12081222. [PMID: 37961074 PMCID: PMC10641710 DOI: 10.3390/buildings12081222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Vat photopolymerization (VP), a type of additive manufacturing process that cures resin to build objects, can emit potentially hazardous particles and gases. We evaluated two VP technologies, stereolithography (SLA) and digital light processing (DLP), in three separate environmental chambers to understand task-based impacts on indoor air quality. Airborne particles, total volatile organic compounds (TVOCs), and/or specific volatile organic compounds (VOCs) were monitored during each task to evaluate their exposure potential. Regardless of duration, all tasks released particles and organic gases, though concentrations varied between SLA and DLP processes and among tasks. Maximum particle concentrations reached 1200 #/cm3 and some aerosols contained potentially hazardous elements such as barium, chromium, and manganese. TVOC concentrations were highest for the isopropyl alcohol (IPA) rinsing, soaking, and drying post-processing tasks (up to 36.8 mg/m3), lowest for the resin pouring pre-printing, printing, and resin recovery post-printing tasks (up to 0.1 mg/m3), and intermediate for the curing post-processing task (up to 3 mg/m3). Individual VOCs included, among others, the potential occupational carcinogen acetaldehyde and the immune sensitizer 2-hydroxypropyl methacrylate (pouring, printing, recovery, and curing tasks). Careful consideration of all tasks is important for the development of strategies to minimize indoor air pollution and exposure potential from VP processes.
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Affiliation(s)
- Lauren N. Bowers
- National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | | | - Alycia K. Knepp
- National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - Ryan F. LeBouf
- National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - Stephen B. Martin
- National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - Anand C. Ranpara
- National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - Dru A. Burns
- National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - M. Abbas Virji
- National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
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Harvey RR, Virji MA, Blackley BH, Stanton ML, Trapnell BC, Carey B, Healey T, Cummings KJ. Two-year follow-up of exposure, engineering controls, respiratory protection and respiratory health among workers at an indium-tin oxide (ITO) production and reclamation facility. Occup Environ Med 2022; 79:550-556. [PMID: 35414568 PMCID: PMC10823493 DOI: 10.1136/oemed-2021-107897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 03/23/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To determine whether engineering controls and respiratory protection had measurable short-term impact on indium exposure and respiratory health among current indium-tin oxide production and reclamation facility workers. METHODS We documented engineering controls implemented following our 2012 evaluation and recorded respirator use in 2012 and 2014. We measured respirable indium (Inresp) and plasma indium (InP) in 2012 and 2014, and calculated change in Inresp (∆Inresp) and InP (∆InP) by the 13 departments. We assessed symptoms, lung function, serum biomarkers of interstitial lung disease (Krebs von den Lungen (KL)-6 and surfactant protein (SP)-D) and chest high-resolution CT at both time points and evaluated workers who participated in both 2012 and 2014 for changes in health outcomes (new, worsened or improved). RESULTS Engineering controls included installation of local exhaust ventilation in both grinding departments (Rotary and Planar) and isolation of the Reclaim department. Respiratory protection increased in most (77%) departments. ∆InP and ∆Inresp often changed in parallel by department. Among 62 workers participating in both 2012 and 2014, 18 (29%) had new or worsening chest symptoms and 2 (3%) had functional decline in lung function or radiographic progression, but average KL-6 and SP-D concentrations decreased, and no cases of clinical indium lung disease were recognised. CONCLUSIONS Increased engineering controls and respiratory protection can lead to decreased Inresp, InP and biomarkers of interstitial lung disease among workers in 2 years. Ongoing medical monitoring of indium-exposed workers to confirm the longer-term effectiveness of preventive measures is warranted.
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Affiliation(s)
- R Reid Harvey
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - M Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Brie H Blackley
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Marcia L Stanton
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Bruce C Trapnell
- Translational Pulmonary Science Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Brenna Carey
- Translational Pulmonary Science Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Terrance Healey
- Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Kristin J Cummings
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
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Bowers LN, Ranpara AC, Roach KA, Knepp AK, Arnold ED, Stefaniak AB, Virji MA. Comparison of product safety data sheet ingredient lists with skin irritants and sensitizers present in a convenience sample of light-curing resins used in additive manufacturing. Regul Toxicol Pharmacol 2022; 133:105198. [PMID: 35659913 PMCID: PMC9351547 DOI: 10.1016/j.yrtph.2022.105198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 11/25/2022]
Abstract
Material jetting and vat photopolymerization additive manufacturing (AM) processes use liquid resins to build objects. These resins can contain skin irritants and/or sensitizers but product safety data sheets (SDSs) might not declare all ingredients. We characterized elemental and organic skin irritants and sensitizers present in 39 commercial products; evaluated the influence of resin manufacturer, system, color, and AM process type on the presence of irritants and sensitizers; and compared product SDSs to results. Among all products, analyses identified 23 irritant elements, 54 irritant organic substances, 22 sensitizing elements, and 23 sensitizing organic substances; SDSs listed 3, 9, 4, and 6 of these ingredients, respectively. Per product, the number and total mass (an indicator of potential dermal loading) of ingredients varied: five to 17 irritant elements (8.32-4756.65 mg/kg), one to 17 irritant organics (3273 to 356,000 mg/kg), four to 17 sensitizing elements (8.27-4755.63 mg/kg), and one to seven sensitizing organics (15-382,170 mg/kg). Median numbers and concentrations of irritants and sensitizers were significantly influenced by resin system and AM process type. The presence of undeclared irritants and sensitizers in these resins supports the need for more complete information on product SDSs for comprehensive dermal risk assessments.
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Affiliation(s)
- Lauren N Bowers
- National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV, 26505, USA
| | - Anand C Ranpara
- National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV, 26505, USA
| | - Katherine A Roach
- National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV, 26505, USA
| | - Alycia K Knepp
- National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV, 26505, USA
| | - Elizabeth D Arnold
- National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV, 26505, USA
| | - Aleksandr B Stefaniak
- National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV, 26505, USA.
| | - M Abbas Virji
- National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV, 26505, USA
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Blackley BH, Anderson KR, Panagakos F, Chipps T, Virji MA. Efficacy of dental evacuation systems for aerosol exposure mitigation in dental clinic settings. J Occup Environ Hyg 2022; 19:281-294. [PMID: 35289720 PMCID: PMC9365099 DOI: 10.1080/15459624.2022.2053140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Dental personnel are ranked among the highest risk occupations for exposure to SARS-CoV-2 due to their close proximity to the patient's mouth and many aerosol generating procedures encountered in dental practice. One method to reduce aerosols in dental settings is the use of intraoral evacuation systems. Intraoral evacuation systems are placed directly into a patient's mouth and maintain a dry field during procedures by capturing liquid and aerosols. Although multiple intraoral dental evacuation systems are commercially available, the efficacy of these systems is not well understood. The objectives of this study were to evaluate the efficacy of four dental evacuation systems at mitigating aerosol exposures during simulated ultrasonic scaling and crown preparation procedures. We conducted real-time respirable (PM4) and thoracic (PM10) aerosol sampling during ultrasonic scaling and crown preparation procedures while using four commercially available evacuation systems: a high-volume evacuator (HVE) and three alternative intraoral systems (A, B, C). Four trials were conducted for each system. Respirable and thoracic mass concentrations were measured during procedures at three locations including (1) near the breathing zone (BZ) of the dentist, (2) edge of the dental operatory room approximately 0.9 m away from the mannequin mouth, and (3) hallway supply cabinet located approximately 1.5 m away from the mannequin mouth. Respirable and thoracic mass concentrations measured during each procedure were compared with background concentrations measured in each respective location. Use of System A or HVE reduced thoracic (System A) and respirable (HVE) mass concentrations near the dentist's BZ to median background concentrations most often during the ultrasonic scaling procedure. During the crown preparation, use of System B or HVE reduced thoracic (System B) and respirable (HVE or System B) near the dentist's BZ to median background concentrations most often. Although some differences in efficacy were noted during each procedure and aerosol size fraction, the difference in median mass concentrations among evacuation systems was minimal, ranging from 0.01 to 1.48 µg/m3 across both procedures and aerosol size fractions.
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Affiliation(s)
- Brie Hawley Blackley
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Kimberly R. Anderson
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Fotinos Panagakos
- School of Dentistry, West Virginia University, Morgantown, West Virginia
| | - Tammy Chipps
- School of Dentistry, West Virginia University, Morgantown, West Virginia
| | - M. Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
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Crooks J, Mroz MM, VanDyke M, McGrath A, Schuler C, McCanlies EC, Virji MA, Rosenman KD, Rossman M, Rice C, Monos D, Fingerlin TE, Maier LA. HLA-DPB1 E69 genotype and exposure in beryllium sensitisation and disease. Occup Environ Med 2022; 79:120-126. [PMID: 34535537 PMCID: PMC8760148 DOI: 10.1136/oemed-2021-107736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/09/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Human leukocyte antigen-DP beta 1 (HLA-DPB1) with a glutamic acid at the 69th position of the ß chain (E69) genotype and inhalational beryllium exposure individually contribute to risk of chronic beryllium disease (CBD) and beryllium sensitisation (BeS) in exposed individuals. This retrospective nested case-control study assessed the contribution of genetics and exposure in the development of BeS and CBD. METHODS Workers with BeS (n=444), CBD (n=449) and beryllium-exposed controls (n=890) were enrolled from studies conducted at nuclear weapons and primary beryllium manufacturing facilities. Lifetime-average beryllium exposure estimates were based on workers' job questionnaires and historical and industrial hygienist exposure estimates, blinded to genotype and case status. Genotyping was performed using sequence-specific primer-PCR. Logistic regression models were developed allowing for over-dispersion, adjusting for workforce, race, sex and ethnicity. RESULTS Having no E69 alleles was associated with lower odds of both CBD and BeS; every additional E69 allele increased odds for CBD and BeS. Increasing exposure was associated with lower odds of BeS. CBD was not associated with exposure as compared to controls, yet the per cent of individuals with CBD versus BeS increased with increasing exposure. No evidence of a gene-by-exposure interaction was found for CBD or BeS. CONCLUSIONS Risk of CBD increases with E69 allele frequency and increasing exposure, although no gene by environment interaction was found. A decreased risk of BeS with increasing exposure and lack of exposure response in CBD cases may be due to the limitations of reconstructed exposure estimates. Although reducing exposure may not prevent BeS, it may reduce CBD and the associated health effects, especially in those carrying E69 alleles.
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Affiliation(s)
- James Crooks
- Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, Colorado, USA
| | - Margaret M Mroz
- Department of Medicine, National Jewish Health, Denver, Colorado, USA
| | - Michael VanDyke
- Department of Environmental & Occupational Health, Colorado School of Public Health, Aurora, Colorado, USA
| | - Alison McGrath
- Environmental Health and Safety, University of Colorado, Denver, Colorado, USA
| | - Christine Schuler
- DRDS/Field Studies Branch, U.S. National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Erin C McCanlies
- HELD, Health Effects Laboratory, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - M Abbas Virji
- DRDS/Field Studies Branch, U.S. National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Kenneth D Rosenman
- Department of Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Milton Rossman
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Carol Rice
- Department of Environmental & Public Health Sciences, University of Cincinnati, Cincinnati, Ohio, USA
| | - Dimitri Monos
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Tasha E Fingerlin
- Center for Genes, Environment & Health, National Jewish Health, Denver, Colorado, USA
| | - Lisa A Maier
- Department of Medicine, National Jewish Health, Denver, Colorado, USA
- Department of Medicine, University of Colorado, Denver, Colorado, USA
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Stefaniak AB, Bowers LN, Cottrell G, Erdem E, Knepp AK, Martin SB, Pretty J, Duling MG, Arnold ED, Wilson Z, Krider B, Fortner AR, LeBouf RF, Virji MA, Sirinterlikci A. Towards sustainable additive manufacturing: The need for awareness of particle and vapor releases during polymer recycling, making filament, and fused filament fabrication 3-D printing. Resour Conserv Recycl 2022; 176:10.1016/j.resconrec.2021.105911. [PMID: 35982992 PMCID: PMC9380603 DOI: 10.1016/j.resconrec.2021.105911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Fused filament fabrication three-dimensional (FFF 3-D) printing is thought to be environmentally sustainable; however, significant amounts of waste can be generated from this technology. One way to improve its sustainability is via distributed recycling of plastics in homes, schools, and libraries to create feedstock filament for printing. Risks from exposures incurred during recycling and reuse of plastics has not been incorporated into life cycle assessments. This study characterized contaminant releases from virgin (unextruded) and recycled plastics from filament production through FFF 3-D printing. Waste polylactic acid (PLA) and acrylonitrile butadiene styrene (ABS) plastics were recycled to create filament; virgin PLA, ABS, high and low density polyethylenes, high impact polystyrene, and polypropylene pellets were also extruded into filament. The release of particles and chemicals into school classrooms was evaluated using standard industrial hygiene methodologies. All tasks released particles that contained hazardous metals (e.g., manganese) and with size capable of depositing in the gas exchange region of the lung, i.e., granulation of waste PLA and ABS (667 to 714 nm) and filament making (608 to 711 nm) and FFF 3-D printing (616 to 731 nm) with waste and virgin plastics. All tasks released vapors, including respiratory irritants and potential carcinogens (benzene and formaldehyde), mucus membrane irritants (acetone, xylenes, ethylbenzene, and methyl methacrylate), and asthmagens (styrene, multiple carbonyl compounds). These data are useful for incorporating risks of exposure to hazardous contaminants in future life cycle evaluations to demonstrate the sustainability and circular economy potential of FFF 3-D printing in distributed spaces.
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Affiliation(s)
- Aleksandr B. Stefaniak
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, 26505, United States
- Corresponding author at: National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV, 26505, United States. (A.B. Stefaniak)
| | - Lauren N. Bowers
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, 26505, United States
| | - Gabe Cottrell
- Robert Morris University, School of Engineering, Mathematics, and Science, Moon Township, PA, 15108, United States
| | - Ergin Erdem
- Robert Morris University, School of Engineering, Mathematics, and Science, Moon Township, PA, 15108, United States
| | - Alycia K. Knepp
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, 26505, United States
| | - Stephen B. Martin
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, 26505, United States
| | - Jack Pretty
- National Institute for Occupational Safety and Health, Health Effects Laboratory Division, Cincinnati, OH, 45213, United States
| | - Matthew G. Duling
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, 26505, United States
| | - Elizabeth D. Arnold
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, 26505, United States
| | - Zachary Wilson
- Robert Morris University, School of Engineering, Mathematics, and Science, Moon Township, PA, 15108, United States
| | - Benjamin Krider
- Robert Morris University, School of Engineering, Mathematics, and Science, Moon Township, PA, 15108, United States
| | - Alyson R. Fortner
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, 26505, United States
| | - Ryan F. LeBouf
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, 26505, United States
| | - M. Abbas Virji
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, 26505, United States
| | - Arif Sirinterlikci
- Robert Morris University, School of Engineering, Mathematics, and Science, Moon Township, PA, 15108, United States
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Virji MA, Cummings KJ, Cox-Ganser JM. A Strategy for Field Evaluations of Exposures and Respiratory Health of Workers at Small- to Medium-Sized Coffee Facilities. Front Public Health 2021; 9:705225. [PMID: 34858915 PMCID: PMC8631862 DOI: 10.3389/fpubh.2021.705225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
Coffee production is a global industry with roasteries throughout the world. Workers in this industry are exposed to complex mixtures of gases, dusts, and vapors including carbon monoxide, carbon dioxide, coffee dust, allergens, alpha-diketones, and other volatile organic compounds (VOCs). Adverse respiratory health outcomes such as respiratory symptoms, reduced pulmonary function, asthma, and obliterative bronchiolitis can occur among exposed workers. In response to health hazard evaluations requests received from 17 small- to medium-sized coffee facilities across the United States, the National Institute for Occupational Safety and Health conducted investigations during 2016-2017 to understand the burden of respiratory abnormalities, exposure characteristics, relationships between exposures and respiratory effects, and opportunities for exposure mitigation. Full-shift, task-based, and instantaneous personal and area air samples for diacetyl, 2,3-pentanedione and other VOCs were collected, and engineering controls were evaluated. Medical evaluations included questionnaire, spirometry, impulse oscillometry, and fractional exhaled nitric oxide. Exposure and health assessments were conducted using standardized tools and approaches, which enabled pooling data for aggregate analysis. The pooled data provided a larger population to better address the requestors' concern of the effect of exposure to alpha-diketones on the respiratory heath of coffee workers. This paper describes the rationale for the exposure and health assessment strategy, the approach used to achieve the study objectives, and its advantages and limitations.
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Affiliation(s)
| | | | - Jean M. Cox-Ganser
- Respiratory Health Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, United States
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Stefaniak AB, Bowers LN, Cottrell G, Erdem E, Knepp AK, Martin S, Pretty J, Duling MG, Arnold ED, Wilson Z, Krider B, LeBouf RF, Virji MA, Sirinterlikci A. Use of 3-Dimensional Printers in Educational Settings: The Need for Awareness of the Effects of Printer Temperature and Filament Type on Contaminant Releases. ACS Chem Health Saf 2021; 28:444-456. [DOI: 10.1021/acs.chas.1c00041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Aleksandr B. Stefaniak
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Lauren N. Bowers
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Gabe Cottrell
- School of Engineering, Mathematics, and Science, Robert Morris University, Moon Township, Pennsylvania 15108, United States
| | - Ergin Erdem
- School of Engineering, Mathematics, and Science, Robert Morris University, Moon Township, Pennsylvania 15108, United States
| | - Alycia K. Knepp
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Stephen Martin
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Jack Pretty
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Cincinnati, Ohio 45213, United States
| | - Matthew G. Duling
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Elizabeth D. Arnold
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Zachary Wilson
- School of Engineering, Mathematics, and Science, Robert Morris University, Moon Township, Pennsylvania 15108, United States
| | - Benjamin Krider
- School of Engineering, Mathematics, and Science, Robert Morris University, Moon Township, Pennsylvania 15108, United States
| | - Ryan F. LeBouf
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - M. Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Arif Sirinterlikci
- School of Engineering, Mathematics, and Science, Robert Morris University, Moon Township, Pennsylvania 15108, United States
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Stefaniak AB, Bowers LN, Martin SB, Hammond DR, Ham JE, Wells JR, Fortner AR, Knepp AK, Preez SD, Pretty JR, Roberts JL, du Plessis JL, Schmidt A, Duling MG, Bader A, Virji MA. Large-Format Additive Manufacturing and Machining Using High-Melt-Temperature Polymers. Part I: Real-Time Particulate and Gas-Phase Emissions. ACS Chem Health Saf 2021; 28:190-200. [DOI: 10.1021/acs.chas.0c00128] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Aleksandr B. Stefaniak
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Lauren N. Bowers
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Stephen B. Martin
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Duane R. Hammond
- National Institute for Occupational Safety and Health, Cincinnati, Ohio 45213, United States
| | - Jason E. Ham
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - J. R. Wells
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Alyson R. Fortner
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Alycia K. Knepp
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Sonette du Preez
- North-West University, Occupational Hygiene and Health Research Initiative, Private Bag X6001, Potchefstroom 2520, South Africa
| | - Jack R. Pretty
- National Institute for Occupational Safety and Health, Cincinnati, Ohio 45213, United States
| | - Jennifer L. Roberts
- National Institute for Occupational Safety and Health, Cincinnati, Ohio 45213, United States
| | - Johan L. du Plessis
- North-West University, Occupational Hygiene and Health Research Initiative, Private Bag X6001, Potchefstroom 2520, South Africa
| | - Austin Schmidt
- Additive Engineering Solutions, Akron, Ohio 44305, United States
| | - Matthew G. Duling
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Andrew Bader
- Additive Engineering Solutions, Akron, Ohio 44305, United States
| | - M. Abbas Virji
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
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11
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Stefaniak AB, Bowers LN, Martin SB, Hammond DR, Ham JE, Wells JR, Fortner AR, Knepp AK, du Preez S, Pretty JR, Roberts JL, du Plessis JL, Schmidt A, Duling MG, Bader A, Virji MA. Large-Format Additive Manufacturing and Machining Using High-Melt-Temperature Polymers. Part II: Characterization of Particles and Gases. ACS Chem Health Saf 2021; 28:268-278. [DOI: 10.1021/acs.chas.0c00129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Aleksandr B. Stefaniak
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Lauren N. Bowers
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Stephen B. Martin
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Duane R. Hammond
- National Institute for Occupational Safety and Health, Cincinnati, Ohio 45213, United States
| | - Jason E. Ham
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - J. R. Wells
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Alyson R. Fortner
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Alycia K. Knepp
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Sonette du Preez
- North-West University, Occupational Hygiene and Health Research Initiative, Private Bag X6001, Potchefstroom 2520, South Africa
| | - Jack R. Pretty
- National Institute for Occupational Safety and Health, Cincinnati, Ohio 45213, United States
| | - Jennifer L. Roberts
- National Institute for Occupational Safety and Health, Cincinnati, Ohio 45213, United States
| | - Johan L. du Plessis
- North-West University, Occupational Hygiene and Health Research Initiative, Private Bag X6001, Potchefstroom 2520, South Africa
| | - Austin Schmidt
- Additive Engineering Solutions, Akron, Ohio 44305, United States
| | - Matthew G. Duling
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
| | - Andrew Bader
- Additive Engineering Solutions, Akron, Ohio 44305, United States
| | - M. Abbas Virji
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, United States
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12
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Stefaniak AB, Wade EE, Lawrence RB, Arnold ED, Virji MA. Particle transfer and adherence to human skin compared with cotton glove and pre-moistened polyvinyl alcohol exposure sampling substrates. J Environ Sci Health A Tox Hazard Subst Environ Eng 2021; 56:585-598. [PMID: 33720803 PMCID: PMC8276042 DOI: 10.1080/10934529.2021.1899524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 06/12/2023]
Abstract
Measurement of skin exposure to particles using interception (e.g., cotton gloves) and removal (e.g., wiping) sampling techniques could be inaccurate because these substrates do not have the same topography and adhesion characteristics as skin. The objective of this study was to compare particle transfer and adherence to cotton gloves, cotton gloves with artificial sebum, and a pre-moistened polyvinyl alcohol (PVA) material with bare human skin (fingertip, palm). Experiments were performed with aluminum oxide powder under standardized conditions for three types of surfaces touched, applied loads, contact times, and powder mass levels. In the final mixed model, the fixed effects of substrate, surface type, applied load, and powder mass and their significant two-way interaction terms explained 71% (transfer) and 74% (adherence) of the observed total variance in measurements. For particle mass transfer, compared with bare skin, bias was -77% (cotton glove with sebum) to +197% (PVA material) and for adherence bias ranged from -40% (cotton glove) to +428% (PVA material), which indicated under- and over-sampling by these substrates, respectively. Dermal exposure assessment would benefit from sampling substrates that better reflect human skin characteristics and more accurately estimate exposures. Mischaracterization of dermal exposure has important implications for exposure and risk assessment.
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Affiliation(s)
- Aleksandr B Stefaniak
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Eleanor E Wade
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Robert B Lawrence
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Elizabeth D Arnold
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - M Abbas Virji
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
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13
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Wu BG, Kapoor B, Cummings KJ, Stanton ML, Nett RJ, Kreiss K, Abraham JL, Colby TV, Franko AD, Green FHY, Sanyal S, Clemente JC, Gao Z, Coffre M, Meyn P, Heguy A, Li Y, Sulaiman I, Borbet TC, Koralov SB, Tallaksen RJ, Wendland D, Bachelder VD, Boylstein RJ, Park JH, Cox-Ganser JM, Virji MA, Crawford JA, Edwards NT, Veillette M, Duchaine C, Warren K, Lundeen S, Blaser MJ, Segal LN. Evidence for Environmental-Human Microbiota Transfer at a Manufacturing Facility with Novel Work-related Respiratory Disease. Am J Respir Crit Care Med 2021; 202:1678-1688. [PMID: 32673495 DOI: 10.1164/rccm.202001-0197oc] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Rationale: Workers' exposure to metalworking fluid (MWF) has been associated with respiratory disease.Objectives: As part of a public health investigation of a manufacturing facility, we performed a cross-sectional study using paired environmental and human sampling to evaluate the cross-pollination of microbes between the environment and the host and possible effects on lung pathology present among workers.Methods: Workplace environmental microbiota were evaluated in air and MWF samples. Human microbiota were evaluated in lung tissue samples from workers with respiratory symptoms found to have lymphocytic bronchiolitis and alveolar ductitis with B-cell follicles and emphysema, in lung tissue samples from control subjects, and in skin, nasal, and oral samples from 302 workers from different areas of the facility. In vitro effects of MWF exposure on murine B cells were assessed.Measurements and Main Results: An increased similarity of microbial composition was found between MWF samples and lung tissue samples of case workers compared with control subjects. Among workers in different locations within the facility, those that worked in the machine shop area had skin, nasal, and oral microbiota more closely related to the microbiota present in the MWF samples. Lung samples from four index cases and skin and nasal samples from workers in the machine shop area were enriched with Pseudomonas, the dominant taxa in MWF. Exposure to used MWF stimulated murine B-cell proliferation in vitro, a hallmark cell subtype found in the pathology of index cases.Conclusions: Evaluation of a manufacturing facility with a cluster of workers with respiratory disease supports cross-pollination of microbes from MWF to humans and suggests the potential for exposure to these microbes to be a health hazard.
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Affiliation(s)
| | | | - Kristin J Cummings
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Marcia L Stanton
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Randall J Nett
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Kathleen Kreiss
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Jerrold L Abraham
- Department of Pathology, State University of New York Upstate Medical University, Syracuse, New York
| | - Thomas V Colby
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Arizona
| | - Angela D Franko
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Francis H Y Green
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Soma Sanyal
- Department of Pathology, State University of New York Upstate Medical University, Syracuse, New York
| | - Jose C Clemente
- Icahn Institute for Genomics and Multiscale Biology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Zhan Gao
- Center for Advanced Biotechnology and Medicine, Rutgers University, New Brunswick, New Jersey
| | - Maryaline Coffre
- Department of Pathology, New York University School of Medicine, New York, New York
| | - Peter Meyn
- Department of Pathology, New York University School of Medicine, New York, New York
| | - Adriana Heguy
- Department of Pathology, New York University School of Medicine, New York, New York
| | | | | | | | - Sergei B Koralov
- Department of Pathology, New York University School of Medicine, New York, New York
| | - Robert J Tallaksen
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | | | | | - Randy J Boylstein
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Ju-Hyeong Park
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Jean M Cox-Ganser
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - M Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Judith A Crawford
- Department of Pathology, State University of New York Upstate Medical University, Syracuse, New York
| | - Nicole T Edwards
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Marc Veillette
- Department of Biochemistry, Microbiology and Bioinformatics, Laval University, Quebec, Canada
| | - Caroline Duchaine
- Department of Biochemistry, Microbiology and Bioinformatics, Laval University, Quebec, Canada
| | - Krista Warren
- St. Luke's Department of Pathology, St. Luke's Hospital, Duluth, Minnesota; and
| | - Sarah Lundeen
- St. Luke's Department of Pathology, St. Luke's Hospital, Duluth, Minnesota; and
| | - Martin J Blaser
- Center for Advanced Biotechnology and Medicine, Rutgers University, New Brunswick, New Jersey
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14
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Virji MA, Kurth L. Peak Inhalation Exposure Metrics Used in Occupational Epidemiologic and Exposure Studies. Front Public Health 2021; 8:611693. [PMID: 33490023 PMCID: PMC7820770 DOI: 10.3389/fpubh.2020.611693] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/07/2020] [Indexed: 12/24/2022] Open
Abstract
Peak exposures are of concern because they can potentially overwhelm normal defense mechanisms and induce adverse health effects. Metrics of peak exposure have been used in epidemiologic and exposure studies, but consensus is lacking on its definition. The relevant characteristics of peak exposure are dependent upon exposure patterns, biokinetics of exposure, and disease mechanisms. The objective of this review was to summarize the use of peak metrics in epidemiologic and exposure studies. A comprehensive search of Medline, Embase, Web of Science, and NIOSHTIC-2 databases was conducted using keywords related to peak exposures. The retrieved references were reviewed and selected for indexing if they included a peak metric and met additional criteria. Information on health outcomes and peak exposure metrics was extracted from each reference. A total of 1,215 epidemiologic or exposure references were identified, of which 182 were indexed and summarized. For the 72 epidemiologic studies, the health outcomes most frequently evaluated were: chronic respiratory effects, cancer and acute respiratory symptoms. Exposures were frequently assessed using task-based and full-shift time-integrated methods, qualitative methods, and real-time instruments. Peak exposure summary metrics included the presence or absence of a peak event, highest exposure intensity and frequency greater than a target. Peak metrics in the 110 exposure studies most frequently included highest exposure intensity, average short-duration intensity, and graphical presentation of the real-time data (plots). This review provides a framework for considering biologically relevant peak exposure metrics for epidemiologic and exposure studies to help inform risk assessment and exposure mitigation.
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Affiliation(s)
- M Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, United States
| | - Laura Kurth
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, United States
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15
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LeBouf RF, Blackley BH, Fortner AR, Stanton M, Martin SB, Groth CP, McClelland TL, Duling MG, Burns DA, Ranpara A, Edwards N, Fedan KB, Bailey RL, Cummings KJ, Nett RJ, Cox-Ganser JM, Virji MA. Exposures and Emissions in Coffee Roasting Facilities and Cafés: Diacetyl, 2,3-Pentanedione, and Other Volatile Organic Compounds. Front Public Health 2020; 8:561740. [PMID: 33072698 PMCID: PMC7531227 DOI: 10.3389/fpubh.2020.561740] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/13/2020] [Indexed: 11/13/2022] Open
Abstract
Roasted coffee and many coffee flavorings emit volatile organic compounds (VOCs) including diacetyl and 2,3-pentanedione. Exposures to VOCs during roasting, packaging, grinding, and flavoring coffee can negatively impact the respiratory health of workers. Inhalational exposures to diacetyl and 2,3-pentanedione can cause obliterative bronchiolitis. This study summarizes exposures to and emissions of VOCs in 17 coffee roasting and packaging facilities that included 10 cafés. We collected 415 personal and 760 area full-shift, and 606 personal task-based air samples for diacetyl, 2,3-pentanedione, 2,3-hexanedione, and acetoin using silica gel tubes. We also collected 296 instantaneous activity and 312 instantaneous source air measurements for 18 VOCs using evacuated canisters. The highest personal full-shift exposure in part per billion (ppb) to diacetyl [geometric mean (GM) 21 ppb; 95th percentile (P95) 79 ppb] and 2,3-pentanedione (GM 15 ppb; P95 52 ppb) were measured for production workers in flavored coffee production areas. These workers also had the highest percentage of measurements above the NIOSH Recommended Exposure Limit (REL) for diacetyl (95%) and 2,3-pentanedione (77%). Personal exposures to diacetyl (GM 0.9 ppb; P95 6.0 ppb) and 2,3-pentanedione (GM 0.7 ppb; P95 4.4 ppb) were the lowest for non-production workers of facilities that did not flavor coffee. Job groups with the highest personal full-shift exposures to diacetyl and 2,3-pentanedione were flavoring workers (GM 34 and 38 ppb), packaging workers (GM 27 and 19 ppb) and grinder operator (GM 26 and 22 ppb), respectively, in flavored coffee facilities, and packaging workers (GM 8.0 and 4.4 ppb) and production workers (GM 6.3 and 4.6 ppb) in non-flavored coffee facilities. Baristas in cafés had mean full-shift exposures below the RELs (GM 4.1 ppb diacetyl; GM 4.6 ppb 2,3-pentanedione). The tasks, activities, and sources associated with flavoring in flavored coffee facilities and grinding in non-flavored coffee facilities, had some of the highest GM and P95 estimates for both diacetyl and 2,3-pentanedione. Controlling emissions at grinding machines and flavoring areas and isolating higher exposure areas (e.g., flavoring, grinding, and packaging areas) from the main production space and from administrative or non-production spaces is essential for maintaining exposure control.
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Affiliation(s)
- Ryan F LeBouf
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Brie Hawley Blackley
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Alyson R Fortner
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Marcia Stanton
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Stephen B Martin
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Caroline P Groth
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, United States
| | - Tia L McClelland
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Matthew G Duling
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Dru A Burns
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Anand Ranpara
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Nicole Edwards
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Kathleen B Fedan
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Rachel L Bailey
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Kristin J Cummings
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States.,California Department of Public Health, Richmond, CA, United States
| | - Randall J Nett
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Jean M Cox-Ganser
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - M Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States
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16
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Virji MA, Schuler CR, Cox-Ganser J, Stanton ML, Kent MS, Kreiss K, Stefaniak AB. Associations of Metrics of Peak Inhalation Exposure and Skin Exposure Indices With Beryllium Sensitization at a Beryllium Manufacturing Facility. Ann Work Expo Health 2020; 63:856-869. [PMID: 31504146 DOI: 10.1093/annweh/wxz064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 05/31/2019] [Accepted: 07/19/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Peak beryllium inhalation exposures and exposure to the skin may be relevant for developing beryllium sensitization (BeS). The objective of this study was to identify risk factors associated with BeS to inform the prevention of sensitization, and the development of chronic beryllium disease (CBD). METHODS In a survey of short-term workers employed at a primary beryllium manufacturing facility between the years 1994-1999, 264 participants completed a questionnaire and were tested for BeS. A range of qualitative and quantitative peak inhalation metrics and skin exposure indices were created using: personal full-shift beryllium exposure measurements, 15 min to 24 h process-specific task and area exposure measurements, glove measurements as indicator of skin exposure, process-upset information gleaned from historical reports, and self-reported information on exposure events. Hierarchical clustering was conducted to systematically group participants based on similarity of patterns of 16 exposure variables. The associations of the exposure metrics with BeS and self-reported skin symptoms (in work areas processing beryllium salts as well as in other work areas) were evaluated using correlation analysis, log-binomial and logistic regression models with splines. RESULTS Metrics of peak inhalation exposure, indices of skin exposure, and using material containing beryllium salts were significantly associated with skin symptoms and BeS; skin symptoms were a strong predictor of BeS. However, in this cohort, we could not tease apart the independent effects of skin exposure from inhalation exposure, as these exposures occurred simultaneously and were highly correlated. Hierarchical clustering identified groups of participants with unique patterns of exposure characteristics resulting in different prevalence of BeS and skin symptoms. A cluster with high skin exposure index and use of material containing beryllium salts had the highest prevalence of BeS and self-reported skin symptoms, followed by a cluster with high inhalation and skin exposure index and a very small fraction of jobs in which beryllium salts were used. A cluster with low inhalation and skin exposure and no workers using beryllium salts had no cases of BeS. CONCLUSION Multiple pathways and types of exposure were associated with BeS and may be important for informing BeS prevention. Prevention efforts should focus on controlling airborne beryllium exposures with attention to peaks, use of process characteristics (e.g. the likelihood of upset conditions to design interventions) minimize skin exposure to beryllium particles, and in particular, eliminate skin contact with beryllium salts to interrupt potential exposure pathways for BeS risk.
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Affiliation(s)
- M Abbas Virji
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA
| | - Christine R Schuler
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA.,National Institute for Occupational Safety and Health, Division of Safety Research, Morgantown, WV, USA
| | - Jean Cox-Ganser
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA
| | - Marcia L Stanton
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA
| | | | - Kathleen Kreiss
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA
| | - Aleksandr B Stefaniak
- National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA
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17
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Virji MA, Liang X, Su FC, LeBouf RF, Stefaniak AB, Stanton ML, Henneberger PK, Houseman EA. Peaks, Means, and Determinants of Real-Time TVOC Exposures Associated with Cleaning and Disinfecting Tasks in Healthcare Settings. Ann Work Expo Health 2020; 63:759-772. [PMID: 31161189 DOI: 10.1093/annweh/wxz043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 04/27/2019] [Accepted: 05/08/2019] [Indexed: 11/14/2022] Open
Abstract
Cleaning and disinfecting tasks and product use are associated with elevated prevalence of asthma and respiratory symptoms among healthcare workers; however, the levels of exposure that pose a health risk remain unclear. The objective of this study was to estimate the peak, average, and determinants of real-time total volatile organic compound (TVOC) exposure associated with cleaning tasks and product-use. TVOC exposures were measured using monitors equipped with a photoionization detector (PID). A simple correction factor was applied to the real-time measurements, calculated as a ratio of the full-shift average TVOC concentrations from a time-integrated canister and the PID sample, for each sample pair. During sampling, auxiliary information, e.g. tasks, products used, engineering controls, was recorded on standardized data collection forms at 5-min intervals. Five-minute averaged air measurements (n = 10 276) from 129 time-series comprising 92 workers and four hospitals were used to model the determinants of exposures. The statistical model simultaneously accounted for censored data and non-stationary autocorrelation and was fit using Markov-Chain Monte Carlo within a Bayesian context. Log-transformed corrected concentrations (cTVOC) were modeled, with the fixed-effects of tasks and covariates, that were systematically gathered during sampling, and random effect of person-day. The model-predicted geometric mean (GM) cTVOC concentrations ranged from 387 parts per billion (ppb) for the task of using a product containing formaldehyde in laboratories to 2091 ppb for the task of using skin wipes containing quaternary ammonium compounds, with a GM of 925 ppb when no products were used. Peak exposures quantified as the 95th percentile of 15-min averages for these tasks ranged from 3172 to 17 360 ppb. Peak and GM task exposures varied by occupation and hospital unit. In the multiple regression model, use of sprays was associated with increasing exposures, while presence of local exhaust ventilation, large room volume, and automatic sterilizer use were associated with decreasing exposures. A detailed understanding of factors affecting TVOC exposure can inform targeted interventions to reduce exposures and can be used in epidemiologic studies as metrics of short-duration peak exposures.
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Affiliation(s)
- M Abbas Virji
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA
| | - Xiaoming Liang
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA
| | - Feng-Chiao Su
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA
| | - Ryan F LeBouf
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA
| | - Aleksandr B Stefaniak
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA
| | - Marcia L Stanton
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA
| | - Paul K Henneberger
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, WV, USA
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18
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Cummings KJ, Stanton ML, Kreiss K, Boylstein RJ, Park JH, Cox-Ganser JM, Virji MA, Edwards NT, Segal LN, Blaser MJ, Weissman DN, Nett RJ. Work-related adverse respiratory health outcomes at a machine manufacturing facility with a cluster of bronchiolitis, alveolar ductitis and emphysema (BADE). Occup Environ Med 2020; 77:386-392. [PMID: 32132182 DOI: 10.1136/oemed-2019-106296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 01/27/2020] [Accepted: 02/14/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Four machine manufacturing facility workers had a novel occupational lung disease of uncertain aetiology characterised by lymphocytic bronchiolitis, alveolar ductitis and emphysema (BADE). We aimed to evaluate current workers' respiratory health in relation to job category and relative exposure to endotoxin, which is aerosolised from in-use metalworking fluid. METHODS We offered a questionnaire and spirometry at baseline and 3.5 year follow-up. Endotoxin exposures were quantified for 16 production and non-production job groups. Forced expiratory volume in one second (FEV1) decline ≥10% was considered excessive. We examined SMRs compared with US adults, adjusted prevalence ratios (aPRs) for health outcomes by endotoxin exposure tertiles and predictors of excessive FEV1 decline. RESULTS Among 388 (89%) baseline participants, SMRs were elevated for wheeze (2.5 (95% CI 2.1 to 3.0)), but not obstruction (0.5 (95% CI 0.3 to 1.1)). Mean endotoxin exposures (range: 0.09-28.4 EU/m3) were highest for machine shop jobs. Higher exposure was associated with exertional dyspnea (aPR=2.8 (95% CI 1.4 to 5.7)), but not lung function. Of 250 (64%) follow-up participants, 11 (4%) had excessive FEV1 decline (range: 403-2074 mL); 10 worked in production. Wheeze (aPR=3.6 (95% CI 1.1 to 12.1)) and medium (1.3-7.5 EU/m3) endotoxin exposure (aPR=10.5 (95% CI 1.3 to 83.1)) at baseline were associated with excessive decline. One production worker with excessive decline had BADE on subsequent lung biopsy. CONCLUSIONS Lung function loss and BADE were associated with production work. Relationships with relative endotoxin exposure indicate work-related adverse respiratory health outcomes beyond the sentinel disease cluster, including an incident BADE case. Until causative factors and effective preventive strategies for BADE are determined, exposure minimisation and medical surveillance of affected workforces are recommended.
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Affiliation(s)
- Kristin J Cummings
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Marcia L Stanton
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Kathleen Kreiss
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Randy J Boylstein
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Ju-Hyeong Park
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Jean M Cox-Ganser
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - M Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Nicole T Edwards
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Leopoldo N Segal
- Department of Medicine, New York University School of Medicine, New York, New York, USA
| | - Martin J Blaser
- Department of Medicine, New York University School of Medicine, New York, New York, USA
| | - David N Weissman
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Randall J Nett
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
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Blackley BH, Cummings KJ, Stanton M, Stefaniak AB, Gibbs JL, Park JY, Harvey RR, Virji MA. Work Tasks as Determinants of Respirable and Inhalable Indium Exposure among Workers at an Indium-Tin Oxide Production and Reclamation Facility. Ann Work Expo Health 2020; 64:175-184. [PMID: 31803905 PMCID: PMC9969414 DOI: 10.1093/annweh/wxz091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/22/2019] [Accepted: 11/12/2019] [Indexed: 11/13/2022] Open
Abstract
Increased global demand for touch screens, photovoltaics, and optoelectronics has resulted in an increase in the production of indium-tin oxide (ITO). Occupational exposure to indium compounds is associated with the development of indium lung disease. Although many previous epidemiologic investigations highlight an excess of lung abnormalities in workplaces where ITO is produced, few assessments of occupational exposure to respirable and inhalable indium are reported to date. The objective of this study was to identify the determinants of respirable and inhalable indium at an ITO production facility to target exposure interventions. In 2012 and 2014, we conducted exposure assessments at an ITO production facility and collected full-shift personal respirable (n = 159) and inhalable (n = 57) indium samples. We also observed workers and recorded information on task duration and location, materials used, and use of personal protective equipment (PPE). Tasks (n = 121) recorded in task diaries were categorized into 40 similar task groups using the Advanced REACH Tool and process-related information. Mixed-effects models were fit separately for log-transformed respirable and inhalable indium, with random effect of subject and fixed effects of task groups. Overall, respirable and inhalable indium measurements ranged from 0.1 to 796.6 µg m-3 and 1.6 to 10 585.7 µg m-3, respectively, and were highly correlated with Spearman correlation coefficient of 0.90. The final model for respirable indium explained 36.3% of total variance and identified sanding, powder transfer tasks in reclaim, powder transfer tasks in refinery, handling indium materials, and liquid transfer tasks in ITO production as tasks associated with increased respirable indium exposure. The final model for inhalable indium explained 24.6% of total variance and included powder transfer tasks in ITO production, cleaning cylinder or tile, and handling indium material tasks. Tasks identified as strong predictors of full-shift exposure to respirable and inhalable indium can guide the use of engineering, administrative, and PPE controls designed to mitigate occupational exposure to indium. Moreover, since the tasks were aligned with REACH activities, results from this study can also be used to inform REACH activity scenarios.
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Affiliation(s)
- Brie Hawley Blackley
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, 1095 Willowdale Rd, MS 2800, Morgantown, WV 26505, USA,Author to whom correspondence should be addressed. Tel: +1-304-285-5751; fax: +1-304-285-5820;
| | - Kristin J. Cummings
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, 1095 Willowdale Rd, MS 2800, Morgantown, WV 26505, USA
| | - Marcia Stanton
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, 1095 Willowdale Rd, MS 2800, Morgantown, WV 26505, USA
| | - Aleksandr B. Stefaniak
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, 1095 Willowdale Rd, MS 2800, Morgantown, WV 26505, USA
| | - Jenna L. Gibbs
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, 1095 Willowdale Rd, MS 2800, Morgantown, WV 26505, USA,Department of Occupational and Environmental Health, University of Iowa, 105 River Street, Iowa City, IA 52242, USA
| | - Ji Young Park
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, 1095 Willowdale Rd, MS 2800, Morgantown, WV 26505, USA,Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea
| | - R. Reid Harvey
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, 1095 Willowdale Rd, MS 2800, Morgantown, WV 26505, USA
| | - M. Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, 1095 Willowdale Rd, MS 2800, Morgantown, WV 26505, USA
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20
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Harvey RR, Fechter-Leggett ED, Bailey RL, Edwards NT, Fedan KB, Virji MA, Nett RJ, Cox-Ganser JM, Cummings KJ. The Burden of Respiratory Abnormalities Among Workers at Coffee Roasting and Packaging Facilities. Front Public Health 2020; 8:5. [PMID: 32083049 PMCID: PMC7003510 DOI: 10.3389/fpubh.2020.00005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 01/08/2020] [Indexed: 12/18/2022] Open
Abstract
Introduction: Respiratory hazards in the coffee roasting and packaging industry can include asthmagens such as green coffee bean and other dust and alpha-diketones such as diacetyl and 2,3-pentanedione that can occur naturally from roasting coffee or artificially from addition of flavoring to coffee. We sought to describe the burden of respiratory abnormalities among workers at 17 coffee roasting and packaging facilities. Methods: We completed medical surveys at 17 coffee roasting and packaging facilities that included interviewer-administered questionnaires and pulmonary function testing. We summarized work-related symptoms, diagnoses, and spirometry testing results among all participants. We compared health outcomes between participants who worked near flavoring and who did not. Results: Participants most commonly reported nose and eye symptoms, and wheeze, with a work-related pattern for some. Symptoms and pulmonary function tests were consistent with work-related asthma in some participants. About 5% of workers had abnormal spirometry and most improved after bronchodilator. Health outcomes were similar between employees who worked near flavoring and who did not, except employees who worked near flavoring reported more chronic bronchitis and ever receiving a diagnosis of asthma than those who did not work near flavoring. Conclusion: The symptoms and patterns likely represent overlapping health effects of different respiratory hazards, including green coffee bean and other dust that can contribute to work-related asthma, and diacetyl and 2,3-pentanedione that can contribute to obliterative bronchiolitis. Healthcare providers and occupational health and safety practitioners should be aware that workers at coffee roasting and packaging facilities are potentially at risk for occupational lung diseases.
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Affiliation(s)
- R. Reid Harvey
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, United States
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21
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Cummings KJ, Stanton ML, Nett RJ, Segal LN, Kreiss K, Abraham JL, Colby TV, Franko AD, Green FH, Sanyal S, Tallaksen RJ, Wendland D, Bachelder VD, Boylstein RJ, Park J, Cox‐Ganser JM, Virji MA, Crawford JA, Green BJ, LeBouf RF, Blaser MJ, Weissman DN. Severe lung disease characterized by lymphocytic bronchiolitis, alveolar ductitis, and emphysema (BADE) in industrial machine-manufacturing workers. Am J Ind Med 2019; 62:927-937. [PMID: 31461179 DOI: 10.1002/ajim.23038] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/25/2019] [Accepted: 08/01/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND A cluster of severe lung disease occurred at a manufacturing facility making industrial machines. We aimed to describe disease features and workplace exposures. METHODS Clinical, functional, radiologic, and histopathologic features were characterized. Airborne concentrations of thoracic aerosol, metalworking fluid, endotoxin, metals, and volatile organic compounds were measured. Facility airflow was assessed using tracer gas. Process fluids were examined using culture, polymerase chain reaction, and 16S ribosomal RNA sequencing. RESULTS Five previously healthy male never-smokers, ages 27 to 50, developed chest symptoms from 1995 to 2012 while working in the facility's production areas. Patients had an insidious onset of cough, wheeze, and exertional dyspnea; airflow obstruction (mean FEV1 = 44% predicted) and reduced diffusing capacity (mean = 53% predicted); and radiologic centrilobular emphysema. Lung tissue demonstrated a unique pattern of bronchiolitis and alveolar ductitis with B-cell follicles lacking germinal centers, and significant emphysema for never-smokers. All had chronic dyspnea, three had a progressive functional decline, and one underwent lung transplantation. Patients reported no unusual nonoccupational exposures. No cases were identified among nonproduction workers or in the community. Endotoxin concentrations were elevated in two air samples; otherwise, exposures were below occupational limits. Air flowed from areas where machining occurred to other production areas. Metalworking fluid primarily grew Pseudomonas pseudoalcaligenes and lacked mycobacterial DNA, but 16S analysis revealed more complex bacterial communities. CONCLUSION This cluster indicates a previously unrecognized occupational lung disease of yet uncertain etiology that should be considered in manufacturing workers (particularly never-smokers) with airflow obstruction and centrilobular emphysema. Investigation of additional cases in other settings could clarify the cause and guide prevention.
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Affiliation(s)
- Kristin J. Cummings
- Respiratory Health Division, National Institute for Occupational Safety and HealthCenters for Disease Control and Prevention Morgantown West Virginia
| | - Marcia L. Stanton
- Respiratory Health Division, National Institute for Occupational Safety and HealthCenters for Disease Control and Prevention Morgantown West Virginia
| | - Randall J. Nett
- Respiratory Health Division, National Institute for Occupational Safety and HealthCenters for Disease Control and Prevention Morgantown West Virginia
| | - Leopoldo N. Segal
- Department of MedicineNew York University School of Medicine New York New York
| | - Kathleen Kreiss
- Respiratory Health Division, National Institute for Occupational Safety and HealthCenters for Disease Control and Prevention Morgantown West Virginia
| | - Jerrold L. Abraham
- Department of PathologyState University of New York Upstate Medical University Syracuse New York
| | - Thomas V. Colby
- Department of Laboratory Medicine and PathologyMayo Clinic Scottsdale Arizona
| | - Angela D. Franko
- Department of Pathology and Laboratory MedicineUniversity of Calgary Calgary Alberta Canada
| | - Francis H.Y. Green
- Department of Pathology and Laboratory MedicineUniversity of Calgary Calgary Alberta Canada
| | - Soma Sanyal
- Department of PathologyState University of New York Upstate Medical University Syracuse New York
| | - Robert J. Tallaksen
- Respiratory Health Division, National Institute for Occupational Safety and HealthCenters for Disease Control and Prevention Morgantown West Virginia
| | | | | | - Randy J. Boylstein
- Respiratory Health Division, National Institute for Occupational Safety and HealthCenters for Disease Control and Prevention Morgantown West Virginia
| | - Ju‐Hyeong Park
- Respiratory Health Division, National Institute for Occupational Safety and HealthCenters for Disease Control and Prevention Morgantown West Virginia
| | - Jean M. Cox‐Ganser
- Respiratory Health Division, National Institute for Occupational Safety and HealthCenters for Disease Control and Prevention Morgantown West Virginia
| | - M. Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and HealthCenters for Disease Control and Prevention Morgantown West Virginia
| | - Judith A. Crawford
- Department of PathologyState University of New York Upstate Medical University Syracuse New York
| | - Brett James Green
- Health Effects Laboratory Division, National Institute for Occupational Safety and HealthCenters for Disease Control and Prevention Morgantown West Virginia
| | - Ryan F. LeBouf
- Respiratory Health Division, National Institute for Occupational Safety and HealthCenters for Disease Control and Prevention Morgantown West Virginia
| | - Martin J. Blaser
- Department of MedicineNew York University School of Medicine New York New York
| | - David N. Weissman
- Respiratory Health Division, National Institute for Occupational Safety and HealthCenters for Disease Control and Prevention Morgantown West Virginia
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22
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Yi J, Duling MG, Bowers LN, Knepp AK, LeBouf RF, Nurkiewicz TR, Ranpara A, Luxton T, Martin SB, Burns DA, Peloquin DM, Baumann EJ, Virji MA, Stefaniak AB. Particle and organic vapor emissions from children's 3-D pen and 3-D printer toys. Inhal Toxicol 2019; 31:432-445. [PMID: 31874579 PMCID: PMC6995422 DOI: 10.1080/08958378.2019.1705441] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 12/11/2019] [Indexed: 01/09/2023]
Abstract
Objective: Fused filament fabrication "3-dimensional (3-D)" printing has expanded beyond the workplace to 3-D printers and pens for use by children as toys to create objects.Materials and methods: Emissions from two brands of toy 3-D pens and one brand of toy 3-D printer were characterized in a 0.6 m3 chamber (particle number, size, elemental composition; concentrations of individual and total volatile organic compounds (TVOC)). The effects of print parameters on these emission metrics were evaluated using mixed-effects models. Emissions data were used to model particle lung deposition and TVOC exposure potential.Results: Geometric mean particle yields (106-1010 particles/g printed) and sizes (30-300 nm) and TVOC yields (
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Affiliation(s)
- Jinghai Yi
- Department of Physiology and Pharmacology, and the Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV, 26506
| | - Matthew G. Duling
- National Institute for Occupational Safety and Health, Morgantown, WV, 26505
| | - Lauren N. Bowers
- National Institute for Occupational Safety and Health, Morgantown, WV, 26505
| | - Alycia K. Knepp
- National Institute for Occupational Safety and Health, Morgantown, WV, 26505
| | - Ryan F. LeBouf
- National Institute for Occupational Safety and Health, Morgantown, WV, 26505
| | - Timothy R. Nurkiewicz
- Department of Physiology and Pharmacology, and the Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV, 26506
- National Institute for Occupational Safety and Health, Morgantown, WV, 26505
| | - Anand Ranpara
- National Institute for Occupational Safety and Health, Morgantown, WV, 26505
| | - Todd Luxton
- U.S. Environmental Protection Agency, Office of Research and Development, National Risk Management Research Laboratory, Cincinnati, OH, 45224
| | - Stephen B. Martin
- National Institute for Occupational Safety and Health, Morgantown, WV, 26505
| | - Dru A. Burns
- National Institute for Occupational Safety and Health, Morgantown, WV, 26505
| | | | | | - M. Abbas Virji
- National Institute for Occupational Safety and Health, Morgantown, WV, 26505
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23
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Virji MA, Liang X, Su FC, Lebouf RF, Stefaniak AB, Stanton ML, Henneberger PK, Houseman EA. Corrigendum to: Peaks, Means, and Determinants of Real-Time TVOC Exposures Associated with Cleaning and Disinfecting Tasks in Healthcare Settings. Ann Work Expo Health 2019; 64:1041. [DOI: 10.1093/annweh/wxz059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Abbas Virji
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Respiratory Health Division, Mailstop, Morgantown, WV, USA
| | - Xiaoming Liang
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Respiratory Health Division, Mailstop, Morgantown, WV, USA
| | - Feng-Chiao Su
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Respiratory Health Division, Mailstop, Morgantown, WV, USA
| | - Ryan F Lebouf
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Respiratory Health Division, Mailstop, Morgantown, WV, USA
| | - Aleksandr B Stefaniak
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Respiratory Health Division, Mailstop, Morgantown, WV, USA
| | - Marcia L Stanton
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Respiratory Health Division, Mailstop, Morgantown, WV, USA
| | - Paul K Henneberger
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Respiratory Health Division, Mailstop, Morgantown, WV, USA
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24
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Su FC, Friesen MC, Stefaniak AB, Henneberger PK, LeBouf RF, Stanton ML, Liang X, Humann M, Virji MA. Exposures to Volatile Organic Compounds among Healthcare Workers: Modeling the Effects of Cleaning Tasks and Product Use. Ann Work Expo Health 2019; 62:852-870. [PMID: 29931140 DOI: 10.1093/annweh/wxy055] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 05/30/2018] [Indexed: 11/12/2022] Open
Abstract
Objectives Use of cleaning and disinfecting products is associated with work-related asthma among healthcare workers, but the specific levels and factors that affect exposures remain unclear. The objective of this study was to evaluate the determinants of selected volatile organic compound (VOC) exposures in healthcare settings. Methods Personal and mobile-area air measurements (n = 143) from 100 healthcare workers at four hospitals were used to model the determinants of ethanol, acetone, 2-propanol, d-limonene, α-pinene, and chloroform exposures. Hierarchical cluster analysis was conducted to partition workers into groups with similar cleaning task/product-use profiles. Linear mixed-effect regression models using log-transformed VOC measurements were applied to evaluate the association of individual VOCs with clusters of task/product use, industrial hygienists' grouping (IH) of tasks, grouping of product application, chemical ingredients of the cleaning products used, amount of product use, and ventilation. Results Cluster analysis identified eight task/product-use clusters that were distributed across multiple occupations and hospital units, with the exception of clusters consisting of housekeepers and floor strippers/waxers. Results of the mixed-effect models showed significant associations between selected VOC exposures and several clusters, combinations of IH-generated task groups and chemical ingredients, and product application groups. The patient/personal cleaning task using products containing chlorine was associated with elevated levels of personal chloroform and α-pinene exposures. Tasks associated with instrument sterilizing and disinfecting were significantly associated with personal d-limonene and 2-propanol exposures. Surface and floor cleaning and stripping tasks were predominated by housekeepers and floor strippers/waxers, and use of chlorine-, alcohol-, ethanolamine-, and quaternary ammonium compounds-based products was associated with exposures to chloroform, α-pinene, acetone, 2-propanol, or d-limonene. Conclusions Healthcare workers are exposed to a variety of chemicals that vary with tasks and ingredients of products used during cleaning and disinfecting. The combination of product ingredients with cleaning and disinfecting tasks were associated with specific VOCs. Exposure modules for questionnaires used in epidemiologic studies might benefit from seeking information on products used within a task context.
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Affiliation(s)
- Feng-Chiao Su
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, USA
| | - Melissa C Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Aleksandr B Stefaniak
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, USA
| | - Paul K Henneberger
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, USA
| | - Ryan F LeBouf
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, USA
| | - Marcia L Stanton
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, USA
| | - Xiaoming Liang
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, USA
| | - Michael Humann
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, USA
| | - M Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, USA
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25
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Affiliation(s)
- Kristin J Cummings
- 1 Respiratory Health Division National Institute for Occupational Safety and Health Morgantown, West Virginia
| | - M Abbas Virji
- 1 Respiratory Health Division National Institute for Occupational Safety and Health Morgantown, West Virginia
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26
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Su FC, Friesen MC, Humann M, Stefaniak AB, Stanton ML, Liang X, LeBouf RF, Henneberger PK, Virji MA. Clustering asthma symptoms and cleaning and disinfecting activities and evaluating their associations among healthcare workers. Int J Hyg Environ Health 2019; 222:873-883. [PMID: 31010790 DOI: 10.1016/j.ijheh.2019.04.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/28/2019] [Accepted: 04/11/2019] [Indexed: 01/09/2023]
Abstract
Asthma is a heterogeneous disease with varying severity and subtypes. Recent reviews of epidemiologic studies have identified cleaning and disinfecting activities (CDAs) as important risk factors for asthma-related outcomes among healthcare workers. However, the complexity of CDAs in healthcare settings has rarely been examined. This study utilized a complex survey dataset and data reduction approaches to identify and group healthcare workers with similar patterns of asthma symptoms, and then explored their associations with groups of participants with similar patterns of CDAs. Self-reported information on asthma symptoms/care, CDAs, demographics, smoking status, allergic status, and other characteristics were collected from 2030 healthcare workers within nine selected occupations in New York City. Hierarchical clustering was conducted to systematically group participants based on similarity of patterns of the 27 asthma symptom/care variables, and 14 product applications during CDAs, separately. Word clouds were used to visualize the complex information on the resulting clusters. The associations of asthma health clusters (HCs) with exposure clusters (ECs) were evaluated using multinomial logistic regression. Five HCs were identified (HC-1 to HC-5), labelled based on predominant features as: "no symptoms", "winter cough/phlegm", "mild asthma symptoms", "undiagnosed/untreated asthma", and "asthma attacks/exacerbations". For CDAs, five ECs were identified (EC-1 to EC-5), labelled as: "no products", "housekeeping/chlorine", "patient care", "general cleaning/laboratory", and "disinfection products". Using HC-1 and EC-1 as the reference groups, EC-2 was associated with HC-4 (odds ratio (OR) = 3.11, 95% confidence interval (95% CI) = 1.46-6.63) and HC-5 (OR = 2.71, 95% CI = 1.25-5.86). EC-3 was associated with HC-5 (OR = 2.34, 95% CI = 1.16-4.72). EC-4 was associated with HC-5 (OR = 2.35, 95% CI = 1.07-5.13). EC-5 was associated with HC-3 (OR = 1.81, 95% CI = 1.09-2.99) and HC-4 (OR = 3.42, 95% CI = 1.24-9.39). Various combinations of product applications like using alcohols, bleach, high-level disinfectants, and enzymes to disinfect instruments and clean surfaces captured by the ECs were identified as risk factors for the different asthma symptoms clusters, indicating that prevention efforts may require targeting multiple products. The associations of HCs with EC can be used to better inform prevention strategies and treatment options to avoid disease progression. This study demonstrated hierarchical clustering and word clouds were useful techniques for analyzing and visualizing a complex dataset with a large number of potentially correlated variables to generate practical information that can inform prevention activities.
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Affiliation(s)
- Feng-Chiao Su
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, USA
| | - Melissa C Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Michael Humann
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, USA
| | - Aleksandr B Stefaniak
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, USA
| | - Marcia L Stanton
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, USA
| | - Xiaoming Liang
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, USA
| | - Ryan F LeBouf
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, USA
| | - Paul K Henneberger
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, USA
| | - M Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, USA.
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Blackley BH, Gibbs JL, Cummings KJ, Stefaniak AB, Park JY, Stanton M, Abbas Virji M. A field evaluation of a single sampler for respirable and inhalable indium and dust measurements at an indium-tin oxide manufacturing facility. J Occup Environ Hyg 2019; 16:66-77. [PMID: 30325716 PMCID: PMC6419101 DOI: 10.1080/15459624.2018.1536826] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Indium-tin oxide production has increased greatly in the last 20 years subsequent to increased global demand for touch screens and photovoltaics. Previous studies used measurements of indium in blood as an indicator of indium exposure and observed associations with adverse respiratory outcomes. However, correlations between measurements of blood indium and airborne respirable indium are inconsistent, in part because of the long half-life of indium in blood, but also because respirable indium measurements do not incorporate inhalable indium that can contribute to the observed biological burden. Information is lacking on relationships between respirable and inhalable indium exposure, which have implications for biological indicators like blood indium. The dual IOM sampler includes the foam disc insert and can simultaneously collect respirable and inhalable aerosol. Here, the field performance of the dual IOM sampler was evaluated by comparing performance with the respirable cyclone and traditional IOM for respirable and inhalable indium and dust exposure, respectively. Side-by-side area air samples were collected throughout an indium-tin oxide manufacturing facility. Cascade impactors were used to determine particle size distribution. Several statistical methods were used to evaluate the agreement between the pairs of samplers including calculating the concordance correlation coefficient and its accuracy and precision components. One-way ANOVA was used to evaluate the effect of dust concentration on sampler differences. Respirable indium measurements showed better agreement (concordance correlation coefficient: 0.932) compared to respirable dust measurements (concordance correlation coefficient: 0.777) with significant differences observed in respirable dust measurements. The dual IOM measurements had high agreement with the traditional IOM for inhalable indium (concordance correlation coefficient: 0.997) but lower agreement for inhalable dust (concordance correlation coefficient: 0.886 and accuracy: 0.896) with a significantly large mean bias (-146.9 µg/m3). Dust concentration significantly affected sampler measurements of inhalable dust and inhalable indium. Results from this study suggest that the dual IOM is a useful single sampler for simultaneous measurements of occupational exposure to respirable and inhalable indium.
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Affiliation(s)
- Brie Hawley Blackley
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Jenna L. Gibbs
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
- Department of Occupational and Environmental Health, The University of Iowa, Iowa City, Iowa
| | - Kristin J. Cummings
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Aleksandr B. Stefaniak
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Ji Young Park
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Marcia Stanton
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - M. Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
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Stefaniak AB, Bowers LN, Knepp AK, Virji MA, Birch EM, Ham JE, Wells JR, Chaolong Q, Schwegler-Berry D, Friend S, Johnson AR, Martin SB, Qian Y, LeBouf RF, Birch Q, Hammond D. Three-dimensional printing with nano-enabled filaments releases polymer particles containing carbon nanotubes into air. Indoor Air 2018; 28:840-851. [PMID: 30101413 PMCID: PMC6398333 DOI: 10.1111/ina.12499] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 08/03/2018] [Accepted: 08/06/2018] [Indexed: 05/14/2023]
Abstract
Fused deposition modeling (FDM™) 3-dimensional printing uses polymer filament to build objects. Some polymer filaments are formulated with additives, though it is unknown if they are released during printing. Three commercially available filaments that contained carbon nanotubes (CNTs) were printed with a desktop FDM™ 3-D printer in a chamber while monitoring total particle number concentration and size distribution. Airborne particles were collected on filters and analyzed using electron microscopy. Carbonyl compounds were identified by mass spectrometry. The elemental carbon content of the bulk CNT-containing filaments was 1.5 to 5.2 wt%. CNT-containing filaments released up to 1010 ultrafine (d < 100 nm) particles/g printed and 106 to 108 respirable (d ~0.5 to 2 μm) particles/g printed. From microscopy, 1% of the emitted respirable polymer particles contained visible CNTs. Carbonyl emissions were observed above the limit of detection (LOD) but were below the limit of quantitation (LOQ). Modeling indicated that, for all filaments, the average proportional lung deposition of CNT-containing polymer particles was 6.5%, 5.7%, and 7.2% for the head airways, tracheobronchiolar, and pulmonary regions, respectively. If CNT-containing polymer particles are hazardous, it would be prudent to control emissions during use of these filaments.
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Affiliation(s)
| | - Lauren N. Bowers
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Alycia K. Knepp
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - M. Abbas Virji
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Eileen M. Birch
- National Institute for Occupational Safety and Health, Cincinnati, Ohio
| | - Jason E. Ham
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - J. R. Wells
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Qi Chaolong
- National Institute for Occupational Safety and Health, Cincinnati, Ohio
| | | | - Sherri Friend
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Alyson R. Johnson
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Stephen B. Martin
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Yong Qian
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Ryan F. LeBouf
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Quinn Birch
- Department of Chemical and Environmental Engineering, College of Engineering and Applied Science, University of Cincinnati, Cincinnati, Ohio
| | - Duane Hammond
- National Institute for Occupational Safety and Health, Cincinnati, Ohio
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Caridi MN, Humann MJ, Liang X, Su FC, Stefaniak AB, LeBouf RF, Stanton ML, Virji MA, Henneberger PK. Occupation and task as risk factors for asthma-related outcomes among healthcare workers in New York City. Int J Hyg Environ Health 2018; 222:211-220. [PMID: 30327176 DOI: 10.1016/j.ijheh.2018.10.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/23/2018] [Accepted: 10/04/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Previous studies have suggested an association of asthma onset and exacerbation with cleaning and disinfecting activities in a number of industries, including healthcare. The objective of the current study was to investigate the association of asthma and related outcomes with occupations and tasks in urban healthcare workers in the United States. METHODS A questionnaire was implemented in a sample of workers from nine healthcare occupations in New York City. We used regression models to examine the association of post-hire asthma, current asthma, exacerbation of asthma, a symptom algorithm for bronchial hyper-responsiveness (BHR-related symptoms), a symptom-based asthma score, and the symptom wheeze with occupation and four healthcare tasks, while adjusting for other risk factors and potential confounders. RESULTS A total of 2030 participants completed the questionnaire. The task of cleaning fixed surfaces was significantly associated with most outcome variables, including current asthma (odds ratio (OR) = 1.84, 95% confidence interval (CI) 1.26-2.68), moderate exacerbation (OR = 3.10, 95% CI 1.25-7.67), and BHR-related symptoms (OR = 1.38, 95% CI 1.08-1.77). In comparison to nursing assistants, the occupations environmental service workers and registered nurses were at higher risk for current asthma, and licensed practical nurses were at higher risk for moderate exacerbation. Other tasks associated with outcomes were administering aerosolized medications with current asthma and moderate exacerbation, and sterilizing medical equipment with BHR-related symptoms. CONCLUSIONS These findings add to the growing body of evidence for the association of asthma with cleaning and other activities in healthcare. Further research is especially needed to investigate the association of asthma-related outcomes with exposure metrics based on tasks, products, and chemical exposures in healthcare.
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Affiliation(s)
- Morgan N Caridi
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, United States
| | - Michael J Humann
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, United States
| | - Xiaoming Liang
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, United States
| | - Feng-Chiao Su
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, United States
| | - Aleksandr B Stefaniak
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, United States
| | - Ryan F LeBouf
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, United States
| | - Marcia L Stanton
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, United States
| | - M Abbas Virji
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, United States
| | - Paul K Henneberger
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV, United States.
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30
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Abstract
Objective Direct reading instruments are valuable tools for measuring exposure as they provide real-time measurements for rapid decision making. However, their use is limited to general survey applications in part due to issues related to their performance. Moreover, statistical analysis of real-time data is complicated by autocorrelation among successive measurements, non-stationary time series, and the presence of left-censoring due to limit-of-detection (LOD). A Bayesian framework is proposed that accounts for non-stationary autocorrelation and LOD issues in exposure time-series data in order to model workplace factors that affect exposure and estimate summary statistics for tasks or other covariates of interest. Method A spline-based approach is used to model non-stationary autocorrelation with relatively few assumptions about autocorrelation structure. Left-censoring is addressed by integrating over the left tail of the distribution. The model is fit using Markov-Chain Monte Carlo within a Bayesian paradigm. The method can flexibly account for hierarchical relationships, random effects and fixed effects of covariates. The method is implemented using the rjags package in R, and is illustrated by applying it to real-time exposure data. Estimates for task means and covariates from the Bayesian model are compared to those from conventional frequentist models including linear regression, mixed-effects, and time-series models with different autocorrelation structures. Simulations studies are also conducted to evaluate method performance. Results Simulation studies with percent of measurements below the LOD ranging from 0 to 50% showed lowest root mean squared errors for task means and the least biased standard deviations from the Bayesian model compared to the frequentist models across all levels of LOD. In the application, task means from the Bayesian model were similar to means from the frequentist models, while the standard deviations were different. Parameter estimates for covariates were significant in some frequentist models, but in the Bayesian model their credible intervals contained zero; such discrepancies were observed in multiple datasets. Variance components from the Bayesian model reflected substantial autocorrelation, consistent with the frequentist models, except for the auto-regressive moving average model. Plots of means from the Bayesian model showed good fit to the observed data. Conclusion The proposed Bayesian model provides an approach for modeling non-stationary autocorrelation in a hierarchical modeling framework to estimate task means, standard deviations, quantiles, and parameter estimates for covariates that are less biased and have better performance characteristics than some of the contemporary methods.
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Affiliation(s)
- E Andres Houseman
- Oregon State University, College of Public Health and Human Sciences, 101 Milam Hall, 2520 SW Campus Way, Corvallis, OR 97331, USA
| | - M Abbas Virji
- National Institute for Occupational Safety and Health, Respiratory Health Division, 1095 Willowdale Rd, Morgantown, WV 26505, USA
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Harvey RR, Hawley BM, Virji MA, Cummings KJ. Serum YKL-40 in workers at an indium-tin oxide production facility. Respirology 2017; 23:341-342. [PMID: 29243861 DOI: 10.1111/resp.13236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 10/26/2017] [Indexed: 11/29/2022]
Affiliation(s)
- R Reid Harvey
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Brie M Hawley
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - M Abbas Virji
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Kristin J Cummings
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
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32
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Stefaniak AB, LeBouf RF, Yi J, Ham J, Nurkewicz T, Schwegler-Berry DE, Chen BT, Wells JR, Duling MG, Lawrence RB, Martin SB, Johnson AR, Virji MA. Characterization of chemical contaminants generated by a desktop fused deposition modeling 3-dimensional Printer. J Occup Environ Hyg 2017; 14:540-550. [PMID: 28440728 PMCID: PMC5967408 DOI: 10.1080/15459624.2017.1302589] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Printing devices are known to emit chemicals into the indoor atmosphere. Understanding factors that influence release of chemical contaminants from printers is necessary to develop effective exposure assessment and control strategies. In this study, a desktop fused deposition modeling (FDM) 3-dimensional (3-D) printer using acrylonitrile butadiene styrene (ABS) or polylactic acid (PLA) filaments and two monochrome laser printers were evaluated in a 0.5 m3 chamber. During printing, chamber air was monitored for vapors using a real-time photoionization detector (results expressed as isobutylene equivalents) to measure total volatile organic compound (TVOC) concentrations, evacuated canisters to identify specific VOCs by off-line gas chromatography-mass spectrometry (GC-MS) analysis, and liquid bubblers to identify carbonyl compounds by GC-MS. Airborne particles were collected on filters for off-line analysis using scanning electron microscopy with an energy dispersive x-ray detector to identify elemental constituents. For 3-D printing, TVOC emission rates were influenced by a printer malfunction, filament type, and to a lesser extent, by filament color; however, rates were not influenced by the number of printer nozzles used or the manufacturer's provided cover. TVOC emission rates were significantly lower for the 3-D printer (49-3552 µg h-1) compared to the laser printers (5782-7735 µg h-1). A total of 14 VOCs were identified during 3-D printing that were not present during laser printing. 3-D printed objects continued to off-gas styrene, indicating potential for continued exposure after the print job is completed. Carbonyl reaction products were likely formed from emissions of the 3-D printer, including 4-oxopentanal. Ultrafine particles generated by the 3-D printer using ABS and a laser printer contained chromium. Consideration of the factors that influenced the release of chemical contaminants (including known and suspected asthmagens such as styrene and 4-oxopentanal) from a FDM 3-D printer should be made when designing exposure assessment and control strategies.
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Affiliation(s)
| | - Ryan F. LeBouf
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Jinghai Yi
- Center for Cardiovascular and Respiratory Sciences and Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Jason Ham
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Timothy Nurkewicz
- Center for Cardiovascular and Respiratory Sciences and Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia
| | | | - Bean T. Chen
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - J. Raymond Wells
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Matthew G. Duling
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Robert B. Lawrence
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Stephen B. Martin
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Alyson R. Johnson
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - M. Abbas Virji
- National Institute for Occupational Safety and Health, Morgantown, West Virginia
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Harvey RR, Virji MA, Cummings KJ. Assessing risk of indium lung disease to workers in downstream industries. Am J Ind Med 2017; 60:310-311. [PMID: 27747908 DOI: 10.1002/ajim.22661] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2016] [Indexed: 11/09/2022]
Affiliation(s)
- R. Reid Harvey
- Centers for Disease Control and Prevention; National Institute for Occupational Safety and Health; Morgantown West Virginia
| | - M. Abbas Virji
- Centers for Disease Control and Prevention; National Institute for Occupational Safety and Health; Morgantown West Virginia
| | - Kristin J. Cummings
- Centers for Disease Control and Prevention; National Institute for Occupational Safety and Health; Morgantown West Virginia
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34
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Stefaniak AB, Virji MA, Badding MA, Cummings KJ. Application of the ICRP respiratory tract model to estimate pulmonary retention of industrially sampled indium-containing dusts. Inhal Toxicol 2017; 29:169-178. [PMID: 28595469 PMCID: PMC5746041 DOI: 10.1080/08958378.2017.1333548] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/10/2017] [Accepted: 05/16/2017] [Indexed: 10/19/2022]
Abstract
Inhalation of indium-containing dusts is associated with the development of indium lung disease. Workers may be exposed to several different chemical forms of indium; however, their lung dosimetry is not fully understood. We characterized the physicochemical properties and measured the lung dissolution kinetics of eight indium-containing dusts. Indium dissolution rates in artificial lung fluids spanned two orders of magnitude. We used the International Commission on Radiological Protection (ICRP) human respiratory model (HRTM) to estimate pulmonary indium deposition, retention and biokinetic clearance to blood. For a two-year (median workforce tenure at facility) exposure to respirable-sized particles of the indium materials, modeled indium clearance (>99.99% removed) from the alveolar-interstitial compartment was slow for all dusts; salts would clear in 4 years, sintered indium-tin oxide (ITO) would clear in 9 years, and indium oxide would require 48 years. For this scenario, the ICRP HRTM predicted that indium translocated to blood would be present in that compartment for 3.5-18 years after cessation of exposure, depending on the chemical form. For a 40-year exposure (working lifetime), clearance from the alveolar-interstitial compartment would require 5, 10 and 60 years for indium salts, sintered ITO and indium oxide, respectively and indium would be present in blood for 5-53 years after exposure. Consideration of differences in chemical forms of indium, dissolution rates, alveolar clearance and residence time in blood should be included in exposure assessment and epidemiological studies that rely on measures of total indium in air or blood to derive risk estimates.
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Affiliation(s)
- Aleksandr B Stefaniak
- a National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention , Morgantown , WV , USA
| | - M Abbas Virji
- a National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention , Morgantown , WV , USA
| | - Melissa A Badding
- a National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention , Morgantown , WV , USA
| | - Kristin J Cummings
- a National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention , Morgantown , WV , USA
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35
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Harvey RR, Virji MA, Edwards NT, Cummings KJ. Comparing plasma, serum and whole blood indium concentrations from workers at an indium-tin oxide (ITO) production facility. Occup Environ Med 2016; 73:864-867. [PMID: 27456157 DOI: 10.1136/oemed-2016-103685] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/17/2016] [Accepted: 07/05/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Occupational exposure to indium compounds including indium-tin oxide (ITO) can result in potentially fatal indium lung disease. We compared plasma, serum and whole blood indium concentrations (InP, InS and InB) from workers at a single ITO production facility to assess the comparability of these matrices used for biological monitoring of indium exposure. METHOD InP, InS and InB were measured using inductively coupled mass spectrometry from consenting workers at an ITO production facility with specimen collection occurring during June-July 2014. Matched pairs from workers were assessed to determine the matrix relationships using the Pearson correlation, paired t-tests, per cent difference, linear regression and κ statistics. RESULTS Indium matrices were collected from 80 workers. Mean (SD) InP, InS and InB were 3.48 (3.84), 3.90 (4.15) and 4.66 (5.32) mcg/L, respectively. The InS-InP difference was 14%; InS was higher in all but two workers. InP and InS were highly correlated (r=>0.99). The InB-InS difference was 19%; InB was higher in 85% of workers. The InB-InP difference was 34%; InB was higher in 66% of workers. InB was highly correlated with both InP and InS (r=0.97 and 0.96, respectively). κ Statistics were 0.84, 0.83 and 0.82 for InP, InS and InB, respectively, for individuals with each matrix ≥1 mcg/L (p<0.01). CONCLUSIONS While all matrices were highly correlated, we encourage the use of InP and InS to reliably compare studies across different populations using different matrices. The higher per cent difference and increased variability of InB may limit its utility in comparisons with InP and InS in different populations.
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Affiliation(s)
- R Reid Harvey
- National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, West Virginia, USA
| | - M Abbas Virji
- National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, West Virginia, USA
| | - Nicole T Edwards
- National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, West Virginia, USA
| | - Kristin J Cummings
- National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, West Virginia, USA
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36
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Cummings KJ, Virji MA, Park JY, Stanton ML, Edwards NT, Trapnell BC, Carey B, Stefaniak AB, Kreiss K. Respirable indium exposures, plasma indium, and respiratory health among indium-tin oxide (ITO) workers. Am J Ind Med 2016; 59:522-31. [PMID: 27219296 DOI: 10.1002/ajim.22585] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2016] [Indexed: 11/05/2022]
Abstract
BACKGROUND Workers manufacturing indium-tin oxide (ITO) are at risk of elevated indium concentration in blood and indium lung disease, but relationships between respirable indium exposures and biomarkers of exposure and disease are unknown. METHODS For 87 (93%) current ITO workers, we determined correlations between respirable and plasma indium and evaluated associations between exposures and health outcomes. RESULTS Current respirable indium exposure ranged from 0.4 to 108 μg/m(3) and cumulative respirable indium exposure from 0.4 to 923 μg-yr/m(3) . Plasma indium better correlated with cumulative (rs = 0.77) than current exposure (rs = 0.54) overall and with tenure ≥1.9 years. Higher cumulative respirable indium exposures were associated with more dyspnea, lower spirometric parameters, and higher serum biomarkers of lung disease (KL-6 and SP-D), with significant effects starting at 22 μg-yr/m(3) , reached by 46% of participants. CONCLUSIONS Plasma indium concentration reflected cumulative respirable indium exposure, which was associated with clinical, functional, and serum biomarkers of lung disease. Am. J. Ind. Med. 59:522-531, 2016. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.
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Affiliation(s)
- Kristin J. Cummings
- National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Morgantown West Virginia
| | - M. Abbas Virji
- National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Morgantown West Virginia
| | - Ji Young Park
- National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Morgantown West Virginia
- Institute of Health and Environment; Seoul National University; Seoul Republic of Korea
| | - Marcia L. Stanton
- National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Morgantown West Virginia
| | - Nicole T. Edwards
- National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Morgantown West Virginia
| | - Bruce C. Trapnell
- Translational Pulmonary Science Center; Cincinnati Children's Hospital Medical Center; Cincinnati Ohio
- Division of Pulmonary, Critical Care, and Sleep Medicine; University of Cincinnati College of Medicine; Cincinnati Ohio
| | - Brenna Carey
- Translational Pulmonary Science Center; Cincinnati Children's Hospital Medical Center; Cincinnati Ohio
| | - Aleksandr B. Stefaniak
- National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Morgantown West Virginia
| | - Kathleen Kreiss
- National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Morgantown West Virginia
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37
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Yi J, LeBouf RF, Duling MG, Nurkiewicz T, Chen BT, Schwegler-Berry D, Virji MA, Stefaniak AB. Emission of particulate matter from a desktop three-dimensional (3D) printer. J Toxicol Environ Health A 2016; 79:453-65. [PMID: 27196745 PMCID: PMC4917922 DOI: 10.1080/15287394.2016.1166467] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 03/13/2016] [Indexed: 05/21/2023]
Abstract
Desktop three-dimensional (3D) printers are becoming commonplace in business offices, public libraries, university labs and classrooms, and even private homes; however, these settings are generally not designed for exposure control. Prior experience with a variety of office equipment devices such as laser printers that emit ultrafine particles (UFP) suggests the need to characterize 3D printer emissions to enable reliable risk assessment. The aim of this study was to examine factors that influence particulate emissions from 3D printers and characterize their physical properties to inform risk assessment. Emissions were evaluated in a 0.5-m(3) chamber and in a small room (32.7 m(3)) using real-time instrumentation to measure particle number, size distribution, mass, and surface area. Factors evaluated included filament composition and color, as well as the manufacturer-provided printer emissions control technologies while printing an object. Filament type significantly influenced emissions, with acrylonitrile butadiene styrene (ABS) emitting larger particles than polylactic acid (PLA), which may have been the result of agglomeration. Geometric mean particle sizes and total particle (TP) number and mass emissions differed significantly among colors of a given filament type. Use of a cover on the printer reduced TP emissions by a factor of 2. Lung deposition calculations indicated a threefold higher PLA particle deposition in alveoli compared to ABS. Desktop 3D printers emit high levels of UFP, which are released into indoor environments where adequate ventilation may not be present to control emissions. Emissions in nonindustrial settings need to be reduced through the use of a hierarchy of controls, beginning with device design, followed by engineering controls (ventilation) and administrative controls such as choice of filament composition and color.
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Affiliation(s)
- Jinghai Yi
- Center for Cardiovascular and Respiratory Sciences and Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Ryan F. LeBouf
- National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Matthew G. Duling
- National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Timothy Nurkiewicz
- Center for Cardiovascular and Respiratory Sciences and Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Bean T. Chen
- National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Diane Schwegler-Berry
- National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - M. Abbas Virji
- National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Aleksandr B. Stefaniak
- National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
- CONTACT Aleksandr B. Stefaniak, PhD, CIH National Institute for Occupational Safety and Health, Respiratory Health Division, 1095 Willowdale Road, Morgantown, WV26505, USA
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Saito R, Virji MA, Henneberger PK, Humann MJ, LeBouf RF, Stanton ML, Liang X, Stefaniak AB. Characterization of cleaning and disinfecting tasks and product use among hospital occupations. Am J Ind Med 2015; 58:101-11. [PMID: 25351791 DOI: 10.1002/ajim.22393] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND Healthcare workers have an elevated prevalence of asthma and related symptoms associated with the use of cleaning/disinfecting products. The objective of this study was to identify and characterize cleaning/disinfecting tasks and products used among hospital occupations. METHODS Workers from 14 occupations at five hospitals were monitored for 216 shifts, and work tasks and products used were recorded at five-minute intervals. The major chemical constituents of each product were identified from safety data sheets. RESULTS Cleaning and disinfecting tasks were performed with a high frequency at least once per shift in many occupations. Medical equipment preparers, housekeepers, floor strippers/waxers, and endoscopy technicians spent on average 108-177 min/shift performing cleaning/disinfecting tasks. Many occupations used products containing amines and quaternary ammonium compounds for >100 min/shift. CONCLUSIONS This analysis demonstrates that many occupations besides housekeeping incur exposures to cleaning/disinfecting products, albeit for different durations and using products containing different chemicals.
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Affiliation(s)
- Rena Saito
- Division of Respiratory Disease Studies; National Institute for Occupational Safety and Health; Morgantown West Virginia
| | - M. Abbas Virji
- Division of Respiratory Disease Studies; National Institute for Occupational Safety and Health; Morgantown West Virginia
| | - Paul K. Henneberger
- Division of Respiratory Disease Studies; National Institute for Occupational Safety and Health; Morgantown West Virginia
| | - Michael J. Humann
- Division of Respiratory Disease Studies; National Institute for Occupational Safety and Health; Morgantown West Virginia
| | - Ryan F. LeBouf
- Division of Respiratory Disease Studies; National Institute for Occupational Safety and Health; Morgantown West Virginia
| | - Marcia L. Stanton
- Division of Respiratory Disease Studies; National Institute for Occupational Safety and Health; Morgantown West Virginia
| | - Xiaoming Liang
- Division of Respiratory Disease Studies; National Institute for Occupational Safety and Health; Morgantown West Virginia
| | - Aleksandr B. Stefaniak
- Division of Respiratory Disease Studies; National Institute for Occupational Safety and Health; Morgantown West Virginia
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Abstract
OBJECTIVES To identify and summarise volatile organic compound (VOC) exposure profiles of healthcare occupations. METHODS Personal (n=143) and mobile area (n=207) evacuated canisters were collected and analysed by a gas chromatograph/mass spectrometer to assess exposures to 14 VOCs among 14 healthcare occupations in five hospitals. Participants were volunteers identified by their supervisors. Summary statistics were calculated by occupation. Principal component analysis (PCA) was used to reduce the 14 analyte inputs to five orthogonal factors and identify occupations that were associated with these factors. Linear regressions were used to assess the association between personal and mobile area samples. RESULTS Exposure profiles differed among occupations; ethanol had the highest geometric mean (GM) among nursing assistants (∼4900 and ∼1900 µg/m(3), personal and area), and 2-propanol had the highest GM among medical equipment preparers (∼4600 and ∼2000 µg/m(3), personal and area). The highest total personal VOC exposures were among nursing assistants (∼9200 µg/m(3)), licensed practical nurses (∼8700 µg/m(3)) and medical equipment preparers (∼7900 µg/m(3)). The influence of the PCA factors developed from personal exposure estimates varied by occupation, which enabled a comparative assessment of occupations. For example, factor 1, indicative of solvent use, was positively correlated with clinical laboratory and floor stripping/waxing occupations and tasks. Overall, a significant correlation was observed (r=0.88) between matched personal and mobile area samples, but varied considerably by analyte (r=0.23-0.64). CONCLUSIONS Healthcare workers are exposed to a variety of chemicals that vary with the activities and products used during activities. These VOC profiles are useful for estimating exposures for occupational hazard ranking for industrial hygienists as well as epidemiological studies.
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Affiliation(s)
- Ryan F LeBouf
- National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - M Abbas Virji
- National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Rena Saito
- National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Paul K Henneberger
- National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Nancy Simcox
- Center for Indoor Environments and Health, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Aleksandr B Stefaniak
- National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
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Stefaniak AB, Duling MG, Lawrence RB, Thomas TA, LeBouf RF, Wade EE, Virji MA. Dermal exposure potential from textiles that contain silver nanoparticles. Int J Occup Environ Health 2014; 20:220-34. [PMID: 25000110 PMCID: PMC4090883 DOI: 10.1179/2049396714y.0000000070] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Factors that influence exposure to silver particles from the use of textiles are not well understood. OBJECTIVES The aim of this study was to evaluate the influence of product treatment and physiological factors on silver release from two textiles. METHODS Atomic and absorbance spectroscopy, electron microscopy, and dynamic light scattering (DLS) were applied to characterize the chemical and physical properties of the textiles and evaluate silver release in artificial sweat and saliva under varying physiological conditions. One textile had silver incorporated into fiber threads (masterbatch process) and the other had silver nanoparticles coated on fiber surfaces (finishing process). RESULTS Several complementary and confirmatory analytical techniques (spectroscopy, microscopy, etc.) were required to properly assess silver release. Silver released into artificial sweat or saliva was primarily in ionic form. In a simulated "use" and laundering experiment, the total cumulative amount of silver ion released was greater for the finishing process textile (0·51±0·04%) than the masterbatch process textile (0·21±0·01%); P<0·01. CONCLUSIONS We found that the process (masterbatch vs finishing) used to treat textile fibers was a more influential exposure factor than physiological properties of artificial sweat or saliva.
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Stefaniak AB, Duling MG, Geer L, Virji MA. Dissolution of the metal sensitizers Ni, Be, Cr in artificial sweat to improve estimates of dermal bioaccessibility. Environ Sci Process Impacts 2014; 16:341-51. [PMID: 24448251 PMCID: PMC4547829 DOI: 10.1039/c3em00570d] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Dermal exposure to sensitizing metals is a serious occupational and public health problem. The usual approach to dermal exposure assessment is to process samples by chemical methods that use reactants to digest the metal particles and quantify the mass. In the case of dermal exposure assessment, these reactants are not representative of the skin surface film liquids and hence, may overestimate bioaccessibility. We hypothesize that the amount and form of sensitizer on a sample that leaches in a biological fluid, as can be estimated using artificial sweat, may be a more relevant metric for assessing health risks. Beryllium metal (Be), nickel metal (Ni), and chromium carbide (Cr3C2) particles were characterized and masses of sensitizing ions were measured using established reactant-assisted digestion procedures and extraction in artificial sweat under physiologically relevant conditions. Chromium ions released into artificial sweat were speciated to understand valence states. The ratios of the fraction of metal dissolved in artificial sweat relative to that dissolved by chemical-specific reactants were 1/2 (Be), 1/108 (Ni), and 1/2500 (Cr). The divalent Be and Ni cations were stable in artificial sweat over time (did not precipitate) whereas hexavalent chromium [Cr(VI)] ions decayed over time. Further analysis using speciated isotope dilution mass spectrometry revealed that the decay of Cr(VI) was accompanied by the formation of Cr(III) in the sweat model. Use of reactant-assisted analytical chemistry to quantify amounts of metal sensitizers on samples could overestimate biologically relevant exposure. In addition to mass, the valence state also influences penetration through the outer stratum corneum of the skin and is an important consideration when assessing exposure to complex sensitizers such as Cr which have multiple valence states with differing penetration efficiencies.
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Affiliation(s)
- Aleksandr B Stefaniak
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 1095 Willowdale Road, Morgantown, WV 26505, USA.
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Gaughan DM, Piacitelli CA, Chen BT, Law BF, Virji MA, Edwards NT, Enright PL, Schwegler-Berry DE, Leonard SS, Wagner GR, Kobzik L, Kales SN, Hughes MD, Christiani DC, Siegel PD, Cox-Ganser JM, Hoover MD. Exposures and cross-shift lung function declines in wildland firefighters. J Occup Environ Hyg 2014; 11:591-603. [PMID: 24568319 PMCID: PMC7781241 DOI: 10.1080/15459624.2014.895372] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Respiratory problems are common among wildland firefighters. However, there are few studies directly linking occupational exposures to respiratory effects in this population. Our objective was to characterize wildland fire fighting occupational exposures and assess their associations with cross-shift changes in lung function. We studied 17 members of the Alpine Interagency Hotshot Crew with environmental sampling and pulmonary function testing during a large wildfire. We characterized particles by examining size distribution and mass concentration, and conducting elemental and morphological analyses. We examined associations between cross-shift lung function change and various analytes, including levoglucosan, an indicator of wood smoke from burning biomass. The levoglucosan component of the wildfire aerosol showed a predominantly bimodal size distribution: a coarse particle mode with a mass median aerodynamic diameter about 12 μm and a fine particle mode with a mass median aerodynamic diameter < 0.5 μm. Levoglucosan was found mainly in the respirable fraction and its concentration was higher for fire line construction operations than for mop-up operations. Larger cross-shift declines in forced expiratory volume in one second were associated with exposure to higher concentrations of respirable levoglucosan (p < 0.05). Paired analyses of real-time personal air sampling measurements indicated that higher carbon monoxide (CO) concentrations were correlated with higher particulate concentrations when examined by mean values, but not by individual data points. However, low CO concentrations did not provide reliable assurance of concomitantly low particulate concentrations. We conclude that inhalation of fine smoke particles is associated with acute lung function decline in some wildland firefighters. Based on short-term findings, it appears important to address possible long-term respiratory health issues for wildland firefighters. [Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Occupational and Environmental Hygiene for the following free supplemental resources: a file containing additional information on historical studies of wildland fire exposures, a file containing the daily-exposure-severity questionnaire completed by wildland firefighter participants at the end of each day, and a file containing additional details of the investigation of correlations between carbon monoxide concentrations and other measured exposure factors in the current study.].
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Affiliation(s)
- Denise M Gaughan
- a Department of Preventive Medicine and the Institute for Translational Epidemiology , Icahn School of Medicine at Mount Sinai , New York , New York
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Armstrong JL, Day GA, Park JY, Stefaniak AB, Stanton ML, Deubner DC, Kent MS, Schuler CR, Virji MA. Migration of Beryllium via Multiple Exposure Pathways among Work Processes in Four Different Facilities. J Occup Environ Hyg 2014; 11:781-792. [PMID: 25357184 PMCID: PMC5003170 DOI: 10.1080/15459624.2014.919392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Inhalation of beryllium is associated with the development of sensitization; however, dermal exposure may also be important. The primary aim of this study was to elucidate relationships among exposure pathways in four different manufacturing and finishing facilities. Secondary aims were to identify jobs with increased levels of beryllium in air, on skin, and on surfaces; identify potential discrepancies in exposure pathways, and determine if these are related to jobs with previously identified risk. Beryllium was measured in air, on cotton gloves, and on work surfaces. Summary statistics were calculated and correlations among all three measurement types were examined at the facility and job level. Exposure ranking strategies were used to identify jobs with higher exposures. The highest air, glove, and surface measurements were observed in beryllium metal production and beryllium oxide ceramics manufacturing jobs that involved hot processes and handling powders. Two finishing and distribution facilities that handle solid alloy products had lower exposures than the primary production facilities, and there were differences observed among jobs. For all facilities combined, strong correlations were found between air-surface (rp ≥ 0.77), glove-surface (rp ≥ 0.76), and air-glove measurements (rp ≥ 0.69). In jobs where higher risk of beryllium sensitization or disease has been reported, exposure levels for all three measurement types were higher than in jobs with lower risk, though they were not the highest. Some jobs with low air concentrations had higher levels of beryllium on glove and surface wipe samples, suggesting a need to further evaluate the causes of the discrepant levels. Although such correlations provide insight on where beryllium is located throughout the workplace, they cannot identify the direction of the pathways between air, surface, or skin. Ranking strategies helped to identify jobs with the highest combined air, glove, and/or surface exposures. All previously identified high-risk jobs had high air concentrations, dermal mass loading, or both, and none had low dermal and air. We have found that both pathways are relevant. [Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Occupational and Environmental Hygiene for the following free supplemental resource: a file describing the forms of beryllium materials encountered during production and characteristics of the aerosols by process areas.].
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Affiliation(s)
- Jenna L. Armstrong
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Gregory A. Day
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Ji Young Park
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, West Virginia
- Institute of Health and Environment, Seoul National University, Seoul, Korea
| | - Aleksandr B. Stefaniak
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Marcia L. Stanton
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | | | | | - Christine R. Schuler
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - M. Abbas Virji
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, West Virginia
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Duling MG, Stefaniak AB, Lawrence RB, Chipera SJ, Virji MA. Release of beryllium from mineral ores in artificial lung and skin surface fluids. Environ Geochem Health 2012; 34:313-322. [PMID: 21866318 DOI: 10.1007/s10653-011-9421-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Accepted: 08/04/2011] [Indexed: 05/31/2023]
Abstract
Exposure to some manufactured beryllium compounds via skin contact or inhalation can cause sensitization. A portion of sensitized persons who inhale beryllium may develop chronic beryllium disease (CBD). Little is understood about exposures to naturally occurring beryllium minerals. The purpose of this study was to assess the bioaccessibility of beryllium from bertrandite ore. Dissolution of bertrandite from two mine pits (Monitor and Blue Chalk) was evaluated for both the dermal and inhalation exposure pathways by determining bioaccessibility in artificial sweat (pH 5.3 and pH 6.5), airway lining fluid (SUF, pH 7.3), and alveolar macrophage phagolysosomal fluid (PSF, pH 4.5). Significantly more beryllium was released from Monitor pit ore than Blue Chalk pit ore in artificial sweat buffered to pH 5.3 (0.88 ± 0.01% vs. 0.36 ± 0.00%) and pH 6.5 (0.09 ± 0.00% vs. 0.03 ± 0.01%). Rates of beryllium released from the ores in artificial sweat were faster than previously measured for manufactured forms of beryllium (e.g., beryllium oxide), known to induce sensitization in mice. In SUF, levels of beryllium were below the analytical limit of detection. In PSF, beryllium dissolution was biphasic (initial rapid diffusion followed by latter slower surface reactions). During the latter phase, dissolution half-times were 1,400 to 2,000 days, and rate constants were ~7 × 10(-10) g/(cm(2)·day), indicating that bertrandite is persistent in the lung. These data indicate that it is prudent to control skin and inhalation exposures to bertrandite dusts.
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Affiliation(s)
- Matthew G Duling
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV 26505, USA
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LeBouf RF, Stefaniak AB, Virji MA. Validation of evacuated canisters for sampling volatile organic compounds in healthcare settings. ACTA ACUST UNITED AC 2012; 14:977-83. [PMID: 22322315 DOI: 10.1039/c2em10896h] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Healthcare settings present a challenging environment for assessing low-level concentrations of specific volatile organic compounds (VOCs) in the presence of high background concentrations of alcohol from the use of hand sanitizers and surface disinfectants. The purposes of this laboratory-based project were to develop and validate a sampling and analysis methodology for quantifying low-level VOC concentrations as well as high-level alcohol concentrations found together in healthcare settings. Sampling was conducted using evacuated canisters lined with fused silica. Gas chromatography/mass spectrometry analysis was performed using preconcentration (for ppb levels) and loop injection (for ppm levels). For a select list of 14 VOCs, bias, precision, and accuracy of both the preconcentration and loop injection methods were evaluated, as was analyte stability in evacuated canisters over 30 days. Using the preconcentration (ppb-level) method, all validation criteria were met for 13 of the 14 target analytes-ethanol, acetone, methylene chloride, hexane, chloroform, benzene, methyl methacrylate, toluene, ethylbenzene, m,p-xylene, o-xylene, alpha-pinene, and limonene. Using the loop injection (ppm-level) method, all validation criteria were met for each analyte. At ppm levels, alpha-pinene and limonene remained stable over 21 days, while the rest of the analytes were stable for 30 days. All analytes remained stable over 30 days at ppb levels. This sampling and analysis approach is a viable (i.e., accurate and stable) methodology that will enable development of VOC profiles for mixed exposures experienced by healthcare workers.
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Affiliation(s)
- Ryan F LeBouf
- National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV 26505, USA.
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Abstract
Inhaled beryllium particles that deposit in the lung airway lining fluid may dissolve and interact with immune-competent cells resulting in sensitization. As such, solubilization of 17 beryllium-containing materials (ore, hydroxide, metal, oxide, alloys, and process intermediates) was investigated using artificial human airway epithelial lining fluid. The maximum beryllium release in 7 days was 11.78% (from a beryl ore melter dust), although release from most materials was < 1%. Calculated dissolution half-times ranged from 30 days (reduction furnace material) to 74,000 days (hydroxide). Despite rapid mechanical clearance, billions of beryllium ions may be released in the respiratory tract via dissolution in airway lining fluid. Beryllium-containing particles that deposit in the respiratory tract dissolve in artificial lung epithelial lining fluid, thereby providing ions for absorption in the lung and interaction with immune-competent cells in the respiratory tract.
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Affiliation(s)
- Aleksandr B Stefaniak
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia 26505, USA.
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Schuler CR, Virji MA, Deubner DC, Stanton ML, Stefaniak AB, Day GA, Park JY, Kent MS, Sparks R, Kreiss K. Sensitization and chronic beryllium disease at a primary manufacturing facility, part 3: exposure–response among short-term workers. Scand J Work Environ Health 2011; 38:270-81. [DOI: 10.5271/sjweh.3192] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Park JY, Virji MA, Stefaniak AB, Stanton ML, Day GA, Kent MS, Schuler CR, Kreiss K. Sensitization and chronic beryllium disease at a primary manufacturing facility, part 2: validation of historical exposures. Scand J Work Environ Health 2011; 38:259-69. [PMID: 21847507 DOI: 10.5271/sjweh.3187] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the validity of a job exposure matrix (JEM) constructed for the period 1994-1999. Historical exposure estimates (HEE) for the JEM were constructed for all job and year combinations by applying temporal factors reflecting annual change in area air measurements (1994-1998) to the personal baseline exposure estimates (BEE) collected in 1999. The JEM was generated for an epidemiologic study to examine quantitative exposure-response relationships with sensitization and chronic beryllium disease. METHODS The validity of the BEE and HEE was evaluated by comparing them with a validation dataset of independently collected personal beryllium exposure measurements from 1999 and 1994-1998, respectively. Agreement between the JEM and validation data was assessed using relative bias and concordance correlation coefficients (CCC). RESULTS The BEE and HEE overestimated the measured exposures in their respective validation datasets by 8% and 6%, respectively. The CCC reflecting the deviation of the fitted line from the concordance line, showed good agreement for both BEE (CCC=0.80) and HEE (CCC=0.72). Proportional difference did not change with exposure levels or by process area and year. Overall, the agreement between the JEM and validation estimates (from combined HEE and BEE) was high (CCC=0.77). CONCLUSIONS This study demonstrated that the reconstructed beryllium exposures at a manufacturing facility were reliable and can be used in epidemiologic studies.
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Affiliation(s)
- Ji Young Park
- National Institute for Occupational Safety and Health (NIOSH), Division of Respiratory Disease Studies, Morgantown, WV, USA
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Virji MA, Park JY, Stefaniak AB, Stanton ML, Day GA, Kent MS, Kreiss K, Schuler CR. Sensitization and chronic beryllium disease at a primary manufacturing facility, part 1: historical exposure reconstruction. Scand J Work Environ Health 2011; 38:247-58. [DOI: 10.5271/sjweh.3188] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Stefaniak AB, Virji MA, Day GA. Dissolution of beryllium in artificial lung alveolar macrophage phagolysosomal fluid. Chemosphere 2011; 83:1181-1187. [PMID: 21251696 DOI: 10.1016/j.chemosphere.2010.12.088] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Revised: 12/22/2010] [Accepted: 12/27/2010] [Indexed: 05/30/2023]
Abstract
Dissolution of a lung burden of poorly soluble beryllium particles is hypothesized to be necessary for development of chronic beryllium lung disease (CBD) in humans. As such, particle dissolution rate must be sufficient to activate the lung immune response and dissolution lifetime sufficient to maintain chronic inflammation for months to years to support development of disease. The purpose of this research was to investigate the hypothesis that poorly soluble beryllium compounds release ions via dissolution in lung fluid. Dissolution kinetics of 17 poorly soluble particulate beryllium materials that span extraction through ceramics machining (ores, hydroxide, metal, copper-beryllium [CuBe] fume, oxides) and three CuBe alloy reference materials (chips, solid block) were measured over 31 d using artificial lung alveolar macrophage phagolysosomal fluid (pH 4.5). Differences in beryllium-containing particle physicochemical properties translated into differences in dissolution rates and lifetimes in artificial phagolysosomal fluid. Among all materials, dissolution rate constant values ranged from 10(-5) to 10(-10)gcm(-2)d(-1) and half-times ranged from tens to thousands of days. The presence of magnesium trisilicate in some beryllium oxide materials may have slowed dissolution rates. Materials associated with elevated prevalence of CBD had faster beryllium dissolution rates [10(-7)-10(-8)gcm(-2)d(-1)] than materials not associated with elevated prevalence (p<0.05).
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Affiliation(s)
- Aleksandr B Stefaniak
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 1095 Willowdale Road, Mail Stop H-2703, Morgantown, WV 26505, USA.
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