Low-cost interventions to improve ventilation in long-term care facilities

Residents of long-term care facilities are particularly vulnerable to communicable diseases. Low-cost interventions to increase air exchange rates (AERs) may be useful in reducing the transmission of airborne communicable diseases between long-term care residents and staff. In this study, carbon dioxide gas was used as a tracer to evaluate the AER associated with the implementation of low-cost ventilation interventions. Under baseline conditions with the room's door closed, the mean AER was 0.67 ACH; while baseline conditions with the door open had a significantly higher mean AER of 3.87 ACH (p < 0.001). Subsequently opening a window with the door open increased mean AER by 1.49 ACH (p = 0.012) and adding a fan in the window further increased mean AER by 1.87 ACH (p < 0.001). Regression analyses indicated that the flow rate of air entering through the window, both passively and through the use of a fan, was significantly associated with an increase in AER (p < 0.001). These results indicate that low-cost interventions that pull outside air into resident rooms were effective in improving the air exchange rates in these facilities. While implementation of these interventions is dependent on facility rules and isolation requirements of residents with airborne communicable diseases, these interventions remain viable options for long-term care facilities to improve resident room ventilation without requiring costly ventilation system upgrades.

Identification of critical industry skills in an industrial hygiene graduate training program

Graduates of industrial hygiene training (IH) programs must be able to meet continuously evolving health and safety needs in a wide variety of occupational settings. Therefore, academic IH graduate programs must regularly evaluate their curricula and solicit input from industry professionals to make curricular changes that will better prepare their students for professional roles in industry. The purpose of this study was to identify the training gaps that existed between industry needs and the current curriculum for a United States-accredited IH graduate training program. The research team facilitated two group interviews with the IH program advisory board, collected alumni survey data, and performed a qualitative analysis to identify skills gaps/needs for the IH Program graduates. The research team identified 3 themes from participant interviews and alumni surveys (technical, applied, and essential skills) and selected several skills within each theme that interview participants thought were necessary proficiencies for junior IH professionals. The skills identified in the qualitative interview and survey data can be incorporated into the curriculum to improve the training of IH graduate students. Additionally, by using qualitative analysis, the researchers uncovered essential skills previously unidentified in IH needs assessments, providing valuable information for all IH graduate programs.

Prevention of COVID-19 in workers: preparation, precaution, and protection

In May 2023 the World Health Organization (WHO) Director General announced the "end" of the COVID-19 Public Health Emergency of International Concern. Although the scale of the pandemic was unprecedented in living memory, it had not been unforeseen. Previous outbreaks of viral respiratory disease have shown important lessons regarding the need to protect healthcare workers (HCW), and research has also been undertaken into the relative effectiveness of control measures and their resource implications. Relevant guidance for worker protection, including HCW protection, which existed at the onset of the COVID-19 pandemic was disregarded both at international and national governmental levels. In many countries there were significant systemic flaws in strategy, culture, and resource availability, and hence in overall preparedness. When the pandemic struck, many experts and organizations advocated a precautionary approach with regard to worker protection, consistent with good occupational hygiene science, practice, and standards. In many Asian countries, protective measures were relatively stringent. However, many workers were left unprotected especially as the WHO, the United States, the United Kingdom, and other governments did not pursue adequate COVID-19 protective measures at work. As the pandemic progressed, improvements in protection were patchy. A notable lack of protection arose from the underestimation of the contribution of aerosol exposure to infection risks, particularly among HCWs providing routine care of potentially infectious patients. A disciplined strategy of source control, pathway control (such as ventilation), and receptor control notably Respiratory Protective Equipment is needed, as well as worldwide vaccination, to contend with this pandemic. Control measures appropriate to the risk of infections transmitted through the air will remain necessary in the longer term, as well as adaptations in the workplace to take account of long-term COVID-19 morbidity and new work practices.

Biomonitoring of polycyclic aromatic hydrocarbons in firefighters at fire training facilities and in employees at respiratory protection and hose workshops

Introduction

Polycyclic aromatic hydrocarbons (PAHs) are carcinogenic to humans and are formed by incomplete combustion. PAHs are always present during firefighting operations, and fire department members can be exposed to them in the workplace.

Methods

In this study, we analyzed 1-hydroxypyrene (1-OHP) in 36 urine samples from nine firefighters, collected before and after fire training sessions, and 32 urine samples from eight employees at respiratory protection and hose workshops. To assess breakthrough PAH exposure through personal protective equipment and potential dermal uptake, some of the workshop employees wore cotton garments under their regular workwear. Cotton samples were then examined for the presence of 17 semi-volatile and low-volatility PAHs.

Results

After firefighting exercises, we observed approximately a fivefold increase in mean 1-OHP concentrations in samples from firefighters, from 0.24 μg/L to 1.17 μg/L (maximum: 5.31 μg/L). In contrast, 1-OHP levels in workshop employees were found to be low, with the majority of urine samples yielding concentrations below the limit of quantification (LOQ: 0.05 μg/L, maximum: 0.11 μg/L). Similarly, low PAH levels were found on the workshop employees' cotton undergarments, with maximum concentrations of 250 and 205 ng/g for pyrene and benzo[a]pyrene, respectively.

Discussion

In conclusion, significant increases in 1-OHP in urine were observed in firefighters after training sessions, whereas work-related exposure remained low among workshop employees.

Infra-Red Imaging to Detect Respirator Leak in Healthcare Workers During Fit-Testing Clinic

OBJECTIVE

This study addressed the problem of objectively detecting leaks in P2 respirators at point of use, an essential component for healthcare workers' protection. To achieve this, we explored the use of infra-red (IR) imaging combined with machine learning algorithms on the thermal gradient across the respirator during inhalation.

RESULTS

The study achieved high accuracy in predicting pass or fail outcomes of quantitative fit tests for flat-fold P2 FFRs. The IR imaging methods surpassed the limitations of self fit-checking.

CONCLUSIONS

The integration of machine learning and IR imaging on the respirator itself demonstrates promise as a more reliable alternative for ensuring the proper fit of P2 respirators. This innovative approach opens new avenues for technology application in occupational hygiene and emphasizes the need for further validation across diverse respirator styles.

SIGNIFICANCE STATEMENT

Our novel approach leveraging infra-red imaging and machine learning to detect P2 respirator leaks represents a critical advancement in occupational safety and healthcare workers' protection.

Prevention of the Occupational Silicosis Epidemic in Australia: What Do Those Who Assess Workplace Health Risk Think Should Be Done Now?

An Australian National Dust Disease Taskforce was established to address the re-emergence of occupational lung disease, in particular silicosis. Exposure to respirable crystalline silica (RCS) occurs in various industries in Australia. We asked occupational hygienists about their practical experiences and perspectives on RCS exposure and regulatory action. A total of 105 members of the Australian Institute of Occupational Hygienists completed an anonymous questionnaire, which addressed individual characteristics, experience, perceived level of employer awareness, effectiveness of current regulation, and recommendations for improvement, across three main industrial sectors. Based on professional experience, 71% were concerned about the potential for RCS over-exposure. Barriers to adequate exposure control included lack of management commitment and financial resources. The employment of specialist occupational hygiene inspectors was considered to be the most effective regulatory strategy. Given the large number of exposed workers in the construction industry, with only a moderate awareness, there is the potential for significant cost shifting of the burden of occupational lung disease from employers on to individuals and the public health system. A nationally consistent approach to RCS exposure control across all industrial sectors is now recommended, with an increased focus on measuring and controlling exposure.

Trading One Risk for Another: Consequences of the Unauthenticated Treatment and Prevention of Silicosis in Ontario Miners in the McIntyre Powder Aluminum Inhalation Program

From 1943 to 1979, miners and factory workers in more than two hundred work sites globally were subjected to mandatory medical treatments by their employers as an unproven, and ultimately ineffective, treatment to prevent the lung disease silicosis. The treatments involved inhaling finely ground aluminum dust known as McIntyre Powder, blown into miners’ change rooms each shift using compressed air systems. Tens of thousands of industrial laborers were exposed to McIntyre Powder, yet their story is scarcely known, and the possible health impacts of their aluminum treatments were rarely studied. This paper integrates the history of the aluminum prophylaxis program and its control by the northern Ontario mining industry with the lived experience of one of the affected miners, whose daughter created a voluntary registry which documents health issues in exposed miners, and stimulated research that found a link to her father’s Parkinson disease.

Health vs. wealth: Employer, employee and policy-maker perspectives on occupational heat stress across multiple European industries

Successful implementation of cooling strategies obviously depends on identifying effective interventions, but in industrial settings, it is equally important to consider feasibility and economic viability. Many cooling interventions are available, but the decision processes affecting adoption by end-users are not well elucidated. We therefore arranged two series of meetings with stakeholders to identify knowledge gaps, receive feedback on proposed cooling interventions, and discuss factors affecting implementation of heat-health interventions. This included four meetings attended by employers, employees, and health and safety officers (n = 41), and three meetings attended primarily by policy makers (n = 74), with feedback obtained via qualitative and quantitative questionnaires and focus group discussions. On a 10-point scale, both employers and employees valued worker safety (9.1 ± 1.8; mean±SD) and health (8.5 ± 1.9) as more important than protecting company profits (6.3 ± 2.3). Of the respondents, 41% were unaware of any cooling strategies at their company and of those who were aware, only 30% thought the interventions were effective. Following presentation of proposed interventions, the respondents rated "facilitated hydration", "optimization of clothing/protective equipment", and "rescheduling of work tasks" as the top-three preferred solutions. The main barriers for adopting cooling interventions were cost, feasibility, employer perceptions, and legislation. In conclusion, preventing negative health and safety effects was deemed to be more important than preventing productivity loss. Regardless of work sector or occupation, both health and wealth were emphasized as important parameters and considered as somewhat interrelated. However, a large fraction of the European worker force lacks information on effective measures to mitigate occupational heat stress. List of abbreviations: OH-Stress: Occupational heat stress; WBGT: Wet Bulb Globe Temperature.

Environmental Contamination and Occupational Exposure of Algerian Hospital Workers

Guidelines are in place to assure limited occupational exposure to cytostatic drugs. Even though this has led to a reduction in exposure, several studies reported quantifiable concentrations of these compounds in healthcare workers. In this study, we evaluated occupational exposure to cytostatic drugs in hospital workers from the University Hospital in Tlemcen, Algeria. Monitoring was performed by collecting wipe samples from surfaces, objects, personal protective equipment (gloves and masks) and from the skin of employees at an Algerian university hospital. Wipe samples were analyzed with ultra-performance liquid chromatography coupled to a mass spectrometer. Concentrations ranged from below the limit of quantification up to 208.85, 23.45, 10.49, and 22.22 ng/cm² for cyclophosphamide, ifosfamide, methotrexate and 5-fluorouracil, respectively. The highest values were observed in the oncology department. Nowadays, there are still no safe threshold limit values for occupational exposure to cytostatic agents. Therefore, contamination levels should be kept as low as reasonably achievable. Yet, healthcare workers in this hospital are still exposed to cytostatic agents, despite the numerous guidelines, and recommendations. Consequently, actions should be taken to reduce the presence of harmful agents in the work environment.

COVID-19 Outbreak in Italy: Protecting Worker Health and the Response of the Italian Industrial Hygienists Association

The number of people infected with severe acute respiratory syndrome—coronavirus 2 (SARS-CoV-2), i.e. the virus causing coronavirus disease (COVID-19), is dramatically increasing worldwide to the size of a pandemic. At the time of writing Italy is ranking first among countries both in terms of number of COVID-19 confirmed cases and in terms of number of deaths. Such a wide spread of COVID-19 has led to concern among workers who are facing the risk of becoming infected during the execution of their duties. We believe it is useful to remark on the need for professional expertise in the field of Occupational Hygiene in this emergency context, in which the indications provided by national and international bodies, the available scientific literature and the legal provisions are constantly and rapidly evolving. It is of fundamental importance that there is an effective analysis of expert inputs, to provide essential guidance to Health, Safety and Environmental managers and other prevention managers in workplaces. In this regard, not only a constant update of the regulatory framework is needed, but also a development and circulation of operational guidance to all the stakeholders to translate general indications into clear operating procedures and implementation tools to be adopted in the workplaces. We believe that the scientific associations in the field of Occupational Hygiene play a crucial role in guiding and assisting prevention professionals. There is considerable expertise in the occupational hygiene and exposure science communities that can help employers and workers to contain and delay the spread of COVID-19. For this reason, the Italian Association of Industrial Hygienists (AIDII—Associazione Italiana degli Igienisti Industriali) published documents containing operational guidelines to provide correct and constantly updated information for: (i) workers employed in essential activities (with low and medium risk of contagion), (ii) health workers and other workers at high or very high risk of contagion, and (iii) for the correct use and handling of personal protective equipment for workers and for the population in general. It is worth pointing out that the documents produced are not intended to replace those produced by authoritative bodies, but to comply with and complete them by reporting an effective summary and further indications about the measures that should be taken in practice under the light of the Italian legislation. At present, the challenge is to produce scientifically sound knowledge, appropriate tools, and effective methodologies, by coordinating the initiatives of different scientific associations, with the final aim to effectively transfer them to employers and workers.

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«A History of Industrial Hygiene: the Clinica del Lavoro in Milan and the Italian Association of Industrial Hygienists». In 1969, the Italian Association of Industrial Hygienists (AIDII) was founded in Milan by Academics working at the Clinica del Lavoro, one of the oldest institutions for work prevention in the world and within the most prolific institutes in the world on Occupational Medicine and Industrial Hygiene. AIDII was founded as a scientific association with the primary purpose of promoting the development, deepening and dissemination of Industrial Hygiene, the scientific discipline aimed at identifying, assessing and controlling chemical, physical and biological risk factors (as well as transversal risks) either inside or outside the workplace, which can alter the health and well-being status of workers and/or the general population, for the purpose of effective prevention and protection of human health. Over the decades, the activities of AIDII have evolved to meet some of the current needs and challenges, while remaining consistent with the basics set by the founders.

Occupational exposures to agricultural dust by Western Australian wheat-belt farmers during seeding operations

Agricultural operations routinely expose farm workers to high levels of soil dust and other airborne particulate matter that have been linked to adverse health outcomes. The main objective of this study was to investigate exposure to agricultural dust during seeding operations of Western Australian farm workers. Twenty-one wheat-belt farms were recruited to participate in the study. Data were collected over the 6-week seeding period of April-June 2014. Each farm was visited once, and workers were asked to complete a workplace survey that asked questions related to minimizing exposure to agricultural dusts and occupational health and safety issues on their farm. Farmers were also asked to simultaneously participate in monitoring of personal exposure to inhalable or respirable dust along with real-time monitoring for particulate air pollution in their tractor cabin. Sampling was undertaken for 4 hr. The results showed that, on average, Western Australian farmers were exposed to personal respirable dust concentrations above the Australian Institute of Occupational Hygienists recommended guideline values, with some farmers being exposed to concentrations up to seven times higher than the value for respirable dusts. In comparison, in-cabin dust concentrations were lower, although some individual tractors recorded intermittently higher levels, which might be attributed to the type of work activity or process being undertaken. Remaining in tractor cabins with closed doors and windows with properly maintained seals might minimize the infiltration of hazardous dusts and may provide some protection from dust exposures. Future research should focus on educating and providing farm owners and workers with more information on adopting work processes and procedures related to minimizing harmful exposures to agricultural dusts.

Changes in Work Practices for Safe Use of Formaldehyde in a University-Based Anatomy Teaching and Research Facility

Anatomy teaching and research relies on the use of formaldehyde (FA) as a preservation agent for human and animal tissues. Due to the recent classification of FA as a carcinogen, university hospitals are facing a challenge to (further) reduce exposure to FA. The aim of this study was to reduce exposure to FA in the anatomy teaching and research facility. Workers participated in the development of improved work practices, both technical and organizational solutions. Over a period of 6 years mitigating measures were introduced, including improvement of a down-flow ventilation system, introduction of local exhaust ventilation, collection of drain liquid from displayed specimens in closed containers and leak prevention. Furthermore, some organizational changes were made to reduce the number of FA peak exposures. Stationary and personal air sampling was performed in three different campaigns to assess the effect of these new work practices on inhalation exposure to FA. Samples were collected over 8 h (full shift) and 15 min (task-based) to support mitigation of exposure and improvement of work practices. Air was collected on an adsorbent coated with 2,4-dinitrophenylhydrazine (DNPH) and analyzed by HPLC-UV. Geometric mean (GM) concentrations of FA in the breathing zone over a work-shift were 123 µg/m³ in 2012 and 114 µg/m³ in 2014, exceeding the workplace standard of 150 µg/m³ (8 h time-weighted average, TWA) on 46% of the workdays in 2012 and 38% of the workdays in 2014. This exposure was reduced to an average of 28.8 µg/m³ in 2017 with an estimated probability of exceeding the OEL of 0.6%. Task-based measurements resulted in a mean peak exposures of 291 µg/m³ in 2012 (n = 19) and a mean of 272 µg/m³ in 2014 (n = 21), occasionally exceeding the standard of 500 µg/m³ (15 min TWA), and were reduced to a mean of 88.7 µg/m³ in 2017 (n = 12) with an estimated probability of exceeding the OEL of 1.6%.

Occupational health and safety in cannabis production: an Australian perspective

The legal Australian cannabis industry has been rapidly expanding due to increased awareness of the plant's therapeutic potential, as well its diverse range of applications including biofuel, textiles, building materials, food, nutritional supplement, and animal feed. The objective of this paper is to describe the current landscape of the commercial Australian cannabis industry, summarise occupational health and safety (OHS) hazards in cannabis-related working environments, and provide suggestions for safeguarding worker health and well-being in this emerging industry. A comprehensive search of peer-reviewed and grey literature published between 1900 and 2017 was undertaken to identify case studies and original epidemiological research on OHS hazards associated with the cannabis cultivation and the manufacture of cannabis-based products. The review found that the majority of OHS studies were undertaken in the hemp textile industry during the late twentieth century, with a small number of articles published from a variety of occupational environments including forensic laboratories and recreational marijuana farms. Cannabis harvesting and initial processing is labour intensive, and presents a physical hazard Depending on the operation, workers may also be exposed to a variety of biological, chemical, and physical hazards including: organic dusts, bioaerosols, pollen/allergens, volatile organic compounds, psychoactive substances (tetrahydrocannabinol [THC])), noise, and ultraviolet radiation. Little research has been undertaken on the exposure to inhalable organic dust and other bioaerosols during the commercial cultivation and manufacture of cannabis-based products. Furthermore, there is an absence of Australian-based research and OHS guidance materials to help professionals develop risk management strategies in this evolving industry. It is recommended that: Investigation into the toxicological properties of cannabis dusts, specifically in relation to potential occupational exposures during cultivation and manufacture, should be a priority. The interim adoption of the respirable cotton dust exposure standard of 0.2 mg/m3 for workplace exposure in hemp facilities until a cannabis workplace exposure standard is developed, and that exposure to medicinal cannabis containing THC are kept as low as reasonably practicable. An industry partnership be established for the development of an Australian health and safety guideline for the production of medicinal cannabis and hemp. A classification to meet the requirements of the Global Harmonization Scheme should be undertaken to ensure consistency in the use of safety and risk phrases in cannabis-related industries.

Exposure to Oil Spill Chemicals and Lung Function in Deepwater Horizon Disaster Response Workers

OBJECTIVE

The aim of this study was to assess the relationship between total hydrocarbon (THC) exposures attributed to oil spill clean-up work and lung function 1 to 3 years after the Deepwater Horizon (DWH) disaster.

METHODS

We used data from the GuLF STUDY, a large cohort of adults who worked on response to the DWH disaster and others who were safety trained but did not work. We analyzed data from 6288 workers with two acceptable spirometry tests. We estimated THC exposure levels with a job exposure matrix. We evaluated lung function using the forced expiratory volume in 1 second (FEV1; mL), the forced vital capacity (FVC; mL), and the FEV1/FVC ratio (%).

RESULTS

Lung function measures did not differ by THC exposure levels among clean-up workers.

CONCLUSION

We did not observe an association between THC exposure and lung function among clean-up workers 1 to 3 years following the DWH disaster.

Work environment investments: outcomes from three cases

Work environment investments are important in order to create a healthy and safe workplace. This article presents findings from a seven-step interventions process aimed at examining and following-up work environment investments in small and medium-sized enterprises (SMEs), with a particular focus on air contaminants. Three different cases were analyzed and included in the study: (a) an educational center for welding; (b) a paint station in furniture manufacturing; (c) a joinery in furniture manufacturing. The results show that the work environment investments were highly appreciated by the employees and managers, but at the same time the investment could be optimized through markedly decreased exposure levels for the worker. Factors such as follow-ups of the investment, education and training in how to use the equipment, worker involvement in the process and leadership engagement are important in order to optimize work environment investments.

[Assessment of predictive dermal exposure to chemicals in the work environment]

Assessment of dermal exposure to chemicals in the work environment is problematic, mainly as a result of the lack of measurement data on occupational exposure to chemicals. Due to common prevalence of occupational skin exposure and its health consequences it is necessary to look for efficient solutions allowing for reliable exposure assessment. The aim of the study is to present predictive models used to assess non-measured dermal exposure, as well as to acquaint Polish users with the principles of the selected model functioning. This paper presents examples of models to assist the employer in the the assessment of occupational exposure associated with the skin contact with chemicals, developed in European Union (EU) countries, as well as in countries outside the EU. Based on the literature data dermal exposure models EASE (Estimation and Assessment of Substance Exposure), COSHH Essentials (Control of Substances Hazardous to Health Regulations), DREAM (Dermal Exposure Assessment Method), Stoffenmanager , ECETOC TRA (European Centre for Ecotoxicology and Toxicology of Chemicals Targeted Risk Assessment), MEASE (Metal's EASE), PHED (Pesticide Handlers Exposure Database), DERM (Dermal Exposure Ranking Method) and RISKOFDERM (Risk Assessment of Occupational Dermal Exposure to Chemicals) were briefly described. Moreover the characteristics of RISKOFDERM, guidelines for its use, information on input and output data were further detailed. Problem of full work shift dermal exposure assessment is described. An example of exposure assessment using RISKOFDERM and effectiveness evaluation to date were also presented. When no measurements are available, RISKOFDERM allows dermal exposure assessment and thus can improve the risk assessment quality and effectiveness of dermal risk management. Med Pr 2017;68(4):557-569.

Albumin adducts and urinary metabolites resulting from occupational exposure to 1,5-naphthalene diisocyanate

OBJECTIVES

1,5-Naphthalene diisocyanate (NDI) is used in the plastic industry as a curing agent. 1,5-Naphthalene diisocyanate is classified as a sensitizing agent. The objective of this study has been to develop biomonitoring methods for the evaluation of exposure to NDI.

MATERIAL AND METHODS

We obtained blood and urine samples from a group of 20 male workers exposed to NDI. The workers answered a questionnaire about their exposure history, job description, the number of years with the company and the time spent working with NDI over the 10 days of the study. Total plasma, albumin, and urine were analyzed for the presence of 1,5-naphthalenediamine (NDA) after acid hydrolysis using gas chromatography-mass spectrometry (GC-MS).

RESULTS

1,5-Naphthalenediamine was found in about 60% of the samples obtained from the workers. 1,5-Naphthalenediamine was obtained after acid hydrolysis of plasma, albumin, and urine at levels up to 1.5 pmol NDA/mg of plasma proteins, 1.15 pmol NDA/mg of albumin, and 55.3 pmol NDA/ml of urine, respectively.

CONCLUSIONS

1,5-Naphthalenediamine found in urine correlates best with the plasma levels (r = 0.91, p < 0.01). The albumin-adduct levels did not correlate with the NDI-specific immunoglobulin E (IgE) or total IgE present in the workers. The adduct and metabolite levels correlate with the air levels of NDI. Int J Occup Med Environ Health 2017;30(4):579-591.

Trends in occupational hygiene in Finland

The aim of this work is to evaluate and describe the current status of, and prospects for, the future of occupational hygiene in Finland. The main sources of information include a seminar held in the annual meeting of Finnish Occupational Hygiene Society and interviews with different stakeholders. Nanotechnology and other new materials, changing work environments, circular economy including green jobs, new medical methods and advances of construction methods were recognized as future challenges. Future work opportunities for occupational hygiene experts included exposure assessments in indoor air surveys, private consulting and entrepreneurship in general, international activities and product safety issues. Unclear topics needing more attention in the future were thought to be in new exposures, sensitive persons, combined effects, skin exposures and applicability of personal protective equipment. Occupational hygiene should broaden its view; occupational hygienists should have to cooperate with other specialists and grasp new challenges.

History of knowledge and evolution of occupational health and regulatory aspects of asbestos exposure science: 1900-1975

The understanding by industrial hygienists of the hazards of asbestos and appropriate ways to characterize and control exposure has evolved over the years. Here, a detailed analysis of the evolution of industrial hygiene practices regarding asbestos and its health risks, from the early 1900s until the advent of the national occupational health and safety regulatory structure currently in place in the US (early-to-mid 1970s) is presented. While industrial hygienists recognized in the early 1900s that chronic and high-level exposures to airborne concentrations of asbestos could pose a serious health hazard, it was not until the mid-1950s that the carcinogenic nature of asbestos began to be characterized and widespread concern followed. With the introduction of the membrane filter sampling method in the late 1960s and early 1970s, asbestos sampling and exposure assessment capabilities advanced to a degree which allowed industrial hygienists to more precisely characterize the exposure-response relationship. The ability of industrial hygienists, analytical chemists, toxicologists, and physicians to more accurately define this relationship was instrumental to the scientific community's ability to establish Occupational Exposure Levels (OELs) for asbestos. These early developments set the stage for decades of additional study on asbestos exposure potential and risk of disease. This was followed by the application of engineering controls and improved respiratory protection which, over the years, saved thousands of lives. This paper represents a state-of-the-art review of the knowledge of asbestos within the industrial hygiene community from about 1900 to 1975.

Characterization of particle exposure in ferrochromium and stainless steel production

This study describes workers' exposure to fine and ultrafine particles in the production chain of ferrochromium and stainless steel during sintering, ferrochromium smelting, stainless steel melting, and hot and cold rolling operations. Workers' personal exposure to inhalable dust was assessed using IOM sampler with a cellulose acetate filter (AAWP, diameter 25 mm; Millipore, Bedford, MA). Filter sampling methods were used to measure particle mass concentrations in fixed locations. Particle number concentrations and size distributions were examined using an SMPS+C sequential mobile particle sizer and counter (series 5.400, Grimm Aerosol Technik, Ainring, Germany), and a hand-held condensation particle counter (CPC, model 3007, TSI Incorporated, MN). The structure and elemental composition of particles were analyzed using TEM-EDXA (TEM: JEM-1220, JEOL, Tokyo, Japan; EDXA: Noran System Six, Thermo Fisher Scientific Inc., Madison,WI). Workers' personal exposure to inhalable dust averaged 1.87, 1.40, 2.34, 0.30, and 0.17 mg m(-3) in sintering plant, ferrochromium smelter, stainless steel melting shop, hot rolling mill, and the cold rolling mill, respectively. Particle number concentrations measured using SMPS+C varied from 58 × 10(3) to 662 × 10(3) cm(-3) in the production areas, whereas concentrations measured using SMPS+C and CPC3007 in control rooms ranged from 24 × 10(3) to 243 × 10(3) cm(-3) and 5.1 × 10(3) to 97 × 10(3) cm(-3), respectively. The elemental composition and the structure of particles in different production phases varied. In the cold-rolling mill non-process particles were abundant. In other sites, chromium and iron originating from ore and recycled steel scrap were the most common elements in the particles studied. Particle mass concentrations were at the same level as that reported earlier. However, particle number measurements showed a high amount of ultrafine particles, especially in sintering, alloy smelting and melting, and tapping operations. Particle number concentration and size distribution measurements provide important information regarding exposure to ultrafine particles, which cannot be seen in particle mass measurements.

Interlaboratory evaluation of cellulosic acid-soluble internal air sampling capsules for multi-element analysis

An interlaboratory study was carried out to evaluate the use of acid-soluble cellulosic air sampling capsules for their suitability in the measurement of trace elements in workplace atmospheric samples. These capsules are used as inserts to perform closed-face cassette sample collection for occupational exposure monitoring. The interlaboratory study was performed in accordance with NIOSH guidelines that describe statistical procedures for evaluating measurement accuracy of air monitoring methods. The performance evaluation materials used consisted of cellulose acetate capsules melded to mixed-cellulose ester filters that were dosed with multiple elements from commercial standard aqueous solutions. The cellulosic capsules were spiked with the following 33 elements of interest in workplace air monitoring: Ag, Al, As, Ba, Be, Ca, Cd, Co, Cr, Cu, Fe, In, K, La, Li, Mg, Mn, Mo, Ni, P, Pb, Sb, Se, Sn, Sr, Te, Ti, Tl, V, W, Y, Zn, Zr. The elemental loading levels were certified by an accredited provider of certified reference materials. Triplicates of media blanks and multielement-spiked capsules at three different elemental loadings were sent to each participating laboratory; the elemental loading levels were not revealed to the laboratories. The volunteer participating laboratories were asked to prepare the samples by acid dissolution and to analyze aliquots of extracted samples by inductively coupled plasma atomic emission spectrometry in accordance with NIOSH methods. It was requested that the study participants report their analytical results in units of μg of each target element per internal capsule sample. For the majority of the elements investigated (30 out of 33), the study accuracy estimates obtained satisfied the NIOSH accuracy criterion (A < 25%). This investigation demonstrates the utility of acid-soluble internal sampling capsules for multielement analysis by atomic spectrometry.

Current Status and Prospects of Occupational Medicine in the Russian Federation

An in-depth analysis conducted on the historical background and current status of occupational medicine in Russia is presented. Scientific and practical bases of occupational medicine in the Russian Federation were based on 2 of the most important principles of health service: free medical care and its preventive orientation. Our analysis of the current situation in occupational medicine in modern Russia shows a transition from the vision of zero occupation-related harm to the strategy of recognizing, assessing, and managing occupational exposures. The system of workplace monitoring is developing successfully, with the creation of a federal database for the state of working conditions and the implementation of mechanisms for occupational risk assessment and management. However, at the same time, the system of medical surveillance for workers needs substantial reform. Over the past few years, the professional community of specialists in occupational medicine has taken several steps to improve the quality of its work. Understanding of the need for reforming the system of occupational medicine has continued to grow, which will improve the quality of medical monitoring for workers and extend professional longevity. Current challenges and prospects of occupational medicine in the Russian Federation are discussed.

Traditional and environmentally preferable cleaning product exposure and health symptoms in custodians

BACKGROUND

We investigated the associations between traditional and environmentally preferable cleaning product exposure and dermal, respiratory, and musculoskeletal symptoms in a population of custodians.

METHODS

We analyzed associations between symptoms and exposure to traditional and environmentally preferable cleaning product exposure among 329 custodians.

RESULTS

We observed increased odds of dermal (P < 0.01), upper (P = 0.01) and lower respiratory (P = 0.01), and upper extremity (P < 0.01), back (P < 0.01), and lower extremity (P = 0.01) musculoskeletal symptoms associated with increased typical traditional cleaning product exposure. We observed significant trends for increased odds of dermal (P = 0.03) and back (P = 0.04) and lower (P = 0.02) extremity musculoskeletal symptoms associated with increased typical environmentally preferable cleaning product exposure.

CONCLUSIONS

Fewer positive associations and reduced odds of health symptoms associated with environmentally preferable cleaning product exposure suggest that these products may represent a safer alternative to traditional cleaning products.

Employment, smoking, and health: the role of the hygienist

The association between smoking and poverty is well established but the relationship between smoking and employment is less clear. Those in work are less likely to smoke, with recent data from Scotland suggesting the unemployed are nearly 2.5 times more likely to smoke than those in employment. This commentary looks at emerging evidence that work may have a positive role in reducing smoking prevalence. Occupational hygienists are uniquely placed to provide health-based information and risk communication that may help workers and those seeking employment to become smoke-free. The public health benefits of such intervention are likely to be substantial and are entirely in keeping with the health protection aims of the discipline of Occupational Hygiene.

Determinants of the accuracy of occupational hygiene expert judgment

An experimental study was performed to determine the applicability and accuracy of occupational hygienist's expert judgment in occupational exposure assessment. The effect of tier 1 model application on improvement of expert judgments were also realized. Hygienists were asked to evaluate inhalation exposure intensity in seven operating units in a tile factory before and after an exposure training session. Participants' judgments were compared to air sampling data in the units; then after relative errors for judgments were calculated. Stepwise regressions were performed to investigate the defining variables. In all situations there were almost a perfect agreement (ICC >0.80) among raters. Correlations between estimated mean exposure and relative percentage error of participants before and after training were significant at 0.01 (correlation coefficients were -0.462 and -0.443, respectively). Results showed that actual concentration and experience resulted in 22.4% prediction variance for expert error as an independent variable. Exposure rating by hygienists was susceptible to error from several sources. Experienced subjects had a better ability to predict the exposures intensity. In lower concentrations, the rating error increased significantly. Leading causes of judgment error should be taken into account in epidemiological studies.

Managing the Risk of Occupational Allergy in the Enzyme Detergent Industry

Enzyme proteins have potential to cause occupational allergy/asthma. Consequently, as users of enzymes in formulated products, detergents manufacturers have implemented a number of control measures to ensure that the hazard does not translate into health effects in the workforce. To that end, trade associations have developed best practice guidelines which emphasize occupational hygiene and medical monitoring as part of an effective risk management strategy. The need for businesses to recognize the utility of this guidance is reinforced by reports where factories which have failed to follow good industrial hygiene practices have given rise to incidences of occupational allergy. In this article, an overview is provided of how the industry guidelines are actually implemented in practice and what experience is to be derived therefrom. Both medical surveillance and air monitoring practices associated with the implementation of industry guidelines at approximately 100 manufacturing facilities are examined. The data show that by using the approaches described for the limitation of exposure, for the provision of good occupational hygiene and for the active monitoring of health, the respiratory allergenic risk associated with enzyme proteins can be successfully managed. This therefore represents an approach that could be recommended to other industries contemplating working with enzymes.

Range-finding risk assessment of inhalation exposure to nanodiamonds in a laboratory environment

This study considers fundamental methods in occupational risk assessment of exposure to airborne engineered nanomaterials. We discuss characterization of particle emissions, exposure assessment, hazard assessment with in vitro studies, and risk range characterization using calculated inhaled doses and dose-response translated to humans from in vitro studies. Here, the methods were utilized to assess workers' risk range of inhalation exposure to nanodiamonds (NDs) during handling and sieving of ND powder. NDs were agglomerated to over 500 nm particles, and mean exposure levels of different work tasks varied from 0.24 to 4.96 µg·m(-3) (0.08 to 0.74 cm(-3)). In vitro-experiments suggested that ND exposure may cause a risk for activation of inflammatory cascade. However, risk range characterization based on in vitro dose-response was not performed because accurate assessment of delivered (settled) dose on the cells was not possible. Comparison of ND exposure with common pollutants revealed that ND exposure was below 5 μg·m(-3), which is one of the proposed exposure limits for diesel particulate matter, and the workers' calculated dose of NDs during the measurement day was 74 ng which corresponded to 0.02% of the modeled daily (24 h) dose of submicrometer urban air particles.

Personal exposure to inhalable dust and the specific latex aero-allergen, Hev b6.02, in latex glove manufacturing in Thailand

OBJECTIVES

Latex product manufacturing is an important industry in south-east Asia but has the potential for considerable occupational exposure of workers to latex allergens. Although exposure to latex allergens can result in adverse health reactions, few studies to characterize this exposure have been conducted to date. This study therefore aimed to characterize current airborne inhalable dust and the specific allergen, Hev b 6.02, exposures in this industry in Thailand.

METHODS

Workers were recruited from three factories in the southern part of Thailand. Full-shift inhalable dust personal air sampling was conducted using IOM sampling heads equipped with polytetrafluoroethylene filters at a 2.0 l min(-1) flowrate. After weighing to determine inhalable dust levels, filters were extracted and analysed for Hev b 6.02 using an enzyme immunometric assay.

RESULTS

Two hundred and seventy-five workers agreed to participate, resulting in a total of 292 measurements. Geometric mean (GM) personal exposure to inhalable dust was 0.88 mg m(-3), but individual exposures up to 12.34 mg m(-3) were measured. The pattern of exposure was similar across factories, with highest exposures in the stripping (GM 2.08-4.05 mg m(-3) for the 3 factories) and tumbling departments (1.11-2.17 mg m(-3)). Within-worker (day-to-day) variability contributed 92% to total variability. The Hev b 6.02 exposure pattern was similar with time-weighted average GM exposure levels in the oldest factory ranging from 8.7 mg m(-3) in the laboratory to 30.2mg m(-3) in the stripping department. In contrast to inhalable dust exposure, total exposure variability was primary driven by variability between workers (67%).

CONCLUSIONS

Workers in these latex product factories get routinely exposed to measurable Hev b 6.02 levels, which may give rise to increased incidence of allergic symptoms and occupational asthma. Also, in this measurement campaign a 10mg m(-3), but not 15 mg m(-3), occupational exposure limit for inhalable dust was occasionally exceeded. Highest Hev b 6.02 exposures were found in the stripping and tumbling departments, which would be natural targets for interventions aimed at reducing exposure.

Occupational hazards to the health of professional gardeners

Professional gardening is a broad occupation that involves a wide range of tasks. Gardeners confront an equally wide variety of physical, chemical, biological and psychosocial hazards in their workplace. Consequently, occupational injuries and mortality are unfortunately common. The aim of this brief review is to collate and summarise the main hazards of gardening, their health effects and control measures. The diversity and size of gardeners' occupational exposures to the hazards outlined in this paper highlight some of the underlying causes of their increased risk of occupational injury or death. The risk can be reduced in many cases by ensuring appropriate protective strategies are adopted. Other ways through which the burden of occupational injury and mortality can be minimised are introduced and discussed in this paper.

Preparation and certification of two new bulk welding fume reference materials for use in laboratories undertaking analysis of occupational hygiene samples

Workers can be exposed to fume, arising from welding activities, which contain toxic metals and metalloids. Occupational hygienists need to assess and ultimately minimize such exposure risks. The monitoring of the concentration of particles in workplace air is one assessment approach whereby fume, from representative welding activities, is sampled onto a filter and returned to a laboratory for analysis. Inductively coupled plasma-atomic emission spectrometry and inductively coupled plasma-mass spectrometry are generally employed as instrumental techniques of choice for the analysis of such filter samples. An inherent difficulty, however, with inductively coupled plasma-based analytical techniques is that they typically require a sample to be presented for analysis in the form of a solution. The efficiency of the required dissolution step relies heavily upon the skill and experience of the analyst involved. A useful tool in assessing the efficacy of this dissolution step would be the availability and subsequent analysis of welding fume reference materials with stated elemental concentrations and matrices that match as closely as possible the matrix composition of welding fume samples submitted to laboratories for analysis. This article describes work undertaken at the Health and Safety Laboratory to prepare and certify two new bulk welding fume reference materials that can be routinely used by analysts to assess the performance of the digestion procedures they employ in their laboratories.

Acid-soluble internal capsules for closed-face cassette elemental sampling and analysis of workplace air

Airborne particles that are collected using closed-face filter cassettes (CFCs), which are used widely in the sampling of workplace aerosols, can deposit in places other than on the filter and thereby may not be included in the ensuing analysis. A technique for ensuring that internal non-filter deposits are included in the analysis is to collect airborne particles within an acid-soluble internal capsule that, following sampling, can be dissolved along with the filter for subsequent elemental analysis. An interlaboratory study (ILS) was carried out to evaluate the use of cellulosic CFC capsule inserts for their suitability in the determination of trace elements in airborne samples. The ILS was performed in accordance with an applicable ASTM International standard practice, ASTM E691, which describes statistical procedures for investigating interlaboratory precision. Performance evaluation materials consisted of prototype cellulose acetate capsules attached to mixed-cellulose ester filters. Batches of capsules were dosed with Pb-containing materials (standard aqueous solutions, and certified reference material soil and paint). Also, aerosol samples containing nine target analyte elements (As, Cd, Co, Cr, Cu, Fe, Pb, Mn, and Ni) were generated using a multiport sampler; various concentrations and sampling times were employed to yield samples fortified at desired loading levels. Triplicates of spiked capsules at three different loadings were conveyed to each volunteer laboratory; loading levels were unknown to the participants. The laboratories were asked to prepare the samples by acid dissolution and to analyze aliquots of extracted samples by atomic spectrometry in accordance with applicable ASTM International Standards. Participants were asked to report their results in units of μg of each target element per sample. For the elements investigated, inter-laboratory precision and recovery estimates from the participating laboratories demonstrated the utility of the cellulosic capsule inserts for the measurement of sampled trace elements.

Throwing the baby out with the bath water? Occupational hygienists' views on the revised dutch system for occupational exposure limits

In 2007, the Dutch Working Conditions Act was revised with the goal to decrease the regulatory burden, and to open up for company-specific solutions of establishing a safe and healthy work environment. One tool geared towards company-specific solutions is the compilation of the Arbocatalogs, which are company or sector-level collections of safe working methods and guidelines developed both by employers and employees. The revision also introduced a new occupational exposure limit (OEL) system in the Netherlands. This system encompasses two kinds of OELs: private and public. Private OELs are to be derived by the industry, while public OELs are issued by the Ministry of Social Affairs and Employment. With this change, the majority of the previously set Dutch OELs were removed, as the substances in question now are falling under the private realm. The motivations, expectations, and practical impacts of these revisions have been investigated through interviews with stakeholder organizations and a questionnaire study targeted at occupational hygienists. The questionnaire results show that although the Arbocatalogs seem to be relatively well received, a majority of the Dutch occupational hygienists are still relatively negative to the changes. There is a fear that private OELs will be less scientifically robust than public OELs and that the lack of robustness will have a negative impact on the field of occupational hygiene as a whole.