Annals Of Work Exposures and Health最新文献

Objectives: Filtering facepiece respirators (FFRs) manufactured in South Africa and elsewhere for use by South African workers are commonly tested against non-South African respirator fit test panels (RFTPs) such as those for the United States and the Chinese population, the 2009 Chinese RFTP. These RFTPs are based on facial measurements of their respective populations. Our study evaluated the applicability of these panels to Black South Africans and developed a representative panel for Black South African respirator users.

Methods: Facial dimensions were collected from 693 Black South African respirator users using traditional anthropometric tools. Face width and Face length were overlaid on the NIOSH and Chinese bivariate RFTPs to determine their applicability by checking distribution within the panels and individual cells. We then developed a dedicated Black South African bivariate panel. This included adjustments of panel boundaries to contain 95% of the study population. Data were analysed using STATA version 17 (and graphed using Microsoft Excel).

Results: Panels developed for the United States and Chinese populations did not adequately represent Black South Africans. Most (96.5%) of Black South Africans fell within the NIOSH panel, however, there was no uniform distribution. The Chinese panel only contained 90.8% within the cell boundaries, which was less than the required 95% population within the panel boundaries. Thus, a new bivariate panel representative of Black South Africans was developed. The new panel boundary limits for the Black South African panel are 95 to 135 mm for face length and 123 and 154 mm for face width, which differ from those of the NIOSH and Chinese panels. The final Black South African bivariate panel contains more than 97% of the study population with a more even distribution of subjects within the cell and panel boundaries.

Conclusions: The findings showed that the NIOSH and Chinese bivariate panels do not adequately represent the Black South African population. Respirators designed and tested using these panels or similar ones may negatively affect the desired fit of a Black South African population. The newly developed bivariate panel for Black South Africans should be validated in future studies. It is uncertain to what extent the findings are generalizable to the South and Southern African population external to the study area of Gauteng.

The International Agency for Research on Cancer has recently classified occupational exposure as a firefighter as carcinogenic (group 1A). Even though the occupation of firefighter is associated with high exposure to pollutants, it is challenging to carry out exposure studies to assess health risks due to the extreme conditions associated with firefighting. Routine monitoring of occupational exposure to polycyclic aromatic hydrocarbons (PAHs) via active sampling of air is thus not feasible; however, polyurethane foam (PUF) passive air samplers are robust enough to enable monitoring of PAH in occupations such as firefighting. Two measurement campaigns were carried out at a firefighter training facility in Sweden. In the first, PAH concentrations in air were measured for firefighters, observers, and post-fire workers during fire extinguishing exercises. A wide range of PAH exposures were found; firefighters' exposures were highest (8,300 to 760,000 ng m-3), followed by those of observers (1,600 to 11,000 ng m-3) and post-fire workers (120 to 3,600 ng m-3). In the second, PAH concentrations in air were measured inside 2 burned out sheds for 38 d, starting 3 h after the end of the fire extinguishing exercise. Gas-phase PAH concentrations inside the shed after the fire was extinguished subsided rapidly initially but were high even a week after the fire (3,000 ng m-3) and were 15 to 20 times higher than ambient air levels after more than a month. Mechanical agitation or stirring ashes during post-firework may lead to elevated exposure to the more carcinogenic PAHs, which have higher molecular weights. The results indicate that PAH exposure can be high at a fire site both during the fire and for weeks after the fire is extinguished. Simple preventive measures such as postponing investigation of a fire site for at least a week and wearing respiratory protection can decrease occupational exposure to PAHs.

The quantification of crystalline silica (quartz) in materials helps communicate the potential risk of exposure when the materials are then included in a work process that could generate an aerosol of particulate. Although many analytical laboratories have developed procedures for quantification of quartz in bulk samples, these procedures are not standardized and are generally limited to their individual needs. Therefore, the International Standards Organization (ISO) working group for silica measurement (ISO/TC146/SC2/WG7 Silica) developed an international standard that describes 3 analytical methods for the determination of quartz in bulk samples by X-ray diffraction (XRD): the external standard method for samples prepared on filters, the internal standard method, and the spiking method. This paper describes the results of an interlaboratory measurement comparison in which the 3 XRD standardized methods were evaluated to verify if the 3 methods produce results that agree with each other. Simple analytical systems, represented by 4 binary mixtures of quartz added to another mineral, were prepared. Sub-samples of the 4 test powders were delivered to the 7 participating laboratories from 6 countries that agreed to participate in this study. The precision of each measurement method, calculated as a percentage of quartz weight within the range 10 to 16 wt%, was similar for the 3 XRD methods. The repeatability SDs, sr, ranged between 0.4 and 0.8 (relative SD, RSDr, between 4.3% and 8.7%) for thin specimens on filter, 0.4 to 1.1 (RSDr between 4.2% and 10.6%) for the internal standard method, and 0.3 to 1.2 (RSDr between 3.7% and 11.9%) for the spiking method. The reproducibility SDs, sR, of the results in the studied wt% range were between 1.1 and 2.1 (RSDR between 12.7% and 21.5%) for the method of thin specimen on filter, 1.1 to 1.4 (RSDR between 7.5% and 14.1%) for the internal standard method and 1.1 to 2.6 (RSDR between 9.5% and 23.7%) for the spiking method. These methods obtained equivalent results at 2 concentration levels of 10% and 16% in these binary mixtures. A further step of interlaboratory testing should be implemented to investigate the performance of the 3 methods at the lower quartz concentration values.

Wildland and wildland-urban interface (W/WUI) fires are increasing in frequency and intensity, increasing concerns about firefighters' exposure to hazardous smoke and the need for respiratory protection. This qualitative study explored the perspectives of California fire service personnel on the use of respiratory protective devices (RPDs), particularly powered air-purifying respirators, and a potential Cal/OSHA regulation mandating their use in W/WUI firefighting. Participants were experienced in W/WUI firefighting and had some role in their fire department related to respiratory protection or other aspect of firefighter safety. While all participants recognized the health risks associated with smoke exposure, including cancer and acute respiratory symptoms, and that RPDs would reduce their exposures, participants had concerns that RPDs would negatively affect fatigue, comfort, communication, mobility, and situational awareness. Some concerns specifically relate to the design of the RPDs. Most participants supported using RPDs in specific scenarios such as mop-up and prescribed burns, but fewer supported RPD use during high-exertion tasks like cutting line. Participants preferred flexibility or guidance rather than prescriptive regulation and advocated for engagement of firefighters in the development of any potential regulation to ensure practicality and feasibility. Some participants acknowledged resistance to change in the industry as a barrier for RPD adoption, but felt that evidence of RPD effectiveness and usability, including opportunities for training with devices and changes to device design, could assist with adoption. A programmatic regulation, coupled with education and engagement, can facilitate the incorporation of RPDs in W/WUI firefighting.

Drilling is a common task throughout various industry sectors. When holes are drilled in silica-containing materials such as concrete, brick, and stone, respirable dust containing respirable crystalline silica (RCS) can be generated. Prolonged exposure to RCS can lead to silicosis, lung cancer, chronic obstructive pulmonary disease. Current good control practice includes the application of local exhaust ventilation (LEV) directly to the drills. This is via an external extraction system fitted to a shroud which extracts the dust generated during drilling. For several years, integrated LEV has been available for drills. Integrated LEV offers advantages over external LEV by providing increased portability, interlocked control, reduced trip hazards and reduced costs. However, little is known regarding the control effectiveness of integrated systems. The capture efficiency of 4 different integrated extractors and 1 external extraction system for controlling dust was measured using a real time respirable dust monitor. Furthermore, for 1 drill personal air sampling was conducted to assess the exposure potential to respirable dust from drilling repeatedly into concrete over a 1-h period using no LEV, integrated LEV, and external LEV options. The capture efficiency for respirable dust for 4 integrated drill LEV units ranged between 98.6% and 99.6%. This was comparable to the respirable dust capture efficiency provided by a self-sealing shroud fitted to an external extraction unit which provided efficiencies between 99.4% and 99.8%. The personal exposure testing showed respirable dust exposure was reduced by 87.6% for integrated LEV and 93.3% for external LEV fitted with a self-sealing shroud. The reason for the lower efficiency for the integrated LEV was attributed to dust generated as their dust bins were emptied more often throughout the tests. Given the size of the integrated LEV dust bins and the frequency at which they may require emptying, appropriate control measures to protect workers from dust exposure should be considered-eg emptying the units outdoors in conjunction with RPE.

Background: Antibiotics are handled in large amounts at hospitals at many different wards due to the wide range of bacterial infections that are treated. Unnecessary use and occupational exposure to antibiotics should be avoided due to the risk of bacterial resistance development and adverse health effects including skin and respiratory hypersensitivity reactions in persons handling these drugs.

Objectives: To develop a wipe test method for sampling and quantification of surface contaminations of antibiotics, to assess the current contamination levels in Swedish hospitals, and to propose hygienic guidance values for antibiotics based on these measurements.

Methods: A screening wipe test method and subsequent mass spectrometric analysis of 6 of the most frequently used antibiotics in healthcare was developed and applied in a screening campaign of 16 hospital wards. Wipe tests were sampled from surfaces such as workbenches, floors, storage shelves and handles in medicine rooms, patient rooms, rinsing rooms, utility rooms and corridors.

Results: Antibiotics were detected in most of the samples (cefotaxime 84% positive samples, piperacillin 81%, cloxacillin 65%, metronidazole 53%, ciprofloxacin 20%, and penicillin V 14%). Median values ranged from not detected up to 160 pg/cm2 for the 6 different compounds and the highest results from an individual wipe sample were 27 × 106 pg/cm2 (cefotaxime) and 3.0 × 106 pg/cm2 (piperacillin). For cloxacillin, piperacillin, and metronidazole, lower levels of contamination were observed in medicine rooms when closed systems were used compared with samples collected in rooms where preparations were made without closed systems. Comparison of contamination levels showed that there were significant differences between different surface categories. Out of the most frequently detected antibiotics, ie cloxacillin, piperacillin, and cefotaxime, highest median values were found for surface categories floor and storage whereas lower median values were found for workbenches.

Conclusion: A widespread environmental contamination of antibiotics was observed in hospital wards that potentially can contribute to the development of antibiotic-resistant bacteria as well as health impacts of exposed personnel. Probable sources include compounding, handling and administration of drug tablets, antibiotic contaminated waste as well as other sources such as excretions from patients and contaminated drug vials. Current surface cleaning routines do not sufficiently reduce spills and leakage regardless of source.

Swine workers may be occupationally exposed to Staphylococcus aureus (S. aureus) during time spent inside swine barns. Exposure may occur by inhaling S. aureus-containing particles or by touching contaminated surfaces or infected animals. Despite strong evidence that swine production work is a risk factor for increased nasal carriage of S. aureus, pathways of worker exposure within the swine barn setting have not been well characterized. We developed a Markov chain model to address this research gap by first describing the fate and transport of S. aureus-containing particles within a swine finishing barn. We defined 7 possible physical locations in and around the barn in which S. aureus-containing particles may exist and used published data to determine the probability that a particle will transition from any of these locations to the other locations during a 1-s time interval. We then used our model to estimate worker exposure to S. aureus during a period of 1 s to 30 min spent inside the swine barn. Finally, we modified inputs to simulate interventions to protect workers, such as ventilation controls, respirator use, and handwashing. Increasing the ventilation rate (ie the rate at which outdoor air replaces indoor air in the barn) in our model from the recommended rate for cold weather to the rate for mild weather resulted in a 59% decrease in the number of S. aureus-containing particles in the worker's respiratory system after 30 min. Increasing ventilation rates further to the recommended rate for hot weather resulted in an additional 58% decrease. Models simulating floor and surface cleaning prior to the worker's entry into the barn had little impact on the air concentration of S. aureus (<1% change) but reduced worker exposure to facial membranes by up to 13%. Simulations of N-95 respirator wearing had the greatest impact on worker exposure. As modeled, a well-fitting N-95 respirator may reduce worker inhalation exposure from 1,772 to 72 S. aureus-containing particles after 30 min in the barn, a 96% reduction. In our model, a poorly fitting N-95 respirator reduced exposure by about 30%, indicating that the type and fit of respirator worn has an important impact on the level worker protection.

Objectives: Studies addressing the epidemiology of silicosis in the artificial stone benchtop industry have shown that this industry includes a large number of migrant workers in Victoria, Australia. The objective of the current analyses was to compare characteristics of migrant workers in the industry with nonmigrant workers.

Methods: Data were derived from artificial stone benchtop workers who had health assessments through a regulator-funded screening program between 2019 and 2024. Migrant workers were defined as workers born outside Australia or had used an interpreter during the assessment. Participant characteristics, lung function, and silicosis prevalence were summarized by migrant status and compared between groups.

Results: There were 1,040 workers (n = 536 migrant workers). Migrant workers were older at assessment than nonmigrant workers (median age 39 versus 33 years, P < 0.001). About 1 quarter of migrant workers used an interpreter (23.8%) and 52% spoke English at home. Silicosis prevalence was higher in migrant compared with nonmigrant workers (23% versus 15%, risk-ratio 1.54, and 95% confidence interval 1.16 to 2.04) and migrant workers who used an interpreter had double the risk of silicosis than those who did not (46% versus 18%, risk-ratio 2.24, 95% confidence interval 1.61 to 3.10). Prelegislative changes, experience of carrying out dry processing was reportedly higher in nonmigrant than migrant workers. Fewer jobs among migrant workers than nonmigrant workers were reported using recommended respirators (44 versus 53%) or ventilation (24% versus 30%).

Conclusions: The risk of silicosis in the artificial stone benchtop industry differed by migration status and was higher among those with lower English language proficiency. As the use of appropriate respirators or ventilation was lower among migrant workers, this suggests the need for improved occupational health and safety practices among migrant workers, making sure the messages are communicated in a manner that is language and culturally appropriate.