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Authors:Cherrie J; Cherrie M, Smith A, et al. Pages: 879 - 892 Abstract: AbstractObjectivesThis systematic review aimed to evaluate the evidence for air and surface contamination of workplace environments with SARS-CoV-2 RNA and the quality of the methods used to identify actions necessary to improve the quality of the data.MethodsWe searched Web of Science and Google Scholar until 24 December 2020 for relevant articles and extracted data on methodology and results.ResultsThe vast majority of data come from healthcare settings, with typically around 6% of samples having detectable concentrations of SARS-CoV-2 RNA and almost none of the samples collected had viable virus. There were a wide variety of methods used to measure airborne virus, although surface sampling was generally undertaken using nylon flocked swabs. Overall, the quality of the measurements was poor. Only a small number of studies reported the airborne concentration of SARS-CoV-2 virus RNA, mostly just reporting the detectable concentration values without reference to the detection limit. Imputing the geometric mean air concentration assuming the limit of detection was the lowest reported value, suggests typical concentrations in healthcare settings may be around 0.01 SARS-CoV-2 virus RNA copies m−3. Data on surface virus loading per unit area were mostly unavailable.ConclusionsThe reliability of the reported data is uncertain. The methods used for measuring SARS-CoV-2 and other respiratory viruses in work environments should be standardized to facilitate more consistent interpretation of contamination and to help reliably estimate worker exposure. PubDate: Fri, 30 Jul 2021 00:00:00 GMT DOI: 10.1093/annweh/wxab026 Issue No:Vol. 65, No. 8 (2021)
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Authors:Rother D; Schlüter U. Pages: 893 - 907 Abstract: AbstractObjectivesDiisocyanates are a chemical group that are widely used at workplaces in many sectors. They are also potent skin- and respiratory sensitizers. Exposure to diisocyanates is a main cause of occupational asthma in the European Union. To reduce occupational exposure to diisocyanates and consequently the cases of diisocyanate-induced asthma, a restriction on diisocyanates was recently adopted under the REACH Regulation in the European Union.MethodsA comprehensive evaluation of the data on occupational exposure to the most important diisocyanates at workplaces was made and is reported here. The diisocyanates considered are methylene diphenyl diisocyanate (MDI), toluene diisocyanate (TDI), and hexamethylene diisocyanate (HDI), accounting for more than 95% of the market volume in the EU. The exposure assessment is based on data from Chemical Safety Reports (CSRs) of REACH Registration Dossiers, workplace air monitoring data from Germany, from the UK Health and Safety Executive (HSE), and literature data relevant for the EU, and the USA.ResultsOccupational exposure to diisocyanates is particularly relevant in: (i) C.A.S.E. applications (Coatings, Adhesives, Sealants, Elastomers), (ii) production of polyurethanes (PUs) (e.g. slab-stock foam), (iii) handling of partly uncured PU products (e.g. cutting, demoulding, spray application of foam), and (iv) when diisocyanates/PUs are heated (e.g. hot lamination, foundry applications/casting forms). Ranking of the reported data on inhalation to diisocyanate exposure at workplaces (maximum values) leads to following order: (i) HDI and its oligomers in coatings, (ii) MDI in spray foam applications, (iii) TDI in manufacture of foam, (iv) TDI in manufacture of PUs and PU composite materials, (v) TDI in adhesives, (vi) MDI in adhesives, (vii) MDI in manufacture of PUs and PU composite materials, (viii) TDI in coatings, (ix) MDI in manufacture of foam, and (x) HDI in adhesives. PubDate: Fri, 23 Apr 2021 00:00:00 GMT DOI: 10.1093/annweh/wxab021 Issue No:Vol. 65, No. 8 (2021)
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Authors:Muñoz S; Nazzal C, Jimenez D, et al. Pages: 908 - 918 Abstract: AbstractObjectivesThis study aims to assess the health effects on mining workers of exposure to chronic intermittent hypoxia (CIH) at high- and very high-altitude mining compared with similar work at lower altitudes in Chile, and it also aims to constitute the baseline of a 5-year follow-up study.MethodsWe designed a cross-sectional study to assess health conditions in 483 miners working at 2 levels of altitude exposure: 336 working at a very high or high altitude (HA; 247 above 3900–4400 m, and 89 at 3000–3900 m), and 147 below 2400 m. Subjects were randomly selected in two stages. First, a selection of mines from a census of mines in each altitude stratum was made. Secondly, workers with less than 2 years of employment at each of the selected mines were recruited. The main outcomes measured at the baseline were mountain sickness, sleep alterations, hypertension, body mass index, and neurocognitive functions.ResultsPrevalence of acute mountain sickness (AMS) was 28.4% in the very high-altitude stratum (P = 0.0001 compared with the low stratum), and 71.7% experienced sleep disturbance (P = 0.02). The adjusted odds ratio for AMS was 9.2 (95% confidence interval: 5.2–16.3) when compared with the very high- and low-altitude groups. Motor processing speed and spatial working memory score were lower for the high-altitude group. Hypertension was lower in the highest-altitude subjects, which may be attributed to preoccupational screening even though this was not statistically significant.ConclusionsDespite longer periods of acclimatization to CIH, subjects continue to present AMS and sleep disturbance. Compromise of executive functions was detected, including working memory at HA. Further rigorous research is warranted to understand long-term health impacts of high-altitude mining, and to provide evidence-based policy recommendations. PubDate: Thu, 26 Aug 2021 00:00:00 GMT DOI: 10.1093/annweh/wxab029 Issue No:Vol. 65, No. 8 (2021)
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Authors:Stevens M; Karstad K, Mathiassen S, et al. Pages: 919 - 927 Abstract: AbstractObjectivesCurrent knowledge on the determinants of step-rate at different organizational levels is limited. Thus, our aim was to identify, in eldercare, at what workplace level differences in step-rate occur and to identify determinants of workers’ step-rate at these levels.MethodsParticipants were 420 eldercare workers from 17 nursing homes (126 wards) in Denmark. Accelerometry was used to assess step-rate (steps per hour) of workers over multiple shifts. We assessed various determinants at different levels of the workplace, i.e. at the (i) shift, (ii) worker, (iii) ward, and (iv) nursing home levels. Variance components analysis identified the percentage contribution to total variance in step-rate from each respective level. Multi-level linear regression modelling was used to investigate the association between candidate determinants at each level and step-rate.ResultsDifferences in eldercare workers’ step-rate occurred primarily between shifts (within workers; 44.9%) and between workers (within wards; 49.1%). A higher step-rate was associated with: (i) weekend and evening shifts (versus weekday/day); (ii) job as a care helper (versus care aide) and an increased proportion of time spent on direct care tasks; (iii) working in a somatic ward (versus dementia), an increased resident–staff ratio and permission to take unscheduled breaks; and (iv) lack of elevators.ConclusionsWe found that nearly all variability in step-rate in eldercare work occurs between shifts (within workers) and between workers (within wards). The main determinants of step-rate were related to the type of shift, type of work tasks, staffing ratio, break policy, and availability of elevators. PubDate: Thu, 17 Jun 2021 00:00:00 GMT DOI: 10.1093/annweh/wxab027 Issue No:Vol. 65, No. 8 (2021)
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Authors:Willson-Kerns C; Brazile W. Pages: 930 - 939 Abstract: AbstractThirty (30) personal noise-exposure samples were collected on 20 tire-changing and repair technicians in three tire-changing facilities to determine their personal noise exposures and to estimate the maximum number of tire changes that could be performed without exceeding occupational exposure limits. Of the 30 projected 8-h time-weighted average noise samples, none exceeded the Occupational Safety and Health Administration’s Permissible Exposure Limit, 1 (3%) exceeded the Occupational Safety and Health Administration’s Action Level, and 18 (60%) exceeded the American Conference for Governmental Industrial Hygienists Threshold limit Value of 85 dBA, indicating the need for a hearing loss prevention program. The average shift time for the technicians was 6 h and 42 min and the average number of tire changes was 18. Based on the projected 8-h noise exposure 95% upper confidence limits, the estimated maximum number of tires that could be changed without exceeding the Occupational Safety and Health Administration’s noise action level was 32 tires, the permissible exposure limit greater than 40 tires, and the American Conference of Industrial Hygienists’ Threshold Limit Value was less than 20 tires. In addition, area noise samples of tire-changing equipment were taken with a sound-level meter to identify the noise sources that contributed to the tire technicians’ exposures. The air ratchet, tire-changing machine, and tire-bead seater were measured at noise levels >85 dBA, increasing the risk of noise-induced hearing loss to the technicians. PubDate: Tue, 06 Jul 2021 00:00:00 GMT DOI: 10.1093/annweh/wxab031 Issue No:Vol. 65, No. 8 (2021)
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Authors:Mohd Ridzwan S; Bhoo-Pathy N, Wee L, et al. Pages: 940 - 954 Abstract: AbstractThis qualitative study explores the medical radiation workers’ (MRWs) beliefs with the support of the theory of planned behaviour’s constructs regarding the use of personal dosimeters in order to identify the facilitating factors and barriers to practising good personal dose monitoring. The exploration was conducted through semi-structured face-to-face interviews with 63 MRWs from the public, private, and university hospitals. Belief statements from the informants were organized under the behavioural, normative, and control belief, as guided by the theory. A thematic analysis found that a majority of informants acknowledged the benefits of using dosimeters. However, several factors influenced the actual usage. The informants were hesitant to use the dosimeter as the loss of the device involved an expensive penalty. They also mentioned that delayed dosimeter supplies due to late budget approval in the hospitals and some other reasons had got them disconnected from the monitoring system. The workers’ attitudes and social norms highly induced their dosimeter usage as well; some perceived themselves to be at low risk for high exposure to radiation, and forgetfulness was also mentioned as a reason for lack of adherence. Device physical factor influenced low dosimeter use too. This study highlighted some unique findings in Asian settings. A better understanding of the underlying reasons for the lack of dosimeter use will be useful in developing strategies to increase good practices in personal radiation monitoring. PubDate: Tue, 25 May 2021 00:00:00 GMT DOI: 10.1093/annweh/wxab025 Issue No:Vol. 65, No. 8 (2021)
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Authors:Made F; Kandala N, Brouwer D. Pages: 955 - 965 Abstract: AbstractObjectivesGlobally, several strategies for compliance testing and within-group exposure variability have been suggested. This study aimed to evaluate the performance of the South African Mining Industry Code of Practice (SAMI CoP) approach for grouping and compliance testing against international standards.MethodsA total of 28 homogenous exposure groups (HEGs) with 728 underground coal mine workers’ eight-hour time-weighted average coal dust concentration data were obtained. Compliance testing was assessed using 10% exceedance above occupational exposure limit (OEL) for SAMI CoP, and the 95th percentile of the lognormal distribution was computed for the European Standardization Committee (CEN) and American Industrial Hygiene Association (AIHA). Comparison of the homogeneity of the HEGs was done between SAMI CoP which mandates that both the arithmetic mean (AM) and 90th percentile must fall in the same exposure band to certify homogeneity and the global geometric standard deviation (GSD) and Rappaport ratio (R-ratio) with specific acceptability criteria. To test the homogeneity of exposure within job titles, eight non-homogenous HEGs that have two or more job titles with three measurements were investigated using GSD and the SAMI CoP criteria.ResultsA total of 21 HEGs out of 28 were non-compliant to the OEL across SAMI CoP, CEN, and AIHA criteria. Compliance to the OEL was observed for seven HEGs according to the SAMI CoP approach, whereas only one HEG was compliant according to both the SAMI CoP and CEN approaches. The GSD criterion and SAMI CoP revealed that 11 and 6 HEGs were homogenous, respectively, and only on 4 occasions, the 2 approaches agreed. The job titles of the majority of non-homogenous HEGs in both SAMI CoP and GSD were actually homogenous. Five out of 10 sub-groups have their AM above that of HEG B. Other HEGs had at least one of their AM and 90th percentile values above that of their respective parent HEGs.ConclusionsAll three approaches mainly confirmed non-compliance of HEGs. SAMI CoP tended to show compliance of HEGs more than CEN. Non-homogenous HEGs had many job titles that were homogenous according to both SAMI CoP and GSD criteria. There was no perfect agreement of homogeneity by all the indicators. For both future constitutions of HEGs as well as a retrospective assessment of high exposure groups, homogeneity can be improved by using job titles. PubDate: Sat, 05 Jun 2021 00:00:00 GMT DOI: 10.1093/annweh/wxab030 Issue No:Vol. 65, No. 8 (2021)
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Authors:Viana M; Salmatonidis A, Bezantakos S, et al. Pages: 966 - 978 Abstract: AbstractIncidental ultrafine particles (UFPs) constitute a key pollutant in industrial workplaces. However, characterizing their chemical properties for exposure and toxicity assessments still remains a challenge. In this work, the performance of an aerosol concentrator (Versatile Aerosol Concentration Enrichment System, VACES) was assessed to simultaneously sample UFPs on filter substrates (for chemical analysis) and as liquid suspensions (for toxicity assessment), in a high UFP concentration scenario. An industrial case study was selected where metal-containing UFPs were emitted during thermal spraying of ceramic coatings. Results evidenced the comparability of the VACES system with online monitors in terms of UFP particle mass (for concentrations up to 95 µg UFP/m3) and between filters and liquid suspensions, in terms of particle composition (for concentrations up to 1000 µg/m3). This supports the applicability of this tool for UFP collection in view of chemical and toxicological characterization for incidental UFPs. In the industrial setting evaluated, results showed that the spraying temperature was a driver of fractionation of metals between UF (<0.2 µm) and fine (0.2–2.5 µm) particles. Potentially health hazardous metals (Ni, Cr) were enriched in UFPs and depleted in the fine particle fraction. Metals vaporized at high temperatures and concentrated in the UF fraction through nucleation processes. Results evidenced the need to understand incidental particle formation mechanisms due to their direct implications on particle composition and, thus, exposure. It is advisable that personal exposure and subsequent risk assessments in occupational settings should include dedicated metrics to monitor UFPs (especially, incidental). PubDate: Tue, 27 Jul 2021 00:00:00 GMT DOI: 10.1093/annweh/wxab011 Issue No:Vol. 65, No. 8 (2021)
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Authors:Massey T; Borucki M, Paik S, et al. Pages: 979 - 987 Abstract: AbstractReuse of filtering facepiece respirators (FFRs, commonly referred to as N95s) normally meant for single use has become common in healthcare facilities due to shortages caused by the COVID-19 pandemic. Here, we report that murine hepatitis coronavirus initially seeded on FFR filter material is inactivated (6 order of magnitude reduction as measured by median tissue culture infective dose, TCID50) after dry heating at 75°C for 30 min. We also find that the quantitative fit of FFRs after heat treatment at this temperature, under dry conditions or at 90% relative humidity, is not affected by single or 10 heating cycles. Previous studies have reported that the filtration efficiency of FFRs is not negatively impacted by these heating conditions. These results suggest that thermal inactivation of coronaviruses is a potentially rapid and widely deployable method to reuse N95 FFRs in emergency situations where reusing FFRs is a necessity and broad-spectrum sterilization is unavailable. However, we also observe that a radiative heat source (e.g. an exposed heating element) results in rapid qualitative degradation of the FFR. Finally, we discuss differences in the results reported here and other recent studies investigating heat as a means to recycle FFRs. These differences suggest that while our repeated decontamination cycles do not affect FFR fit, overall wear time and the number of donning/doffing cycles are important factors that likely degrade FFR fit and must be investigated further. PubDate: Mon, 17 May 2021 00:00:00 GMT DOI: 10.1093/annweh/wxab020 Issue No:Vol. 65, No. 8 (2021)
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Authors:Gbetchedji A; Mansouri I, Hounsossou H, et al. Pages: 988 - 997 Abstract: AbstractThe ease of prescribing radiological examinations has prompted an expansion in radiological procedures and, consequently, an increase of occupational dose to medical imaging workers. However, little is known about radiation exposure in the workplace of medical radiology professionals in many countries, and in Benin particularly. The purpose of this study was to assess ambient radiation doses in diagnostic X-ray medical facilities in Benin and to observe whether exposure levels are below reference levels. A total of 72 public and private medical imaging centres participated in a cross-sectional study carried out from June 2019 to February 2020 in Benin. These centres had 59 X-ray, four chest and six computed tomography (CT) scan rooms. A calibrated radiameter able to measure short, pulsed or continuous X fields and gamma/beta (50 nSv to 10 Sv) was used to measure exposure levels in these functional rooms. Scattered X-ray doses and exposure time from radiological examinations both behind the lead glass of the control area to assess the levels of exposure of professionals and outside of the examination room to evaluate the level of exposure of the public (including non-exposed workers) have been provided. Equivalent doses estimated per hour were compared with the reference levels of 7.50 and 0.05 µSv per hour for workers and the public, respectively. At the control area, the mean/median (min-max) equivalent doses were 0.09/0.07 (0.00–0.21), 2.39/0.13 (0.00–75.67), and 228.39/28.65 (0.39–869.75) µSv per hour for the chest, X-ray, and CT-scan rooms, respectively. Among 69 examination rooms, 13.04% of the equivalent dose estimated in the workplace behind the lead glass was greater than 7.50 µSv per hour; 65 out of 69 examination rooms showed that 40.00% of the equivalent dose estimated behind the doors was greater than 0.05 µSv per hour. These results demonstrated that current controls, including leaded glass separating the control panel and leaded doors between the examination room and the corridor, are inadequate to limit radiation exposures. The controls must be upgraded and a dosimetry program should be implemented to monitor exposures of employees, patients, and visitors. PubDate: Tue, 13 Jul 2021 00:00:00 GMT DOI: 10.1093/annweh/wxab046 Issue No:Vol. 65, No. 8 (2021)
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Authors:Marraha F; Al Faker I, Charif F, et al. Pages: 998 - 1003 Abstract: AbstractObjectivesHealth care workers (HCWs) adopted several protective measures, including hand hygiene and wearing personal protective equipment (PPE) during the COVID-19 outbreak. However, the frequent use of these preventive measures can lead to skin reactions. Our study aimed to determine the frequency of these reactions in Northern Morocco. In addition, we also looked at the risk factors and the consequences of these injuries on work efficiency and performance.Materials and MethodsAn anonymous online survey was used to collect data, which was sent to 500 health workers in the study region. Descriptive and inferential statistics were used to analyze the data on IBM SPSS software.ResultsIn total, 273/500 responded to the questionnaire (55%). For the participants’ profession, 41% were doctors, 32% were nursing staff, and 26% held other jobs. The general prevalence rate of adverse reactions for all health workers was (80%), including skin problems: after wearing goggles (58%), after wearing surgical masks and respirators (57%), after handwashing and wearing gloves (45%), after wearing a face shield (23%), and after wearing protective clothing (11%). Bleach immersion was highly significantly associated with hand reaction (OR: 2.9, 95% CI: 1.77–4.90; P < 0.001). Moreover, we found a statistically significant association between hand cream use more than twice daily and fewer reactions (OR: 1.9, 95% CI: 0.98–3.77; P = 0.038). The skin reactions related to goggles use were also significantly associated with use duration (OR: 1.7, 95% CI: 0.988–3.12; P = 0.05). Similarly, wearing masks and N95 respirators and their related adverse reactions were significantly associated with use duration (OR: 0.5, 95% CI: 0.20–0.7; P = 0.02). In addition, adverse reactions of regular use of protective clothing were related to the frequency of its use per shift (OR: 3.5, 95% CI: 1.47–8.54; P = 0.05).ConclusionsOur survey-based study showed that the prevalence of these skin reactions in our context should not be neglected. The length of daily wearing time and the frequency of PPE uses were the most implicated factors. More attention must be paid to these reactions for better care of HCWs during these critical times. PubDate: Tue, 20 Apr 2021 00:00:00 GMT DOI: 10.1093/annweh/wxab018 Issue No:Vol. 65, No. 8 (2021)
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Authors:Chen F; Zhan W, Xu H, et al. Pages: 1004 - 1008 Abstract: AbstractObjectivesThe aim of the present study was to investigate changes in the psychological state of medical personnel in the Department of Radiotherapy during the COVID-19 epidemic.MethodsPsychological state was evaluated using the Pittsburgh Sleep Quality Index (PSQI), Self-Rating Depression Scale (SDS), and Self-Rating Anxiety Scale (SAS). All three questionnaires were first completed by medical personnel on 17–18 February 2020 and were repeated every 3 months thereafter until 17–18 August. The number and intentions of patients receiving radiotherapy (RT) in our department were also collected.ResultsTwenty medical personnel participated in the present study. The global PSQI score recorded in August was significantly lower than that recorded in February (P = 0.045). Among the seven components of the PSQI, sleep quality (P = 0.048) and daytime dysfunction (P = 0.006) in August were significantly improved compared with February, whereas SDS and SAS did not significantly differ among the three different time points. The proportion of patients who received palliative radiotherapy was significantly higher on 18 May than on 17 February (P = 0.005).ConclusionsMedical personnel in the Department of Radiotherapy experienced a significantly elevated incidence of sleeping problems during the early COVID-19 outbreak period. Multiple combinations of protective measures to avoid infection could improve sleep quality and ensure the safe delivery of RT to cancer patients. PubDate: Wed, 28 Apr 2021 00:00:00 GMT DOI: 10.1093/annweh/wxab015 Issue No:Vol. 65, No. 8 (2021)
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Authors:Lucas D; Jouve E, Clamagirand V, et al. Pages: 1009 - 1010 Abstract: Recently, Dueck et al. (2021) from Edmonton, Alberta, Canada published an article on welding fumes exposure and health risk assessment in a cohort of apprentice welders. Interestingly, they found that levels of atmospheric concentration of total particles and metals increased during training course and especially for manganese, chrome, nickel, and zinc. In multivariate analysis, the principal determinant of particles concentrations was the welding process. PubDate: Mon, 16 Aug 2021 00:00:00 GMT DOI: 10.1093/annweh/wxab052 Issue No:Vol. 65, No. 8 (2021)
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