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Occupational exposure to polycyclic aromatic hydrocarbons: A cross-sectional study in bars and restaurants in Santiago, Chile

American Journal of Industrial Medicine - Mon, 06/27/2016 - 09:15
Objective

To evaluate indoor polycyclic aromatic hydrocarbon (PAH) concentrations in bars and restaurants and identify the main determinants of airborne PAH concentrations.

Methods

This study included 57 bars/restaurants in Santiago, Chile. PAH concentrations (ng/m3) were measured using photoelectric aerosol sensor equipment (PAS 2000CE model). Nicotine concentrations (μg/m3) were measured using active sampling pumps followed by gas-chromatography. Linear regression models were used to identify determinants of PAH concentrations.

Results

PAH concentrations were higher in venues that allowed smoking compared to smoke-free venues. After adjusting, the air PAH concentrations were 1.40 (0.64–3.10) and 3.34 (1.43–7.83) ng/m3 higher for tertiles 2 and 3 of air nicotine compared to the lowest tertile.

Conclusions

In hospitality venues where smoking is allowed, secondhand smoke exposure is a major source of PAHs in the environment. This research further supports the importance of implementing complete smoking bans to protect service industry workers from PAH exposure. Am. J. Ind. Med. © 2016 Wiley Periodicals, Inc.

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Work-related deaths among youth: Understanding the contribution of US child labor violations

American Journal of Industrial Medicine - Mon, 06/27/2016 - 09:15
Background

Evidence shows that violations of the United States (US) child labor regulations are common. The main purpose of this study was to investigate the magnitude and nature of work-related deaths among youth involving violations of US child labor regulations.

Methods

We analyzed Census of Fatal Occupational Injury data from 2001 to 2012 using descriptive statistics and Chi-square tests.

Results

Between 2001 and 2012, 406 workers under age 18 were recorded in the CFOI as having suffered a fatal work-related injury. Among these cases, 233 were covered by the US child labor regulations. Forty-three percent of these cases involved at least one violation. The majority of cases that were not covered by the regulations involved decedents working on their family's farms (N = 139).

Conclusions

Violations of federal child labor regulations are a significant contributor to work-related deaths among youth in the United States. Increased investment in enforcement is needed to prevent further young worker deaths involving child labor violations. Am. J. Ind. Med. 9999:1–10, 2016. © 2016 Wiley Periodicals, Inc.

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Foremen's intervention to prevent falls and increase safety communication at residential construction sites

American Journal of Industrial Medicine - Mon, 06/27/2016 - 09:15
Background

This research aimed to improve residential construction foremen's communication skills and safety behaviors of their crewmembers when working at heights.

Methods

Eighty-four residential construction foremen participated in the 8-hr fall prevention and safety communication training. We compared pre- and post-intervention surveys from foremen and their crewmembers to measure the effect of training.

Results

Foremen and crewmembers’ ratings showed improvements in fall prevention knowledge, behaviors, and safety communication and were sustained 6-months post-training, with emphasized areas demonstrating larger increases. Ratings were similar between foremen and crewmembers, suggesting that the foremen effectively taught their crew and assigned accurate ratings. Based upon associations between safety behaviors and reported falls observed in prior research, we would expect a 16.6% decrease in the one year cumulative incidence of self-reported falls post-intervention.

Conclusions

This intervention improved safety knowledge and behaviors of a large number of workers by training construction foremen in fall prevention and safety communication skills. Am. J. Ind. Med. © 2016 Wiley Periodicals, Inc.

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Access to properly fitting personal protective equipment for female construction workers

American Journal of Industrial Medicine - Mon, 06/27/2016 - 09:10
Background

Previous literature suggests that most personal protective equipment (PPE) for construction is designed for males and does not accommodate female anthropometry. We conducted a pilot study to identify whether female construction workers currently have adequate access to properly fitting PPE.

Methods

Semi-structured focus group interviews were conducted with union female carpenters, laborers, and ironworkers. Researchers coded focus group transcriptions and extracted major themes using thematic framework analysis.

Results

Participants (n = 23) had a mean of 15.1 years of construction experience (range 3–34.5 years). A majority reported fit problems for many types of PPE (gloves, harnesses, safety vests, work boots, outerwear), generally noting that the equipment provided by contractors was too large. Other emergent themes included female workers purchasing their own PPE, exposure to various safety hazards from poorly fitted PPE, and perceived indifferent safety culture.

Conclusions

Female construction workers continue to have difficulty accessing properly fitting PPE. Am. J. Ind. Med. 9999:XX–XX, © 2016 Wiley Periodicals, Inc.

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An analysis of fatal and non-fatal injuries and injury severity factors among electric power industry workers

American Journal of Industrial Medicine - Mon, 06/27/2016 - 09:10
Abstract Background

The electric power industry represents a unique subset of the U.S. workforce. We aimed to evaluate the relationships between occupational category, nature of injury, and injury severity among electric power industry workers.

Methods

The Occupational Health and Safety Database (1995–2013) was used to calculate injury rates, assess patterns of injury severity, and identify at-risk occupations in this population.

Results

Over the surveillance period, a total of 63,193 injuries were reported. Overall, and severe injury rates were 3.20 and 0.52 per 100 employee-years, respectively. The fatal injury rate was 3.29 per 100,000 employee-years. Line workers experienced the highest risk for fatal injuries and second highest for non-fatal severe injuries, following meter readers. The most severe non-fatal injuries were hernia and rupture; multiple injuries; and CTD/RSI. Fatal injuries were most commonly associated with vehicle collisions and contact with electric current.

Conclusions

Industry specific surveillance and interventions tailored to high-risk occupations are needed to further reduce severe injuries in this population. Am. J. Ind. Med. © 2016 Wiley Periodicals, Inc.

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Waste Workers Exposure to Airborne Fungal and Bacterial Species in the Truck Cab and During Waste Collection

Annals of Occupational Hygiene - Tue, 06/21/2016 - 15:03

A large number of people work with garbage collection, and exposure to microorganisms is considered an occupational health problem. However, knowledge on microbial exposure at species level is limited. The aim of the study was to achieve knowledge on waste collectors’ exposure to airborne inhalable fungal and bacterial species during waste collection with focus on the transport of airborne microorganisms into the truck cab. Airborne microorganisms were collected with samplers mounted in the truck cab, on the workers’ clothes, and outdoors. Fungal and bacterial species were quantified and identified. The study showed that the workers were exposed to between 112 and 4.8x104 bacteria m–3 air and 326 and 4.6x104 fungi m–3 air. The personal exposures to bacteria and fungi were significantly higher than the concentrations measured in the truck cabs and in the outdoor references. On average, the fungal and bacterial concentrations in truck cabs were 111 and 7.7 times higher than outdoor reference measurements. In total, 23 fungal and 38 bacterial species were found and identified. Most fungal species belonged to the genus Penicillium and in total 11 Penicillium species were found. Identical fungal species were often found both in a personal sample and in the same person’s truck cab, but concentrations were on average 27 times higher in personal samples. Concentrations of fungal and bacterial species found only in the personal samples were lower than concentrations of species also found in truck cabs. Skin-related bacteria constituted a large fraction of bacterial isolates found in personal and truck cab samples. In total, six Staphylococcus species were found. In outdoor samples, no skin-related bacteria were found. On average, concentrations of bacterial species found both in the truck cab and personal samples were 77 times higher in personal samples than in truck cab samples. In conclusion, high concentrations of fungi were found in truck cabs, but the highest concentrations were found in personal samples; fungal and bacterial species found in high concentrations in personal samples were also found in truck cabs, but in lower concentrations indicating that both fungi and bacteria are transported by the workers into the truck cab, and are subsequently aerosolized in the truck cab.

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A Method for Semi-quantitative Assessment of Exposure to Pesticides of Applicators and Re-entry Workers: An Application in Three Farming Systems in Ethiopia

Annals of Occupational Hygiene - Tue, 06/21/2016 - 15:03
Objective:

To develop an inexpensive and easily adaptable semi-quantitative exposure assessment method to characterize exposure to pesticide in applicators and re-entry farmers and farm workers in Ethiopia.

Methods:

Two specific semi-quantitative exposure algorithms for pesticides applicators and re-entry workers were developed and applied to 601 farm workers employed in 3 distinctly different farming systems [small-scale irrigated, large-scale greenhouses (LSGH), and large-scale open (LSO)] in Ethiopia. The algorithm for applicators was based on exposure-modifying factors including application methods, farm layout (open or closed), pesticide mixing conditions, cleaning of spraying equipment, intensity of pesticide application per day, utilization of personal protective equipment (PPE), personal hygienic behavior, annual frequency of application, and duration of employment at the farm. The algorithm for re-entry work was based on an expert-based re-entry exposure intensity score, utilization of PPE, personal hygienic behavior, annual frequency of re-entry work, and duration of employment at the farm.

Results:

The algorithms allowed estimation of daily, annual and cumulative lifetime exposure for applicators, and re-entry workers by farming system, by gender, and by age group. For all metrics, highest exposures occurred in LSGH for both applicators and female re-entry workers. For male re-entry workers, highest cumulative exposure occurred in LSO farms. Female re-entry workers appeared to be higher exposed on a daily or annual basis than male re-entry workers, but their cumulative exposures were similar due to the fact that on average males had longer tenure. Factors related to intensity of exposure (like application method and farm layout) were indicated as the main driving factors for estimated potential exposure. Use of personal protection, hygienic behavior, and duration of employment in surveyed farm workers contributed less to the contrast in exposure estimates.

Conclusions:

This study indicated that farmers’ and farm workers’ exposure to pesticides can be inexpensively characterized, ranked, and classified. Our method could be extended to assess exposure to specific active ingredients provided that detailed information on pesticides used is available. The resulting exposure estimates will consequently be used in occupational epidemiology studies in Ethiopia and other similar countries with few resources.

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Occupational Exposure to Cobalt and Tungsten in the Swedish Hard Metal Industry: Air Concentrations of Particle Mass, Number, and Surface Area

Annals of Occupational Hygiene - Tue, 06/21/2016 - 15:03

Exposure to cobalt in the hard metal industry entails severe adverse health effects, including lung cancer and hard metal fibrosis. The main aim of this study was to determine exposure air concentration levels of cobalt and tungsten for risk assessment and dose–response analysis in our medical investigations in a Swedish hard metal plant. We also present mass-based, particle surface area, and particle number air concentrations from stationary sampling and investigate the possibility of using these data as proxies for exposure measures in our study. Personal exposure full-shift measurements were performed for inhalable and total dust, cobalt, and tungsten, including personal real-time continuous monitoring of dust. Stationary measurements of inhalable and total dust, PM2.5, and PM10 was also performed and cobalt and tungsten levels were determined, as were air concentration of particle number and particle surface area of fine particles. The personal exposure levels of inhalable dust were consistently low (AM 0.15mg m–3, range <0.023–3.0mg m–3) and below the present Swedish occupational exposure limit (OEL) of 10mg m–3. The cobalt levels were low as well (AM 0.0030mg m–3, range 0.000028–0.056mg m–3) and only 6% of the samples exceeded the Swedish OEL of 0.02mg m–3. For continuous personal monitoring of dust exposure, the peaks ranged from 0.001 to 83mg m–3 by work task. Stationary measurements showed lower average levels both for inhalable and total dust and cobalt. The particle number concentration of fine particles (AM 3000 p·cm–3) showed the highest levels at the departments of powder production, pressing and storage, and for the particle surface area concentrations (AM 7.6 µm2·cm–3) similar results were found. Correlating cobalt mass-based exposure measurements to cobalt stationary mass-based, particle area, and particle number concentrations by rank and department showed significant correlations for all measures except for particle number. Linear regression analysis of the same data showed statistically significant regression coefficients only for the mass-based aerosol measures. Similar results were seen for rank correlation in the stationary rig, and linear regression analysis implied significant correlation for mass-based and particle surface area measures. The mass-based air concentration levels of cobalt and tungsten in the hard metal plant in our study were low compared to Swedish OELs. Particle number and particle surface area concentrations were in the same order of magnitude as for other industrial settings. Regression analysis implied the use of stationary determined mass-based and particle surface area aerosol concentration as proxies for various exposure measures in our study.

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Biological Monitoring of Occupational Exposure to Polycyclic Aromatic Hydrocarbons at an Electric Steel Foundry in Tunisia

Annals of Occupational Hygiene - Tue, 06/21/2016 - 15:03

Occupational exposures during iron and steel founding have been classified as carcinogenic to humans, and the exposure to polycyclic aromatic hydrocarbons (PAHs) in this industrial setting may contribute to cancer risk. The occupational exposure to PAHs was assessed in 93 male workers at an electric steel foundry in Tunisia by biomonitoring, with the aims of characterizing the excretion profile and investigating the influence of job title and personal characteristics on the biomarkers. Sixteen 2–6 ring unmetabolized PAHs (U-PAHs) and eight hydroxylated PAH metabolites (OHPAHs) were analyzed by gas chromatography-triple quadrupole tandem mass spectrometry and liquid chromatography triple quadrupole tandem mass spectrometry, respectively. Among U-PAHs, urinary naphthalene (U-NAP) was the most abundant compound (median level: 643ng l–1), followed by phenanthrene (U-PHE, 18.5ng l–1). Urinary benzo[a]pyrene (U-BaP) level was <0.30ng l–1. Among OHPAHs, 2-hydroxynaphthalene (2-OHNAP) was the most abundant metabolite (2.27 µg l–1). Median 1-hydroxypyrene (1-OHPYR) was 0.52 µg l–1. Significant correlations among urinary biomarkers were observed, with Pearson’s r ranging from 0.177 to 0.626. 1-OHPYR was correlated to benzo[a]pyrene, but not to five- and six-rings PAHs. A multiple linear regression model showed that job title was a significant determinant for almost all U-PAHs. In particular, employees in the steel smelter workshop had higher levels of high-boiling U-PAHs and lower levels of low-boiling U-PAHs than those of workers with other job titles. Among OHPAHs, this model was significant only for naphthols and 1-hydroxyphenanthrene (1-OHPHE). Smoking status was a significant predictor for almost all biomarkers. Among all analytes, U-PHE and 1-OHPHE were the less affected by tobacco smoke, and they were significantly correlated with both low- and high-molecular-weight compounds, and their levels were related to job titles, so they could be proposed as suitable biomarkers of PAH exposure at steel foundries. Based on 1-OHPYR levels, our findings show that occupational exposure of these workers was similar to that reported in recent studies of electric steel foundry workers. The multianalytic approach is useful in revealing different exposure levels among job titles.

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Detection of Carbonaceous Aerosols Released in CNT Workplaces Using an Aethalometer

Annals of Occupational Hygiene - Tue, 06/21/2016 - 15:03
Objectives:

Black carbon (BC) originating from various combustion sources has been extensively surveyed to characterize the effects of BC on global warming and human health, and many online monitors are available. In this study, BC was considered as a surrogate for carbon-based nanomaterials in an occupational health study.

Methods:

Specifically, BC concentrations were monitored continuously with an aethalometer for 24h at four carbon nanotube (CNT) workplaces located in rural, urban, and industrial areas, which had different background air pollution levels. Average BC concentrations for both nonworking (background) and working periods were compared with the recommended exposure limit (REL) of 1 μg m–3 for elemental carbon that was suggested by the National Institute for Occupational Safety and Health (NIOSH).

Results:

Diurnal variation of BC concentrations indicated that BC measurements corresponded well with carbonaceous aerosols such as vehicle exhaust particles and CNT aerosols. In the rural CNT workplace, the average background BC concentration (0.36 μg m–3) was lower than the REL, but the BC concentration without background correction was higher than the REL during manufacturing hours. In this case, BC measurement is useful to estimate CNT exposure for comparison with the REL. Conversely, in the urban and industrial CNT workplaces, average background BC concentrations (2.05, 1.82, and 2.64 μg m–3) were well above the REL, and during working hours, BC concentrations were substantially higher than the background level at workplace C; however, BC concentrations showed no difference from the background levels at workplaces B and D. In these cases (B and D), it is hard to determine CNT exposure because of the substantial environmental exposures.

Conclusion:

Most of the urban ambient BC concentrations were above the REL. Therefore, further analysis and test methods for carbonaceous aerosols need to be developed so that the exposure assessment can be easily carried out at CNT workplaces with high background BC levels such as in urban and industrial areas.

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Transport and Deposition of Welding Fume Agglomerates in a Realistic Human Nasal Airway

Annals of Occupational Hygiene - Tue, 06/21/2016 - 15:03

Welding fume is a complex mixture containing ultra-fine particles in the nanometer range. Rather than being in the form of a singular sphere, due to the high particle concentration, welding fume particles agglomerate into long straight chains, branches, or other forms of compact shapes. Understanding the transport and deposition of these nano-agglomerates in human respiratory systems is of great interest as welding fumes are a known health hazard. The neurotoxin manganese (Mn) is a common element in welding fumes. Particulate Mn, either as soluble salts or oxides, that has deposited on the olfactory mucosa in human nasal airway is transported along the olfactory nerve to the olfactory bulb within the brain. If this Mn is further transported to the basal ganglia of the brain, it could accumulate at the part of the brain that is the focal point of its neurotoxicity. Accounting for various dynamic shape factors due to particle agglomeration, the current computational study is focused on the exposure route, the deposition pattern, and the deposition efficiency of the inhaled welding fume particles in a realistic human nasal cavity. Particular attention is given to the deposition pattern and deposition efficiency of inhaled welding fume agglomerates in the nasal olfactory region. For particles in the nanoscale, molecular diffusion is the dominant transport mechanism. Therefore, Brownian diffusion, hydrodynamic drag, Saffman lift force, and gravitational force are included in the model study. The deposition efficiencies for single spherical particles, two kinds of agglomerates of primary particles, two-dimensional planar and straight chains, are investigated for a range of primary particle sizes and a range of number of primary particles per agglomerate. A small fraction of the inhaled welding fume agglomerates is deposited on the olfactory mucosa, approximately in the range 0.1–1%, and depends on particle size and morphology. The strong size dependence of the deposition in olfactory mucosa on particle size implies that the occupation deposition of welding fume manganese can be expected to vary with welding method.

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Performance of N95 FFRs Against Combustion and NaCl Aerosols in Dry and Moderately Humid Air: Manikin-based Study

Annals of Occupational Hygiene - Tue, 06/21/2016 - 15:03
Objectives:

The first objective of this study was to evaluate the penetration of particles generated from combustion of plastic through National Institute for Occupational Safety and Health (NIOSH)-certified N95 filtering facepiece respirators (FFRs) using a manikin-based protocol and compare the data to the penetration of NaCl particles. The second objective was to investigate the effect of relative humidity (RH) on the filtration performance of N95 FFRs.

Methods:

Two NIOSH-certified N95 FFRs (A and B) were fully sealed on a manikin headform and challenged with particles generated by combustion of plastic and NaCl particles. The tests were performed using two cyclic flows [with mean inspiratory flow (MIF) rates = 30 and 85 l min–1, representing human breathing under low and moderate workload conditions] and two RH levels (20 and 80%, representing dry and moderately humid air). The total and size-specific particle concentrations inside (C in) and outside (C out) of the respirators were measured with a condensation particle counter and an aerosol size spectrometer. The penetration values (C in/C out) were calculated after each test.

Results:

The challenge aerosol, RH, MIF rate, and respirator type had significant (P < 0.05) effects on the performance of the manikin-sealed FFR. Its efficiency significantly decreased when the FFR was tested with plastic combustion particles compared to NaCl aerosols. For example, at RH 80% and MIF = 85 l min–1, as much as 7.03 and 8.61% of combustion particles penetrated N95 respirators A and B, respectively. The plastic combustion particles and gaseous compounds generated by combustion likely degraded the electric charges on fibers, which increased the particle penetration. Increasing breathing flow rate or humidity increased the penetration (reduced the respirator efficiency) for all tested aerosols. The effect of particle size on the penetration varied depending on the challenge aerosol and respirator type. It was observed that the peak of the size distribution of combustion particles almost coincided with their most penetrating particle size, which was not the case for NaCl particles. This finding was utilized for the data interpretation.

Conclusions:

N95 FFRs have lower filter efficiency when challenged with contaminant particles generated by combustion, particularly when used under high humidity conditions compared to NaCl particles.

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Factors Affecting the Capture Efficiency of a Fume Extraction Torch for Gas Metal Arc Welding

Annals of Occupational Hygiene - Tue, 06/21/2016 - 15:03

Welding fumes are classified as Group 2B ‘possibly carcinogenic’ and this prompts to the implementation of local exhaust ventilation (LEV). The fume extraction torch with LEV integrated into the tool is the most attractive solution but its capture efficiency is often disappointing in practice. This study assesses the main parameters affecting fume capture efficiency namely the extraction flow rate, the positioning of the suction openings on the torch, the angle of inclination of the torch to the workpiece during welding, the metal transfer modes, and the welding deposition rate. The theoretical velocity induced by suction, estimated from the extraction flow rate and the position of the suction openings, is the main parameter affecting effectiveness of the device. This is the design parameter and its value should never be <0.25 m s–1. The angle of the torch relative to the workpiece also has a great deal of influence. To improve efficiency, work station layouts need to favour positions where the torch is held with angles closer to perpendicular (<15°). Welding with high deposition rates (>1.1g s–1) and spray transfer leads to low capture efficiency if induced velocities are <0.5 m s–1. The results of the study can be used in the design of integrated on-torch extraction systems and provide information for fixing system objectives.

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Efficiency of Respirator Filter Media against Diesel Particulate Matter: A Comparison Study Using Two Diesel Particulate Sources

Annals of Occupational Hygiene - Tue, 06/21/2016 - 15:03

Diesel engines have been a mainstay within many industries since the early 1900s. Exposure to diesel particulate matter (DPM) is a major issue in many industrial workplaces given the potential for serious health impacts to exposed workers; including the potential for lung cancer and adverse irritant and cardiovascular effects. Personal respiratory protective devices are an accepted safety measure to mitigate worker exposure against the potentially damaging health impacts of DPM. To be protective, they need to act as effective filters against carbon and other particulates. In Australia, the filtering efficiency of respiratory protective devices is determined by challenging test filter media with aerosolised sodium chloride to determine penetration at designated flow rates. The methodology outlined in AS/NZS1716 (Standards Australia International Ltd and Standards New Zealand 2012. Respiratory protective devices. Sydney/Wellington: SAI Global Limited/Standards New Zealand) does not account for the differences between characteristics of workplace contaminants like DPM and sodium chloride such as structure, composition, and particle size. This study examined filtering efficiency for three commonly used AS/NZS certified respirator filter models, challenging them with two types of diesel emissions; those from a diesel generator and a diesel engine. Penetration through the filter media of elemental carbon (EC), total carbon (TC), and total suspended particulate (TSP) was calculated. Results indicate that filtering efficiency assumed by P2 certification in Australia was achieved for two of the three respirator models for DPM generated using the small diesel generator, whilst when the larger diesel engine was used, filtering efficiency requirements were met for all three filter models. These results suggest that the testing methodology specified for certification of personal respiratory protective devices by Standards Australia may not ensure adequate protection for respirator users against DPM under all circumstances of diesel generated particles.

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Secondhand smoke in the operating room? Precautionary practices lacking for surgical smoke

American Journal of Industrial Medicine - Fri, 06/10/2016 - 11:32
Background

Consensus organizations, government bodies, and healthcare organization guidelines recommend that surgical smoke be evacuated at the source by local exhaust ventilation (LEV) (i.e., smoke evacuators or wall suctions with inline filters).

Methods

Data are from NIOSH's Health and Safety Practices Survey of Healthcare Workers module on precautionary practices for surgical smoke.

Results

Four thousand five hundred thirty-three survey respondents reported exposure to surgical smoke: 4,500 during electrosurgery; 1,392 during laser surgery procedures. Respondents were mainly nurses (56%) and anesthesiologists (21%). Only 14% of those exposed during electrosurgery reported LEV was always used during these procedures, while 47% reported use during laser surgery. Those reporting LEV was always used were also more likely to report training and employer standard procedures addressing the hazards of surgical smoke. Few respondents reported use of respiratory protection.

Conclusions

Study findings can be used to raise awareness of the marginal use of exposure controls and impediments for their use. Am. J. Ind. Med. Published 2016. This article is a U.S. Government work and is in the public domain in the USA

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A systematic literature review of the effectiveness of occupational health and safety regulatory enforcement

American Journal of Industrial Medicine - Tue, 06/07/2016 - 11:11
Background

We aimed to determine the strength of evidence on the effectiveness of legislative and regulatory policy levers in creating incentives for organizations to improve occupational health and safety processes and outcomes.

Methods

A systematic review was undertaken to assess the strength of evidence on the effectiveness of specific policy levers using a “best-evidence” synthesis approach.

Results

A structured literature search identified 11,947 citations from 13 peer-reviewed literature databases. Forty-three studies were retained for synthesis. Strong evidence was identified for three out of nine clusters.

Conclusions

There is strong evidence that several OHS policy levers are effective in terms of reducing injuries and/or increasing compliance with legislation. This study adds to the evidence on OHS regulatory effectiveness from an earlier review. In addition to new evidence supporting previous study findings, it included new categories of evidence–compliance as an outcome, nature of enforcement, awareness campaigns, and smoke-free workplace legislation. Am. J. Ind. Med. © 2016 Wiley Periodicals, Inc.

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Mortality study of employees at a chemical manufacturing plant using administrative databases

American Journal of Industrial Medicine - Mon, 06/06/2016 - 10:15
Background

This study investigated mortality in a cohort of 1,988 male workers at a chemical manufacturing plant (1981–2011) and evaluated the quality of the results obtained using administrative databases.

Methods

Information about the workers was obtained from the archives of the Italian National Institute for Social Insurance. Vital status and causes of death were ascertained through record linkage with electronic archives and follow-up mailing. Regional reference rates were used to calculate standardized mortality ratios (SMRs) and 90% confidence intervals (CI).

Results

The analysis showed increased SMR for selected cancers of a priori interest: respiratory system (SMR: 126.8; 90%CI: 105–152), pleura (330.5; 90%CI 164–596), and non-Hodgkin lymphoma (196.1; 90%CI 102–342).

Conclusions

The results indicate an effect of hazardous exposures among workers in this chemical manufacturing plant. Using administrative databases to construct historical cohorts is an efficient method in time and resources, for estimating the risk of mortality and generating hypotheses. Am. J. Ind. Med. 9999:XX–XX, © 2016 Wiley Periodicals, Inc.

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Regular use of pain medication due to musculoskeletal disorders in the general working population: Cross-sectional study among 10,000 workers

American Journal of Industrial Medicine - Wed, 06/01/2016 - 11:17
Background

We aimed to determine the association between work, health, and lifestyle with regular use of pain medication due to musculoskeletal disorders in the general working population.

Methods

Currently employed wage earners (N = 10,024) replied to questions about health, work, and lifestyle. The odds for regularly using medication for musculoskeletal disorders were modeled using logistic regression controlled for various confounders.

Results

Pain intensity increased the odds for using pain medication in a dose–response fashion. With seated work as reference, the odds for using pain medication were 1.26 (95%CI: 1.09–1.47) for workers engaged in standing or walking work that is not strenuous and 1.59 (95%CI: 1.39–1.82) for workers engaged in standing or walking work with lifting tasks or heavy and fast strenuous work.

Conclusions

Workers with higher levels of physical activity at work are more likely to use pain medication on a regular basis for musculoskeletal disorders, even when adjusting for pain intensity, lifestyle, and influence at work. Am. J. Ind. Med. © 2016 Wiley Periodicals, Inc.

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Shiftwork and decline in endothelial function among police officers

American Journal of Industrial Medicine - Wed, 06/01/2016 - 11:17
Background

Our objective was to assess the influence of shiftwork on change in endothelial function.

Methods

This longitudinal study was conducted in 188 police officers (78.2% men). Shiftwork status (day, afternoon, night) was assessed objectively using daily Buffalo, NY payroll work history records. Brachial artery flow-mediated dilation (FMD) was assessed using ultrasound. Mean change in FMD% between 2004–2009 and 2010–2015 was compared across shiftwork using analysis of variance/covariance.

Results

Overall, mean FMD% decreased from 5.74 ± 2.83 to 3.88 ± 2.11 over an average of 7 years among all officers; P < 0.0001. Effect modification by gender was significant. Among men (but not women), those who worked day shifts had a smaller mean (±SE) decrease in FMD% (−0.89 ± 0.35) compared with those who worked the afternoon (−2.69 ± 0.39; P = 0.001) or night shifts (−2.31 ± 0.45; P = 0.020) after risk factor adjustment.

Conclusions

Larger declines in endothelial function were observed among men who worked afternoon or night shifts. Further investigation is warranted. Am. J. Ind. Med. Published 2016. This article is a U.S. Government work and is in the public domain in the USA

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Suicide mortality among firefighters: Results from a large, urban fire department

American Journal of Industrial Medicine - Tue, 05/24/2016 - 13:40
Background

Research regarding suicide mortality among firefighters within the U.S. has been sparse and has yielded inconsistent findings. This study aimed to: (i) describe suicide rates within a large, urban fire department; and (ii) compare firefighter suicide rates with demographically adjusted general population suicide rates.

Methods

Rosters were obtained from the Philadelphia Fire Department (PFD) for all members employed by or separated from the department between 1993 and 2014 (N = 4,395). Vital statistics for each member were obtained from the CDC's National Death Index.

Results

Overall, 272 deaths were recorded; 11 (4.0%) were certified as suicides. The overall suicide rate among firefighter affiliates of the PFD between 1993 and 2014 was 11.61 per 100,000 person-years.

Conclusions

The suicide rate among firefighters appears comparable to, and perhaps lower than, demographically adjusted general population estimates. Infrastructure to triangulate and monitor suicide rates from multiple departments, both career and volunteer, is needed to derive a more representative and informative estimate of firefighter suicide rates. Am. J. Ind. Med. © 2016 Wiley Periodicals, Inc.

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