Efficacy Of Personal Protective Equipment Research Articles

Soft-armor Vest Effectiveness and Intrathoracic Biomechanics in Rodents Exposed to Primary Blast.

The biomechanics and efficacy of personal protective equipment in mitigating injuries from blast overpressure remain unclear. The objectives of this study were to define intrathoracic pressures in response to blast wave (BW) exposure and biomechanically evaluate a soft-armor vest (SA) at diminishing these perturbations. Male Sprague-Dawley rats were instrumented with pressure sensors in the thorax and were exposed laterally to multiple exposures ranging from 33 to 108kPa BW with SA and without SA. There were significant increases in rise time, peak negative pressure, and negative impulse in the thoracic cavity compared to the BW. Esophageal measurements were increased to a greater extent when compared to the carotid and the BW for all parameters (except positive impulse, which decreased). SA minimally altered the pressure parameters and energy content. This study establishes the relationship of external blast flow conditions and intra-body biomechanical responses in the thoracic cavity of rodents with and without SA.

Efficacy of personal protective equipment to prevent environmental infection of COVID-19 among healthcare workers: a systematic review

Healthcare workers (HCWs) employed personal protective equipment (PPE) during the COVID-19 pandemic, crucial to protecting themselves from infection. To highlight the efficacy of PPE in preventing environmental infection among HCWs, a systematic review was conducted in line with PRISMA guidance. A search of the PubMed and Web of Science databases was conducted from January 2019 to April 2021 using pre-defined search terms. Articles were screened by three researchers. The approved papers were read in full and included in this review if relevance was mutually agreed upon. Data were extracted by study design and types of PPEs. 47 of 108 identified studies met the inclusion criteria, with seven reviews and meta-analyses, seven cohort, nine case-control, fifteen cross-sectional studies, four before and after, four case series, and one modeling studies. Wearing PPE offered COVID-19 protection in HCWs but required adequate training. Wearing surgical masks provided improved protection over cloth masks, while the benefit of powered air-purifying respirators is less clear, as are individual gowns, gloves, and/or face shields. Wearing PPE, especially facial masks, is necessary among HCWs, while training in proper use of PPE is also important to prevent COVID-19 infection.

Estimation of the risk of COVID-19 transmission through aerosol-generating procedures.

The outbreak of the coronavirus disease 2019 (COVID-19) pandemic was associated with the provision of multiple guidelines for the dental profession. All elective procedures were restricted, and only emergency procedures were performed. There was fear and anxiety among dentists while performing aerosol-generating procedures (AGPs), as they were considered to pose a high risk of COVID-19 transmission. The aim of this study was to assess the risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during AGPs, and to examine the association between risk severity and the number of AGPs performed per day. The efficacy of personal protective equipment (PPE) was also assessed. This cross-sectional cohort study was based on an online questionnaire form completed by 629 general and specialized dentists between January 1 and February 28, 2021. The collected data referred to the sources of COVID-19 infection, the type of PPE used and the number of AGPs performed each day by dental healthcare professionals (DHCPs). For each question, the absolute numbers of responses as well as percentages were calculated. Among the 629 DHCPs, 113 (17.97%) contracted COVID-19. The risk of contracting COVID-19 during AGPs was the same as in the case of non-AGPs, and the infection risk was not associated with the number of AGPs performed per day. The efficacy of a surgical mask with a face shield/eye goggles was higher in comparison with all other types of PPE. Differences in the infection risk across the different types of PPE used were statistically significant (p < 0.001). The risk of COVID-19 transmission during AGPs is the same as in the case of non-AGPs. Thus, restrictions on the performance of elective AGPs should be lifted. On the other hand, the best protection during AGPs is provided by a surgical mask with a face shield/eye goggles.

The face behind the Covid-19 mask - A comprehensive review.

The threat of epidemic outbreaks like SARS-CoV-2 is growing owing to the exponential growth of the global population and the continual increase in human mobility. Personal protection against viral infections was enforced using ambient air filters, face masks, and other respiratory protective equipment. Available facemasks feature considerable variation in efficacy, materials usage and characteristic properties. Despite their widespread use and importance, face masks pose major potential threats due to the uncontrolled manufacture and disposal techniques. Improper solid waste management enables viral propagation and increases the volume of associated biomedical waste at an alarming rate. Polymers used in single-use face masks include a spectrum of chemical constituents: plasticisers and flame retardants leading to health-related issues over time. Despite ample research in this field, the efficacy of personal protective equipment and its impact post-disposal is yet to be explored satisfactorily. The following review assimilates information on the different forms of personal protective equipment currently in use. Proper waste management techniques pertaining to such special wastes have also been discussed. The study features a holistic overview of innovations made in face masks and their corresponding impact on human health and environment. Strategies with SDG3 and SDG12, outlining safe and proper disposal of solid waste, have also been discussed. Furthermore, employing the CFD paradigm, a 3D model of a face mask was created based on fluid flow during breathing techniques. Lastly, the review concludes with possible future advancements and promising research avenues in personal protective equipment.

Aerosol Transmission of Infectious Disease and the Efficacy of Personal Protective Equipment (PPE): A Systematic Review.

Objective:Health care professionals and governmental agencies are in consensus regarding contact and droplet transmission of infectious diseases. However, personal protective equipment (PPE) efficacy is not considered for aerosol or airborne transmission of infectious diseases. This review discusses the inhalation of virus-laden aerosols as a viable mechanism of transmission of various respiratory infectious diseases and PPE efficacy.Methods:The Preferred Reporting Items for Systematic reviews, and Meta-Analysis (PRISMA) guidelines was used.Results:The transmission of infectious disease is of concern for all respirable diseases discussed (SARS-CoV-1, SARS-CoV-2, MERS, influenza, and tuberculosis), and the effectiveness of facemasks is dependent on the efficiency of the filter, fit, and proper use.Conclusion:PPE should be the last resort in preventing the spread of infectious disease and should only be used for protection and not to control the transmission.

Placement on COVID-19 Units Does Not Increase Seroconversion Rate of Pediatric Graduate Medical Residents.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated disease COVID-19 (coronavirus disease 2019) has presented graduate medical education (GME) training programs with a unique set of challenges. One of the most pressing is how should hospital systems that rely on graduate medical residents provide appropriate care for patients while protecting trainees. This question is of particular concern as healthcare workers are at high risk of SARS-CoV-2 exposure.Objective: This cross-sectional study sought to assess the impact of hospital COVID-19 patient placement on pediatric graduate medical residents by comparing rates of SARS-CoV-2 seroconversion rates of residents who worked on designated COVID-19 teams and those who did not.Methods: Forty-four pediatric and medicine–pediatric residents at Riley Children's Hospital (Indianapolis, IN) were tested for SARS-CoV-2 immunoglobulin M (IgM) and IgG seroconversion in May 2020 using enzyme-linked immunosorbent assays (Abnova catalog no. KA5826), 2 months after the first known COVID-19 case in Indiana. These residents were divided into two groups: those residents who worked on designated COVID-19 teams, and those who did not. Groups were compared using χ2 or Fisher exact test for categorical variables, and continuous variables were compared using Student t testing.Results: Forty-four of 104 eligible residents participated in this study. Despite high rates of seroconversion, there was no difference in the risk of SARS-CoV-2 seroconversion between residents who worked on designated COVID-19 teams (26% or 8/31) and those who did not (31% or 4/13). Eleven of 44 residents (25%) tested positive for SARS-CoV-2 IgG, whereas only 5/44 (11.4%) tested positive for SARS-CoV-2 IgM, without a detectable difference between exposure groups.Conclusion: We did not observe a difference in SARS-CoV-2 seroconversion between different exposure groups. These data are consistent with growing evidence supporting the efficacy of personal protective equipment. Further population-based research on the role of children in transmitting the SARS-CoV-2 virus is needed to allow for a more evidence-based approach toward managing the COVID-19 pandemic.

Efficacy of personal protective equipment against coronavirus transmission via dental handpieces

BackgroundThis laboratory study was done to evaluate the efficacy of personal protective equipment (PPE) and high-volume evacuation (HVE) against the spread of human coronavirus type 229E (HCoV-229E) during a standard dental procedure. MethodsPatient and operator manikins were used to recreate a dental setting inside a custom-built class III cabinet–like chamber. The mouth of the patient manikin was inoculated with an HCoV-229E suspension, the viral load of which was similar to that of asymptomatic people infected with severe acute respiratory syndrome coronavirus 2. The dental procedure was performed with an air turbine handpiece and HVE for 10 seconds. The efficacy of surgical masks, N95 (filtering facepiece class 2) and filtering facepiece class 3 respirators, and face shields was tested via quantitative real-time polymerase chain reaction. ResultsThe wide surface on which the inoculum was spread caused low contamination. Over the external surfaces of masks and respirators, when a face shield was not worn, viral loads ranged from 1.2 through 1.4 log10 mean gene copies per cm2. When the shield was worn, viral loads dropped below the detection limit (< 0.317 log10 gene copies/cm2) for all PPE. On the operator’s forehead, viral loads were 0.6 through 0.8 log10 gene copies/cm2. Inside the operator manikin’s mouth, viral loads were under the detection limit when using any PPE, with or without the shield. HVE did not significantly change viral loads. ConclusionsAll PPE combinations significantly reduced viral loads in the operator manikin’s mouth to below the detection limit, but HVE did not decrease viral contamination. Practical ImplicationsAlthough caution is suggested when removing and disposing of PPE to avoid self-contamination, the combination of PPE and face shields drastically decreases the risk of transmitting human coronavirus during aerosol-generating dental procedures.

COVID-19: A systematic evaluation of personal protective equipment (PPE) performance during restraint.

BackgroundRestraint is widely practised within inpatient mental health services and is considered a higher-risk procedure for patients and staff. There is a sparsity of evidence in respect of the efficacy of personal protective equipment (PPE) used during restraint for reducing risk of infection.MethodsA series of choreographed restraint episodes were used to simulate contact contamination in research participants playing the roles of staff members and a patient. For comparison, one episode of simulated recording of physical observations was taken. Ultraviolet (UV) fluorescent material was used to track the simulated contact contamination, with analysis undertaken using established image registration techniques of UV photographs. This was repeated for three separate sets of PPE.ResultsAll three PPE sets showed similar performance in protecting against contamination transfer. For teams not utilising coveralls, this was dependent upon effective cleansing as part of doffing. There were similar patterns of contamination for restraint team members assigned to specific roles, with hands and upper torso appearing to be higher-risk areas. The restraint-related contamination was 23 times higher than that observed for physical observations.DiscussionA second layer of clothing that can be removed showed efficacy in reducing contact contamination. PPE fit to individual is important. Post-restraint cleansing procedures are currently inadequate, with new procedures for face and neck cleansing required. These findings leave scope for staff to potentially improve their appearance when donning PPE and engaging with distressed patients.

Risk of Covid-19 infection during endoscopy: Efficacy of personal protective equipment (PPE) in protecting health professionals.

Objectives:To correlate compliance to personal protective equipment (PPE) protocols and risk of exposure to SARS-COV-2 infection in endoscopy staff.Methods:We included 85 endoscopic procedures performed at Lahore General Hospital from May to July 2020. Standard operating procedures (SOPs) were implemented for patient selection, risk stratification and personal protective equipment (PPE) use for endoscopy staff. Patient and endoscopy staff were followed for Covid-19 infection. PPE scores for staff and Covid-19 positivity on follow-up were correlated using student’s t test.Results:Following 85 procedures included, 2 (2.3%) patients became Covid-19 positive. PPE score was <9 in 5 (5.8%) procedures for endoscopist and Covid-19 developed in 2 (2.3%) of them, PPE score was <9 during 19 (22.3%) procedures in 1st assistant and 9 (10.5%) developed infection and for 2nd assistant PPE score was <9 in 19(22.3%) endoscopies and 5 (5.9%) tested positive for covid-19. Infectivity of endoscopy staff was 6.2%. Association between PPE score and risk of Covid-19 was not significant. (p value 0.51 for endoscopist, 0.10 for 1st assistant and 0.09 for 2nd assistant).Conclusion:Compliance of SOPs for infection control reduces risk of acquiring Covid-19 infection during endoscopy. Proper use of PPE is effective for safety of endoscopy staff.

Efficacy of personal protective equipment and H2O2‐based spray against coronavirus in dental setting

Oral DiseasesVolume 28, Issue S1 p. 1010-1012 LETTER TO THE EDITOR Efficacy of personal protective equipment and H2O2-based spray against coronavirus in dental setting Andrei Cristian Ionescu, Corresponding Author Andrei Cristian Ionescu Andrei.ionescu@unimi.it orcid.org/0000-0001-9051-4109 Oral Microbiology and Biomaterials Laboratory, Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy Correspondence Andrei Cristian Ionescu, Microbiology Institute, via Pascal, 36, 20133 Milan, Italy. Email: Andrei.ionescu@unimi.it Contribution: Conceptualization, Methodology, Writing - original draftSearch for more papers by this authorEugenio Brambilla, Eugenio Brambilla orcid.org/0000-0003-0094-4565 Oral Microbiology and Biomaterials Laboratory, Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy Contribution: Conceptualization, Validation, Writing - original draftSearch for more papers by this authorLamberto Manzoli, Lamberto Manzoli orcid.org/0000-0002-8129-9344 Department of Medical Sciences, University of Ferrara, Ferrara, Italy Contribution: Formal analysis, Resources, Writing - review & editingSearch for more papers by this authorGiovanna Orsini, Giovanna Orsini orcid.org/0000-0002-2641-0695 Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, Ancona, Italy Contribution: Writing - review & editingSearch for more papers by this authorValentina Gentili, Valentina Gentili orcid.org/0000-0003-4572-5497 Department of Chemical and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy Contribution: Data curation, MethodologySearch for more papers by this authorRoberta Rizzo, Roberta Rizzo orcid.org/0000-0001-9507-9126 Department of Chemical and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy Contribution: Data curation, Writing - review & editingSearch for more papers by this author Andrei Cristian Ionescu, Corresponding Author Andrei Cristian Ionescu Andrei.ionescu@unimi.it orcid.org/0000-0001-9051-4109 Oral Microbiology and Biomaterials Laboratory, Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy Correspondence Andrei Cristian Ionescu, Microbiology Institute, via Pascal, 36, 20133 Milan, Italy. Email: Andrei.ionescu@unimi.it Contribution: Conceptualization, Methodology, Writing - original draftSearch for more papers by this authorEugenio Brambilla, Eugenio Brambilla orcid.org/0000-0003-0094-4565 Oral Microbiology and Biomaterials Laboratory, Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy Contribution: Conceptualization, Validation, Writing - original draftSearch for more papers by this authorLamberto Manzoli, Lamberto Manzoli orcid.org/0000-0002-8129-9344 Department of Medical Sciences, University of Ferrara, Ferrara, Italy Contribution: Formal analysis, Resources, Writing - review & editingSearch for more papers by this authorGiovanna Orsini, Giovanna Orsini orcid.org/0000-0002-2641-0695 Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, Ancona, Italy Contribution: Writing - review & editingSearch for more papers by this authorValentina Gentili, Valentina Gentili orcid.org/0000-0003-4572-5497 Department of Chemical and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy Contribution: Data curation, MethodologySearch for more papers by this authorRoberta Rizzo, Roberta Rizzo orcid.org/0000-0001-9507-9126 Department of Chemical and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy Contribution: Data curation, Writing - review & editingSearch for more papers by this author First published: 28 November 2020 https://doi.org/10.1111/odi.13736Citations: 5Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume28, IssueS1Special Issue: COVID-19, Part 2 of a 2-Part SeriesApril 2022Pages 1010-1012 RelatedInformation

COVID-19 and Keeping Clean: A Narrative Review To Ascertain the Efficacy of Personal Protective Equipment To Safeguard Health Care Workers Against SARS-CoV-2.

Identifying the optimal amount of personal protective equipment (PPE) is a formidable challenge when faced with a new contagion such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Unequivocally, there are dangers to health care workers (and by extension, their patients, colleagues, and communities) if not enough equipment is donned to safeguard them. And yet, there are also dangers to patients, colleagues, and the community if resources are overconsumed and result in hoarding, shortages, and inequitable distribution, all of which are occurring as the worldwide coronavirus disease 2019 (COVID-19) pandemic continues.Research to ascertain the precise PPE required to defend specifically against SARS-CoV-2 encompasses an area of active investigation that will likely remain unresolved for some time. While awaiting more definitive conclusions, we must look to past evidence to provide a reasonable basis on which protocols and policies might be refined. What follows is a narrative review of PPE efficacy and how existing evidence might apply to protecting health care workers against COVID-19. Findings are extrapolated from investigations in 4 general domains: early investigations into SARS-CoV-2, retrospective studies about severe acute respiratory syndrome coronavirus 1, prospective studies of influenza and other common respiratory viruses, and laboratory PPE studies.Available evidence suggests that contact and droplet precautions, in addition to eye protection and standard hygiene measures, should be adequate in the vast majority of clinical settings when caring for patients with SARS-CoV-2. Adherence to guidelines promoting appropriate levels of PPE should safeguard practitioners while mitigating against resource overuse.

Early Results from Severe Acute Respiratory Syndrome Coronavirus 2 Polymerase Chain Reaction Testing of Healthcare Workers at an Academic Medical Center in New York City.

Coronavirus disease 2019 (COVID-19) reverse-transcription polymerase chain reaction employee testing was implemented across New York University Langone Health. Over 8 weeks, 14 764 employees were tested; 33% of symptomatic employees, 8% of asymptomatic employees reporting COVID-19 exposure, and 3% of employees returning to work were positive. Positivity rates declined over time, possibly reflecting the importance of community transmission and efficacy of personal protective equipment.

Evaluation of the efficacy of personal protective equipment against occupational exposure to cold.

The temperature of climate controlled areas in the food industry varies from -35°C to 12°C to ensure the quality of food. However, this temperature range might be harmful to the health of workers. To analyze parameters related to occupational exposure to cold risks to calculate clothing insulation indices and establish the efficacy of personal protective equipment (PPE). In stage 1 we analyzed environmental variables (air temperature and velocity and relative humidity) and the metabolic rate; in stage 2 we calculated the resultant clothing insulation index; in stage 3 we calculated the basic clothing insulation required to maintain the thermal balance and investigated the efficacy of PPE. While the air temperature was lower for activities developed in the freezing tunnel (secondary packaging department), required basic clothing insulation was higher for activities involving operating forklifts. Protection was efficacious for 83.3% of the analyzed activities, however, occurrence of thermal discomfort cannot be ruled out as a function of excessive clothing. Although protection was insufficient for 16.7% of the analyzed activities, breaks for thermal recovery neutralized the risk of hypothermia.

B5-4 Personal Protective Equipment Design and Ergonomic Work Analysis: Protecting Farm Pineapple Growers

Pineapple growing is one of the most aggressive agricultural activities and worker protection is a considerable technical challenge. Previous studies point to the lack of efficacy of personal protective equipment (PPE) usually used by workers to protect themselves against accidents with poisonous animals and punctures by pointed leaves, particularly on harvesting activities. In view of these results, this study proposes a two-phase approach. First, a set of PPEs commonly used by rural workers was experimentally evaluated for its effectiveness in protecting workers against real venomous snake attacks. Four sets of PPEs were tested, including shoes and protective gloves, leggings and over sleeves, each set with three different models. The PPE that passed the real attack tests were then evaluated by a group of workers in real use situations, according to qualitative criteria, including comfort and usability. The results of the experimental evaluation showed that only 5 models were effective in protecting the workers against snake attacks, including one shoe model, two models of leggings and two models of gloves. The usability analysis of these PPE revealed that some of them were considered uncomfortable, not effective and obstructive. The next phase of this study relies on the results of the first phase and aims the conception, design and fabrication of a PPE set for the activity of growing pineapples. To generate the design parameters, it will be used an approach based on ergonomic work analysis and conventional design methods, with an emphasis on the QFD method. It is expected that the new set of PPEs will effectively protect the workers and facilitate, or at least not interfere adversely with task execution.

Personal protective equipment and improving compliance among healthcare workers in high-risk settings.

Personal protective equipment (PPE) protects healthcare workers (HCWs) from infection by highly virulent pathogens via exposure to body fluids and respiratory droplets. Given the recent outbreaks of contagious infectious diseases worldwide, including Ebola virus and Middle Eastern respiratory syndrome, there is urgent need for further research to determine optimal PPE use in high-risk settings. This review intends to provide a general understanding of PPE and to provide guidelines for appropriate use based on current evidence. Although previous studies have focused on the efficacy of PPE in preventing transmission of pathogens, recent studies have examined the dangers to HCWs during removal of PPE when risk of contamination is highest. Access to adequate PPE supplies is crucial to preventing transmission of pathogens, especially in resource-limited settings. Adherence to appropriate PPE use is a challenge due to inadequate education on its usage, technical difficulties, and tolerability of PPE in the workplace. Future projects aim at ameliorating this situation, including redesigning PPE which is crucial to improving the safety of HCWs. PPE remains the most important strategy for protecting HCW from potentially fatal pathogens. Further research into optimal PPE design and use to improve the safety of HCWs is urgently needed.

Examination of the protective roles of helmet/faceshield and directionality for human head under blast waves

A parametric study was conducted to delineate the efficacy of personal protective equipment (PPE), such as ballistic faceshields and advanced combat helmets, in the case of a blast. The propagations of blast waves and their interactions with an unprotected head, a helmeted one, and a fully protected finite element head model (FEHM) were modeled. The biomechanical parameters of the brain were recorded when the FEHM was exposed to shockwaves from the front, back, top, and bottom. The directional dependent tissue response of the brain and the variable efficiency of PPE with respect to the blast orientation were two major results of this study.

Determination of Exposure to Bitumen and Fume from Bitumen in the Oil Industry Through Determination of Urinary 1-Hydroxypyrene

Since 1986, Shell routinely monitors occupational exposure of its operators to polycyclic aromatic hydrocarbons (PAHs) by determination of urinary 1-hydroxypyrene (1-HOPyr). Up till now, about 100 different studies in a wide variety of industrial settings, involving more than 4,000 samples in total, have been performed. The upper limit of the 95% confidence interval of background levels of 1-HOPyr in 121 workers without occupational exposure to PAHs was 0.51 μ mol/mol creatinine (median 0.11; range < 0.05 to 1.08 μ mol/mol creatinine). Due to the variation in composition of the PAH mixture (in particular the ratio between pyrene and carcinogenic PAHs) to which workers may be exposed in different processes ànd by different routes of exposure, it is not feasible to set a limit value for urinary 1-HOPyr. However, a value of 0.50 μ mol/mol creatinine can be used as an indicator whether or not occupational exposure to PAHs has occurred. This article focuses on a selection of studies in which operators were potentially exposed to to PAHs from bitumen and fume from bitumen. The selected studies involved manufacturing, maintenance of production facilities, and road tanker loading of bitumen. Studies over a number of years in a bitumen manufacturing plant indicated that exposures to PAHs as measured by 1-hydroxypyrene were not statistically significantly different from control values with median values of approximately 0.10 μ mol/mmol creatinine. However, occasionally values just over the the internal reference value (up to 0.72 μ mol/mol creatinine) were observed. Similar observations were made during road tanker loading and maintenance/cleaning operations although the value of 0.50 μ mol/mol creatinine was not exceeded in these studies. In several studies multiple pre- and post-shift samples were collected from individual operators during a number of consecutive days. Detailed analysis of the data strongly suggests that small changes over the shift, as seen during loading, manufacturing, and maintenance operations, were due to confounding factors (such as diet and smoking) rather than occupational exposure to PAHs. Several studies were performed to investigate the role of dermal exposure to PAH in more detail. In these studies industrial hygienists made detailed work observations to assess semi-quantitatively the extent of inhalatory and dermal exposure. In addition, studies in workers digging contaminated soil in which different forms of personal protective equipment providing variable degrees of respiratory and dermal protection during identical tasks, were used to show the effectiveness this equipment. Overal, these studies show that dermal exposure to PAHs may be significant in the total exposure to PAHs and that 1-HOPyr can be used to assess the efficacy of personal protective equipment. With appropriate personal protective equipment, exposure to PAHs, as assessed by the determination of urinary 1-HOPyr, could be reduced to background levels. The contribution of dermal exposure to the total uptake of PAHs, however, proved difficult to quantify exactly. In conclusion, both inhalatory and dermal exposure to PAHs from a variety of sources, including bitumen, can readily be assessed by the determination of 1-HOPyr in urine. Results from biomonitoring indicate that both inhalation and dermal exposure to PAHs during manufacturing and handling of bitumen is negligible.