Workplace Exposure Research Articles

Predictability Augmentation by In-silico Study to In-vivo and In-vitro Results of Lung Doses of Airborne Fine and Ultrafine Particles Inhaled by Humans at Industrial Workplaces

This study correlates computational predictions with in vivo and in vitro experimental results of inhaled fine and ultrafine particulate matter (PM) transport, dissemination, and deposition in the human respiratory airways. Epidemiological studies suggest that workplace exposure to anthropogenic pollutant PMs is a risk factor for increased susceptibility to acute broncho-pulmonary illnesses. However, investigations on detailed human inhalation and PM transport processes are restrictive from time, cost, and ethical perspectives. Computational simulation based on the Multiple Path Particle Dosimetry (MPPD) model was employed to quantify the risks associated with workplace exposure of these PMs. Here, the physical, mechanical, and electrical properties of PMs of carbon black (CB) and ultrafine particles (UFPs) from wire-cut electrical discharge machining (WEDM), with mass median aerodynamic diameter (CMAD) in the range of 1 nm to 1000 nm, were used as input parameters of MPPD. Additionally, it mimicked occupational workers’ age, body mass index, and oronasal-combinational nose and mouth breathing exposure time. The deposition results were compared with several vivo and in vitro experimental data reported in the literature, and satisfactory agreements were found. For example, a total lung dose of CB-PMs of 100 nm is the highest (28%), while a 380 nm dose is the lowest (15%). Afterward, deposition increases with particle size, reaching 26% for 1000 nm. In the case of WEDM-UFPs, about 98% of all 1.0 nm inhaled particles remain in the lung. Subsequently, the deposition dose decreases with the particle size and reaches up to 28% for 100 nm particles. Approximately 51% of deposited WEDM-UFPs are of CMAD ≤ 5 nm. The images of lung geometry also observed the maximum deposited mass and mass flux rate in the head, tracheobronchial, and pulmonary airways.

Work Attendance with Acute Respiratory Illness Before and During COVID-19 Pandemic, United States, 2018-2022.

Both SARS-CoV-2 and influenza virus can be transmitted by asymptomatic, presymptomatic, or symptomatic infected persons. We assessed effects on work attendance while ill before and during the COVID-19 pandemic in the United States by analyzing data collected prospectively from persons with acute respiratory illnesses enrolled in a multistate study during 2018-2022. Persons with previous hybrid work experience were significantly less likely to work onsite on the day before through the first 3 days of illness than those without that experience, an effect more pronounced during the COVID-19 pandemic than during prepandemic influenza seasons. Persons with influenza or COVID-19 were significantly less likely to work onsite than persons with other acute respiratory illnesses. Among persons with positive COVID-19 test results available by the second or third day of illness, few worked onsite. Hybrid and remote work policies might reduce workplace exposures and help reduce spread of respiratory viruses.

Testing the association between shoulder pain prevalence and occupational, physical activity, and mental health factors in two generations of Australian adults

BackgroundShoulder pain is common among the adult population, but it appears to reduce in prevalence around retirement age. Associations between shoulder pain and work-place exposures, physical activity, or mental health status are unclear and may change with age. This study aimed to determine the prevalence of self-reported shoulder pain in Australian adults across two generations and test the association with occupational factors, physical activity, and mental health.MethodsIn this cross-sectional study we used data from a longitudinal Australian pregnancy cohort (the Raine Study). We analysed data from the children (Gen2) at the 22-year follow-up (N = 1128) and parents (Gen1) at the 26-year follow-up (N = 1098). Data were collected on self-reported shoulder pain, occupational factors (employment status and work description), physical activity, and mental health at the respective follow-ups. Prevalence rates were provided as percentages with 95% confidence intervals. Univariate analysis for group comparisons included chi squared for categorical comparisons. The association of predictor variables and shoulder pain was assessed using logistical regression.ResultsIn Gen1 31.4% of adults aged 40–80 reported the presence of shoulder pain in the last month, with no significant difference between females and males. Gen1 participants younger than 65 reported more shoulder pain (OR[95%CI] = 1.80 [1.04–3.09]). Gen2 females (14.7%) reported shoulder pain in either shoulder more frequently than males (7.7%) and bilateral shoulder pain (8.0%) more frequently than males (1.9%). Gen1 had increased odds of reporting shoulder pain if their work was “physical or heavy manual” compared to “sedentary” (OR [95% CI] = 1.659 [1.185–2.323]) and when categorised with depression (OR [95% CI] = 1.940 [1.386–2.715]) or anxiety (OR [95% CI] = 1.977 [1.368–2.857]). Gen2 participants with depression (OR [95% CI] = 2.356 [1.620–3.427]) or anxiety (OR [95% CI] = 2.003 [1.359–2.952]) reported more shoulder pain.ConclusionOverall, shoulder pain was more prevalent in young females than males and was more prevalent in those under the age of 65. Cross-sectional associations were established between some occupational factors in older adults and depression in all adults, and shoulder pain.

Potential Work-related Exposure to SARS-CoV-2 by Standard Occupational Grouping Based on Pre-lockdown Working Conditions in France

This study aims to ascertain occupations potentially at greatest risk of exposure to SARS-CoV-2 based on pre-lockdown working conditions in France. We combined two French population-based surveys documenting workplace exposures to infectious agents, face-to-face contact with the public, and working with colleagues just before the pandemic. Then, for each 87-level standard French occupational grouping, we estimated the number and percentage of the French working population reporting these occupational exposure factors, by gender, using survey weights. As much as 40% (11 million) of all workers reported at least two exposure factors. Most of the workers concerned were in the healthcare sector. However, army/police officers, firefighters, hairdressers, teachers, cultural/sports professionals, and some manual workers were also exposed. Women were overrepresented in certain occupations with potentially higher risks of exposure such as home caregivers, childminders, and hairdressers. Our gender-stratified matrix can be used to assign prelockdown work-related exposures to cohorts implemented during the pandemic.

Hazards Associated With Nanotechnology in Clinical Dentistry.

Nanotechnology has transformed the field of dentistry with immense potential to provide comprehensive oral health care using nanomaterials, advanced clinical tools, and devices. New materials with superior properties can be developed using nanotechnology by making use of their atomic or molecular properties. Although there are numerous ways in which nanomaterials impact our health, the primary causeis that they comprise chemicals that may have an inadvertent reaction in the body. Moreover, they are used on a daily basis, increasing human contact with them. It is observed to be smaller in size than the physiological barrier in our bodies, making it much simpler for them to pass through and enter the body and they are being used more frequently. It is observed to be smaller in size than the physiological barrier in our bodies, making it much simpler for them to pass through and enter the body and being used more frequently. Although there are numerous ways in which nanomaterials impact our health, the primary causeis they comprise chemicals that may have an inadvertent reaction in the body. The review discusses various types of toxicity, including the cytotoxicity of composites, carbon nanoparticles, silver nanoparticles (SNPs), and quantum dots. It also covers genotoxicity, the effect of nanoparticles on salivary secretion, oral and gastrointestinal mucosa passage of nanoparticles, the tooth surface microenvironment, and interactions with engineered nanomaterials (ENMs). It is concluded that there is scarce information regarding the presence of chemicals that are released from nanoparticles used in dental materials. Nanotechnology is at an infant stage, although it has progressed by leaps and bounds, hailing a new age that provides better treatment modalities in various branches of dentistry. Although the development and application of nanodentistry are of considerable interest, knowledge regarding the possible toxicity of such materials must be meticulously evaluated, and potential benefits must be weighed against the risks to identify potential gaps in the safety assessment. Further research is needed on workplace exposure to nanoparticles in dentistry.

Detection and characterization of mono- and bimetallic nanoparticles produced by electrical discharge plasma generators using laser-induced breakdown spectroscopy

This work investigates the performance of laser induced breakdown spectroscopy (LIBS) for the detection and characterization of nanoparticles generated by spark discharge generators (SDG) and arc discharge generators (ADG). LIBS nanoaerosol analysis was carried out according to both on-line (in a gas stream) and off-line (after collection on a filter) methodologies for monometallic (Cu and Au) and bimetallic (AgCo, SnCu, AgAu) nanoparticles generated by ADG and SDG. It was shown that LIBS is not only capable of detecting the presence of nanoparticles in real time, but LIBS spectra can also be used to provide qualitative and quantitative compositional information, as well as estimates for the particle number concentration. This analytical capability, combined with the compact and robust character of LIBS instrumentation, can be put to use for the real-time monitoring of industrial gas-phase nanoparticle synthesis or environmental or workplace exposure to nanoparticles.

Assessing Causality Between Second-Hand Smoking and Potentially Associated Diseases in Multiple Systems: A Two-Sample Mendelian Randomization Study.

The global disease burden may be exacerbated by exposure to passive smoking (SHS), with the workplace being a primary location for such exposure. Numerous epidemiological studies have identified SHS as a risk factor for diseases affecting various systems, including cardiovascular, respiratory, immune, endocrine, and nervous systems. The conventional observational study has certain methodological constraints that can be circumvented through a Mendelian randomization (MR) study. Our MR study intends to investigate the causal link between workplace exposure to SHS and the potential associated diseases. Summary statistics data involving European participants were sourced from three databases: the UK Biobank, the FinnGen study, and the European Bioinformatics Institute. Genetic variants linked with exposure to SHS in the workplace were identified as instrumental variables. The MR was carried out using inverse variance weighted (IVW), MR-Egger, and weighted median methods. Sensitivity tests were also undertaken within the MR to evaluate the validity of the causality. According to the IVW model, genetically determined atrial fibrillation (AF) and stroke (p = 6.64E-04 and 5.68E-07, odds ratio = 2.030 and 2.494, 95% confidence interval = 1.350 to 3.051 and 1.743 to 3.569) were robustly associated with exposure to SHS in the workplace. Suggestive associations were found between workplace SHS and myocardial infarction (MI), asthma, and depression. The MR study demonstrates that exposure to SHS in the workplace is a significant risk factor for AF and stroke in European individuals. Whether workplace exposure to SHS influences other diseases and the causality between them requires further exploration. This study explored the causality between exposure to SHS in the workplace and potential associated diseases in multiple systems, including MI, AF, stroke, lung cancer, asthma, allergic disease, type 2 diabetes, and depression, using an MR study. The MR study can circumvent the methodological constraints of observational studies and establish a causal relationship. The two-sample MR analysis provides evidence supporting the causal association of frequent workplace SHS with AF and stroke. Individuals exposed to SHS in the workplace may also have a heightened risk of MI, asthma, and depression. However, whether SHS affects other diseases and the causality between them requires further investigation. To our knowledge, this is the first two-sample MR study to determine the causal relationship between SHS and potential diseases. Exposure to SHS in the workplace is a prevalent issue and may contribute to a global disease burden. The reduction of exposure following the introduction of smoke-free laws has led to a decrease in the admission rate for cardiac events and an improvement in health indicators. It is crucial to further advance smoke-free policies and their implementation.

238MO Long-term residential and workplace exposure to air pollution and breast cancer risk: A case-control study nested in the French E3N cohort from 1990 to 2011

238MO Long-term residential and workplace exposure to air pollution and breast cancer risk: A case-control study nested in the French E3N cohort from 1990 to 2011

Irritant asthma and work: cases from the UK SWORD reporting scheme from 1999 to 2018

BackgroundAcute irritant asthma is a preventable health consequence of a workplace exposure and has a number of adverse outcomes. While cases and case series are reported, little is known about...

Occupational Exposure during Pregnancy and Effects on Newborns: A Nested Case-Control Study.

The protection of pregnant workers should be based on evidence regarding the risks to reproductive health from exposure to specific work environments and conditions. The objective of this study was to identify the effects on mothers and newborns resulting from environmental exposure to various occupational risks. The study cohort was composed of 399 women admitted to the Obstetrics/Postpartum ward at Hospital La Fe in Valencia, Spain. Face-to-face interviews were conducted to establish associations between workplace exposure during pregnancy and its effects on maternal and newborn health. Sex, anthropometric characteristics, and blood gas analysis in arterial and venous umbilical cord blood at delivery were collected. A total of 138 women were exposed to biological and/or chemical risks, 122 to physical risks, and 139 at no risk of exposure. In the group with chemical and/or biological risks, the frequency of women who resorted to in vitro fertilization to achieve the studied pregnancy is less than half of the group exposed to physical risks, with statistically significant differences (p = 0.047). The mean values for the arterial analysis in both exposure groups were within average values, with similar pH values between them, but the mean values of PCO2 and PO2 were lower in the group of neonates of mothers exposed to physical risks, with a significant difference for arterial PO2 (p = 0.027). Our analysis contributes evidence for planning and prioritizing preventive actions to protect women's reproductive health. The results suggest the continuation of a future project that would consider more factors and potentially increase the sample size.

Risk Assessment of Coronavirus Disease (COVID-19) Transmission among Physicians Working at a COVID-dedicated Tertiary-care Hospital

Background and aims: In the earlier stage of pandemic, a sizeable number of physicians and other healthcare workers were infected with SARS-CoV-2. The aim of this study was to assess the factors associated with the risk of SARS-CoV-2 infection among physicians working at a COVID-dedicated tertiary care hospital, within and outside the medical workplace.
 Methods: This case control study was conducted among the physicians and surgeons working at different departments of Mugda Medical College and Hospital and undergone different pattern of exposure to COVID patients within the period of 20 April, 2020 and 20 July, 2020. Respondents were queried regarding job description, workplace exposures, respiratory protection, hospital policy of disease prevention, and extra-occupational activities during duty period. Chi-square test was done and odds ratios for physicians’ infection were calculated. A p-value <0.05 was considered as statistical significant.
 Results: Increased risk of SARS-CoV-2 infection in physicians was associated with the use of mobile phone during duty hour (OR, 15, 95% confidence interval 1.971 to 121.905, p=0.001), and breech of PPE during doffing (OR, 2.52, 95% confidence interval 0.821 to 7.76, p=0.099). Extra-occupational risk factors included contact with known COVID patient (OR, 5.735, 95% confidence interval 2.072 to 15.872, p=<0.001), and visit any gathering (OR, 1.076, 95% confidence interval 0.412 to 2.81, p=0.881). Physicians worked in roster group (50%) and round group (34.38%) were mostly infected than other facilities.
 Conclusion: COVID-19 transmissions to physicians was associated with exposure at workplace, breech in PPE during doffing, use of device during round/roster period, extra-occupational exposure to known COVID patients outside the hospital, and visit any gathering. Close monitoring of infection control measures in workplace and increase awareness of the risks of outdoor activities in pandemic situation, may reduce the incidence of infection among physicians.
 Mugda Med Coll J. 2022; 5(2): 93-97

“Asthma is a very bully disease” – patient experiences of living with chronic respiratory diseases in Cape Town, South Africa

BackgroundChronic respiratory diseases are common in Cape Town, South Africa. Yet the experiences of how adults with these conditions, such as asthma or COPD (chronic obstructive pulmonary disease), negotiate the health system are poorly understood. Qualitative methodology lends itself to investigate this question.Aim of studyTo explore the “emic” experiences of adults with CRDs in Cape Town when they were negotiating the health system using semi-structured interviews.MethodsInterviews were conducted following informed consent with purposively sampled adults who had attended public hospitals in Cape Town with chronic respiratory disease flare-ups. This work was nested in the quantitative “Diagnosing Airways Disease” study. The topic guide explored patients’ experiences of accessing healthcare including receiving and interpretations of the diagnosis and management, and impacts on daily life. Interviews were conducted in Afrikaans, isiXhosa, or English; transcribed, and translated into English and thematically analysed until saturation.ResultsThirty-two interviews (16 in Afrikaans, 8 in isiXhosa, 8 in English) were completed in 2022. 17 women and 15 men participated. Most participants were older than 50 years (25/32), and most were unemployed (13/32) or retired (11/32).The identified themes were: Perceived causes of illness; experiences of healthcare; perceived risks and barriers when accessing healthcare; and impact on earnings. The perceived causes of their illness and risks were structural, and included air pollution, poor quality housing, occupational exposures, limited healthcare services, and fear of violence. These factors led to self-treatment, sharing of medicines, and delay in receiving a diagnosis. Many paid privately for treatments or services to overcome identified shortcomings of the public healthcare system, and many reported additional significant indirect costs. Being ill had a profound impact on income. The identified themes were explored through the lens of “structural violence”, where “social structures stop individuals … from reaching their full potential” (Galtung, 1969).ConclusionIn Cape Town structural elements such as stretched healthcare professionals, insufficiently enforced policies on e.g., housing or work-place exposures, poverty and crime made it difficult for participants to successfully navigate their illness experience. It forced some to pay out of pocket to receive perceived better healthcare privately.

Occupational exposure to electromagnetic fields from dental devices: A descriptive study

Abstract
 
 Objective: Electromagnetic Field sources which are widely used as part of the operating mechanism occupational exposure occurs with the electricity is generated, distributed or usage in the everyday environment. We aimed to obtain the Extremely Low Frequency-Magnetic Field exposure profile for dental health workers from electrical devices used in dentistry. 
 Methods: Measurements were performed while appliances under working conditions, 10 cm distance with the device for 6 minutes and for 7 days. The highest measured value in every 10 second was recorded. The mean ± SD of minimum and maximum Extremely Low Frequency-Magnetic Field for high-speed dental handpiece with LED, low-speed dental handpiece, model-trimming machine, automatic boil-out unit, steam machine, vacuum device, and polishing machine were recorded in milliGauss. 
 Results: The values which obtains from model-trimming machine and polishing machine were remarkable (809.17 ± 37.70 / 975.00 ± 10.27, 649.33 ± 201.37 / 1367.00 ± 32.17, respectively). Conclusion: The results show that periodic Electromagnetic Field exposure measurements should be conducted to obtain more detailed information about workplace exposures and sources.
 
 Keywords: Health, electromagnetic field, extremely low-frequency field, exposure, occupational

Did the prevalence of depressive symptoms change during the COVID-19 pandemic? A multilevel analysis on longitudinal data from healthcare workers.

Healthcare workers (HCW) are at high risk to develop mental health problems during the COVID-19 pandemic because of additional work load, perceived stress, and exposure to patients with COVID-19. Currently, there are few studies on change over time in the prevalence of depressive symptoms during pandemic start among HCW. Thus, the aims of the current study were to examine whether depressive symptoms increased during the pandemic and were associated with perceived stress and own COVID-19 infection and workplace exposure to virus-infected patients. The cohort study used longitudinal data from HCW collected monthly (July 2020 till December 2020) during the first year of the pandemic before vaccination became available. The sample of n = 166 was drawn from a German hospital and included medical (e.g. nurses, therapists, and physicians) and administrative staff. Using multilevel models, we analyzed the change in depressive symptoms [assessed with General Depression Scale (GDS), a validated German version of the Center for Epidemiological Studies Depression Scale (CES-D)] and its association with perceived stress across the study period. Laboratory-confirmed own infection was tested as a potential moderator in this context. Subscales of the GDS were used to examine change over time of depressive symptom modalities (e.g. emotional, somatic, and social interactions (β, 95% confidence interval). Depression scores increased significantly during the study period (β = .03, 95% CI [0.02, 0.05]). Perceived stress was associated with depressive symptoms (β = .12, 95% CI [0.10, 0.14]) but did not change over time. Exposure to COVID-19 infection was associated with a higher increase of depressive symptoms (β = .12, 95% CI [0.10, .14]). Somatic symptoms of depression increased among medical HCW with workplace exposure to COVID-19 (β = .25, 95% CI [0.13, 0.38]), but not in administrators (β = .03, 95% CI [-0.04, 0.11]). Research is needed to identify factors that promote the reduction of depressive symptoms in medical HCW with exposition to COVID-19 patients. Awareness of infection protection measures should be increased.

Occupational exposure science.

This commentary describes developments in occupational exposure science over the last 30 yr, highlighting theoretical descriptions of inhalation, dermal, inadvertent ingestion, and ocular exposure in the workplace and how they are intertwined. In particular, the way that we define "exposure" in the theory determines what is and is not measured in workplace investigations, and what contextual information about the work and the environment is recorded alongside the exposure measurements. Central to all the theoretical models described is the unifying concept of uptake, or the mass of hazardous substance entering the body by different routes over a workday. Measurement of uptake is currently practicable for inhalation exposure, although further methodological developments are needed to allow uptake measurement for the other relevant exposure routes. Little attempt has been made to date to try to integrate worker behaviour into exposure assessment, despite this clearly being an important determinant of exposure. It is argued that adopting a new exposure paradigm, centred on uptake, would bring many advantages and provide new insights into workplace exposures.

Blood and body fluids exposure, post-exposure prophylaxis, and HIV self-testing among healthcare workers in northern Nigeria

Introduction In high-HIV burden settings, such as Nigeria, HIV self-testing and post-exposure prophylaxis (PEP) are often recommended, but not widely practiced. This study aims to identify the predictors of PEP utilization and preferences for HIV self-testing among healthcare workers in Nigeria. Methods A total of 403 healthcare workers from a tertiary hospital in Nigeria completed questionnaires. Adjusted odds ratios were derived from logistic regression models. Results Among the respondents, 141 (35.0%) reported experiencing at least one workplace exposure incident, with 72 (51.1%) of them receiving PEP. The majority of healthcare workers (n = 354, 87.8%) expressed a preference for HIV self-testing over traditional HIV testing and counseling. The occurrence of exposure incidents was predicted by the respondent’s sex (adjusted odds ratio [aOR] = 1.25; 95% confidence interval [CI]: 1.15-3.08, female vs. male), age (aOR = 0. 16; 95% CI: 0.03-0.92, >40 vs. <30 years), profession (aOR = 1.88; 95% CI: 1.18-4.66, nurse/midwife vs. physician), work unit (aOR = 0.06; 95% CI: 0.02-0.23, obstetrics/gynecology vs. surgery), and previous HIV testing and counseling (aOR = 0.01; 95% Cl: 0.004-0.03, no vs. yes). Respondent’s profession, work unit, and previous HIV testing and counseling independently predicted a preference for HIV self-testing. Conclusion Further exploration of the feasibility of implementing HIV self-testing as an alternative to traditional HIV testing and counseling for workplace exposures is warranted.

Characterization of environmental radiological parameters on dose coefficient - Realistic dosimetry compared with epidemiological dosimetry models

Radiation exposure due to all-natural sources amounts to about 2.4 mSv per year. However, this amount might be changed to over 3 mSv y−1 according to the recently introduced ICRP radon dose coefficient factor. Previously, the radon contribution to the total dose from natural sources was about 1.2 mSv y−1. However, after the latest introduced dose conversion factor by ICRP, this value could technically be increased to around 2 mSv y−1. This paper attempts to address the following questions: (i) whether reducing radon concentration to the recommended level could address concerns about radiation exposure in underground workplaces, and (ii) the effects of the difference between the epidemiological dosimetry models and realistic dose estimation. The actual dose conversion factor (DCF) was calculated using measured annual average unattached and equilibrium factors, ranging from 16 ± 9 to 25 ± 10 mSv·WLM−1. Then, the estimated inhalation dose, both from self-calculated DCF and the value reported by ICRP-137, was compared: 5.6 ± 0.7–7.6 ± 0.9 mSv y−1 and 3.3 ± 0.4–3.6 ± 0.5 mSv y−1, respectively. It can be observed that exposure to a radon concentration lower than the recommended level does not guarantee a lower dose than the recommended value. The estimated dose was at least two times greater than the dose using pre-estimated values from epidemiological dosimetry models, specifically in this case study. Further experiments in different underground working environments, excluding caves, are needed for more precise observations. It might also be time to update the data regarding the dose contribution from natural radiation sources, as the radon contribution increased according to ICRP.

Technical Report Evaluation and study of radon occupational exposure levels in dams: a case study of the Gallery of Medau Zirimilis Dam (Sardinia, Italy)

Protection of people from radon exposure in workplaces is an important factor in decreasing lung cancer risk. International authorities have set ‘reference levels’ to control enhanced radon exposure. Radiometric investigations, including in-situ radon measurements and laboratory gamma-spectroscopy, were carried out to monitor the radon exposure and define the radon transfer model in the workplaces of Medau-Zirimilis Dam in Sardinia. It was found that a shale formation is the main source of radon accumulated in the gallery of this dam. The water passing through the bedrock transports a considerable amount of sediments containing uranium-bearing minerals. Outgassing of radon from water flowing in the drainage canal and its accumulation due to poor ventilation could be the main reasons for the enhanced indoor radon level. The methodology introduced here can be adopted in underground workplaces like mines and tunnels to understand the natural radiation hazard and the effectiveness of the possible mitigation strategies.

The changing outlook of psychedelic drugs: The importance of risk assessment and occupational exposure limits.

Serotonergic psychedelics, such as lysergic acid diethylamide (LSD), psilocybin, dimethyltryptamine (DMT), and 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT), are currently being investigated for the treatment of psychiatric disorders such as depression and anxiety. Clinical trials with psilocybin and LSD have shown improvement in emotional and psychological scores. Although these drugs are reported to be safe in a controlled environment (such as clinical trials), exposure to low doses of these drugs can result in psychedelic effects, and therefore, occupational safety is an important consideration to prevent adverse effects in the workplace from low daily exposure. This article will discuss the factors involved in the derivation of occupational exposure limits (OELs) and risk assessment of these psychedelic drugs. To support the OEL derivations of psychedelic drugs, information regarding their mechanism of action, adverse effect profiles, pharmacokinetics, clinical effects, and nonclinical toxicity were considered. Additionally, psilocybin and LSD, which are the most extensively researched psychedelic substances, are employed as illustrative examples in case studies. The OELs derived for psilocybin and for LSD are 0.05 and 0.002μg/m3 , respectively, which indicates that these are highly hazardous compounds, and it is important to take into account suitable safety measures and risk-management strategies in order to minimize workplace exposure.

Occupational interstitial lung diseases.

Millions of workers are exposed to substances known to cause occupational interstitial lung diseases (ILDs), particularly in developing countries. However, the burden of the disease is likely to be underestimated due to under-recognition, under-reporting or both. The diagnosis of occupational ILD requires a high level of suspicion and a thorough occupational history, as occupational and non-occupational ILDs may be clinically, functionally and radiologically indistinguishable, leading to delayed diagnosis and inappropriate management. A potential occupational aetiology should always be considered in the differential diagnosis of ILD, as removal from the workplace exposure, with or without treatment, is a key therapeutic intervention and may lead to significant improvement. In this article, we provide an overview of the 'traditional' inorganic dust-related ILDs but also address idiopathic pulmonary fibrosis and the immunologically mediated chronic beryllium disease, sarcoidosis and hypersensitivity pneumonitis, with emphasis on the importance of surveillance and prevention for reducing the burden of these conditions. To this end, health-care professionals should be specifically trained about the importance of occupational exposures as a potential cause of ILD.