Exposure Limits Research Articles

P-407 Exploring the effectiveness of tailoring estradiol supplementation duration to mimic the natural cycle length in artificial endometrial preparation for frozen embryo transfer cycles

Abstract Study question Is an estrogen supplementation duration similar in length to the follicular phase of a natural cycle associated with a better clinical pregnancy rate? Summary answer An estradiol supplementation duration, which is proportional to the natural follicular phase length, results in significantly better outcomes compared to shorter exposure durations What is known already The last decade witnessed a major increase in the use of single euploid frozen embryos. Artificial endometrial preparation (AEP) has proven to be effective to prepare the endometrium for implantation. However, several features of AEP need to be clarified mainly the duration of estrogen supplementation and until now no study took into consideration the difference between exogenous estrogen supplementation and the actual length of the follicular phase of each patient during AEP. Furthermore, most of the studies focused on upper limit of estrogen exposure while few considered the lower limit. Unfortunately, the results on pregnancy rates were mixed. Study design, size, duration 663 single euploid frozen embryo transfer cycles were included. Patients underwent vaginal ultrasound and hormonal blood measurement (Estradiol, Progesterone) on day 2 of their cycle. Estradiol valerate (4 mg the first 2 days then 6 mg daily, Orally) was started on the same day and another control was done around day 10. When triple lining pattern of the endometrium was seen, vaginal progesterone was initiated (800 mg daily) and SET was done after 120 hours. Participants/materials, setting, methods Patients with reported regular menstrual cycle (25-35 days) were included and the difference between estrogen supplementation and the actual follicular phase was calculated for each patient. Patients were sorted into 2 groups as follows: 231 women with normal interval (±2 days of follicular phase length), and 432 women with short interval (-3 days or shorter). Only the first single euploid embryo transfer cycles were analyzed for these patients. Main results and the role of chance Whereas patients had similar characteristics in both groups, the corresponding clinical pregnancy rates in normal and short supplementation groups were 69.3% (160/231) and 64% (277/432), respectively. After balancing the groups for BMI, embryo quality and endometrial thickness with inverse treatment probability weighting, those who received estradiol supplementation proportional to their natural follicular phase length had significantly higher clinical pregnancy rates compared to those who received it for shorter durations (adjusted OR: 1.48, 95% CI: 1.16 – 1.89, P = 0.002). Serum estradiol levels were available for 523 cycles, the clinical pregnancy rate in those within the 1st quartile (<155pmol/L), 2nd to 3rd quartile (155 to 275pmol/L) and 4th quartile (>275pmol/L) were 70%, 64.7% and 63%. After adjusting for BMI and embryo quality, higher (>275pmol/L) (adjusted OR: 0.84, 95% CI: 0.53-1.32, P = 0.442) and lower(<155pmol/L) (adjusted OR: 1.37, 95% CI: 0.85-2.22, P = 0.202) estradiol levels were not significantly associated with clinical pregnancy. Limitations, reasons for caution The present study could not address the influence of very long estrogen supplementation on clinical pregnancy rate due to limited samples. Further prospective studies, including larger populations, are needed to confirm our findings Wider implications of the findings Our data indicate that mimicking individually the natural cycle regarding estrogen supplementation duration in AEP for single euploid embryo transfer cycles can produce significant improvement in clinical pregnancy rates. Trial registration number not applicable

Longitudinal changes in cardiovascular disease–related proteins in welders

ObjectiveOccupational exposure to welding fumes is linked to a higher risk of cardiovascular disease; however, the threshold exposure level is unknown. Here, we aimed to identify changes in proteins associated with cardiovascular disease in relation to exposure to welding fumes.MethodsData were obtained from two timepoints six years apart for 338 non-smoking men (171 welders, 167 controls); of these, 174 (78 welders, 96 controls) had measurements available at both timepoints. Exposure was measured as personal respirable dust (adjusted for personal protective equipment), welding years, and cumulative exposure. Proximity extension assays were used to measure a panel of 92 proteins involved in cardiovascular processes in serum samples. Linear mixed models were used for longitudinal analysis. The biological functions and diseases related to the identified proteins were explored using the Ingenuity Pathway Analysis software.ResultsAt both timepoints, the median respirable dust exposure was 0.7 mg/m3 for the welders. Seven proteins were differentially abundant between the welders and controls and increased incrementally with respirable dust: FGF23, CEACAM8, CD40L, PGF, CXCL1, CD84, and HO1. CD84 was significant after adjusting for multiple comparisons. These proteins have been linked to disorders of blood pressure, damage related to clogged blood vessels, and chronic inflammatory disorders.ConclusionExposure to mild steel welding fumes below current occupational exposure limits for respirable particles and welding fumes in Europe and the US (1–5 mg/m3) was associated with changes in the abundance of proteins related to cardiovascular disease. Further research should evaluate the utility of these proteins as prospective biomarkers of occupational cardiovascular disease.

Environmental factors affecting female fertility.

Over the recent years, scientific community has increased its interest on solving problems of female fertility pathology. Many factors acting separately or in combination affect significantly the reproductive life of a woman. This review summarizes current evidence regarding the direct and/or indirect action of environmental factors and endocrine disrupting chemicals (EDCs; i.e. heavy metals, plasticizers, parabens, industrial chemicals, pesticides, or medications, by-products, anti-bacterial agents, perfluorochemicals) upon assisted and non-assisted female fertility, extracted from in vivo and in vitro animal and human published data. Transgenerational effects which could have been caused epigenetically by the action of EDCs have been raised. This narrative review englobes and describes data from in vitro and in vivo animal and human studies with regard to the action of environmental factors, which include EDCs, on female fertility following the questions for narrative reviews of the SANRA (a scale for the quality assessment of narrative review articles). The identification of the studies was done: through the PubMed Central and the PubMed of the MEDLINE, the Google Scholar database and the Cochrane Library database until December 2023 combining appropriate keywords ("specific environmental factors" including "EDCs" AND "specific negative fertility outcomes"); by manual scanning of references from selected articles and reviews focusing on these subjects. It includes references to EDCs-induced transgenerational effects. From the reported evidence emerge negative or positive associations between specific environmental factors or EDCs and infertility outcomes such as infertility indices, disrupted maturation of the oocytes, anovulation, deranged transportation of the embryo and failure of implantation. The revealed adverse outcomes related to female fertility could be attributed to exposure to specific environmental factors such as temperature, climate, radiation, air pollutants, nutrition, toxic substances and EDCs. The recognition of fertility hazards related to the environment will permit the limitation of exposure to them, will improve female fertility and protect the health potential of future generations.

Subchronic oral toxic effects of 2,4-dinitroaniline in wistar rats: A comprehensive toxicity evaluation

2,4-dinitroaniline (2,4-D), a widely used dye intermediate, is one of the typical pollutants, and its potential health risks and toxicity are still largely unknown. To explore its subchronic oral toxicity, Wistar rats (equal numbers of males and females) were used as test animals, and a 90-day oral dosing experiment was conducted, divided into control group, low-dose group (0.055 mg/kg), medium-dose group (0.22 mg/kg), medium-high dose group (0.89 mg/kg), and high-dose group (3.56 mg/kg). The body weight data, clinical appearance, and drug reactions of each test rat within 90 days of dosing were recorded; morning urine samples were collected four times to test for eight urinary indicators; blood samples were collected to test for nineteen hematological indicators and sixteen biochemical indicators; tissue samples were collected for pathological analysis; moreover, the no-observed-adverse-effect level (NOAEL) was determined, and the benchmark dose method was used to support this determination and provide a statistical estimate of the dose corresponding. The results indicated that the chronic toxicity of 2,4-dinitroaniline showed certain gender differences, with the eyes, liver, and kidneys being the main potential target organs of toxicity. Moreover, the subchronic oral NOAEL for 2,4-dinitroaniline was determined to be 0.22 mg/kg body weight (0.22 mg/kg for males and 0.89 mg/kg for females), and a preliminary calculation of the safe exposure limit for human was 0.136 mg/kg. The research results greatly enriched the safety evaluation data of 2,4-dinitroaniline, contributing to a robust scientific foundation for the development of informed safety regulations and public health precautions.

Review of international criteria for the chemical hazards in the assessment of working conditions at petrochemical facilities

The article considers the practice of implementing standards for occupational exposure limits or OEL (Occupational exposure limits) of chemicals according to foreign studies and sources. Comparative data are provided on the application of the method of comprehensive hygienic assessment of working conditions by country as the legislative basis for the employer's responsibility to ensure the assessment and minimize the impact of hazardous substances on occupational health. The need to introduce a correction factor to the established MPC/MPR in the Republic of Kazakhstan for a six-day working week, following the example of other countries (for example, Brazil, Chile), as well as the use of methods for assessing occupational risk for hazardous substances for which occupational exposure limits have not been established, were considered. An assessment of the safe experience under the influence of dust, including strongly fibro genic aerosols, was considered as an effective measure to limit the effect of hazardous substances on the respiratory organs of workers.

Evaluation of airborne asbestos concentrations associated with the maintenance of brakes on an industrial overhead crane

Objectives To evaluate potential airborne asbestos exposures during brake maintenance and repair activities on a P&H overhead crane, and during subsequent handling of the mechanic’s clothing. Methods Personal (n = 27) and area (n = 61) airborne fiber concentrations were measured during brake tests, removal, hand sanding, compressed air use, removal and reattachment of chrysotile-containing brake linings, and reinstallation of the brake linings. The mechanic’s clothing was used to measure potential exposure during clothes handling. Results All brake linings contained between 19.9% to 52.4% chrysotile asbestos. No amphibole fibers were detected in any bulk or airborne samples. The average full-shift airborne chrysotile concentration was 0.035 f/cc (PCM-equivalent asbestos-specific fibers, or PCME). Average task-based personal air samples collected during brake maintenance, sanding, compressed air use, and brake lining removal tasks ranged from 0 to 0.48 f/cc (PCME). The calculated 30-minute time-weighted average (TWA) airborne chrysotile concentration associated with 5-15 minutes of clothes handling was 0–0.035 f/cc PCME. Conclusion The results indicated that personal and area TWA fiber concentrations measured during all crane brake maintenance and clothes handling tasks were below the current OSHA 8-h TWA Permissible Exposure Limit for asbestos of 0.1 f/cc. Further, no airborne asbestos fibers were measured during routine brake maintenance tasks following the manufacturer’s maintenance manual procedures. All short-term airborne chrysotile concentrations measured during non-routine tasks were below the current 30-minute OSHA excursion limit for asbestos of 1 f/cc. This study adds to the available data regarding chrysotile exposure potential during maintenance on overhead cranes.

Occupational exposure limits for reproductive toxicants – A comparative analysis

We investigated the level of protection of reproductive and developmental toxicity offered through occupational exposure limits (OELs) and Derived No-Effect Levels for workers’ inhalation exposure (wDNELs). We compared coverage of substances that have a harmonised classification as reproductive toxicant 1 A or 1B (Repr.1 A/B), numerical values and scientific basis of 12 lists of OELs and wDNELs from REACH Registrants’ and the Committee for Risk Assessment. Across the 14 sources of OELs and wDNELs, 53 % of the Repr1A/B-substances had at least one exposure limit (counting groups of metals as one entry). Registrants’ wDNELs covered the largest share, 40 %. The numerical values could be highly variable for the same substance across the lists. How often reproductive toxicity is identified as the critical effect varies between the examined lists, both due to different assessments of the same substance and different substance coverage. Reviewing the margin of safety to reproductive toxicity cited in the documents, we found that 15 % of safety margins were lower to reproductive toxicity than the critical effect. To conclude, neither the REACH nor work environment legislation supply wDNELs or OELs for a substantial share of known reproductive toxicants. EU OELs cover among the fewest substances in the range, and in many cases national OELs or wDNELs are set at more conservative levels.

Using ANN for thermal neutron shield designing for BNCT treatment room

Occupational radiation protection should be applied to the design of treatment rooms for various radiation therapy techniques, including BNCT, where escaping particles from the beam port of the beam shaping assembly (BSA) may reach the walls or penetrate through the entrance door. The focus of the present study is to design an alternative shielding material, other than the conventional material of lead, that can be considered as the material used in the door and be able to effectively absorb the BSA neutrons which have slowed down to the thermal energy range of <1\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$< 1$$\\end{document} eV after passing through the walls and the maze of the room. To this aim, a thermal neutron shield, composed of polymer composite and polyethylene, has been simulated using the Geant4 Monte Carlo code. The neutron flux and dose values were predicted using an artificial neural network (ANN), eliminating the need for time-consuming Monte Carlo simulations in all possible suggestions. Additionally, this technique enables simultaneous optimization of the parameters involved, which is more effective than the traditional sequential and separate optimization process. The results indicated that the optimized shielding material, chosen through ANN calculations that determined the appropriate thickness and weight percent of its compositions, can decrease the dose behind the door to lower than the allowable limit for occupational exposure. The stability of ANN was tested by considering uncertainties with the Gaussian distributions of random numbers to the testing data. The results are promising as they indicate that ANNs could be used as a reliable tool for accurately predicting the dosimetric results, providing a drastically powerful alternative approach to the time-consuming Monte Carlo simulations.

Occupational Inhalation Health Risk Assessment of TCE Exposure in the Korean Manufacturing Industry

This study aimed to assess the health risks to workers in the Korean manufacturing industries using trichloroethylene (TCE). In Republic of Korea, TCE has permissible exposure limits. In 2014, the permissible exposure limits were exceeded in two cases, necessitating a health risk assessment. The exposure value of TCE in the workplace was determined using Korea’s Workplace Environmental Monitoring Program (WEMP), and risk assessment was performed by applying a probabilistic distribution using a Monte Carlo simulation. When evaluating non-carcinogenic risks at the 50th percentile, all 20 industries had acceptable risk, and at the 95th percentile, 12 of the 20 industries had unacceptable risk. Following the cancer risk assessment, 17 out of 20 industries had unacceptable risks, and the 95th percentile of all industries had unacceptable risks. The non-carcinogenic and carcinogenic risks of TCE were highest during metal fabrication. Based on these results, metal fabrication was chosen as an industry that should receive management priority in Korea. The findings of this study serve as a foundation for managing TCE among manufacturing workers.

High seminal BPA in IVF patients correlates with lower sperm count and up-regulated miR-21 and miR-130a

Bisphenol A (BPA) is a widespread industrial chemical, used as the key monomer of polycarbonate plastics and epoxy resins. BPA has been detected in human seminal fluid and has been correlated with changes in sperm parameters, crucial in determining male fertility. In this study, semen samples were collected from 100 patients aged 29–47 years undergoing fertility assessment between 2021 and 2023 and analyzed according to WHO guidelines. BPA levels in the seminal plasma were then measured through an enzyme-linked immunosorbent assay (ELISA) and compared to sperm quality metrics. The relative mRNA/miRNA expression of key genes associated to male reproduction, including androgen receptor, miR-34c, miR-21, miR-130a, was then quantified and compared between groups with high or low BPA content. Our results revealed that BPA levels were increased with age and were negatively correlated with sperm counts (p<0.05). The negative correlation remained significant when patients were age-matched. No other relationships between seminal BPA and motility, morphology or DNA fragmentation levels were observed. qPCR analysis showed that androgen receptor mRNA expression was significantly greater in sperm with high seminal BPA (p<0.05). Moreover, we found that the expression of miR-21 and miR-130a was also upregulated in the higher BPA group (p<0.05). These results display a relationship between BPA content in the semen and male fertility parameters, and provide insights into the molecular mechanisms through which BPA may be affecting male reproductive capability. Ultimately, this research can potentially drive changes to guidelines and exposure limits for BPA exposure.

Air-liquid interface exposure of A549 human lung cells to characterize the hazard potential of a gaseous bio-hybrid fuel blend.

Gaseous and semi-volatile organic compounds emitted by the transport sector contribute to air pollution and have adverse effects on human health. To reduce harmful effects to the environment as well as to humans, renewable and sustainable bio-hybrid fuels are explored and investigated in the cluster of excellence "The Fuel Science Center" at RWTH Aachen University. However, data on the effects of bio-hybrid fuels on human health is scarce, leaving a data gap regarding their hazard potential. To help close this data gap, this study investigates potential toxic effects of a Ketone-Ester-Alcohol-Alkane (KEAA) fuel blend on A549 human lung cells. Experiments were performed using a commercially available air-liquid interface exposure system which was optimized beforehand. Then, cells were exposed at the air-liquid interface to 50-2000 ppm C3.7 of gaseous KEAA for 1 h. After a 24 h recovery period in the incubator, cells treated with 500 ppm C3.7 KEAA showed significant lower metabolic activity and cells treated with 50, 250, 500 and 1000 ppm C3.7 KEAA showed significant higher cytotoxicity compared to controls. Our data support the international occupational exposure limits of the single KEAA constituents. This finding applies only to the exposure scenario tested in this study and is difficult to extrapolate to the complex in vivo situation.

A South African case study on anatomical embalming for human body donation programmes with toxicological considerations

Body embalming, a practice with deep historical roots across various cultures, forms the backbone of contemporary human body donation educational programmes. In this study, we explored current embalming practices within six South African human anatomical dissection programmes, focusing on the use and volumes of key chemicals—formalin, phenol, and alcohol—and their associated health risks and potential toxicity. We measured and compared aspects of embalming practices such as the duration of body preservation and the annual intake of bodies. Variations in embalming practices and chemical ratios across different South African universities were found. However, the consistent use of formalin, phenol and alcohol were observed across all six programmes. Formaldehyde concentrations used in South African dissection programmes were within the generally acceptable international range. Regarding arterial embalming, South African dissection programmes showed widespread adherence to international embalming practices, with one programme using a substantially lower concentration of formalin. The dual nature of formaldehyde as both an effective preservative and a recognised carcinogen was underscored in relation to human health regarding chemical toxicity. Phenol, like formaldehyde, was consistently used as it is important for the inhibition of bacterial and fungal growth. Alcohol was also consistently used, but there was much greater variation in its volume across South African institutions. Our data showed a slight positive relationship between storage duration and the volumes of formalin and phenol in human embalming fluid. South African regulators enforce stricter exposure limits than those set by the World Health Organisation and various European agencies. While South African institutions operate within internationally acceptable ranges of chemical use that both maximise preservation and minimise toxicity, we acknowledge that these data are preliminary. Further investigation is encouraged to ensure embalming practices effectively protect all those involved and support the educational goals of human anatomical dissection programmes in South Africa.

Status of occupational exposure limits of air toxic substances in the GESTIS Substances Database

Objective: In order to understand the current situation of air toxic substances without occupational exposure limits (OELs) in the workplace in the Germany GESTIS Substance Database, and to provide an effective reference for formulating OELs of corresponding toxic substances and improving health standards. Methods: From March 2022 to May 2023, based on the standard of GBZ 2.1-2019 Occupational Exposure Limits for Hazardous Agents in the Workplace-Part 1: Chemical Hazardous Agents, air toxic substances without OELs in the standard of GBZ/T 300.1-2017 Determination of Toxic Substances in Workplace Air-Part 1: General Principles were screened out, then corresponding OELs in other countrie/regions were queried through the Germany GESTIS Substance Database. Results: Among the 333 kinds (classes) of air toxic substances in 160 parts of GBZ/T 300.1-2017 standard, 48 kinds (classes) of air toxic substances were screened out and had not yet been formulated OELs in GBZ 2.1-2019 standard. By querying the Germany GESTIS Substance Database, it was found that among the 48 kinds (classes) of air toxic substances, 35 kinds (classes) of air toxic substances had both 8-hour occupational exposure limit and short-term occupational exposure limit, 4 kinds (classes) of air toxic substances had 8-hour occupational exposure limit but no short-term occupational exposure limit, 9 kinds (classes) of air toxic substances hadn't been retrieved any OELs. In addition, standard test methods of 7 kinds of air toxic substances hadn't been published in the present, including trimethylchlorosilane, trimethylbenzenes, cumene, chloroethane, chloropropane, dibromoethane and acetophenone. Conclusion: In the process of formulating or revising the standards of GBZ 2.1-2019 and GBZ/T 300, the latest published OELs in the Germany GESTIS Substance Database could be used as a reference basis.

Are Infants and Children at Risk of Adverse Health Effects from Dietary Deoxynivalenol Exposure? An Integrative Review.

Deoxynivalenol (DON) is a foodborne mycotoxin produced by Fusarium molds that commonly infect cereal grains. It is a potent protein synthesis inhibitor that can significantly impact humans' gastrointestinal, immune, and nervous systems and can alter the microbiome landscape. Low-dose, chronic exposure to DON has been found to stimulate the immune system, inhibit protein synthesis, and cause appetite suppression, potentially leading to growth failure in children. At higher doses, DON has been shown to cause immune suppression, nausea, vomiting, abdominal pain, headache, diarrhea, gastroenteritis, the malabsorption of nutrients, intestinal hemorrhaging, dizziness, and fever. A provisional maximum tolerable daily intake (PMTDI) limit of 1 µg/kg/body weight has been established to protect humans, underscoring the potential health risks associated with DON intake. While the adverse effects of dietary DON exposure have been established, healthcare communities have not adequately investigated or addressed this threat to child health, possibly due to the assumption that current regulatory exposure limits protect the public appropriately. This integrative review investigated whether current dietary DON exposure rates in infants and children regularly exceed PMTDI limits, placing them at risk of negative health effects. On a global scale, the routine contamination of cereal grains, bakery products, pasta, and human milk with DON could lead to intake levels above PMTDI limits. Furthermore, evidence suggests that other food commodities, such as soy, coffee, tea, dried spices, nuts, certain seed oils, animal milk, and various water reservoirs, can be intermittently contaminated, further amplifying the scope of the issue. Better mitigation strategies and global measures are needed to safeguard vulnerable youth from this harmful toxicant.

Optical sensor for BTEX detection: Integrating machine learning for enhanced sensing

Optical sensors provide a fast and real-time approach to detect benzene, toluene, ethylbenzene, and xylenes (BTEX) in environmental monitoring and industrial safety. However, detecting the concentration of a particular gas in a mixture can be challenging. Here, we develop a machine-learning model that can precisely measure BTEX concentrations simultaneously based on an absorption spectroscopy gas sensing system. The convolutional neural network (CNN) is utilized to identify the absorbance spectra for each volatile, along with their concentrations in a mixture. A synthetic data set is generated using a series of physics-based simulations to create the predictive model. The data set consists of the overall absorbance of numerous random BTEX mixtures over time, based on various percentages of the permissible exposure limit (PEL). It is worth noting that benzene has a negligible absorbance (very low PEL, 1–5 ppm) compared to other volatile gases, which makes it difficult to detect. To address this challenge, we introduce a 3-stage solution to accurately discriminate between all BTEX species, regardless of their concentration levels. As a result, the R-squared above 0.99 for toluene, ethylbenzene, and o-xylene, and the R-squared above 0.96 for benzene, is achieved, indicating the model's capability to predict BTEX concentrations.

Association Between Early Hyperoxemia Exposure and Intensive Care Unit Mortality in Intracerebral Hemorrhage: An Observational Cohort Analysis.

Supraphysiologic levels of oxygen could have potential adverse effects on the brain that may be dose and time dependent in patients with brain injury. We therefore aimed to assess whether exposure to excess supplemental oxygen, measured as time-weighted mean exposure to hyperoxemia, was associated with intensive care unit (ICU) mortality in patients with intracerebral hemorrhage (ICH). In this single-center retrospective cohort study, we included all patients admitted to our ICU with a diagnosis of primary spontaneous ICH. To provide a longitudinal measure of hyperoxemia exposure, we calculated the hyperoxemia dose, defined as the area under the partial pressure of oxygen in arterial blood (PaO2) time curve above the threshold PaO2 value of 100mm Hg (13.3kPa) divided by the number of hours of potential exposure. To provide consistent potential exposure windows and limit bias from informative censoring, nested subsets were created with progressively longer exposure periods (0-1day, 0-2days, 0-3days, 0-4days, 0-5days, 0-6days, 0-7days). We used multivariable Cox regression, with hyperoxemia dose as a time-dependent covariate, to model ICU mortality. Admission ICH and Acute Physiology and Chronic Health Evaluation II scores were included as predictor covariables. A step-function extended Cox model was also fitted. Between September 2019 and July 2022, 275 patients met the inclusion criteria, with 24,588 arterial blood gas results available for analysis. The mean age was 57.19years (± 13.99), 59.64% were male, 23.64% had an infratentorial origin of hemorrhage, and ICU mortality was 35.64%. Almost all patients (97.45%) were exposed to hyperoxemia during their ICU admission. Cox regression modeling showed an association between hyperoxemia dose and ICU mortality (hazard ratio 1.15, confidence interval 1.05-1.25, p = 0.003). This association was observed in the 0-1day subset in the step-function extended Cox model (hazard ratio 1.19, confidence interval 1.06-1.35, p = 0.005) but not in any of the subsequent exposure periods. In patients with ICH admitted to the ICU, we observed an association between hyperoxemia dose and ICU mortality. Further prospective study is required to inform guidance on early systemic oxygen targets in ICH.

Volatile gas scavenging in the paediatric intensive care unit: Occupational health and safety assessment.

The use of volatile anesthetic agents in the paediatric intensive care unit (PICU) is experiencing increased interest since the availability of the miniature vapourizing device. However, the effectiveness of scavenging systems in the presence of humidifiers in the ventilator circuit is unknown. We performed a bench study to evaluate the effectiveness of the Deltasorb® scavenging system in the presence of isoflurane and active humidity by simulating both infant and child ventilator test settings. A total of four ventilators were set to ventilate test lungs, all with active humidity and a Deltasorb scavenging canister collecting exhaled ventilation gas. Two ventilators also had isoflurane delivered using the Anesthesia Conserving Device- small (ACD®-S) on the inspiratory limb (also called alternative ventilator configuration). We performed instantaneous measurements of isoflurane and continuous sampling with passive badges to measure average environmental exposure over a test period of 6.5 hours. Scavenging canisters were returned to the company, where desorption analysis showed the volume of water and isoflurane captured in each canister. Both instantaneous point sampling and diffusive sampling results were below the occupational exposure limit confirming safety. The canisters collected both isoflurane and a portion of the water vapour delivered; the percentage of captured water and isoflurane collected in infants was higher than the child ventilator test settings. The tested scavenging configuration was effective in maintaining a safe working environment with active humidity and inspiratory limb (alternative) ventilator configuration of the the miniature vapourizing device.

Farmworker-Relevant Heat Exposure in Different Crop and Shade Conditions

ABSTRACT Objectives Agricultural workers are at risk of heat-related illness, which is preventable. Few field studies have compared farmworker-relevant heat exposure in different conditions. We examined heat exposure over time in different potential shade and work locations to inform future occupational heat prevention approaches. Methods We assessed heat exposure in Eastern Washington State (WA) cherry and grape fields in August 2022. QUESTemp° monitors recorded Wet Bulb Globe Temperature (WBGT) and Black Globe Temperature (BGT) every 10 min from approximately 07:00–14:00 for three days in the center of crop rows (mid-row), under portable shade structures (shade), and in open field (open) locations. Linear mixed effects regression (LMER) models compared WBGT and BGT among field locations. Hourly time-weighted average WBGT and comparisons with occupational exposure limits (OELs) were computed for different hypothetical work-rest cycles during the hottest sampling hours, assuming different worker effort levels, rest locations (mid-row versus shade), and acclimatization statuses. Results Across all crops and locations during the study period, the mean/SD air temperature was 31°C (88°F)/3.9°C (6.9°F), with a maximum temperature of 39°C (102°F) and a mean/SD relative humidity of 30%/9.6%. LMER models suggested no significant difference in mid-row versus open WBGT but significantly lower WBGT in shade versus open locations for both cherries (main effect −5.14: 95% confidence interval [CI] −6.97,−3.32) and grapes (−6.20: 95%CI −7.73,−4.67), though this difference diminished over the course of the day. BGT was significantly higher in the mid-row than the shade (cherries main effect 14.33: 95%CI 9.52,19.13 and grapes 17.10: 95%CI 13.44,20.75). During the hottest sampling hour, the exceedances of OELs were reduced with assumptions of increased shaded break lengths, reduced effort level, and acclimatization. Conclusions Shade canopies, but not the crops studied, provided significant reductions in heat exposure. We observed increased protection from heat assuming longer shaded breaks and reduced effort levels. Results highlight the need for additional field research on the effectiveness, feasibility, and acceptability of different shade types and work-rest cycles to guide employer optimization of best practices for worker protections, including acclimatization before high heat, sufficient shaded rest time, reduced effort levels as the day warms, and avoiding work in peak heat.

Evaluating DIY air cleaner variability and potential for post-construction emission of aromatic VOCs during wildfire events

While do-it-yourself (DIY) air cleaners such as the Corsi-Rosenthal Box (CR Box) are an increasingly popular choice for low-cost, accessible air cleaning during a wildfire event, construction and performance variability remains a concern. Using the same set of instructions, materials, and location of assembly, seven CR Boxes are constructed by individuals with no prior DIY air cleaner experience and clean air delivery rates (CADRs) are experimentally determined for each of the devices. Against a challenge aerosol consisting of fresh smoke generated via pine needle combustion, average number-based, PM2.5 CR Box CADRs range from 313–396 m3/h (relative standard deviation = 7.6 %). Over this modest range of observed variability, constructed units outperform many higher-cost commercial air cleaners. A review of the literature demonstrates that across studies, substantial CADR variability is observed (285–1448 m3/h); differences in materials (including filter type) used during air cleaner construction, challenge aerosols tested, and evaluation protocol are major contributors to variability. To evaluate the potential for exposure to aromatic volatile organic compounds (VOCs) from CR Box materials, we place three devices in a large chamber for 24–72 hours immediately following construction. Toluene and C8 aromatics (ethylbenzene and xylenes) are emitted at 2289 and 89 μg/h, respectively, with emission rates decreasing by 94 % and 82 % after 12 hours. Using experimentally determined PM2.5 CADRs and VOC emission rates, a hypothetical wildfire event impacting the bedroom of a home is modeled at four outdoor air exchange rates (AERs) to assess tradeoffs between building airtightness, particle removal effectiveness, and VOC off-gassing from a newly built CR Box. PM2.5 effectiveness ranges from 0.88 to 0.95, depending on AER (0.1–1 h−1). While modeled maximum VOC concentrations remain orders of magnitude below short-term permissible exposure limits at all AERs considered, modeled and observed VOC dynamics imply that an off-gassing period of ∼6–12 hours would avoid episodic emission of VOCs at rates that may cause accumulation in excess of the lower-limit of toluene odor threshold estimates.

Real time monitoring of carbon dioxide levels in surgical helmet systems worn during hip and knee arthroplasty

BackgroundOrthopaedic surgical helmet systems (SHS) rely on an intrinsic fan to force clean external air over the wearer. Carbon dioxide (CO2) is produced through aerobic metabolism and can potentially accumulate inside the SHS. Levels above 2500 ppm have previously been shown to affect cognitive and practical function. Maximum Health and Safety Executive (HSE) 8-h exposure limit is 5000 ppm. There is a paucity of data on real-world CO2 levels experienced during arthroplasty surgery whilst wearing a SHS. ObjectivesTo determine intra-operative levels of CO2 experienced within SHS. MethodsCO2 levels were continuously recorded during 30 elective arthroplasties, both primary and revision. Data was recorded at 0.5Hz throughout the procedure utilising a Bluetooth CO2 detector, worn inside a surgical helmet worn with a toga gown. Five surgeons contributed real time data to the study. ResultsThe average CO2 level across all procedures was 3006 ppm, with 23 of the cases measured within the surgeons’ helmets having a mean above 2500 ppm, but none having a mean above 5000 ppm. For each procedure, the time spent above 2500 and 5000 ppm was calculated, with the means being 72.6 % and 5.4 % respectively. Minimum fan speed was associated with only a marginally higher mean CO2 value than maximum fan speed. DiscussionThe use of surgical helmet systems for elective orthopaedic surgery, can result in CO2 levels regularly rising to a point which may affect cognitive function. ConclusionFurther research is needed to corroborate these findings however, we recommend that future designs of SHS include active management of exhaust gases, possibly returning to Charnley's original design principles of the body exhaust system.