Risk Of Occupational Exposure Research Articles

Exposure to fipronil induces cell cycle arrest, DNA damage, and apoptosis in porcine trophectoderm and endometrial epithelium, leading to implantation defects during early pregnancy

Fipronil, a phenyl-pyrazole insecticide, has a wide range of uses, from agriculture to veterinary medicine. Due to its large-scale applications, the risk of environmental and occupational exposure and bioaccumulation raises concerns. Moreover, relatively little is known about the intracellular mechanisms of fipronil in trophoblasts and the endometrium involved in implantation. Here, we demonstrated that fipronil reduced the viability of porcine trophectoderm and luminal epithelial cells. Fipronil induced cell cycle arrest at the sub-G1 phase and apoptotic cell death through DNA fragmentation and inhibition of DNA replication. These reactions were accompanied by homeostatic changes, including mitochondrial depolarization and cytosolic calcium depletion. In addition, we found that exposure to fipronil compromised the migration and implantation ability of pTr and pLE cells. Moreover, alterations in PI3K-AKT and MAPK-ERK1/2 signal transduction were observed in fipronil-treated pTr and pLE cells. Finally, the antiproliferative and apoptotic effects of fipronil were also demonstrated in 3D cell culture conditions. In summary, our results suggest that fipronil impairs implantation potentials in fetal trophectoderm and maternal endometrial cells during early pregnancy.

Occupational Risk of Airborne Mycobacterium tuberculosis Exposure: A Situational Analysis in a Three-Tier Public Healthcare System in South Africa.

This study aimed to detect airborne Mycobacterium tuberculosis (MTB) at nine public health facilities in three provinces of South Africa and determine possible risk factors that may contribute to airborne transmission. Personal samples (n = 264) and stationary samples (n = 327) were collected from perceived high-risk areas in district, primary health clinics (PHCs) and TB facilities. Quantitative real-time (RT) polymerase chain reaction (PCR) was used for TB analysis. Walkabout observations and work practices through the infection prevention and control (IPC) questionnaire were documented. Statistical analysis was carried out using Stata version 15.2 software. Airborne MTB was detected in 2.2% of samples (13/572), and 97.8% were negative. District hospitals and Western Cape province had the most TB-positive samples and identified risk areas included medical wards, casualty, and TB wards. MTB-positive samples were not detected in PHCs and during the summer season. All facilities reported training healthcare workers (HCWs) on TB IPC. The risk factors for airborne MTB included province, type of facility, area or section, season, lack of UVGI, and ineffective ventilation. Environmental monitoring, PCR, IPC questionnaire, and walkabout observations can estimate the risk of TB transmission in various settings. These findings can be used to inform management and staff to improve the TB IPC programmes.

Knowledge of occupational exposure to HIV among healthcare workers in college campus clinics and tertiary hospitals

ABSTRACT As the number of college students infected with the human immunodeficiency virus (HIV) has increased significantly in China, the risk of occupational exposure to HIV among healthcare workers (HCW) in college campus clinics has also increased. Our study aimed to evaluate the awareness of HCWs in terms of preventing occupational HIV exposure in college campus clinics compared with HCWs in tertiary hospitals. This cross-sectional study was conducted in nine provinces in China from September to October 2019 (10 college campus clinics, 7 tertiary hospitals). The study’s response rate was recorded to be at 87.62% (184 of 210). The knowledge score of HIV among all HCWs was determined to be generally low (67.17 ± 11.17 points), and that of college campus clinics and tertiary hospitals showed no significant difference (66.36 ± 10.36 vs. 67.63 ± 11.61 points, P=0.463). Overall, HCWs in both college campus clinics and tertiary hospitals showed inadequate knowledge regarding occupational HIV exposure. Training for the prevention of occupational HIV exposure should be strengthened in both medical institutions.

Occupational Risk Exposures and Adverse Health Findings Among Farmers in Southern Philippines

Introduction. Pesticides are widely used in the agricultural sector to increase production by cutting costs and improving product quality. However, these chemicals come with serious health effects when individuals are exposed to large quantities at once or low amounts over time.
 Objective. This study aimed to identify the health symptoms and physical assessment findings affecting farmers from their repeated occupational exposure to pesticides in a rural region in the Philippines.
 Methods. This research study used a cross-sectional design, and samples were drawn based on a multistage sampling of 387 agricultural workers. The target site was in the southern Philippines, and the sample was selected randomly from the identified municipalities. Survey questionnaires were given to the respondents, and a physical assessment was made by medical doctors and trained registered nurses. The data were encoded using SPSS™ 13.0. The statistics used were both descriptive and inferential.
 Results. The farmers used pesticides in their farms with an average of 2.3 days per week (SD: 2.13). The mean total spraying time was 3.07 hours (SD: ± 14.76) per day. The average amount of pesticide used in an application was 1.33 L per application (SD: ± 6.53). Sixty-three percent (63%) had spills while spraying, and 47% reported having spilled pesticides while mixing. Farmers were assessed and found to have experienced symptoms and exhibited physical assessment findings surrounding the following body systems: general, EENT, neurologic, gastrointestinal, respiratory, cardiovascular, and integumentary systems. Abnormalities in laboratory parameters were also observed among the respondents. The mini-mental state examination was done to test if the respondents showed signs of cognitive impairment. The results showed that most respondents (93.95%) had normal cognitive function, while 6.05% of respondents had some level of cognitive impairment. Associations were also tested using Phi Coefficient, and certain pesticide exposure variables were associated with farmers' physical findings and symptoms experienced by farmers.
 Conclusion. This study translates pesticide’s health impact by identifying the common symptoms experienced by farmers and concerning physical assessment findings. The study found that farmers suffered from various symptoms concerning the general health, eye, ears, nose, and throat region, neurological system, gastrointestinal system, respiratory system, cardiovascular system, and the integumentary system. In addition, the laboratory parameters of the participants also exhibited abnormalities indicative of exposure and possible adverse effects from pesticides.

A probabilistic model for risk assessment and predicting the health risk of occupational exposure to pesticides in agriculture

Introduction. The main point is the influence of a complex of chemical and physical stressors on agricultural machine operators. The processes of occurrence and interaction of harmful factors are probable. Markov processes are a convenient model that can describe the behaviour of physical processes with random dynamics. Purpose of the work: was to develop a probabilistic model of risk assessment for agriculture workers during the application of pesticides based on Markov processes’ theory and evaluate with the help of the developed model the probability of occurrence, the degree of severity and the prediction of the different influence of adverse factors on the operator. Materials and methods. The mechanized treatment of pesticide is presented in the form of a system, the states of which are ranked according to the degree of danger to the operator: from non-dangerous to dangerous. The transition occurs under the influence of negative factors and is characterized by the probability of pij transition. Based on the marked graph of the system states, a stochastic matrix P[ij] of transition probabilities was constructed in one step. There are formulas by which it is possible to calculate the state of systems in k steps for a homogeneous and non-homogeneous Markov chain. Results. Based on Markov chains’ theory, the system’s behaviour is modelled when using single-component preparations based on imidacloprid for rod spraying of field crops. Received vector of probabilities of possible hazardous conditions for the employee after each hour of spraying within 10 hours. After 6 hours of working, the probabilistic risk for the operator to stay in a non-dangerous state is about 50 %, and the probability risk of going into a dangerous - at 24 %. The stationary probability distribution results show the inevitability of the transition to a hazardous state of the system if enough steps have been taken. Conclusion. With this model, you can supplement the operator’s health risk assessment system, analyze, compare and summarize the results of years of research. The calculated statistical probabilities can be used in the development of new hygiene regulations with using pesticides.

Occupational Exposure to Ultrafine Particles in Metal Additive Manufacturing: A Qualitative and Quantitative Risk Assessment.

Ultrafine particles (UFPs) can be released unintentionally during metal additive manufacturing (AM). Experts agree on the urgent need to increase the knowledge of the emerging risk of exposure to nanoparticles, although different points of view have arisen on how to do so. This article presents a case study conducted on a metal AM facility, focused on studying the exposure to incidental metallic UFP. It intends to serve as a pilot study on the application of different methodologies to manage this occupational risk, using qualitative and quantitative approaches that have been used to study exposure to engineered nanoparticles. Quantitative data were collected using a condensation particle counter (CPC), showing the maximum particle number concentration in manual cleaning tasks. Additionally, scanning electron microscopy (SEM) and energy dispersive X-ray analyzer (EDS) measurements were performed, showing no significant change in the particles’ chemical composition, size, or surface (rugosity) after printing. A qualitative approach was fulfilled using Control Banding Nanotool 2.0, which revealed different risk bands depending on the tasks performed. This article culminates in a critical analysis regarding the application of these two approaches in order to manage the occupational risk of exposure to incidental nanoparticles, raising the potential of combining both.

Occupational Exposure and Multiple Myeloma Risk: An Updated Review of Meta-Analyses.

The precise etiology of multiple myeloma remains elusive, but both genetic and environmental factors have been suggested to contribute to disease risk. Several occupational categories and toxic agents have been implicated as potentially causative, yet findings from the literature are inconsistent. The aim of this review was to summarize and critically comment on the accumulated epidemiological evidence, across published meta-analyses, about the association between occupational exposure and risk of multiple myeloma. Overall, results from eleven meta-epidemiological studies underscore a significantly increased risk for firefighters, hairdressers, and employees exposed to engine exhaust, whereas farming and methylene chloride exposure have been non-significantly correlated with the disease. Further epidemiological studies are of utmost importance whilst emphasis should be placed on occupational hazard surveillance, as such studies will obtain a more accurate picture of disease occurrence in working populations, and will enable both the implementation of preventive actions and the evaluation of their effectiveness.

Pro-inflammatory response and genotoxicity caused by clay and graphene nanomaterials in A549 and THP-1 cells

Nanoclays and graphene oxide nanomaterials represent a class of materials sharing similar shapes constituted of high aspect ratio platelets. The increased production of these materials for various industrial applications increases the risk of occupational exposure, consequently with elevated risk of adverse reactions and development of pulmonary diseases, including lung cancer. In this study, pro-inflammatory responses and genotoxicity were assessed in alveolar epithelial cells (A549) and activated THP-1 macrophages (THP-1a) after exposure to three nanoclays; a pristine (Bentonite) and two surface modified (benzalkonium chloride-coated Nanofil9, and dialkyldimethyl-ammonium-coated NanofilSE3000); graphene oxide (GO) and reduced graphene oxide (r-GO) nanomaterials. The pro-inflammatory response in terms of IL-8 expression was strongest in cells exposed to Bentonite, whereas surface modification resulted in decreased toxicity in both cell lines when exposed to Nanofil9 and NanofilSE3000. GO and r-GO induced a pro-inflammatory response in A549 cells, while no effect was detected with the two nanomaterials on THP-1a cells. The pro-inflammatory response was strongly correlated with in vivo inflammation in mice after intra-tracheal instillation when doses were normalized against surface area. Genotoxicity was assessed as DNA strand breaks, using the alkaline comet assay. In A549 cells, an increase in DNA strand breaks was detected only in cells exposed to Bentonite, whereas Bentonite, NanofilSE3000 and GO caused an increased level of genotoxicity in THP-1a cells. Genotoxicity in THP-1a cells was concordant with the DNA damage in bronchoalveolar lavage fluid cells following 1 and 3 days after intra-tracheal instillation in mice. In conclusion, this study shows that surface modification of pristine nanoclays reduces the inflammatory and genotoxic response in A549 and THP-1a cells, and these in vitro models show comparable toxicity to what seen in previous mouse studies with the same materials.

Exposure Assessment at a Pullet Barn - A Case Study

ABSTRACT Poultry production is an integral part of agriculture and of the U.S. economy, accounting for millions of eggs and chicken products consumed annually. Most ubiquitous to the poultry industry from farm production to research are broiler and layer poultry operations, with pullet operations at the forefront. Although essential to the cycles of production, there is a dearth of evidence regarding the occupational exposure risks of pullet production. The aim of this case study was to measure total dust and ammonia levels during the growth cycle of pullets. Ammonia and total dust concentrations were measured as single day measurements at three different points of time during the 16.5-week growth cycle of pullet flocks using two fixed sampling stations configured to represent the breathing zone height of poultry workers. As birds grew from chicks to hens, concentrations of total dust and ammonia increased. Notably, from 3 weeks-of-age to 9 weeks-of-age concentrations of total dust increased from 1.1–1.2 mg/m3 to 16.0–18.0 mg/m3; and from 9 weeks-of-age to 15 weeks-of-age, dust concentrations reached 43.0–50.0 mg/m3. Concentrations of ammonia also increased from 9 weeks to 15 weeks from 1.1–2.7 ppm to 22.0–30.0 ppm. Both levels of ammonia and total dust reached levels that have the potential to induce adverse health effects among farmers raising pullets.

Demographic, occupational and societal risk exposures to physical injuries in a rural community in Western Kenya: a 12-week longitudinal study

ObjectiveWe studied factors associated with the weekly occurrence of physical injuries in a rural setting to determine injury-related burden and risk exposures.DesignProspective cohort study.SettingSuna-West subcounty, Migori County, Western Kenya.Participants390 study...

1275Lifetime cancer risks from occupational radiation exposure among workers at interventional radiology departments

Abstract Background Interventional medical radiation workers represent an under-studied population worldwide, although they receive relatively high occupational radiation doses. This study aimed to estimate the lifetime cancer risk from occupational radiation exposure among workers at interventional radiology departments. Methods A field survey of interventional medical workers in nationwide branches of the Korean Society of Interventional Radiology was conducted in 2017. Organ-specific radiation doses were estimated using national dose registry data and conversion coefficients provided by the International Commission on Radiological Protection. Lifetime attributable risk (LAR) and lifetime fractional risk (LFR) were calculated based on realistic exposure scenarios using a radiation risk assessment tool. Results LARs from occupational radiation exposure until the age of retirement for all cancers combined were 338 (90.3-796.1), 121 (33.5-288.7), and 156 (41.1-390.6) per 100,000 individuals for male radiologists, male radiologic technologists, and female nurses, respectively. LFR for all cancers combined ranged from 0.22% (0.06-0.53) to 0.63% (0.17-1.47). Regarding the organ site, the highest LAR and LFR among all groups were observed for thyroid cancer. Conclusions This study provides timely evidence of potential cancer burden from the current levels of occupational radiation exposure among workers at interventional radiology departments. The risks varied by occupational groups, and workers, particularly interventional radiologists, need to be carefully monitored for radiation. Key messages We projected lifetime cancer risks from occupational radiation exposure among workers at interventional radiology departments in South Korea. Particularly, interventional radiologists, should be prioritized for careful protection from the potential health risks of occupational radiation exposure.

Biomonitoring of Uruguayan workers exposed to arsenic from chromated copper arsenate (CCA) used in wood impregnation process

BACKGROUND AND AIM: In Uruguay there are 20 wood-impregnation plants which mostly use chromated copper arsenate (CCA) as preservative. This study aims to show the results of our CCA-woodworkers’ Arsenic exposure biomonitoring for over seven years. In CCA plants, the wood is impregnated into a pressure cylinder performing different cycles of vacuum-pressure-vacuum. Exposure to arsenic in woodworkers may occur through inhalation, dermal exposure, and ingestion during working hours. Owing to the difficulty of replacing CCA for economic reasons, Uruguayan authorities promote the use of GMP that consider recommendations of international occupational safety organizations to minimize negative impacts on the environment and workers’ health. In this regard, the “Guidelines on good practices in wood impregnation” were published in 2007 which establish safety and prevention measures including the use of personal protection equipment. As Uruguay adopted the American Conference of Governmental Industrial Hygienists (ACGIH) recommendations, urine samples of exposed workers must be collected twice a year, for urinary inorganic arsenic plus metabolites analysis (As-U). The recommended biological limits values (BLV) provided by ACGIH for As-U should be below to 35 μgL−1 METHODS: We present and discuss the working conditions and results of As-U from 2014 to 2020, in 479 urine samples from workers of six CCA impregnation plants that were analyzed in our lab by Hydride Generation Atomic Absorption Spectrometry. RESULTS:The As-U results were below BLV in 96,5% of samples. Only 17 samples were higher and after a minimum period of 15 days of workplace removal as requested by guidelines, the workers re-established safe As-U values. CONCLUSIONS:As shown, results indicate low occupational exposure risks to arsenic and reveal the importance of the correct use of personal protective equipment and the relevance of having national guidelines for these practices. Besides the biological control, it is necessary to identify possible causes and carry out the appropriate corrective actions. KEYWORDS: arsenic, chromated copper arsenate (CCA), biomonitoring arsenic

Long-Term Impact of COVID-19 on Mental Health among the General Public: A Nationwide Longitudinal Study in China.

COVID-19 might have long-term mental health impacts. We aim to investigate the longitudinal changes in mental problems from initial COVID-19 peak to its aftermath among general public in China. Depression, anxiety and insomnia were assessed among a large-sample nationwide cohort of 10,492 adults during the initial COVID-19 peak (28 February 2020 to 11 March 2020) and its aftermath (8 July 2020 to 8 August 2020) using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Insomnia Severity Index. We used generalized estimating equations and linear mixed models to explore factors associated with long-term mental health symptoms during COVID-19. During the five months, mental health symptoms remained consistently elevated (baseline 46.4%; follow-up 45.1%). Long-term depression, anxiety and insomnia were associated with several personal and work-related factors including quarantine (adjusted OR for any mental health symptoms 1.31, 95%CI 1.22–1.41, p < 0.001), increases in work burden after resuming work (1.77, 1.65–1.90, p < 0.001), occupational exposure risk to COVID-19 (1.26, 1.14–1.40, p < 0.001) and living in places severely affected by initial COVID-19 peak (1.21, 1.04–1.41, p = 0.01) or by a COVID-19 resurgence (1.38, 1.26–1.50, p < 0.001). Compliance with self-protection measures, such as wearing face masks (0.74, 0.61–0.90, p = 0.003), was associated with lower long-term risk of mental problems. The findings reveal a pronounced and prolonged mental health burden from the initial COVID-19 peak through to its aftermath in China. We should regularly monitor the mental health status of vulnerable populations throughout COVID-19.

Occupational Safety and Health and Illicit Opioids: State of the Research on Protecting Against the Threat of Occupational Exposure.

The nationwide opioid crisis continues to affect not only people who use opioids but also communities at large by increasing the risk of accidental occupational exposure to illicit opioids. In addition, the emergence of highly potent synthetic opioids such as fentanyl and carfentanil increases the need to protect workers who may encounter unknown drug substances during job activities. To support the National Institute for Occupational Safety and Health Opioids Research Gaps Working Group, we examined the state of the literature concerning methods to protect workers against accidental occupational exposure to illicit opioids, and have identified unmet research needs concerning personal protective equipment, decontamination methods, and engineering controls. Additional studies are needed to overcome gaps in technical knowledge about personal protective equipment, decontamination, and control methods, and gaps in understanding how these measures are utilized by workers. Increasing our knowledge of how to protect against exposure to illicit opioids has the potential to improve occupational health across communities.

Toxicity risks of occupational exposure in 3D printing and bioprinting industries: A systematic review.

3-Dimensional (3D) printing and bioprinting are the new technologies. In 3D printing, synthetic polymers such as acrylonitrile, butadiene, and styrene, polylactic acid, nylon, and some metals are used as feedstocks. During 3D printing, volatile organic compounds (VOCs) and nanoparticles can be released. In the bioprinting process, natural polymers are most commonly used. All of these materials have direct and indirect toxic effects in exposed people. Therefore, the aim of this study was to provide a comprehensive review of toxicity risks due to occupational exposure to pollutants in the 3D printing and bioprinting industries. The Cochrane review method was used as a guideline for systematic review. Articles were searched in the databases including PubMed, Scopus, Web of Science, and Google Scholar. This systematic review showed that VOCs and ultra-fine particles are often released in fused deposition modeling and selective laser sintering, respectively. Asthma, chronic obstructive pulmonary disease, allergic rhinitis, and DNA damage were observed in occupational exposure to synthetic polymers. Metal nanoparticles can induce adverse health effects on the respiratory and nervous systems. This study emphasized the need to further study the toxicity of 3D printing and bioprinting-induced air pollutants. Also, consideration of safety and health principles is necessary in 3D printing and bioprinting workplaces.

Hepatitis B vaccination coverage in Germany: systematic review

BackgroundDespite being considered as a low prevalence country for hepatitis B (HBV), some populations in Germany are at higher risk of infection. In the context of the World Health Organization’s (WHO) viral hepatitis elimination goals, a valid epidemiological data base is needed to plan and monitor the national response. Prevention strategies include general and targeted HBV vaccination programmes.ObjectiveThe aim of this work was to estimate the HBV vaccination coverage (VC) in the general population (GP) and different population groups in Germany from available evidence and to identify current evidence gaps for future research.MethodsWe conducted a systematic review on HBV VC in the general population and populations at high risk of HBV exposure or severe infection in Germany. We included eligible publications (01/01/2017 to 06/06/2020) from databases Embase, Pubmed and Livivo, from a previous scoping review (including data published 01/01/2005–17/03/2017), from the national surveillance system and screened the reference lists of all publications at full text level. Risk of bias was assessed using the Hoy et al. tool.ResultsWe included 68 publications of 67 studies and assigned them to one or more suitable population groups. Twenty-one studies contained data among children/adolescents and three among adults from the GP (VC 65.8–90.5% and 22.9–52.1%, respectively), one among travelers (VC 89.0%), 13 among immunocompromised populations (VC 7.8–89.0%), 16 among populations with occupational risk and 16 with non-occupational risk of HBV exposure (VC 63.6–96.5% and 4.4–84.5%, respectively).ConclusionComprehensive evidence at low risk of bias was identified for children/adolescents. However, 25 years after including HBV in the national immunisation schedule, VC in Germany is still below the 95%-goal defined by WHO. For people at occupational risk of HBV exposure, VC was mostly reported to be over the WHO goal of 80%, but quality of evidence was heterogenous and should be improved. For people at non-occupational risk of HBV exposure, evidence was sparse and of low quality. The low VC highlights the need for future research to plan vaccination programmes targeting these populations.

Diffusion simulation, health risks, ozone and secondary organic aerosol formation potential of gaseous pollutants from rural comprehensive waste treatment plant

Comprehensive waste treatment plants (CWTPs) are significant sources of gaseous pollutants such as odors, volatile organic compounds (VOCs) and nitrogen oxides (NOx), polluting the environment and endangering human health. This study conducted on-site investigations on gaseous pollutants emissions from different areas of a CWTP. A total of 10 pollutants were identified of which ammonia (11.32 mg/m³ in average) was the main odorous substance, and benzene (19.51 mg/m³ in average) and toluene (42.07 mg/m³ in average) were the main VOCs. The feeding workshop (FW) was considered the main source of gaseous pollutants. The Gaussian plume model demonstrated that the pollution became more serious after spreading in the southeast downwind direction. Occupational exposure risks of on-site workers were mainly attributed to hydrogen sulfide, ammonia, benzene, and toluene, as their hazard index (HI) and lifetime cancer risk (CR) exceeded the recommended occupational safety limits. The gaseous pollutants diffused from CWTP may still pose a potential health risk to residents within a range of up to 7.5 km. The emulation and quantification of ozone formation potential by methods of Propyl-Equiv and MIR demonstrated that the contribution rate of toluene presented in each stage of CWTP exceed 80 %. Toluene was also the largest contributor to secondary organic aerosol with the contribution rate reached 56.34–85.14 %, followed by benzene (14.72–38.52 %). This research provides a basis for the reduction and control of gaseous pollutants in the treatment and disposal of rural domestic waste.

Granulometric Characterization of Wood Dust Emission from CNC Machining of Natural Wood and Medium Density Fiberboard

The aim of this paper was to determine the particle size composition of wood dust emission from CNC milling of natural wood and medium-density fiberboard (MDF) and evaluate the associated occupational exposure risks. The paper is focused on some of the most commonly used materials in the woodworking and furniture industry, i.e., solid wood (beech, oak, and spruce) and composite materials (MDF panels). In addition to the influence of the machined material, the effect of the technical-technological parameters, namely, feed speed and depth of cut on the particle size distribution, was also investigated. The selected values of the technical-technological parameters used in this study followed the common work practice in small wood processing companies. The particle size distribution was evaluated by using sieve analysis of samples from the total mass of collected wood dust. The results demonstrated that machining of natural wood is characterized mostly by the formation of coarse dust fractions (2 mm–1 mm sieves), whilst the processing of MDF was associated with generation of fine dust fractions with a size below 100 μm. The results obtained can be used for optimizing the technological programs of CNC milling machines, thus, reducing the occupational exposure to harmful wood dust emissions in the wood-processing industry.

The Persistence of Blast- Versus Impact-Induced Concussion Symptomology Following Deployment.

To examine the persistence of concussion-related symptoms following injury as a function of mechanism of injury (high-level blast [HLB] vs impact) and low-level blast (LLB) exposure among Marines. Upon return from deployment and approximately 6 months later, respectively, Marines completed the Post-Deployment Health Assessment and Post-Deployment Health Re-Assessment in an operational or clinic setting. Data from active duty enlisted Marines who completed both assessments (n = 102 075) and who reported a potentially mild traumatic brain injury (mTBI)-inducing event and completed an mTBI screen (n = 8106) were analyzed. This was a retrospective cohort study of Marines deployed between 2008 and 2012. Marines were categorized into groups with relatively high versus low risk for occupational risk of LLB exposure. A mixed model analysis of variance was used to examine the number of symptoms Marines reported experiencing during deployment as a function of probable concussion, HLB exposure, occupational risk, type of symptom, and time of measurement. Self-reported deployment exposures including HLB, probable mTBIs, and occupational risk of LLB exposure were identified. Outcomes included the proportion of neurological, musculoskeletal, and immunological symptoms for which Marines reported seeking care during and following deployment were analyzed. Probable HLB-induced mTBIs (vs impact-induced) were associated with significantly more neurological symptoms at return from deployment and approximately 6 months later. Although symptom reporting decreased at statistically equivalent rates regardless of mechanism of injury, those with a probable HLB-induced concussion continued to report elevated symptomology post-deployment. Additionally, Marines with probable concussion working in occupations with LLB exposure reported elevated levels of persistent neurological symptoms. Both HLB and LLB exposure were associated with neurological symptoms that persisted following deployment. These findings suggest that blast-induced brain injuries may be fundamentally different from impact-induced injuries, and that additional screening and symptomatic treatment for blast-exposed patients may be warranted.

Risks of Occupational-Related Adverse Events (ORAEs) and Effect of Bundled Interventions Among Health Care Workers in Novel Coronavirus Pneumonia Wards.

The aims of the study were to investigate the burden for health care workers (HCWs) who suffer from occupational-related adverse events (ORAEs) while working in contaminated areas in a specialized hospital for novel coronavirus pneumonia, to explore related risk factors, to evaluate the effectiveness of bundled interventions, as well as to provide scientific evidence regarding the reduction of risks concerning ORAEs and occupational exposure events. The study was completed using a special team of 138 HCWs assembled for a specialized hospital for novel coronavirus pneumonia in Wuhan, dated from February 16 to March 26, 2020. The incidence of occupational exposure was determined by data reported from the hospital, while the prevalence of ORAEs was derived from questionnaire results. The relation coefficients of ORAEs and the variable potential risk factors are analyzed by logistic regression. After the risk factors were identified, targeted organized intervention was implemented and chi-square tests were performed to compare the incidence of occupational exposure and the prevalence of ORAEs in contaminated areas before and after the interventions. Ninety one out of 138 (65.94%) had reported ORAEs with 300 (27.96%) cases of ORAEs being recorded in a total of 1073 entries into contaminated areas. The prevalence of different ORAEs include 205 tenderness (24.73%), 182 headache/dizziness (21.95%), 138 dyspnea (16.65%), 130 blurred vision (15.68%), and 95 nausea/vomiting (11.46%). Personal protective equipment (PPE) is significantly associated with ORAEs in contaminated areas (P < 0.05). Among non-PPE-related factors, insomnia is associated with the majority of ORAEs in contaminated areas. Significant differences were achieved after organized interventions in the incidence of occupational exposure of HCWs (χ2 = 39.07, P < 0.001) and the prevalence of ORAEs in contaminated areas (χ2 = 22.95, P < 0.001). During the epidemic period of novel severe respiratory infectious disease, the burden of the ORAEs in contaminated areas and the risk of occupational exposure of HCWs were relatively high. In time, comprehensive and multi-level bundled interventions may help decrease the risk of both ORAEs and occupational exposure.