Potential Occupational Exposure Research Articles

Respiratory and Enteric Bacterial Pathogens in Municipal Wastewater: A Potential Risk of Infection to Workers

Investigating human pathogens in wastewater is crucial for identifying and predicting potential occupational health risks faced by wastewater treatment plant (WWTP) workers. This study aimed to determine the occurrence and levels of Legionella pneumophila, Mycobacterium spp., Arcobacter butzleri, and Aeromonas hydrophila in untreated municipal wastewater. Grab influent, activated sludge, and secondary settling tank (SST) effluent samples were collected bi-weekly over 6 months from 5 WWTPs in Tshwane, South Africa. Mycobacterium spp., A. butzleri, and A. hydrophila were detected using quantitative PCR (qPCR), while Legionella was detected using both a culture method and qPCR. The four pathogens were identified in most samples at varying levels. Legionella pneumophila had a positivity rate of 92%, ranging from 2 to 5.4 log10 MPN/100 mL. Detection rates of Legionella spp., L. pneumophila, and L. pneumophila serogroup 1 were 97%, 75%, and 69%, respectively, with up to 5.3 log10 gene copies (GC)/mL. Importantly, this study demonstrates molecular typing of L. pneumophila serogroup 1 in wastewater, a topic that has been rarely documented. Mycobacterium spp. were detected in all samples at varying levels (log10 GC/mL) in influent (2.8–7.6), activated sludge (4.8–8.9), and SST effluent (3.8–8.9) samples. Arcobacter butzleri and A. hydrophila were detected in 96% and 82% of the samples, respectively, with GC levels in influent, activated sludge, and SST effluent ranging from 0.8 to 6.6, 1.5 to 6.5, and 0.7 to 6.6 log10 GC/mL for A. butzleri, and similar levels for A. hydrophila. These findings underscore the presence of respiratory and enteric pathogens at various treatment points, suggesting potential occupational exposure for WWTP workers. This emphasises the need for microbiological risk assessments (RAs) or reviewing existing RAs and implementing necessary control measures to protect WWTP workers.

Global Cancer Nurse's Experiences and Perceptions of Potential Occupational Exposure to Cytotoxic Drugs: Mixed Method Systematic Review With Framework Synthesis.

To conceptualise experiences and perceptions of cancer nurses' potential for occupational exposure when dealing with cytotoxic drugs (CDs). A mixed methods systematic review with framework synthesis. A literature search was conducted in February 2022 in CINAHL PubMed, Web of Science, Ovid Nursing, and PsycINFO, and it was reported using the PRISMA guidance. A synthesis of 38 studies revealed new categories of perceived solutions, side effects, and risky behaviour as well as three levels of experience and perception: individual, shared, and cultural, rather than the a priori theory. The review conclude that individuals espouse safe handling and administration of CDs. Synthesis highlights a complex interplay between self-reported perception and the observed experience of potential occupational exposure to cytotoxic drugs. The framework synthesis highlights the difference between the perception of espoused practice and the experience of practice. Observation and risk assessment must be used to enhance safe practice. Organisations must take seriously the perception and experience of the adverse effects of administering cytotoxic drugs to support cancer nurses. Joanna Briggs Institute's (JBI) methodology for systematic reviews and framework synthesis indexed studies deductively and inductively. No patient or public contribution. PROSPERO: CRD42022289276.

Addressing the need for individual-level exposure monitoring for firefighters using silicone samplers.

Firefighters are occupationally exposed to hazardous chemical mixtures. Silicone passive sampling devices capture unique exposures over time with minimal impact to the participant and allow for the analysis of a broad chemical space. Silicone dog tags were worn by firefighters while on- and off-duty to measure individual exposures, identify potential occupational exposures, and assess their relation to occupational variables including fire response frequency, rank, and years as a firefighter. Fifty-six firefighters were recruited from two fire departments with relatively high and low call volumes in the Kansas City metropolitan area to wear two different silicone dog tags as passive samplers while on- and off-duty. Each dog tag was worn for a cumulative 30-day exposure period. Extracts of the dog tags were analyzed with gas chromatography, mass spectrometry methods for 43 flame retardants (FRs), 21 volatile organic compounds (VOCs), 42 polychlorinated biphenyls (PCBs), and 63 polycyclic aromatic hydrocarbons (PAHs). Ninety-two total chemicals were detected, with eight chemicals not previously reported in firefighter exposure studies. Based on the magnitude and frequency of increased exposure in on-duty dog tags, relative to paired off-duty dog tags, five PBDEs and sec-butylbenzene were identified as potential occupational exposures; sec-butylbenzene and PBDE 49 have not previously been reported in firefighter exposure studies to the authors' knowledge. Multivariate analyses for these six compounds indicated that firefighter rank, fire response rates, and years in the fire service were poor indicators of increased occupational exposure. The greatest on-duty exposures to PBDEs were found in the low-call volume department among operational firefighters. Dog tags from firefighters at the high-call volume department accounted for 75% of PCB detections; one particular fire response may have contributed to this. Additionally, there was measurable similarity in total chemical exposure profiles between paired on- and off-duty tags for some firefighters. This study used personal silicone passive samplers in the configuration of dog tags worn around the neck to quantify firefighter occupational exposure in on-duty samples relative to paired off-duty samples for several chemical categories: flame retardants, VOCs, and PCBs. Five PBDEs and sec-butylbenzene were identified as potential occupational exposures, however their prevalence in on-duty tags was not associated with frequency of fire responses, firefighter rank, or years the firefighter has been in the fire service. Additionally, similarity between chemical exposures in on- and off-duty tags from the same firefighter invites further investigation into individual behaviors influencing occupational and para-occupational exposures.

Cashiers and bisphenols: Occupational exposure and health implications in south China

Bisphenols are ubiquitous chemicals used in various industries, raising concerns due to their potential to disrupt endocrine systems, particularly among occupational populations. This study concurrently assessed bisphenol A (BPA) and its 12 analogues in 325 urine samples from cashiers and non-cashiers residing in South China. Results revealed that BPA was the most prevalent bisphenol in urine, subsequent to bisphenol S (BPS), bisphenol F, bisphenol AF (BPAF) and bisphenol E (BPE), with detection frequencies at 60−99%. BPA exhibited the highest median concentration of 1.16 ng/mL. Urine samples from cashiers showed relatively high levels of BPA, BPS and BPE, highlighting potential occupational exposure implications. Variations in urinary bisphenol concentrations across gender and age groups were explored. Significant correlations were identified between urinary BPA and BPE, as well as BPS and BPAF, indicative of shared exposure sources and pathways. Cashiers had 1.50–13.4 times higher exposure than non-cashiers to these bisphenols. The median exposure to five bisphenols exceeded the established tolerable daily intake for BPA, set at 0.2 ng/kg bw/day, by 1.10–180 times. This study underscores the urgent need for assessing the potential health implications of bisphenol exposure, especially for high-exposure groups like cashiers, and suggests actions to reduce these risks.

Contact allergy in Swedish professional ice hockey players.

Professional ice hockey players may contract irritant and allergic contact dermatitis. To investigate the presence of contact allergy (CA) in professional ice hockey players in Sweden. Ten teams from the two top leagues were assessed for potential occupational exposure to sensitizers. Exactly 107 players were patch tested with an extended baseline series and a working series, in total 74 test preparations. The CA rates were compared between the ice hockey players and controls from the general population and dermatitis patients. One out of 4 players had at least one contact allergy. The most common sensitizers were Amerchol L 101, nickel and oxidized limonene. CA was as common in the ice hockey players as in dermatitis patients and significantly more common than in the general population. Fragrances and combined sensitizers in cosmetic products (fragrances + preservatives + emulsifier) were significantly more common in ice hockey players compared with the general population. The possible relationship between CA to fragrances and cosmetic products on the one hand and the presence of dermatitis on the other should be explored further.

Assessment of emissions and potential occupational exposure to carbon monoxide during biowaste composting.

To date, only a few studies focused on the carbon monoxide (CO) production during waste composting; all targeted on CO inside piles. Here, the CO net emissions from compost piles and the assessment of worker's occupational risk of exposure to CO at large-scale composting plants are shown for the first time. CO net emissions were measured at two plants processing green waste, sewage sludge, or undersize fraction of municipal solid waste. Effects of the location of piles (hermetised hall vs. open yard) and turning (before vs. after) were studied. Higher CO net emission rates were observed from piles located in a closed hall. The average CO flux before turning was 23.25 and 0.60 mg‧m-2‧h-1 for hermetised and open piles, respectively, while after- 69.38 and 5.11 mg‧m-2‧h-1. The maximum CO net emissions occurred after the compost was turned (1.7x to 13.7x higher than before turning). The top sections of hermetised piles had greater CO emissions compared to sides. Additionally, 5% of measurement points of hermetised piles switched to 'CO sinks'. The 1-h concentration in hermetised composting hall can reach max. ~50 mg CO∙m-3 before turning, and >115 mg CO∙m-3 after, exceeding the WHO thresholds for a 1-h and 15-min exposures, respectively.

Effectiveness of interventions to increase healthcare workers' adherence to vaccination against vaccine-preventable diseases: a systematic review and meta-analysis, 1993 to 2022.

BackgroundVaccination adherence among healthcare workers (HCWs) is fundamental for the prevention of vaccine-preventable diseases (VPDs) in healthcare. This safeguards HCWs' well-being, prevents transmission of infections to vulnerable patients and contributes to public health.AimThis systematic review and meta-analysis aimed to describe interventions meant to increase HCWs' adherence to vaccination and estimate the effectiveness of these interventions.MethodsWe searched literature in eight databases and performed manual searches in relevant journals and the reference lists of retrieved articles. The study population included any HCW with potential occupational exposure to VPDs. We included experimental and quasi-experimental studies presenting interventions aimed at increasing HCWs' adherence to vaccination against VPDs. The post-intervention vaccination adherence rate was set as the main outcome. We included the effect of interventions in the random-effects and subgroup meta-analyses.ResultsThe systematic review considered 48 studies on influenza and Tdap vaccination from database and manual searches, and 43 were meta-analysed. A statistically significant, positive effect was seen in multi-component interventions in randomised controlled trials (relative risk (RR) = 1.37; 95% CI: 1.13-1.66) and in observational studies (RR = 1.43; 95% CI: 1.29-1.58). Vaccination adherence rate was higher in community care facilities (RR = 1.58; 95% CI: 1.49-1.68) than in hospitals (RR = 1.24; 95% CI: 0.76-2.05).ConclusionInterventions aimed at increasing HCWs' adherence to vaccination against VPDs are effective, especially multi-component ones. Future research should determine the most effective framework of interventions for each setting, using appropriate study design for their evaluation, and should compare intervention components to understand their contribution to the effectiveness.

Evaluation of Potential Occupational Exposure and Release of Nanoparticles in Semiconductor-Manufacturing Environments

Occupational exposure to airborne nanoparticles in semiconductor-manufacturing facilities is of growing concern. Currently, comprehensive information regarding atmospheric concentrations, potential origins, and the physical and chemical properties of nanoparticles in these industrial settings is lacking. This study investigated the occurrence of airborne nanoparticles within a semiconductor-research and -manufacturing facility, during both routine operation and maintenance activities. A Scanning Mobility Particle Sizer was used to monitor size-resolved airborne-nanoparticle number concentrations spanning the range of 6 to 220 nm. Breathing zone filter samples were also collected during maintenance processes and underwent subsequent analyses via Transmission Electron Microscopy and Inductively Coupled Plasma Mass Spectrometry, to discover the size, morphology, and chemical composition of the observed nanoparticles. The findings reveal low levels of airborne nanoparticles during routine operations, but maintenance tasks resulted in substantial concentration surges particularly for plasma-enhanced chemical vapor deposition tools with concentrations up to 11,800 particles/cm3. More than 80% of observed particles were smaller than 30 nm. These smallest particles were predominately composed of metals such as iron, nickel, and copper. Moreover, larger particles above 100 nm were also identified, comprising process-related materials such as silicon and indium. Comparative assessment against established mass-based exposure limits did not yield any exceedances. Current exposure limits do not typically consider size though, and the preponderance of small nanoparticles (<30 nm) would warrant a more size-differentiated exposure-risk assessment.

Sustained Culture of Safety After Select Agent Exposure

Abstract Introduction/Objective In January of 2021 our laboratory experienced the occupational exposure of 3 technologists to the select agent Burkholderia pseudomallei due to improper recognition and manipulation outside a biosafety cabinet. Subsequently, an interactive computer module was created to train technologists on timely recognition, followed by a “fake” patient test to evaluate comprehension. In that initial period, 100% compliance and successful recognition was demonstrated. To evaluate sustained compliance and recognition, another wave of evaluation was performed Jan- Dec 2022. Methods/Case Report During the study period several new staff members were hired and demonstrated compliance with completing the computer module. Clinical isolates suspicious for a select agent were reported to the Medical Director on rounds daily and reviewed for potential exposure, which was defined as manipulation of the suspicious isolate outside of the biosafety cabinet. Additional challenge “fake” patients were circulated. Results (if a Case Study enter NA) During the study period, 16 isolates were deemed suspicious for select agents based on macroscopic and microscopic morphology and biochemical reactions. Of these, 0 resulted in laboratory exposures. Of the challenge isolates, 1 resulted in a near-miss potential for exposure due to the lack of recognition of macroscopic characteristics. Conclusion The use of an interactive computer module focused around timely recognition and safe handling of potential select agents resulted in sustained laboratory safety and avoidance of potential occupational exposures.

COVID-19 Testing Among Out-of-Hospital Cardiac Arrest Patients: Implications for Public Health

Objective The objective of this study was to compare COVID-19 test positivity among out-of-hospital cardiac arrest patients whose resuscitative efforts were terminated in the field with the surrounding community. Methods This was a retrospective cohort study of out-of-hospital cardiac arrest patients for whom unsuccessful resuscitative efforts were terminated in the field. Emergency medical services (EMS) personnel obtained postmortem COVID-19 nasal swab specimens from these patients between July 1, 2020 and February 28, 2022 to facilitate patient contact tracing and awareness of potential occupational exposure. A chi-square (n-1) was used to compare test result proportions between cardiac arrest patients and the community at large. A Pearson correlation was used to correlate test positivity among the two groups. Results EMS personnel obtained postmortem specimens from 648 cardiac arrest patients; 20 (3.1%) were inconclusive. Of the 628 specimens successfully tested, 69 (11.0%) were positive, and 559 (89.0%) were negative. Monthly positivity ranged from 0.0% to 34.0%. For the community at large, overall test positivity during the same period was 5.1%, with a monthly range from 0.4% to 15.2%. Overall, expired and tested cardiac arrest patients had 5.9% (95%CI 3.68 − 8.59) greater COVID-19 test positivity than the general community. There was significant correlation in monthly positivity rates between the groups (r = 0.778, p < .001, 95%CI0.51 − 0.91). Conclusions Compared to the general population, COVID-19 was over-represented among EMS cardiac arrest patients who died in the field. Postmortem testing by EMS personnel, not typical practice, identified infectious disease cases that would have otherwise gone undetected, indicating potential for future surveillance applications.

Internal exposure risk based on urinary metabolites of PAHs of occupation and non-occupation populations around a non-ferrous metal smelting plant

The emission of various metals from non-ferrous metal smelting activities is well known. However, relative investigations on potential occupational exposure of organic pollutants are still limited. Herein, total of 619 human urine samples were collected from workers engaged in smelting activities and residents living near and/or far from the smelting sites, and ten mono-hydroxylated metabolites of polycyclic aromatic hydrocarbons (OH-PAHs) in human urine were determined. The median levels of Σ10OH-PAHs in smelting workers (25.6 ng/mL) were significantly higher (p < 0.01) than that of surrounding residents (9.00 ng/mL) and rural residents as the control (8.17 ng/mL), indicating an increase in occupational PAH exposure in non-ferrous metal smelting activities. The composition profiles of OH-PAH congeners were similar in three groups, in which naphthalene metabolites accounted for 76–82% of the total. The effects of smoking, drinking, gender, BMI, and occupational categories on urinary OH-PAHs were considered. The partial correlation analysis showed an insignificant effect of non-ferrous metal smelting activities on PAH exposure for surrounding residents. In the health risk assessments, almost all smelting workers had cancer risks exceeded the acceptable level of 10−6. This study provides a reference to occupational PAH exposure and reinforce the necessary of health monitoring among smelting workers.

Workers' exposure to dust and potentially toxic elements during steel cutting in two ship dismantling cases

Ship dismantling is the recommended recycling solution for the end of a ship's life, but the process is not free of occupational risk. Despite proper regulations, there are underlying chemical and physical hazards, mainly due to the cutting of steel parts, which is the core of the recycling process. The overall aim of this research study is to determine, in two case study examples, the ship recycling workers' potential occupational exposure by inhalation of chemical agents generated by the torch cutting process of coated and de-coated steel. This was carried out specifically through (i) monitoring and measuring ship recycling workers' local environment for the inhalable (total dust) and respirable (fine dust) fractions during their working operations, (ii) analysing the heavy metal content of the dust and (iii) calculating and comparing this against occupational exposure limits, (iv) comparing de-coating operations with cutting of coated and de-coated steel. Results of this study show that without further mitigation workers involved in torch cutting processes are at high risk of exposure to heavy metals by inhalation as these are exceeding the norms defined by regulatory bodies.

A Comprehensive Sampling Study on SARS-CoV-2 Contamination of Air and Surfaces in a Large Meat Processing Plant Experiencing COVID-19 Clusters in June 2020.

We aimed to assess SARS-CoV-2 contamination of air and surfaces to gain insight into potential occupational exposure in a large meat processing plant experiencing COVID-19 clusters. Methods: Oro-nasopharyngeal SARS-CoV-2 screening was performed in 76 workers. Environmental samples ( n = 275) including air, ventilation systems, sewage, and swabs of high-touch surfaces and workers' hands were tested for SARS-CoV-2 RNA by real-time quantitative polymerase chain reaction. Results: Twenty-seven (35.5%) of the (predominantly asymptomatic) workers tested positive with modest to low viral loads (cycle threshold ≥ 29.7). Six of 203 surface swabs, 1 of 12 personal air samples, and one of four sewage samples tested positive; other samples tested negative. Conclusions: Although one third of workers tested positive, environmental contamination was limited. Widespread SARS-CoV-2 transmission via air and surfaces was considered unlikely within this plant at the time of investigation while strict COVID-19 control measures were already implemented.

The Relationship Between Potential Occupational Sensitizing Exposures and Asthma: An Overview of Systematic Reviews.

The aim was to identify, appraise, and synthesize the scientific evidence of the relationship between potential occupational sensitizing exposures and the development of asthma based on systematic reviews. The study was conducted as an overview of systematic reviews. A systematic literature search was conducted for systematic reviews published up to 9 February 2020. Eligibility study criteria included persons in or above the working age, potential occupational sensitizing exposures, and outcomes defined as asthma. Potential occupational sensitizing exposures were divided into 23 main groups comprising both subgroups and specific exposures. Two reviewers independently selected studies, extracted study data, assessed study quality, and evaluated confidence in study results and level of evidence of the relationship between potential occupational sensitizing exposures and asthma. Twenty-seven systematic reviews were included covering 1242 studies and 486 potential occupational sensitizing exposures. Overall confidence in study results was rated high in three systematic reviews, moderate in seven reviews, and low in 17 reviews. Strong evidence for the main group of wood dusts and moderate evidence for main groups of mites and fish was found. For subgroups/specific exposures, strong evidence was found for toluene diisocyanates, Aspergillus, Cladosporium, Penicillium, and work tasks involving exposure to laboratory animals, whereas moderate evidence was found for 52 subgroups/specific exposures. This overview identified hundreds of potential occupational sensitizing exposures suspected to cause asthma and evaluated the level of evidence for each exposure. Strong evidence was found for wood dust in general and for toluene diisocyanates, Aspergillus, Cladosporium, Penicillium, and work tasks involving exposure to laboratory animals.

Characterizing Nanoparticle Release Patterns of Laser Powder Bed Fusion in Metal Additive Manufacturing: First Step Towards Mitigation Measures.

Laser Powder Bed Fusion (L-PBF) is a well-known Additive Manufacturing (AM) technology with a wide range of industrial applications. Potential occupational exposures to metal nanoparticles (NP) as by-products could occur in these processes, and no cogent occupational exposure limits are available. To contribute to this assessment, a monitoring campaign to measure the NP release pattern in two metal L-PBF facilities was carried out in two academic laboratories adopting L-PBF technology for research purposes. The monitored processes deal with two devices and three feedstock types, namely stainless steel (AISI 316L), aluminium-silicon alloy (A357) and pure copper, which are associated with different levels of industrial maturity. Prolonged environmental and personal real-time monitoring of NP concentration and size were performed, temperature and relative humidity were also measured during environmental monitoring. The measurements reveal a controlled NP release of the monitored processes, resulting in an average reduced exposure of the operators during the whole working shift, in compliance with proposed limit values (20 000 n cm-3 for density >6000 kg m-3 or 40 000 n cm-3 for density <6000 kg m-3). Nonetheless, the monitoring results show release events with an increase in NP concentration and a decrease in NP size corresponding with several actions usually performed during warm-up and cleaning, leading to exposures over 40-50 000 n cm-3 during a considerable time interval, especially during the manufacturing of pure copper powder. The results show that the actions of the operators, boundary conditions (relative humidity) and set-up of the L-PBF device have an impact on the amount of NP released and their size. Several release events (significant increase in NP concentration and decrease in NP size) are identified and associated with specific job tasks of the workers as well as building conditions. These results contribute to the definition of NP release benchmarks in AM processes and provide information to improve the operational conditions of L-PBF processes as well as safety guidelines for operators.

A Clinician's Guide to Occupational Exposures in the Military.

Adverse occupational and environmental exposures are common causes of respiratory disease and health consequences requiring medical care. Understanding how these various exposures affect patients and how to elicit an adequate history is critical for any clinician. Military personnel are often overlooked when discussing groups at risk for environmental exposure-associated airway disease. There are close to 20 million active duty and veterans in the USA, and nearly all clinicians will at some point care for a patient that has served in the military. Exposures related to military work include burn pits, chemicals/toxins, sandstorms, and living conditions. Burn pits and military waste are increasingly recognized as potential hazards attributed to the ongoing conflicts in the Middle East. The link between these various military exposures and acute or chronic airway diseases remains difficult. Epidemiological studies are emerging to demonstrate correlations with chronic lung disease and prolonged burn pit exposure. This review provides an overview of potential occupational and environmental exposures that may affect current and/or former military service men and women.

A generic scenario analysis of end-of-life plastic management: Chemical additives

Plastic growing demand and the increment in global plastics production have raised the number of spent plastics, out of which over 90% are either landfilled or incinerated. Both methods for handling spent plastics are susceptible to releasing toxic substances, damaging air, water, soil, organisms, and public health. Improvements to the existing infrastructure for plastics management are needed to limit chemical additive release and exposure resulting from the end-of-life (EoL) stage. This article analyzes the current plastic waste management infrastructure and identifies chemical additive releases through a material flow analysis. Additionally, we performed a facility-level generic scenario analysis of the current U.S. EoL stage of plastic additives to track and estimate their potential migration, releases, and occupational exposure. Potential scenarios were analyzed through sensitivity analysis to examine the merit of increasing recycling rates, using chemical recycling, and implementing additive extraction post-recycling. Our analyses identified that the current state of plastic EoL management possesses high mass flow intensity toward incineration and landfilling. Although maximizing the plastic recycling rate is a reasonably straightforward goal for enhancing material circularity, the conventional mechanical recycling method requires improvement because major chemical additive release and contamination routes act as obstacles to achieving high-quality plastics for future reuse and should be mitigated through chemical recycling and additive extraction. The potential hazards and risks identified in this research create an opportunity to design a safer closed-loop plastic recycling infrastructure to handle additives strategically and support sustainable materials management efforts to transform the US plastic economy from linear to circular.

CN32 Cancer nurses' experiences and perceptions of potential occupational exposure to cytotoxic drugs: Systematic review utilising framework analysis

In the UK control of substances Hazardous to Health Regulations (COSHH) define chemotherapy as a hazardous substance. Therefore, it is imperative that employers assess the risk and take suitable precautions for their employees. The ‘Safe Handling of Cytotoxic Drugs in the workplace’ recommends a hierarchy of protection; closed systems and personal protection equipment (PPE) to reduce the exposure to cytotoxic drugs. In the UK, closed systems are not mandatory, and the evidence base for use is inconclusive.

Evaluation of Face Shields, Goggles, and Safety Glasses as a Virus Transmission Control Measure to Protect the Wearer Against Cough Droplets.

Face shields (also referred to as visors), goggles and safety glasses have been worn during the COVID-19 pandemic as one measure to control transmission of the virus. However, their effectiveness in controlling facial exposure to cough droplets is not well established and standard tests for evaluating eye protection for this application are limited. A method was developed to evaluate face shields, goggles, and safety glasses as a control measure to protect the wearer against cough droplets. The method uses a semi-quantitative assessment of facial droplet deposition. A cough simulator was developed to generate droplets comparable to those from a human cough. The droplets consisted of a UV fluorescent marker (fluorescein) in water. Fourteen face shields, four pairs of goggles and one pair of safety glasses were evaluated by mounting them on two different sizes of breathing manikin head and challenging them with the simulated cough. The manikin head was positioned in seven orientations relative to the cough simulator to represent various potential occupational exposure scenarios, for example, a nurse standing over a patient. Droplet deposition in the eyes, nose and mouth regions were visualised following three ‘coughs’. Face shields, goggles, and safety glasses reduced, but did not eliminate exposure to the wearer from droplets such as those produced by a human cough. The level of protection differed based on the design of the personal protective equipment and the relative orientation of the wearer to the cough. For example, face shields, and goggles offered the greatest protection when a cough challenge was face on or from above and the least protection when a cough challenge was from below. Face shields were also evaluated as source control to protect others from the wearer. Results suggested that if a coughing person wears a face shield, it can provide some protection from cough droplets to those standing directly in front of the wearer.

Socio-Demographic Composition and Potential Occupational Exposure to SARS-CoV2 under Routine Working Conditions among Key Workers in France.

This study aims to describe the socio-demographic profile of so-called “key workers” during the first lockdown in France and to assess their potential occupational exposure to SARS-CoV-2 under routine, pre-pandemic working conditions. We used the French list of essential jobs that was issued during the first lockdown to identify three subgroups of key workers (hospital healthcare, non-hospital healthcare, non-healthcare). Based on the population-based “Conditions de travail-2019” survey, we described the socio-demographic composition of key workers and their potential work-related exposures (to “infectious agents,” “face-to-face contact with the public,” and “working with colleagues”) using modified Poisson regression. In general, women, clerical and manual workers, workers on temporary contracts, those with lower education and income, and non-European immigrants were more likely to be key workers, who accounted for 22% of the active population. Non-healthcare essential workers (57%) were the most socially disadvantaged, while non-hospital healthcare workers (19%) were polarized at both extremes of the social scale; hospital healthcare workers (24%) were intermediate. Compared to non-key workers, all subgroups had greater exposure to infectious agents and more physical contact with the public. This study provides evidence of accumulated disadvantages among key workers concerning their social background, geographical origin, and potential SARS-CoV-2 exposure.