Use Of Respiratory Protective Equipment Research Articles

Self-reported exposure to dust and diesel exhaust, respiratory symptoms, and use of respiratory protective equipment among Arctic miners

ABSTRACT Arctic miners face significant risks from diesel exhaust and dust exposure, potentially leading to adverse respiratory health. Employers must limit harmful exposures, using personal protective equipment (PPE) as a last line of defense. This study explored the association between reported respiratory exposure and symptoms, and PPE training and usage. Data from the MineHealth study (2012–2014) included a total of 453 Arctic open pit miners in Norway, Sweden, and Finland. Participants answered questions on exposure to dust and diesel exhaust, respiratory symptoms, and PPE use, in addition to age, gender, BMI, smoking, and self-rated health. Estimated exposure to dust was common, reported by 91%, 80%, and 82% and that of diesel exhaust by 84%, 43%, and 47% of workers in Sweden, Finland, and Norway, respectively. Reported dust exposure was significantly related to respiratory symptoms (OR 2.2, 95% CI 1.3–3.7), diesel exposure increased the occurrence of wheezing (OR 2.6, 95% CI 1.3–5.4). PPE use varied between the studied mines. Non-use was common and related to reduced visibility, wetness, skin irritation and fogging of the respiratory PPE. Future research should employ more precise exposure assessment, respiratory function as well as explore the reasons behind the non-compliance of PPE use.

Welding fume exposure and prevalence of chronic respiratory symptoms among welders in micro- and small-scale enterprise in Akaki Kality sub-city, Addis Ababa, Ethiopia: a comparative cross-sectional study.

Exposure to welding fumes can lead to different respiratory health disorders, including lung cancer, due to long-term exposures. In Ethiopia, large numbers of people are engaged in the welding sector. Often, these workers are exposed to welding fumes at their workplaces, however, the level of exposure and its health effects have never been studied. To measure the level of personal welding fume exposure and assess chronic respiratory symptoms and associated factors, among micro and small-scale enterprise metal workshop workers, in Akaki Kality Sub city, Ethiopia. A comparative cross-sectional study involving 226 welders and 217 controls. Chronic respiratory symptoms were assessed using a standardized questionnaire adopted from the American Thoracic Society (ATS). Welding fumes were collected from the welder's breathing zone using 37mm close-faced plastic cassettes fitted with Polyvinyl Chloride (PVC) filters connected to Casella pumps at an airflow rate of 2L/min. The overall prevalence of chronic respiratory symptoms among welders and controls were 54 (23.9%) and 20 (9.2%) respectively. The geometric mean and geometric standard deviation (GSD) of personal welding fume exposure, among welders was 5.98 mg/m3 (± GSD = 1.54). In this study, 53.3% of the samples exceeded the Occupational Exposure Limit defined by the American Conference of Governmental Industrial Hygiene. Chronic respiratory symptoms were significantly associated with educational status (Adjusted Odds Ratio (AOR): 5.11, 95% CI: 1.35, 19.33), respiratory protective equipment use (AOR: 3.33, 95% CI: 1.52, 7.31), safety training (AOR: 2.41, 95% CI: 1.10, 5.28), smoking (AOR:3.57, 95% CI: 1.54, 8.23), welding machine maintenance (AOR: 1.87, 95% CI: 1.01, 3.59) and welding site (i.e. indoors vs. outdoor) (AOR: 6.85. 95% CI: 2.36, 19.89). The prevalence of chronic respiratory symptoms among welding workers was significantly higher than controls. More than half of the samples exceeded the Occupational Exposure Limit. Educational status, implementation of safety training, and welding sites were significantly associated with chronic respiratory symptoms. The results suggested a need to reduce welding fume exposure to improve the respiratory health of the workers.

Use, failure, and non-compliance of respiratory personal protective equipment and risk of upper respiratory tract infections-A longitudinal repeated measurement study during the COVID-19 pandemic among healthcare workers in Denmark.

Upper respiratory tract infections (URTI) are common and a common cause of sick-leave for healthcare workers, and furthermore pose a threat especially for patients susceptible to other diseases. Sufficient use of respiratory protective equipment (RPE) may protect both the workers and the patients. The COVID-19 pandemic provided a unique opportunity to study the association between use of RPE and URTI in a real-life setting. The aim of this study was to examine if failure of RPE or non-compliance with RPE guidelines increases the risk of non-COVID-19 URTI symptoms among healthcare workers. In a longitudinal cohort study, we collected self-reported data daily on work tasks, use of RPE, and URTI symptoms among healthcare workers with patient contact in 2 Danish Regions in 2 time periods during the COVID-19 pandemic. The association between failure of RPE or non-compliance with RPE guidelines and URTI symptoms was analyzed separately by generalized linear models. Persons tested positive for severe acute respiratory syndrome coronavirus 2 were censored from the analyses. The 2 waves of data collection were analyzed separately, as there were differences in recommendations of RPE during the 2 waves. We found that for healthcare workers performing work tasks with a risk of transmission of viruses or bacteria, failure of RPE was associated with an increased risk of URTI symptoms, RR: 1.65[0.53-5.14] in wave 1 and RR: 1.30[0.56-3.03] in wave 2. Also non-compliance with RPE guidelines was associated with an increased risk of URTI symptoms compared to the use of RPE in wave 1, RR: 1.28[0.87-1.87] and wave 2, RR: 1.39[1.01-1.91]. Stratifying on high- versus low-risk tasks showed that the risk related to failure and non-compliance was primarily associated with high-risk tasks, although not statistically significant. The study was conducted during the COVID-19 pandemic and thus may be affected by other preventive measures in society. However, this gave the opportunity to study the use of RPE in a real-life setting, also in departments that did not previously use RPE. The circumstances in the 2 time periods of data collection differed and were analyzed separately and thus the sample size was limited and affected the precision of the estimates. Failures of RPE and non-compliance with RPE guidelines may increase the risk of URTI, compared to those who reported use of RPE as recommended. The implications of these findings are that the use of RPE to prevent URTI could be considered, especially while performing high-risk tasks where other prevention strategies are not achievable.

Health and Safety Executive research on wood dust exposure controls in British manufacturing.

To generate new intelligence on occupational exposure to wood dust in woodworking manufacturing activities in Britain, the Health and Safety Executive (HSE) performed 22 occupational hygiene site visits to assess exposure and exposure controls between 2014 and 2017. The work aimed to characterise good practice and therefore sites with a poor health and safety record, as identified from HSE inspection records, were not invited to participate. Sites selected covered furniture production, joinery, saw milling, and boat building and repair. Twenty-three follow-up telephone interviews were also carried out across 15 of the companies with supervisors and managers to explore how they tried to promote good practice among the workforce, and if there are any potential challenges encountered. The aim of the interviews was to gain a better understanding of how to enable organisations to improve the management of wood dust exposure. This study found that 6.0% of all wood dust exposure measurements (15 out of 252) were above 5 mg/m³, and 17.6% of exposures to hardwood dust or mixtures of hardwood and softwood dust (38 out of 216) were above 3 mg/m³ (the then current and future workplace exposure limits). Sanding, cleaning, and maintenance activities were of particular concern. Improvements to exposure controls are required, in particular, improvements to local exhaust ventilation controls for hand-held power tools and hand sanding. The management, selection, and use of respiratory protective equipment were poor. All the managers and supervisors recognised that exposure to wood dust can pose serious health risks, and that controls were crucial to protecting workers' health. The findings from the telephone interviews suggest that supervision and provision of information about the health effects of exposure to wood dust were common approaches that organisations used to raise awareness and promote good practice, in relation to managing wood dust exposure. Worker attitudes towards controls, such as perceptions that they hinder task completion and habitual ways of working, were identified as factors influencing the use of controls. Risk communication approaches that focus on increasing workers' awareness of their susceptibility to ill-health using credible sources, such as peers, can help enhance the uptake of messages on the use of controls. Financial constraints were identified as a challenge to improving the control of wood dust, particularly for small companies.

The use of respiratory protective equipment redefines breathing zone and increases inhalation exposure of self-exhaled pollutants

The size of the breathing zone influenced by respiratory protective equipment (RPE) plays an important role in evaluating inhalation exposure (self-exhaled and external pollutants). The objective of this study was to define this size and evaluate the inhalation exposure of self-exhaled pollutants. The flow characteristics of ten types of RPE were experimentally investigated to obtain boundary conditions for Computational Fluid Dynamics (CFD) simulations. The CFD modeling framework of RPE was established and validated scientifically with experimental data, which was used to investigate the time-series characteristics of the thermo-fluid parameters inside and outside the RPE, the size of the breathing zone, and the influence of RPE on inhalation exposure. The results show that the range of viscous resistance and inertial resistance coefficients were 5.13 × 108–4.35 × 1010 and 1.42 × 105–7.62 × 105, respectively, for different types of RPE. The time-area averaged temperature and relative humidity inside the N95 mask would be up to 29.8 °C and 63.3 %, respectively, causing discomfort and possibly health problems. The breathing zone of an RPE wearer can be roughly defined as a hemisphere region with a radius of 11 cm around the mouth. Wearing RPE would lead to excessive inhalation exposure, with 36.5–59.8 % of the exhaled pollutants being re-inhaled. The time-averaged oxygen content in inhaled air would decrease from 21 % to 18.0–19.2 %, implying that long-term wearing RPE may impair the wearer's well-being. The data obtained provide boundary conditions for CFD simulation of different types of RPE, and give guidance for monitoring inhalation exposure and improving RPE.

Nurses' Knowledge, Perceptions and Practices Regarding the Use of Respiratory Protective Equipment during the Coronavirus Pandemic

Background: Nurses are at high risk of several respiratory hazards comprising respiratory pathogens. So, respiratory protective equipment (RPE) are vital to protect nurses from novel coronavirus (2019-nCoV) outbreak. Purpose: The current study aimed to examine the knowledge level, practice and perceptions among nurses in a specialized cancer center using RPE. Methods: A descriptive study design was used. The Occupational Safety and Health Administration Questionnaire was utilized to collect data. The data was collected from 387 nurses working at a specialized cancer center as a convenience sampling technique. Results: An overall number of 387 staff nurses participated in the study. The majority of nurses had moderate knowledge levels, where the mean total score of nurses' knowledge was 12.98, with a range between 4 and 20. Also, the majority of nurses had good perceptions regarding the use of RPE (Total mean= 30.44, SD= 3.62). Regarding practice, most of the nurses wash their hands after contact with the outer surface of the respirator (F= 357, 92.2%). Conclusion: The good nurses' knowledge and perceptions regarding RPE's use were sufficient to provide an adequate practice level. However, implementing the RPE policy in hospitals could be useful to enhance the nurses' and other healthcare workers' knowledge, perceptions and practice regarding RPE. Implications for Nursing: Good practices are a crucial element in respiratory safety and nurses' protection against their place of work respiratory hazards. Keywords: 2019-nCoV, Nurses, Knowledge, Perceptions, Practice, Respiratory protective equipment

52 Use of Exposure Data to Evaluate the Impact of the Boelv on Industry Practices; case Study ASW/RCF.

Abstract This study assesses the impact of the 0.3f/ml BOELV for aluminosilicate wools/refractory ceramic fibres (ASW/RCF), as implemented in 2020, on exposure levels at industrial sites. Now in its 26th year, CARE/PSP is the European programme collecting representative data for occupational exposure to airborne fibrous dust. With the changing regulatory landscape, CARE participants conducted a review of the data, focusing on evidence of reduced exposure or changed industrial practices since 2017 when the BOELV was first introduced. The data was split pre- and post- 2017 and also compared to alkaline earth silicate wool (AES/LBP) which is not classified and thus not covered by the BOELV, to consider the impact on exposure. An independent third-party statistician extracted the relevant data for this study. There are significant differences in workplace exposure among functional job categories (FJCs), since the introduction of the BOELV there has been a reduction in exposure, greater use of alternative AES/LBP and move to increased use of respiratory protective equipment (RPE) across all FJCs where ASW/RCF is being used. The data review for the period 2017-2021 has demonstrated an overall reduction in fibre exposure at both manufacturers and users’ facilities. The introduction of the BOELV for ASW/RCF has led to a greater awareness of the need to control fibrous dust. An increased uptake in the use of RPE and the use of RPE with higher protection factor is observed. There also appeared to be a move to alternative non-classified HTIW where appropriate.

Protocol of a prospective comprehensive evaluation of an elastic band beard cover for filtering facepiece respirators in healthcare.

Individuals who are unable to be clean shaven for religious, medical or cultural reasons are unable to wear a filtering facepiece respirator (FFR), as the respirator cannot provide adequate protection against aerosol-transmissible diseases. There is currently a paucity of validated techniques to ensure the safe inclusion of bearded healthcare workers in the pandemic workforce. We propose to undertake a healthcare-based multi-modal evaluation study on the elastic band beard cover for FFR technique, examining the quantitative fit test (QNFT) results, usability and skill level of participants with repeated assessments over time. This is a prospective study conducted through the Respiratory Protection Program at the Royal Melbourne Hospital. Healthcare workers are invited to participate if they require respiratory protection and cannot shave for religious, cultural or medical reasons. An online education package on the use of respiratory protective equipment and the elastic band beard cover for FFR technique is provided. This is followed by a face-to-face session, where the participant will receive: one-on-one training; undergo a skill assessment on their donning, doffing and user seal check techniques; complete QNFTs and a usability survey. Participants will be invited to repeat the assessment within 3 months of the first session and at 12 months. This study involves multimodal and repeated assessments of an elastic band beard cover for FFRs. The findings of this study will provide information on: whether this simple technique can provide safe, consistent and effective respiratory protection; whether it will interfere with occupational activities; and whether it is comfortable and tolerable for the duration of wear. This is of significant importance to the health workforce around the world, who cannot shave but require access to respiratory protective equipment during the COVID-19 pandemic.

Use of Respiratory Protective Equipment during and after Lifting of Public Health Restrictions due to the COVID-19 Pandemic

Introduction: The COVID-19 pandemic has shown the importance of non-specific measures of infectious disease prevention, including the use of respiratory protective equipment. Despite the improvement in the epidemiological situation and gradual lifting of public health restrictions, some people keep wearing face masks. Objective: To analyze the use of respiratory protective equipment in accordance with COVID-19 face mask requirements and after the end of the mask mandate among medical students in Moscow. Materials and methods: The questionnaire-based survey was conducted in two stages in March 2021 and in March–April 2022 among 988 and 830 third year students of the Institute of Clinical Medicine, Sechenov University, respectively, to collect data on socio-demographic characteristics, the practice of wearing face masks in public places, and the incentives to use them. The observational study was carried out in March 2022 among 816 Russian and 96 foreign students by counting those wearing face masks in the classrooms. Results: We established that 97.5 % of the respondents used respiratory protective equipment during the period of restrictive public health measures. The main reasons for doing that were a mask mandate due to coronavirus and the necessity of personal contacts with other people. The survey showed that masks were most often used in health facilities, supermarkets, pharmacies, subway, and at the university. During the first two weeks after abolishing mandatory wearing of face masks, 18.3 % of all the respondents continued their use, mainly out of concern for other people’s health, of whom 9.9 % and 89.6 % were Russian and foreign medical students, respectively. The second survey demonstrated that 7.2 % of the Russian medical students kept wearing masks in some settings later on. In case of yet another increase in the COVID-19 incidence, 97.6 % of the respondents intend to use respiratory protective equipment and 74.7 % of them plan to recommend this preventive measure to their relatives. Conclusions: Medical students continue using respiratory protective equipment after the restrictions are lifted, mainly to protect others.

Second-hand Smoke Exposure Among Home Care Workers (HCWs) in Scotland.

Second-hand tobacco smoke (SHS) is a serious cause of ill-health, and concern around SHS exposure at work has driven legislation in public places. In Scotland, most workers are now protected from SHS at work. However, home care workers (HCWs) may still be exposed, as they enter private homes where smoking is unregulated. In this study, we aimed to understand the extent, duration and intensity of that exposure among HCWs in Lanarkshire, Scotland. We surveyed HCWs in four organisations involved in providing care at home: a public healthcare agency (NHS Lanarkshire), two local government entities and a private healthcare company. We also conducted personal exposure monitoring (PEM) of exposure to airborne nicotine and SHS-related fine particulate matter (PM2.5) with 32 HCWs. The vast majority of HCWs surveyed reported being exposed to SHS at work (395/537, 74%), and 50% of those who reported exposure in the home indicated daily exposure. We conducted PEM over 82 home visits, with 21% (17) demonstrating PM2.5 concentrations in excess of the WHO's 2010 air quality guideline limit for 24 h exposure. Duration of exposure to SHS tended to be short and as a result all nicotine samples were below the limit of quantification. Most HCWs are exposed to minimal levels of SHS at work. However, a minority may be exposed to concentrations which affect health. Policies to mitigate this exposure should be considered, such as the use of respiratory protective equipment, improved ventilation during visits, and interventions to reduce smoking in homes.

Cross-sectional Study of Workers Employed at a Copper Smelter-Effects of Long-term Exposures to Copper on Lung Function and Chronic Inflammation.

The aim of the study was to assess the effect of exposure to copper-containing dust on lung function and inflammatory endpoints among workers of a German copper plant, effects rarely studied before. One hundred four copper-exposed smelter workers and 70 referent workers from the precious metal and lead facilities were included, with different metal exposures in both groups due to the different process materials. Body plethysmography, exhaled nitric oxide (FeNO) measurements, and blood sampling were conducted in all workers. Smoking status and the use of respiratory protective equipment were considered. In a subgroup of 40 nonsmoking volunteers (28 copper-exposed and 12 referents), sputum biomarkers were assessed. Median lung function values of both copper-exposed and the referent groups were within reference ranges of "healthy" individuals, and statistical differences between the groups were mostly not evident. Similarly, differences in blood and sputum biomarkers were too small to be biologically relevant. The results suggest the absence of the detectable effects of copper-containing dust exposure on lung function or chronic inflammation within the investigated cohort.

Anaesthetists' current practice and perceptions of aerosol-generating procedures: a mixed-methods study.

SummaryThe evidence base surrounding the transmission risk of ‘aerosol‐generating procedures’ has evolved primarily through quantification of aerosol concentrations during clinical practice. Consequently, infection prevention and control guidelines are undergoing continual reassessment. This mixed‐methods study aimed to explore the perceptions of practicing anaesthetists regarding aerosol‐generating procedures. An online survey was distributed to the Membership Engagement Group of the Royal College of Anaesthetists during November 2021. The survey included five clinical scenarios to identify the personal approach of respondents to precautions, their hospital's policies and the associated impact on healthcare provision. A purposive sample was selected for interviews to explore the reasoning behind their perceptions and behaviours in greater depth. A total of 333 survey responses were analysed quantitatively. Transcripts from 18 interviews were coded and analysed thematically. The sample was broadly representative of the UK anaesthetic workforce. Most respondents and their hospitals were aware of, supported and adhered to UK guidance. However, there were examples of substantial divergence from these guidelines at both individual and hospital level. For example, 40 (12%) requested respiratory protective equipment and 63 (20%) worked in hospitals that required it to be worn whilst performing tracheal intubation in SARS‐CoV‐2 negative patients. Additionally, 173 (52%) wore respiratory protective equipment whilst inserting supraglottic airway devices. Regarding the use of respiratory protective equipment and fallow times in the operating theatre: 305 (92%) perceived reduced efficiency; 376 (83%) perceived a negative impact on teamworking; 201 (64%) were worried about environmental impact; and 255 (77%) reported significant problems with communication. However, 269 (63%) felt the negative impacts of respiratory protection equipment were appropriately balanced against the risks of SARS‐CoV‐2 transmission. Attitudes were polarised about the prospect of moving away from using respiratory protective equipment. Participants' perceived risk from COVID‐19 correlated with concern regarding stepdown (Spearman's test, R = 0.36, p < 0.001). Attitudes towards aerosol‐generating procedures and the need for respiratory protective equipment are evolving and this information can be used to inform strategies to facilitate successful adoption of revised guidelines.

Implementation Evaluation of a Cluster Randomized Controlled Trial to Promote the Use of Respiratory Protective Equipment Among Migrant Workers Exposed to Organic Solvents in Small and Medium-Sized Enterprises.

BackgroundWhile the effectiveness of several occupational healthcare interventions has been demonstrated, successful implementation of such programs among internal migrant workers (IMWs) in small and medium-sized enterprises (SMEs) has been limited. This study aimed to evaluate the implementation of a three-arm cluster randomized controlled trial promoting respiratory protective equipment (RPE) use among IMWs exposed to organic solvents in SMEs and to assess the association between participants' compliance and effectiveness of intervention.MethodsA total of 60 SMEs were randomly allocated to a low- or high-intensive intervention group, or a control group that did not receive any intervention. The low-intensive intervention group was subjected to both traditional and mHealth occupational health education. The high-intensive intervention group was subjected to the low-intensive group activities and peer education. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to guide implementation evaluation of this 6-months intervention. Generalized linear mixed models (GLMMs) were used to evaluate the effects of participants' compliance with the intervention on the primary outcomes, regarding the appropriate use of RPE.ResultsOf 4,527 potentially eligible participants, 1,211 individuals were enrolled, with a reach rate of 26.8%. Sixty of the 66 SMEs approached (90.9%) SMEs adopted the intervention. Fidelity to traditional education (100.0%) and mHealth intervention (97.5%) was higher than fidelity to peer education (20.0%). Peer leaders cited inconvenient time and unfamiliarity with peers as two major barriers to delivering peer education. Compared with the control group, IMWs who complied with the interventions in both groups were more likely to wear RPE appropriately [low-intensive group: adjusted odds ratio (aOR) = 2.58, 95% confidence interval (CI): 1.56–4.28; high-intensive group: aOR = 7.52, 95% CI: 3.72–15.23]. Most participants (95.8%) were satisfied with the program and 93.1% stated that they would maintain the use of RPE in the future.ConclusionsA multi-component occupational health intervention to promote the use of RPE among IMWs in SMEs was feasible and acceptable. Peer education had great potential to enhance the occupational health behavior of IMWs, and thus strategies to improve participants' adherence to this component warrant further investigation.Clinical Trial Registrationhttp://www.chictr.org.cn, identifier: ChiCTR-IOR-15006929.

Pneumokokkenvaccinatie en lassers: als de rook om je hoofd is verdwenen

Pneumococcal vaccination and welders: when the smoke dissipates… Although pneumococcal disease is a major cause of morbidity and mortality, it is a rare disease in the working population. Since several decades, exposure to metal fumes is known to increase the risk of lobar pneumonia among an important occupational group, namely welders and metal workers. The theory is that metal fume alters the bacterial properties and/or the worker’s ability to withstand infection. The exact mechanisms are, however, still unclear. Outbreaks of invasive pneumococcal disease (IPD) caused by the siderophilic, gram-positive bacterium Streptococcus pneumoniae have been quite rare. However, several outbreaks have been reported at Finnish, French, Northern Irish, Norwegian, Singaporean and Swedish shipyards since 2015. Shipyard workers might have a higher risk of developing IPD mainly due to specific environmental factors present at shipyards. Preventive measures may include pneumococcal vaccination, improved ventilation, occupational hygiene measures, reinforcement of the proper use of respiratory protective equipment and anti-smoking campaigns. Therefore, targeted pneumococcal vaccination is recommended and should be offered to welders and potentially others with relevant occupational exposure to metal fumes (inorganic dusts) after the for an employer obligated risk assessment. This has been discussed in for example Norway, Sweden and the United Kingdom, but there is a need for increased international awareness of the occupational risk of severe pneumococcal disease.

Urinary Metals as a Marker of Exposure in Men and Women in the Welding and Electrical Trades: A Canadian Cohort Study.

Men and women working in the welding trades undergo the same apprenticeship training but it is unknown whether, once in the trade, their exposures differ. Comparison of urinary metal concentrations, having adjusted for estimated airborne exposure, may provide an answer. Men and women were recruited to a cohort study of workers in the welding and electrical trades (the Workers Health in Apprenticeship Trades-Metal working and Electrical [WHAT-ME study]). They completed a recruitment questionnaire and further questionnaires every 6 months for up to 5 years. At each follow-up, they gave details on employment and, if welding, answered trade-specific questionnaires. Urine samples were collected by mail. Welding exposure matrices were developed to estimate metal exposures from welding process, base metal, and consumables. Urinary metal concentrations, determined by ICP-MS, were compared by trade (welding or electrical). Within welding, the relation of urinary concentrations to estimated airborne exposure was examined, with adjustment for potential confounders including sex, use of respiratory protective equipment (RPE), and time spent outdoors. Natural logarithms were taken of exposure estimates and urinary concentrations, to reduce skew. All regression analyses included creatinine concentration. Urinary metal concentrations were analysed for 12 metals in 794 samples. Antimony, arsenic, lead, and mercury had a high proportion of samples with no metal detected and were not considered further. The urinary concentrations of aluminum, cadmium, chromium, cobalt, copper, manganese, nickel, and zinc were compared for welders (434 samples) and electrical workers (360). After adjustment for potential confounders, welders had higher urinary concentrations for aluminum (β = 0.13 95%CI 0.03-0.24) and chromium (β = 0.66 95%CI 0.55-0.77). Of 434 welder urines, 334 could be matched securely to detailed information about the most recent day welding. For these, an estimate of airborne exposure was made for aluminum, chromium, manganese, and nickel. Male welders were estimated to have higher airborne exposure to chromium and nickel than women welders. No difference was seen in the estimated exposures for aluminum or manganese (or total dust). Regression analyses of the relation of urinary metals to estimated exposure showed a good concordance for aluminum (β = 0.09 95%CI 0.04-0.15 (P < 0.001) and chromium (β = 0.11 95%CI 0.05-0.17 P < 0.001). The concordance for manganese and nickel was positive, but much weaker. Urinary concentrations of aluminum and nickel were somewhat lower with increasing time wearing RPE and, for chromium and nickel, with time working outdoors. Having adjusted for estimated exposure, creatinine and other confounders, male welders had lower urine concentrations of aluminum (β = -0.35 95%CI -0.51 to -0.19 P < 0.001) chromium (β = -0.38 95%CI -0.57 to -0.19 P < 0.001) and manganese (β = -0.36 95%CI -0.49 to -0.23 P < 0.001) than female welders. Welders had higher urinary concentrations of aluminum and chromium than electrical workers. Exposure estimates of aluminum and chromium for welders were a valid representation of the airborne exposures to these metals. Although male welders were estimated to have higher exposures of chrome and nickel than female welders, the higher urinary metal concentrations in women welders is of concern, particularly for women who may conceive while in the trade.

Respiratory Protective Equipment Reconsiderations in the Age of SARS-CoV-2

The use of respiratory protective equipment (RPE) has been recognized as an effective measure to mitigate droplet and airborne transmission of SARS-CoV-2. Although there are various types of RPE available, different RPEs serve different purposes and offer various levels of protection against aerosols. Additionally, recent evidence highlights the role of good fit in ensuring the effectiveness of RPEs. Some modified procedures can enhance the effectiveness of surgical masks by improving fit. In the age of SARS-CoV-2, there is an urgent need for knowledge about RPEs. The correct selection and use of RPEs are of pivotal importance for breaking the transmission chain of SARS-CoV-2.

Nanotextiles — materials suitable for respiratory tract protection but a source of nano- and microplastic particles in the environment

Abstract The paper deals with the formation of nanomaterials (nanoparticles and nanofibers) in the manufacture and use of respiratory protective equipment. It focuses mainly on processes leading to the release of nanoplastics into the workplace and the environment. Based on selected properties of materials used for the manufacture of protective equipment, their stability in the environment is revealed. The paper demonstrates the impact on the environment considering semichronic phytotoxicity of nanoplastics.

Airborne protection for staff is associated with reduced hospital-acquired COVID-19 in English NHS trusts

IntroductionThe rate of hospital-acquired coronavirus disease 2019 has reduced from 14.3% to 4.2% over the last year, but substantial differences still exist between English National Health Service (NHS) hospital trusts.MethodsThis study assessed rates of hospital-acquired infection (HAI), comparing NHS hospital trusts using airborne respiratory protection (e.g. FFP3 masks) for all staff, as a marker of measures to reduce airborne spread, with NHS hospital trusts using mainly droplet precautions (e.g. surgical masks).Results/discussionThe use of respiratory protective equipment was associated with a 33% reduction in the odds of HAI in the Delta wave, and a 21% reduction in the odds of HAI in the Alpha wave (P<0.00001). It is recommended that all hospitals should prioritize airborne mitigation.

Hubungan Praktik Penggunaan APD dan Karakteristik Individu dengan Keluhan Gangguan Pernapasan pada Pemulung di TPA Sanggrahan Kabupaten Temanggung

Sanggrahan landfill is an area used as place to collect solid waste in Temanggung Regency. The existence of a landfill to reduce waste accumulation in the environment, but on the other side a landfill can cause a problem like air pollution caused by waste decomposition. Waste pickers in the landfill have a risk respiratory disorder as a result of exposure to air pollutants. The purpose of this study was to analyze association between the use of personal protective equipment (PPE) and individual characteristics with respiratory disorders on waste pickers at Sanggrahan landfill. The type of this study was an observational analitical using a cross sectional approach. Subjects involved in this reseach were 69 waste pickers and were taken by using total sampling technique. The results showed that there were 68,12% waste pickers suffered complaints of respiratory disorder, the most of them having cough 43,4%, flu 47,8% and fever 27,5%. Chi square analyze showed that there were no association between gender(p=0,464), age (p=0,206), education (p=0,318), and smoking habit (p=0,585) with complaints of respiratory disorder. While, there were association between the working hours (p=0,039), length ofwork(p=0,025), use of PPE(p=0,0019), and the use of respiratory protective equipment (p=0,021) with complaints of respiratory disorder. It is expected that waste pickers can use full PPE such as a hats, long clothes, gloves, foot protection, and standard mask during their working activites or while working in the landfill area.

Consistency between air and biological monitoring for assessing polycyclic aromatic hydrocarbon exposure and cancer risk of workers

BackgroundAtmospheric levels of polycyclic aromatic hydrocarbons (PAHs) have been monitored in many companies since 1940. Because of the use of respiratory protective equipment (RPE) and cutaneous absorption, the measurement of urinary 1-hydroxypyrene (1-OHP), metabolite of pyrene (Pyr), and, more recently, 3-hydroxybenzo[a]pyrene (3-OHBaP), metabolite of benzo[a]pyrene (BaP), has been carried out to assess PAH exposure and estimate health risks. ObjectivesThis study aimed to investigate the agreement between 523 air and biological levels recorded in the Exporisq-HAP database by taking into account the effectiveness of RPE. MethodsThe agreement/consistency between 523 air and biological exposure levels was assessed by estimating and comparing the probability of exceeding French limit values (LVs) for both BaP and 3-OHBaP and ACGIH LV for 1-OHP, respectively. PAH airborne levels (wPAHs) were weighted by an assigned protection factor (APF) depending on the type of mask worn by workers, while urinary 1-OHP concentrations were adjusted with the wBaP/wPyr ratio of each industrial sector (wadj1-OHP). ResultsWithin occupational groups, there was an overall agreement between airborne PAH levels and urinary biomarker concentrations. A clear dichotomy was found between “petroleum-derived” and “coal-derived” groups, with much higher exposures in the latest group despite the use of RPEs by two-thirds of the workers. The type of RPE varied from one plant to another, which underlines the importance of taking into account their effectiveness. The analysis of urinary 3-OHBaP was not relevant for low PAH exposure levels. In addition, this biomarker underdiagnosed the exceedance of LV relative to BaP levels for 6% of “coal-derived” groups. ConclusionsThe use of urinary wadj1-OHP seemed to be more protective to assess the exceedance of LVs than those of urinary 3-OHBaP and air wBaP, but adjustment of the 1-OHP concentration by the BaP/Pyr ratio requires air sampling due to highly variable ratios observed in the studied occupational groups.