Workplace Control Measures Research Articles

Wood dust and asthma.

Review recent developments on asthma associated with wood dust, given the increasing scale of wood handling and processing activities globally. Work in wood industries is associated with a significantly increased risk of respiratory symptoms, rhinitis and asthma. This can be attributed to traditional processing techniques and newer technologies producing complex bioaerosol exposures, which may include chemicals. Meta-analysis studies indicate strong evidence for wood dusts as occupational sensitizers for asthma, but the underlying mechanisms remain poorly understood. The global prevalence of asthma in wood workers ranges between 6-18% and for rhinitis 16-33%. Exposure estimates show wide variation. Risk factors include atopy and exposure to certain wood species, elevated current and cumulative particulate exposures. Future studies should focus on better characterization of wood dust allergens and other bioaerosol components, specific immunoglobulin E responses to different wood species, pathophysiological mechanisms underlying asthma, and modelling dose-response relationships using refined exposure metrics for dust particulate and other bioaerosol components. There is a need for improved health-based international exposure standards and effective workplace control measures to reduce exposures to wood dust particulate (hard and soft woods), endotoxin and β-glucan, to reduce the risks of asthma in wood workers.

Occupational inhalant allergy in food handling occupations.

Review article on recent developments on inhalant food allergens associated with occupational respiratory allergy and asthma. This review has found that occupational inhalant allergy in food handling occupations is a common and recognisable clinical entity (class 3 food allergy) in high-risk food occupations such as bakeries and seafood processing. Aerosolised food proteins from plant or animal food sources, additives and biological food contaminants cause occupational sensitization, rhinitis and asthma. The risk of allergy may be enhanced across the food value chain as a result of food processing techniques including the introduction of new food allergens in the food matrix. Occupational food allergy and asthma can be prevented by improved health-based exposure standards, workplace control measures, education and training activities, and early diagnosis accompanied with exposure reduction. Future studies need to focus on exposure-response studies to establish improved exposure limits especially for flour dust, the relevance of cooked vs raw foods in influencing risk, identifying and characterising major inhalant food allergens accompanied with component resolved diagnostic approaches, and evaluating the effectiveness of interventions for common high-risk food sensitizers causing occupational rhinitis and asthma.

Underascertainment of COVID-19 cases among first responders: a seroepidemiological study

BackgroundProviding frontline support places first responders at a high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.AimsThis study was aimed to determine the anti-SARS-CoV-2 seroprevalence in a cohort of first responders (i.e. firefighters/paramedics), to detect the underascertainment rate and to assess risk factors associated with seropositivity.MethodsWe conducted a serological survey among 745 first responders in Germany during 27 November and 4 December 2020 to determine the anti-SARS-CoV-2 seroprevalence using Elecsys® Anti-SARS-CoV-2 immunoassay (Roche Diagnostics, Mannheim, Germany). As part of the examination, participants were asked to provide information on coronavirus disease 2019 (COVID-19)-like-symptoms, information on sociodemographic characteristics and workplace risk factors for a SARS-CoV-2 infection and any prior COVID-19 infection. Descriptive statistics and logistic regression analysis were performed and seroprevalence estimates were adjusted for test sensitivity and specificity.ResultsThe test-adjusted seroprevalence was 4% (95% CI 3.1–6.2) and the underascertainment rate was 2.3. Of those tested SARS-CoV-2 antibody positive, 41% were aware that they had been infected in the past. Seropositivity was elevated among paramedics who worked in the emergency rescue team providing first level of pre-hospital emergency care (6% [95% CI 3.4–8.6]) and those directly exposed to a COVID-19 case (5% [95% CI 3.5–8.1]). Overall, the seroprevalence and the underascertainment rate were higher among first responders than among the general population.ConclusionsThe high seroprevalence and underascertainment rate highlight the need to mitigate potential transmission within and between first responders and patients. Workplace control measures such as increased and regular COVID-19-testing and the prompt vaccination of all personnel are necessary.

Lung Function Impairment and Workplace Control Measures among Marble Stone Carvers in Sa-Kyin Village, Madayar Township, Myanmar

Introduction: Marble rocks, composed of dust containing calcium carbonate and silica particles, predispose to a higher prevalence of occupational lung diseases. This study aimed to assess workplace control measures and lung function impairment among marble stone carvers.
 Methods: A cross-sectional descriptive study was conducted among 120 marble stone carvers in Sa-Kyin Village, Madayar Township in May 2019. Information about existing control measures in the workplace was assessed using a pre-tested structured questionnaire and participants’ lung function using spirometry. Respirable dust measurements in twelve randomly selected workers were performed by personal air sampling pumps.
 Results: It was found that 9.2% of marble stone carvers used disposable or cloth masks throughout the working time, but no one was found using appropriate devices like respirators. No one reported about regular medical checkup and provision of health education at the workplaces. Spirometry testing showed 55.8% had lung function impairment. Concentrations of respirable dust ranged from 7.19 to 10.13 mg/m3, significantly higher than the recommended Threshold Limit Value (3 mg/m3). In multivariable logistic regression analysis, development of lung function impairment was associated with age [adjusted Odds Ratio (aOR) = 2.84; 95% CI = 1.02,7.91] and use of face mask (aOR = 0.11; 95% CI = 0.01,0.91).
 Conclusion: The working environment was found dusty, and a significant proportion of workers had lung function impairment. It is essential to adopt proper dust control measures in stone carving workplaces. Preventive measures like medical surveillance and health education program are vital to reduce the burdens from occupational lung diseases.

Prevalence of COVID-19 IgG Antibodies in a Cohort of Municipal First Responders.

Although first responders (FRs) represent a high-risk group for exposure, little information is available regarding their risk of coronavirus disease 2019 (COVID-19) infection. The purpose of the current study was to determine the serological prevalence of past COVID-19 infection in a cohort of municipal law enforcement (LE) and firefighters (FFs). Descriptive analysis of a de-identified data reporting Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) immunoglobulin G (IgG), or COR2G, serology results for municipal FRs. As part of the serology process, FRs were surveyed for COVID-19-like symptoms since February 2020 and asked to report any prior COVID-19 nasal swab testing. Descriptive statistics and two-sided Chi Square tests with Yates correction were used to compare groups. Of 318 FRs, 225 (80.2%) underwent serology testing (LE: 163/207 [78.7%]; FF: 92/111 [82.9%]). The prevalence of positive serology for all FRs tested was 3/255 (1.2%). Two LE (1.2%) and one FF (1.1%) had positive serology (P = 1.0). Two hundred and twenty-four FRs responded to a survey regarding prior symptoms and testing. Fifty-eight (25.9%) FRs (44 LE; 14 FFs) reported the presence of COVID-19-like symptoms. Of these, only nine (15.5%) received reverse transcriptase - polymerase chain reaction (RT-PCR) testing; none were positive. Two of the three FRs with positive serology reported no COVID-19-like symptoms and none of these responders had received prior nasal RT-PCR swabs. The overall community positive RT-PCR rate was 0.36%, representing a three-fold higher rate of positive seroprevalence amongst FRs compared with the general population (P = .07). Amongst a cohort of municipal FRs with low community COVID-19 prevalence, the seroprevalence of SARS-CoV-19 IgG Ab was three-fold greater than the general community. Two-thirds of positive FRs reported a lack of symptoms. Only 15.5% of FRs with COVID-19-like symptoms received RT-PCR testing. In addition to workplace control measures, increased testing availability to FRs is critical in limiting infection spread and ensuring response capability.

Methacrylate perspective in current dental practice.

To provide a current perspective concerning dental personnel sensitivity to methacrylate materials. Methacrylate related sensitivity and allergies are currently beyond traditional thoughts concerning denture base resins and methyl methacrylate provisional materials. Methacrylates are now ubiquitous in current dental practice and dental personnel should be aware that dental adhesives contain potent sensitizers that may also cross-sensitize individuals to other methacrylates not experienced. The growing sensitivity to 2-hydroxyethyl methacrylate (HEMA) has been described to be epidemic in nature due to the artificial nail industry with dental patients and dental personnel may be more susceptible to dental methacrylate sensitization. While contact dermatitis remains the most prevalent methacrylate-related clinical presentation, respiratory complications and asthma are increasing associated with methacrylate exposure. While additional personal protective equipment (PPE) is thought to be first protective choice, the National Institute for Occupational Safety and Health (NIOSH) considers PPE overall largely ineffective and should be considered only as a last resort. Dental personnel need to be more aware of methacrylate sources and use workplace control measures to limit methacrylate exposures to both dental personnel and patients. Sensitivity to methacrylate materials is a growing dental workplace major concern and dental personnel should be aware of both the methacrylate content of current materials and the products that contain ingredients with the most sensitization potential.

Prevention of baker's asthma.

Baker's allergy and asthma continue to represent an important contributor of occupational asthma globally. This review identified recent studies related to the prevention of baker's allergy and asthma. Studies with respect to regulatory exposure standards, workplace control measures aimed at reduction of flour dust exposures, surveillance programmes (exposure monitoring, medical surveillance) and workplace information, education and training programmes were identified. Detailed knowledge on risk factors and detection methods to assess exposure and early identification of high-risk workers exist, but workplace control measures remain sub-optimal because they are rarely multifaceted. This is compounded by the lack of health-based exposure standards globally. Exposure level monitoring and medical surveillance are integral to assessing effectiveness of preventive strategies. Triage systems for optimizing the efficiency of medical surveillance programmes show promise, but need replication in different contexts. Future studies need to focus on evaluating the relevance and quantification of peak exposures in increasing risk; developing standardized respiratory questionnaires for medical surveillance; and further exploration of serial fractional exhaled nitric oxide (FeNO) measurements as an adjunct to allergic sensitization for the early identification of baker's asthma and assessing the long-term impact of interventions.

The Australian Work Exposures Study: Prevalence of Occupational Exposure to Formaldehyde.

The aims of this study were to produce a population-based estimate of the prevalence of work-related exposure to formaldehyde, to identify the main circumstances of exposure and to describe the use of workplace control measures designed to decrease those exposures. The analysis used data from the Australian Workplace Exposures Study, a nationwide telephone survey, which investigated the current prevalence and exposure circumstances of work-related exposure to 38 known or suspected carcinogens, including formaldehyde, among Australian workers aged 18-65 years. Using the web-based tool OccIDEAS, semi-quantitative information was collected about exposures in the current job held by the respondent. Questions were addressed primarily at tasks undertaken rather than about self-reported exposures. Of the 4993 included respondents, 124 (2.5%) were identified as probably being exposed to formaldehyde in the course of their work [extrapolated to 2.6% of the Australian working population-265 000 (95% confidence interval 221 000-316 000) workers]. Most (87.1%) were male. About half worked in technical and trades occupations. In terms of industry, about half worked in the construction industry. The main circumstances of exposure were working with particle board or plywood typically through carpentry work, building maintenance, or sanding prior to painting; with the more common of other exposures circumstances being firefighters involved in fighting fires, fire overhaul, and clean-up or back-burning; and health workers using formaldehyde when sterilizing equipment or in a pathology laboratory setting. The use of control measures was inconsistent. Workers are exposed to formaldehyde in many different occupational circumstances. Information on the exposure circumstances can be used to support decisions on appropriate priorities for intervention and control of occupational exposure to formaldehyde, and estimates of burden of cancer arising from occupational exposure to formaldehyde.

The Australian Work Exposures Study: Occupational Exposure to Lead and Lead Compounds.

The aims of this study were to produce a population-based estimate of the prevalence of work-related exposure to lead and its compounds, to identify the main circumstances of exposures, and to collect information on the use of workplace control measures designed to decrease those exposures. Data came from the Australian Workplace Exposures Study, a nationwide telephone survey which investigated the current prevalence and circumstances of work-related exposure to 38 known or suspected carcinogens, including lead, among Australian workers aged 18-65 years. Using the web-based tool, OccIDEAS, semi-quantitative information was collected about exposures in the current job held by the respondent. Questions were addressed primarily at tasks undertaken rather than about self-reported exposures. A total of 307 (6.1%) of the 4993 included respondents were identified as probably being exposed to lead in the course of their work. Of these, almost all (96%) were male; about half worked in trades and technician-related occupations, and about half worked in the construction industry. The main tasks associated with probable exposures were, in decreasing order: soldering; sanding and burning off paint while painting old houses, ships, or bridges; plumbing work; cleaning up or sifting through the remains of a fire; radiator-repair work; machining metals or alloys containing lead; mining; welding leaded steel; and working at or using indoor firing ranges. Where information on control measures was available, inconsistent use was reported. Applied to the Australian working population, approximately 6.3% [95% confidence interval (CI) = 5.6-7.0] of all workers (i.e. 631000, 95% CI 566000-704000 workers) were estimated to have probable occupational exposure to lead. Lead remains an important exposure in many different occupational circumstances in Australia and probably other developed countries. This information can be used to support decisions on priorities for intervention and control of occupational exposure to lead and estimates of burden of cancer arising from occupational exposure to lead.

The Australian Work Exposures Study: Occupational Exposure to Polycyclic Aromatic Hydrocarbons.

The aims of this study were to produce a population-based estimate of the prevalence of work-related exposure to polycyclic aromatic hydrocarbons (PAHs), to identify the main circumstances of exposure and to describe the use of workplace control measures designed to decrease those exposures. The analysis used data from the Australian Workplace Exposures Study, a nationwide telephone survey which investigated the current prevalence and exposure circumstances of work-related exposure to 38 known or suspected carcinogens, including PAHs, among Australian workers aged 18-65 years. Using the web-based tool OccIDEAS, semi-quantitative information was collected about exposures in the current job held by the respondent. Questions were addressed primarily at tasks undertaken rather than about self-reported exposures. Of the 4,993 included respondents, 297 (5.9%) were identified as probably being exposed to PAHs in their current job [extrapolated to 6.7% of the Australian working population-677 000 (95% confidence interval 605 000-757 000) workers]. Most (81%) were male; about one-third were farmers and about one-quarter worked in technical and trades occupations. In the agriculture industry about half the workers were probably exposed to PAHs. The main exposure circumstances were exposure to smoke through burning, fighting fires or through maintaining mowers or other equipment; cleaning up ash after a fire; health workers exposed to diathermy smoke; cooking; and welding surfaces with a coating. Where information on control measures was available, their use was inconsistent. Workers are exposed to PAHs in many different occupational circumstances. Information on the exposure circumstances can be used to support decisions on appropriate priorities for intervention and control of occupational exposure to PAHs, and estimates of burden of cancer arising from occupational exposure to PAHs.

0162 Prevalence of occupational exposure to lead in Australia

ObjectivesTo determine the prevalence of work-related exposure to lead, the main circumstances of work-related exposure to lead in the general workforce, and the use of workplace control measures designed to...

P205 21 years of SHIELD: decreasing incidence of Occupational Asthma in the West Midlands, UK?

IntroductionNotifications of occupational asthma (OA) to the West Midlands SHIELD reporting scheme have declined between 1991 and 2011. This may be due in part to reporter fatigue or restrictions on...

Cytotoxicity of single-walled carbon nanotubes, multi-walled carbon nanotubes, and chrysotile to human lung epithelial cells

Carbon nanotubes (CNTs) have found numerous applications in various industries. Recently, adverse effects of these materials on human and animal cells in vitro have been reported. In the present study, the cytotoxicity of single-walled carbon nanotubes (SWCNTs), multi-walled carbon nanotubes (MWCNTs), and chrysotile asbestos in human lung epithelial cells has been studied using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The cells were exposed for 6 h and 24 h to between 0.97 and 1500 μg mL−1 of CNTs and chrysotile fibers prepared in two culture media containing 5% serum and 0.5% dimethylsulfoxide. Dose–response curves were obtained to determine the nonobservable adverse effect concentration and the half-maximum inhibitory concentration (IC50). The way of dispersion affects the cytotoxicity of CNTs. For MWCNT, the toxicological indexes were lower than for SWCNT. Chrysotile fibers were even less cytotoxic than CNTs. Therefore, workplace control measures are recommended as priority for occupational and environmental conditions.

Provision of control measures for exposure of the hands to wet-working conditions in Australian workplaces

To analyze the occupational and demographic characteristics for workers participating in the Australian National Hazard Exposure Worker Surveillance (NHEWS) Survey, who reported the provision of various types of workplace control measures for exposure of the hands to wet-working conditions, and to identify the barriers for the provision of controls. Computer-assisted telephone interviews were conducted with 4500 workers in 2008. Workers were asked about the types of control measures provided to them in the workplace for exposure of the hands to liquids. Workplace size was the strongest predictor for the provision of control measures. Compared to workplaces with fewer than five employees, workers in workplaces with 200 or more employees were more likely to report provision of gloves, barrier creams and moisturizers, labeling and warning, and ongoing training and education about skin care. Smaller workplaces have poorer access to control measures to mitigate exposure to wet work.

Work-related symptoms and hazard preventative measures among oral health care workers in Nigeria

The aim of this study was to assess the prevalence of work-related symptoms among oral health workers other than the dentist in Nigeria and the preventive measures put in place to reduce exposure to hazardous agents and practices. The study was by means of self-administered questionnaires filled by all cadres of oral health staff who attended two National update courses as well as in all the four teaching hospitals and all public hospitals in Lagos State. Ninety (90) questionnaires were returned properly filled out of one hundred and ten (110) distributed. Forty-five(50%) of them responded positively to the question on the presence of work-related illnesses. There was a significant relationship between answering positively to the question and working in awkward positions (p=0.0006), lifting heavy equipments (p=0.01), working with noisy equipments (p=0.02) and being over 40 years of age (p=0.03). However, gender and years of practice were not significantly associated with a positive response. Use of preventive measures was inadequate. Hepatitis B vaccination coverage was found only in 33(36.7%) of them while workplace control measures were not satisfactory. In conclusion, proper regulation of the dental work environment as well as personal protection of employee especially mandatory uptake of hepatitis B vaccination is advocated. Keywords: work-related, occupational, symptoms, oral health workers Nigerian Journal of Health and Biomedical Sciences Vol. 5 (2) 2006: 62-65

Current best practice for the health surveillance of enzyme workers in the soap and detergent industry.

This study defines current best practice for the health surveillance of workers who are potentially exposed to enzymes in the manufacture of enzymatic detergent products. It is recommended that health surveillance is performed 6-monthly for the first 2 years and annually thereafter. The health surveillance programme should include a respiratory questionnaire to detect symptoms, assessment of lung function to detect pre-symptomatic changes and an immunological test to detect specific immunoglobulin E (IgE) to enzymes. The International Union Against Tuberculosis and Lung Disease respiratory questionnaire should be used since it has been validated extensively for detecting asthma. Operators should observe the American Thoracic Society performance criteria for spirometers and standardized procedures for conducting spirometry. Since current airborne monitoring techniques for enzymes do not detect short-duration peak exposures, the incidence of employee sensitizations remains the most reliable measure of the integrity of environmental control. The Pepys skin prick test has been validated as a sensitive, specific and practical test for detecting specific IgE to many inhalant allergens including enzymes. For newly sensitized workers, a multi-cause investigation should be conducted to identify potential sources of exposure. Group results of immunological test results assist in the evaluation of workplace control measures, and should be used to monitor the effectiveness of hygiene and engineering programmes and to help prioritize areas for improvement. Positive responses to a questionnaire or abnormal spirometry should be assessed further. Occupational asthma should be excluded in any case of adult-onset asthma that starts or deteriorates during working life. This is particularly important because an accurate diagnosis of occupational asthma with early avoidance of exposure to its cause can result in remission of symptoms and restoration of lung function.