WORLD UNIVERSITY DIRECTORY
Medical Education Annals of Occupational Hygiene - current issue

  Back to "News Updates - Homepage"


| More


Annals of Occupational Hygiene - current issue - Recent Educational Updates

-->
Healthcare workers’ experiences protecting themselves and their families during the COVID-19 pandemic in 2020–2021
<span class="paragraphSection"><div class="boxTitle">Abstract</div>We characterized experiences and strategies used by frontline healthcare workers to prevent severe-acute-respiratory-syndrome-related coronavirus transmission at work and to household members during the coronavirus disease pandemic. Alongside an online questionnaire (<span style="font-style:italic;">n</span> = 234), remote semi-structured interviews (<span style="font-style:italic;">n</span> = 23: 15 clinicians, 8 non-clinicians) were conducted in 2021. Mitigation challenges and facilitators were identified from data to represent experiences as a process considering the before, during, and after work shifts. Journey mapping was utilized to visually describe how healthcare workers experienced the stages of the work environment, leaving work, commuting home, and the home environment, and strategies implemented to stay safe. Major facilitators included the uptake of coronavirus disease vaccines and testing, information regarding virus transmission, and adequate personal protective equipment. The most critical challenges identified included a lack of designated areas for end-of-day disinfection, changing rooms, showers, and lockers in the leaving work stage. Psychosocial and environmental factors must be considered in future hospital pandemic preparations.</span>


Comparison of a radiofrequency electric and magnetic field source-based job-exposure matrix with personal radiofrequency exposure measurements
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Objectives</div>Assessing occupational exposure to radiofrequency electromagnetic fields (RF-EMF) presents significant challenges due to the considerable variability in exposure levels within and between occupations. This spatial and temporal variability complicates the reliable evaluation of potential health risks associated with RF-EMF exposure in the workplace. Accurate assessment methods are crucial to understand the extent of exposure and to evaluate potential health risks, especially given the potential for higher exposures in occupational settings compared to the general population. This study compares the historical RF-EMF exposure estimates in the INTEROCC RF-EMF job-exposure matrix (RF-JEM) with recent personal measurement data collected in 2 countries as part of the OccRF-Health study, to assess the broader applicability of the RF-JEM.<div class="boxTitle">Methods</div>Weighted kappa (<span style="font-style:italic;">k</span><sub>w</sub>) coefficients and Spearman rank correlation tests were performed to assess the alignment between RF-JEM estimates and measurements for 8 h time-weighted average exposure intensity and prevalence estimates across various occupations. The comparisons were mainly based on 22 jobs having ≥5 measured workers in the OccRF-Health study.<div class="boxTitle">Results</div>Poor agreement was found for both exposure prevalence and intensity between both methods (<span style="font-style:italic;">k</span><sub>w</sub> &lt; 0.1). RF-JEM values likely overestimated exposure levels for both electric (<span style="font-style:italic;">E</span>) and magnetic (<span style="font-style:italic;">H</span>) fields (mean percentage difference &gt;194%) compared to current personal measurements.<div class="boxTitle">Conclusions</div>Findings suggest that the INTEROCC-JEM likely overestimates current exposure intensity levels in the measured jobs. Adopting a semiquantitative JEM could also mitigate misclassification errors due to exposure variability, improving accuracy in exposure assessment. These findings indicate the need for more targeted personal measurements, including among highly exposed workers, and for potentially considering new exposure metrics to more accurately assess occupational RF-EMF exposures in occupational epidemiological research.</span>


A cross-sectional study on occupational hygiene in biowaste plants
<span class="paragraphSection"><div class="boxTitle">Abstract</div>Recycling demands are increasing and new biowaste plants are established. The aim of this study is to obtain knowledge about occupational hygiene in biowaste pretreatment plants. At 6 plants, bioaerosol exposure, hand hygiene, and bioaerosol concentrations in work areas were investigated repeatedly. The total inflammatory potential (TIP) of exposures was measured using the human HL-60 cell line. Exposure to airborne bacteria, bacteria able to grow anaerobic, fungi(37°C), endotoxin, and TIP differed between plants and was lowest in a plant transporting waste in closed pipes compared to plants where waste was delivered on the receiving hall floor. Conversely, high exposures were measured in a plant that also processes compost. All microbial components had an impact on TIP of workers’ exposure with main effects of fungi and endotoxin. Seasonality was found for several exposures and TIP, and they were lowest in the winter. Concentrations of bacteria and fungi on workers’ hands at the end of the workday were 15 times higher for production than for nonproduction workers. In work areas, the concentrations of airborne fungi were highest in the waste-receiving area. Bacteria (3.2 µm) and anaerobic bacteria (4.0 µm) were present as larger airborne particles than fungi (2.8 µm), and bacteria were largest in the waste-receiving area. The microbial community compositions of exposures and work areas differed between plants and work areas. In conclusion, measures to reduce exposure should focus on the waste-receiving area and on the production workers. Differences in exposures and community compositions were found between seasons, work areas, work groups, and plants.</span>


Effort-reward imbalance at work assessed at midlife and prediabetes prevalence assessed 18 years later in a prospective cohort of white-collar workers
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Objectives</div>Evidence suggests that workers exposed to psychosocial stressors at work from the effort-reward imbalance (ERI) model are at increased risk for type 2 diabetes mellitus (T2DM). However, evidence about the effect of ERI on prediabetes is scarce. This study aimed to examine the association between effort-reward imbalance at work, glycated hemoglobin level and the prevalence of prediabetes in women and men from a prospective cohort study.<div class="boxTitle">Methods</div>This study was conducted among 1354 white-collar workers followed for an average of 18 years. Effort-reward imbalance at work was measured in 1999 to 2001 using a validated instrument. Glycated hemoglobin was assessed at follow-up (2015 to 2018). Differences in mean glycated hemoglobin levels were estimated with linear models. Prediabetes prevalence ratios (PRs) were computed using robust Poisson regression models.<div class="boxTitle">Results</div>In women, those exposed to effort-reward imbalance at work at baseline had a higher prevalence of prediabetes (PR = 1.60, 95% confidence interval: 1.02–2.49) at follow-up following adjustment for sociodemographic, lifestyle-related, clinical, and other occupational risk factors. There was no difference in mean glycated hemoglobin levels.<div class="boxTitle">Conclusion</div>Among women, effort-reward imbalance at work at midlife was associated with the prevalence of prediabetes, at older age. Preventive workplace interventions aiming to reduce the prevalence of effort-reward imbalance at work may be effective to reduce the prevalence of prediabetes among women.</span>


A field investigation of 3 masks proposed as respiratory protection for wildland firefighters: a randomized controlled trial in British Columbia, Canada
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Introduction</div>Wildland firefighters are exposed through the lungs and skin to particulate matter, fumes, and vapors containing polycyclic aromatic hydrocarbons (PAH). Wearing respiratory protection should reduce pulmonary exposure, but there is uncertainty about the most effective and acceptable type of mask.<div class="boxTitle">Methods</div>Firefighters from 6 unit crews working with the British Columbia Wildfire Service were approached and those consenting were randomly allocated within each crew to a “no mask” control group or to use 1 of 3 types of masks: X, half-face respirator with P100/multi gas cartridge; Y, cloth with alpaca filter; Z mesh fabric with a carbon filter. Crews were followed for 3 consecutive firefighting days. The mask allocated was constant for each firefighter throughout. All participants completed a brief questionnaire at the start and end of each day, giving information on mask use, respiratory symptoms, and assessment of mask qualities. Spot urine samples were collected pre and post shift to assess 1-hydroxypyrene (1-HP) concentration as an indicator of total PAH absorption. Skin wipe samples from the hands and throat were collected pre and post shift and analyzed for PAH concentration. On each day monitored, 4 participants carried sampling pumps to measure total particulates and PAHs on particles and in vapor phase. The primary outcome was the concentration of urinary 1-HP at the end of the fire day. Secondary outcomes were changes in respiratory and eye symptoms during the course of the shift, reported mask use, and perception of mask qualities. The analysis used a 3-level random intercept regression model that clustered observations within individuals and crews. We aimed to detect any relation of allocated mask type to the 4 outcomes, having allowed for estimated exposure.<div class="boxTitle">Results</div>Information was collected from 89 firefighters, including 14 women: 49% (37/75) of male firefighters were bearded. Nineteen fire days were monitored for a total of 263 firefighter × days, 64 to 68 for each intervention group. The end of shift 1-HP was higher than the start of the shift. Urinary 1-HP was more strongly related to PAHs on the skin than in the breathing zone. Men with beards had higher end-of-shift urinary log 1-HP/creat (ng/g) than other firefighters. None of the groups allocated a mask had lower 1-HP than the no-mask group, either in the study group overall or when stratified by beard-wearing. Among those without either beards or a failed fit-test, Mask Z reduced at the end of shift 1-HP where airborne PAH concentration was high. End-of-shift symptoms were related to particle mass in the breathing zone but was not mitigated by any of the masks. Hours electing not to wear a mask increased from the first to third shift for all mask types. Mask Z was rated as more comfortable than other types. Mask X was rated highest on fit and perceived protection. Mask Y gained the lowest ratings on fit, comfort and feelings of protection.<div class="boxTitle">Conclusions</div>Allocated masks did not provide protection overall, but the results highlighted the need for a wider understanding of the circumstances in which wearing efficient protection is well-advised.</span>


Occupational mechanical exposures as risk factor for shoulder osteoarthritis: a systematic review
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Objectives</div>The aim of this systematic review was to study the association between occupational mechanical exposures and shoulder osteoarthritis (OA).<div class="boxTitle">Methods</div>A protocol was registered in PROSPERO. Four databases were systematically searched based on PECOS criteria. Outcome was defined as shoulder OA (acromioclavicular (AC) and/or glenohumeral OA) and exposure as occupational mechanical exposures (vibration, upper arm elevation, force, lifting, repetition, and combined mechanical exposures). We included epidemiological studies estimating the prevalence of shoulder OA or the association between occupational mechanical exposures and shoulder OA. Two researchers independently screened articles, performed data extraction, and assessed the risk of bias and level of evidence using GRADE.<div class="boxTitle">Results</div>A total of 1642 articles were screened, of which 7 met the inclusion criteria. Four studies were assessed as having a high risk of bias, 1 with a moderate risk, and 2 with a low risk. Based on job titles, higher prevalence estimates (2.9% to 61.8%) were found in exposed job groups. For all occupational mechanical exposures, exposure–response relations were found in relation to AC OA. For vibration, the odds ratio (OR) ranged between 1.7 and 3.1 in the highest exposure groups, while the ORs for upper arm-elevation, force, lifting, repetition, and combined mechanical exposures ranged between 0.5 to 2.2, 1.3 to 1.8, 7.3 to 10.3, 2.4, and 2.2 to 2.9. Low or very low level of evidence was found for all exposures.<div class="boxTitle">Conclusions</div>This systematic review found an indication of an association between occupational mechanical exposures and shoulder OA, especially AC OA. However, the level of evidence varied between low and very low. High-quality studies assessing the association and differentiating between the specific shoulder joints are highly warranted.</span>


“Why should care workers be any different from prison workers?” A qualitative study of second-hand smoke exposure during home-care visits and potential measures to eliminate exposure
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Introduction</div>Despite world-leading measures in place to protect employees from second-hand smoke exposure in workplaces in the United Kingdom, workers who deliver health and social care in private homes remain unprotected legally in this setting from second-hand smoke exposure (SHS).<div class="boxTitle">Methods</div>Fourteen individuals took part in either an in-depth telephone interview (<span style="font-style:italic;">n</span> = 11) or an online focus group discussion (<span style="font-style:italic;">n</span> = 3), including home-care workers (<span style="font-style:italic;">n</span> = 5) and managers (<span style="font-style:italic;">n</span> = 5) based in Lanarkshire (Scotland) and local/national policy makers (<span style="font-style:italic;">n</span> = 4). Participants were asked about the extent to which exposure to SHS is an issue during home visits and possible additional measures that could be put in place to eliminate exposure.<div class="boxTitle">Results</div>Participants highlighted the difficulties in balancing the provision of care in a person’s own home with the right of workers to be able to breathe clean air and be protected from SHS. Current strategies to reduce staff exposure to SHS during home visits were often reported as inadequate with SHS not a hazard considered by managers beyond protecting pregnant staff or those with pre-existing respiratory conditions such as asthma. Simple respiratory protective equipment (as used during the COVID-19 pandemic) was rightly identified as being ineffective. Methods such as nicotine replacement therapy and e-cigarettes were identified as potential ways to help people who smoke achieve temporary asbstinence prior to a home visit.<div class="boxTitle">Conclusion</div>Implementing appropriate and proportionate measures to protect home-care workers from the harms posed by SHS should be a priority to help protect the health of this often overlooked occupational group.</span>


Managing SARS-CoV-2 transmission risk in workplace COVID-19 outbreaks
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Objectives</div>A Coronavirus disease 2019 (COVID-19) workplace outbreak is a risk to the health of workers and business continuity. To minimise this risk, companies have implemented risk management measures (RMMs) designed to mitigate SARS-CoV-2 transmission within the workforce. The objective of this work was to gather insights into the application of RMMs in non-healthcare workplaces and to improve understanding of the practical barriers to their implementation.<div class="boxTitle">Methods</div>Data were collected using a pre-designed framework from 12 volunteer workplaces through discussions with staff responsible for site safety and during site visits to observe the RMMs and work processes. To evaluate ventilation effectiveness, measurements for carbon dioxide (CO<sub>2</sub>) were taken during the site visit and logged over an extended period in selected occupied areas.<div class="boxTitle">Results</div>RMMs that were implemented well included working at home for office and other non-production staff, provision, and use of face coverings, provision for hand hygiene, and as methods became commonly available, carrying out testing for infected people. However, maintaining adequate physical distancing in many production areas proved difficult because established factory layouts cannot be easily changed and there is often a need for workers to be close to each other to communicate. A major shortcoming identified was the understanding and application of measures to improve workplace ventilation. Rapidly installing and/or upgrading mechanical ventilation systems during a pandemic may not be practical and ideally should be considered in building design. Measuring CO<sub>2</sub> in occupied workspaces proved to be a useful tool for identifying areas with potentially inadequate ventilation.<div class="boxTitle">Conclusions</div>Preventing workplace attendance by identifying infected individuals is challenging, making effective RMMs crucial to mitigating virus transmission. The effectiveness of individual RMMs can be uncertain; therefore, it is necessary to adopt multilayered RMMs. Successful implementation relies on measures that are specific to individual workplaces, identified by accurate risk assessment, regularly reviewed for effectiveness, and worker compliance. Establishing suitable risk mitigation policies and providing staff supervision are vital to ensure the sustained and effective implementation of RMMs. For RMMs that require technical understanding, such as workplace ventilation systems, specialist support may be necessary to ensure effective implementation.</span>


Occupational exposure to chrysotile in an asbestos cement factory in Kyrgyzstan
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Objectives</div>An increasing number of countries are banning the production and use of asbestos, in compliance with the ratification of the C162 Asbestos Convention and the Basel Convention, and in response to the call for its elimination in the ILO resolution and WHO reports on the health risks associated with asbestos. Nevertheless, several countries, including Kyrgyzstan, are still miners and/or manufacturers of asbestos. The main objective of the study is to assess the occupational exposure to chrysotile of workers engaged in a production facility of asbestos-cement products in Kyrgyzstan.<div class="boxTitle">Methods</div>Monitored workers (<span style="font-style:italic;">n</span> = 16, for a total of <span style="font-style:italic;">n</span> = 18 samples) were divided into 3 “Similar Exposure Groups” (SEGs; SEG-1: asbestos loading; SEG-2; asbestos-cement mixing; SEG-3: cutting of asbestos-cement sheets) according to EN 689 standard. Samples were collected through personal sampling and subsequently examined by means of scanning electron microscope equipped with an energy-dispersive spectrometer for the compositional analysis of each fibre. The numerical concentration of airborne asbestos fibres was henceforward determined by dividing the number of fibres and the volume of sampled air (expressed in the number of fibres per millilitre of air: ff/ml).<div class="boxTitle">Results</div>Investigated workers resulted to be exposed to chrysotile fibres. Results (GM ± GSD) outlined extremely high exposure levels for SEG-1 (2.2 ± 2.1 ff/ml) and SEG-3 (4.7 ± 1.6 ff/ml) workers and lower—but still relevant—exposure values for SEG-2 (0.91 ± 2.6 ff/ml) workers.<div class="boxTitle">Conclusions</div>The results obtained in this case study can help to document potentially critical situations of occupational exposure to asbestos that can still occur nowadays in low and middle-income countries where asbestos is still mined and processed.</span>