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Journal: The Annals of occupational hygiene

169

OBJECTIVES: To investigate the association between occupational contamination and exposure levels to antineoplastic drugs and the application of control measures in a hospital work environment. Methods : Wipe samples of equipments were collected at a hospital in Osaka Prefecture, Japan, from 2007 to 2011. These samples were subjected to measurements of cyclophosphamide (CP), gemcitabine (GEM), platinum-containing drugs (Pt), and fluorouracil (5FU). Additionally, 24-h urine samples were collected from pharmacists who handled antineoplastic drugs, which were analyzed for CP and alpha-fluoro-beta-alanine (AFBA). The application of control measures was scored according to a checklist, which consisted of the following five items: safety equipment and maintenance, training and documentation, devices for safe handling, personal protective equipment, and emergency care. The aim was to obtain a score of 80%. Results : The median CP, GEM, and 5FU concentrations of all wipe samples were significantly lower during the period when the mean score was >80% (attainment period) versus when the mean score was ≤80% (nonattainment period; all P < 0.001, Mann-Whitney's U-test). Additionally, the median urinary CP and AFBA concentrations of pharmacists during the attainment period tended to be lower than that of those during the nonattainment period (P = 0.061 and 0.061, respectively, using Mann-Whitney's U-test). Conclusions : Contamination and levels of exposure to antineoplastic drugs decreased with a score higher than 80%. The scores of the items on the checklist appeared to adequately reflect the condition of the control measures, as increases in all five items were associated with reductions in the contamination by and levels of exposure to all drugs.

Concepts: Prefectures of Japan, Personal protective equipment, Pharmacy, Osaka Prefecture, Protection, Scores, Arithmetic mean, Occupational safety and health

156

Chemical pesticides, regardless of their inherent hazard, are used intensively in the fast changing agricultural sector of Ethiopia. We conducted a cross-sectional pesticide Knowledge Attitude and Practice (KAP) survey among 601 farmers and farm workers (applicators and re-entry workers) in three farming systems [large-scale closed greenhouses (LSGH), large-scale open farms (LSOF), and small-scale irrigated farms (SSIF)]. Main observations were that 85% of workers did not attain any pesticide-related training, 81% were not aware of modern alternatives for chemical pesticides, 10% used a full set of personal protective equipment, and 62% did not usually bath or shower after work. Among applicators pesticide training attendance was highest in LSGH (35%) and was lowest in SSIF (4%). None of the female re-entry farm workers had received pesticide-related training. Personal protective equipment use was twice as high among pesticide applicators as among re-entry workers (13 versus 7%), while none of the small-scale farm workers used personal protection equipment. Stockpiling and burial of empty pesticide containers and discarding empty pesticide containers in farming fields were reported in both LSOF and by 75% of the farm workers in SSIF. Considerable increment in chemical pesticide usage intensity, illegitimate usages of DDT and Endosulfan on food crops and direct import of pesticides without the formal Ethiopian registration process were also indicated. These results point out a general lack of training and knowledge regarding the safe use of pesticides in all farming systems but especially among small-scale farmers. This in combination with the increase in chemical pesticide usage in the past decade likely results in occupational and environmental health risks. Improved KAP that account for institutional difference among various farming systems and enforcement of regulatory measures including the available occupational and environmental proclamations in Ethiopia are urgently needed.

Concepts: DDT, Tractor, Farm, Irrigation, Protection, Personal protective equipment, Agriculture, Pesticide

27

OBJECTIVES: The high values of thermal resistance (R(ct)) and/or vapor resistance (R(et)) of chemical protective clothing (CPC) induce a considerable thermal stress. The present study compared the physiological strain induced by CPCs and evaluates the relative importance of the fabrics' R(ct), R(et), and air permeability in determining heat strain. METHODS: Twelve young (20-30 years) healthy, heat-acclimated male subjects were exposed fully encapsulated for 3h daily to an exercise-heat stress (35°C and 30% relative humidity, walking on a motor-driven treadmill at a pace of 5 km h(1) and a 4% inclination, in a work-rest cycle of 45min work and 15min rest). Two bipack CPCs (PC1 and PC2) were tested and the results were compared with those attained by two control suits-a standard cotton military BDU (CO1) and an impermeable material suit (CO2). RESULTS: The physiological burden imposed by the two bilayer garments was within the boundaries set by the control conditions. Overall, PC2 induced a lower strain, which was closer to CO1, whereas PC1 was closer to CO2. Air permeability of the PC2 cloth was almost three times higher than that of PC1, enabling a better heat dissipation and consequently a lower physiological strain. Furthermore, air permeability characteristic of the fabrics, which is associated with its construction and weave, significantly correlated with the physiological strain, whereas the correlation with R(ct), R(et), and weight was poor. CONCLUSIONS: The results emphasize the importance of air permeability in reducing the physiological strain induced by CPCs.

Concepts: Textile, Clothing, Linear elasticity, Psychrometrics, Relative humidity, Humidity, Water vapor, Heat

27

Background:According to epidemiological research, exposure to rubber fumes can cause various types of cancer and can lead to an increase in death rate because of cardiovascular diseases. OBJECTIVES: In this study, we have assessed the characteristics of ultrafine particles emitted into the air during the manufacturing of rubber products using waste tires. METHODS: To assess the aerosol distribution of rubber fumes in the workplace from a product during curing, we have performed particle number concentration mapping using a handheld condensation particle counter.The particle number concentration of each process, count median diameter (CMD), and nanoparticle ratio (<100nm) were determined using an electrical low-pressure impactor (ELPI), and the surface area concentration was determined using a surface area monitor. The shape and composition of the sampled rubber fumes were analyzed using an ELPI-transmission electron microscopy grid method. Further, the rubber fume mass concentration was determined according to the Methods for the Determination of Hazardous Substances 47/2. RESULTS: The results of particle mapping show that the rubber fumes were distributed throughout the air of the workplace. The concentration was the highest during the final process of the work. The particle number concentration and the surface area concentration were 545 000cm(-3) and 640 µm(2) cm(-3), respectively, approximately 10- and 4-fold higher than those in the outdoor background.During the final process, the CMD and the nanoparticle ratio were 26nm and 94%, respectively. Most of the rubber fume particles had a compact shape because of the coagulation between particles. The main components of these fumes were silicon and sulfur, and heavy metals such as zinc were detected in certain particles. The filter concentration of the rubber fumes was 0.22mg m(-3), lower than the UK workplace exposure limit of 0.6mg m(-3). CONCLUSIONS: Therefore, the rubber manufacturing process is a potentially dangerous process that produces a high concentration of specific nanoparticles.

Concepts: Particle physics, Nanoparticle, Heavy metal music, Epidemiology, Electron, Nanomaterials, Ultrafine particles

26

Background: The production and use of carbon nanotubes (CNTs) is rapidly growing. With increased production, there is potential that the number of occupational exposed workers will rapidly increase. Toxicological studies on rats have shown effects in the lungs, e.g. inflammation, granuloma formation, and fibrosis after repeated inhalation exposure to some forms of multi-walled CNTs (MWCNTs). Still, when it comes to health effects, it is unknown which dose metric is most relevant. Limited exposure data for CNTs exist today and no legally enforced occupational exposure limits are yet established. The aim of this work was to quantify the occupational exposures and emissions during arc discharge production, purification, and functionalization of MWCNTs. The CNT material handled typically had a mean length <5 μm. Since most of the collected airborne CNTs did not fulfil the World Health Organization fibre dimensions (79% of the counted CNT-containing particles) and since no microscopy-based method for counting of CNTs exists, we decided to count all particle that contained CNTs. To investigate correlations between the used exposure metrics, Pearson correlation coefficient was used.

Concepts: World Health Organization, Occupational exposure limit, Toxicology, Covariance and correlation, Carbon nanotube, Spearman's rank correlation coefficient, Correlation and dependence, Pearson product-moment correlation coefficient

5

To date, occupational exposure assessment of electromagnetic fields (EMF) has relied on occupation-based measurements and exposure estimates. However, misclassification due to between-worker variability remains an unsolved challenge. A source-based approach, supported by detailed subject data on determinants of exposure, may allow for a more individualized exposure assessment. Detailed information on the use of occupational sources of exposure to EMF was collected as part of the INTERPHONE-INTEROCC study. To support a source-based exposure assessment effort within this study, this work aimed to construct a measurement database for the occupational sources of EMF exposure identified, assembling available measurements from the scientific literature.

Concepts: Occupational safety and health, Energy, Psychometrics, Photon, Quantum mechanics

4

Professional orchestral musicians risk permanent hearing loss while playing their instruments. Protecting the hearing of these musicians in the workplace is critical to their ongoing ability to play their instruments, but typical workplace hearing conservation measures can have very damaging effects on the product (music) and the musicians' abilities to hear one another sufficiently. To enable effective intervention, orchestras as employers must encourage engagement with hearing protection programs and implement controls while preserving the integrity of the music. To achieve this, typical approaches used in other industries must be redesigned to suit this unique workplace. In response to these challenges, the Queensland Symphony Orchestra (Brisbane, Australia) introduced a comprehensive hearing conservation strategy in 2005 based upon best practice at the time. This strategy-which has been regularly refined-continues to be implemented on a daily basis. This investigation aimed to assess the successes, difficulties, and practical viability of the program. To achieve this a process evaluation was carried out, incorporating archival analyses, player and management focus groups, and an interview with the program’s administrator. Results show the program has successfully become integrated into the orchestra’s and the musicians' daily operations and significantly contributes to managing the risk of hearing loss in this population. While there is room for improvement in the orchestra’s approach-particularly regarding usable personal protective devices and improved education and training, results are encouraging. This study provides a basis for those wishing to implement or evaluate similar paradigms.

Concepts: Symphony No. 9, Protection, Symphony, Musical instrument, Hearing, Hector Berlioz, Orchestra

3

For exposure to hand-transmitted vibration (HTV), personal protective equipment is sold in the form of anti-vibration (AV) gloves, but it remains unclear how much these gloves actually reduce vibration exposure or prevent the development of hand-arm vibration syndrome in the workplace. This commentary describes some of the issues that surround the classification of AV gloves, the assessment of their effectiveness and their applicability in the workplace. The available information shows that AV gloves are unreliable as devices for controlling HTV exposures. Other means of vibration control, such as using alternative production techniques, low-vibration machinery, routine preventative maintenance regimes, and controlling exposure durations are far more likely to deliver effective vibration reductions and should be implemented. Furthermore, AV gloves may introduce some adverse effects such as increasing grip force and reducing manual dexterity. Therefore, one should balance the benefits of AV gloves and their potential adverse effects if their use is considered.

Concepts: Hand, Fine motor skill, Occupational safety and health, Effect, Protection, Personal protective equipment, Effectiveness, Protective gear

2

Outdoor workers are at high risk of exposure to solar ultraviolet radiation (UVR), a known human carcinogen. In Canada, no objective measures of UVR exposure are available for occupational settings.

Concepts: Solar water disinfection, Sunlight, Carcinogen, Electromagnetic spectrum, Sun, Ionizing radiation, Cancer, Ultraviolet

2

Many ailments can be linked to exposure to indoor airborne fungus. However, obtaining a precise measurement of airborne fungal levels is complicated partly due to indoor air fluctuations and non-standardized techniques. Electrostatic dust collector (EDC) sampling devices have been used to measure a wide range of airborne analytes, including endotoxins, allergens, β-glucans, and microbial DNA in various indoor environments. In contrast, viable mold contamination has only been assessed in highly contaminated environments such as farms and archive buildings. This study aimed to assess the use of EDCs, compared with repeated air-impactor measurements, to assess airborne viable fungal flora in moderately contaminated indoor environments. Indoor airborne fungal flora was cultured from EDCs and daily air-impaction samples collected in an office building and a daycare center. The quantitative fungal measurements obtained using a single EDC significantly correlated with the cumulative measurement of nine daily air impactions. Both methods enabled the assessment of fungal exposure, although a few differences were observed between the detected fungal species and the relative quantity of each species. EDCs were also used over a 32-month period to monitor indoor airborne fungal flora in a hospital office building, which enabled us to assess the impact of outdoor events (e.g. ground excavations) on the fungal flora levels on the indoor environment. In conclusion, EDC-based measurements provided a relatively accurate profile of the viable airborne flora present during a sampling period. In particular, EDCs provided a more representative assessment of fungal levels compared with single air-impactor sampling. The EDC technique is also simpler than performing repetitive air-impaction measures over the course of several consecutive days. EDC is a versatile tool for collecting airborne samples and was efficient for measuring mold levels in indoor environments.

Concepts: Fire protection, Accuracy and precision, Fungus, Quantity, Psychometrics, Building, Assessment, Measurement