2018-08-01 12:00 - Messages

In-cab air filtration in plant vehicles to control exposure to hazardous dust

Quarry industry example
Tackling occupational lung disease is a priority for HSE. In-cab air filtration systems are installed on plant vehicles used in a wide range of industries where drivers can potentially breathe in hazardous airborne dust, such as farming, waste management and quarrying. Plant vehicles include tractors, diggers, dumper trucks, excavators and mechanical shovels. However, little is known about the effectiveness of in-cab air filtration as a control measure. This report describes research to develop this evidence; the research was carried out with the support of the quarry industry as a representative sector.br> The research looked at the factors that influence the effectiveness of in-cab air filtration systems throughout their operational lifecycle, including system design, in-service use, and maintenance. The research included developing a new scientific method to evaluate filtration system efficiency whilst a vehicle is being driven.
The research found: penetration of hazardous dust into vehicle cabs; some vehicle cab filters of low efficiency; and that staff had variable knowledge about the effectiveness of in-cab air filtration and the level of protection it afforded. The research identified practical steps that industry can take to improve protection of workers. Improved understanding of good practice for in-cab air filtration systems is needed by vehicle designers and manufacturers and within the sectors using the vehicles – including the importance of filter maintenance and ensuring that drivers are made aware of the actions they need to take.

Source: http://www.hse.gov.uk/research/rrhtm/rr1126.htm

Agreement in Occupational Exposures Between Men and Women Using Retrospective Assessments by Expert Coders

Objectives: To estimate the level of agreement and identify notable differences in occupational exposures (agents) between men and women from retrospective assessments by expert coders.
Methods: Lifetime occupational histories of 1657 men and 2073 women from two case–control studies, were translated into exposure estimates to 243 agents, from data on 13882 jobs. Exposure estimates were summarized as proportions and frequency-weighted intensity of exposure for 59 occupational codes by sex. Agreement between metrics of exposure in men’s and women’s jobs was determined with intraclass correlation coefficients (ICC) and weighted Kappa coefficients, using as unit of analysis (‘cell’) a combination of occupational code and occupational agent. ‘Notable’ differences between men and women were identified for each cell, according to a Bayesian hierarchical model for both proportion and frequency-weighted intensity of exposure.
Results: For cells common to both men and women, the ICC for continuous probability of exposure was 0.84 (95% CI: 0.83–0.84) and 7.4% of cells showed notable differences with jobs held by men being more often exposed. A weighted kappa of 0.67 (95% CI: 0.61–0.73) was calculated for intensity of exposure, and an ICC of 0.67 (95% CI: 0.62–0.71) for frequency-weighted intensity of exposure, with a tendency of higher values of exposure metrics in jobs held by men.
Conclusions: Exposures were generally in agreement between men and women. Some notable differences were identified, most of them explained by differential sub-occupations or industries or dissimilar reported tasks within the studied occupations.

Source: Lacourt, A., Labrèche, F., Goldberg, M. S., Siemiatycki, J. et Lavoué, J. (2018). Annals of Work Exposures and Health.
https://doi.org/10.1093/annweh/wxy074

Welding, Molybdenum Trioxide, and Indium Tin Oxide

IARC Monographs on the Evaluation of Carcinogenic Risks to Humans Volume 118
This volume of the IARC Monographs provides evaluations of the carcinogenicity of welding and welding fumes, molybdenum trioxide, and indium tin oxide.
Worldwide, an estimated 11 million workers have a job title of welder, and around 110 million additional workers probably incur welding-related exposures. Welding can involve exposures to fumes, gases, ultraviolet radiation and electromagnetic fields, and co-exposures to asbestos and solvents. The extent and type of exposure can depend on the process used, the material welded, ventilation, degree of enclosure, and use of personal protection.
Molybdenum trioxide, which occurs rarely naturally, is a chemical with a high production volume that is mainly used in steel manufacture, but also in biocides and in photovoltaic technology. Most occupational exposures occur in mining and metallurgy, steel foundries, welding, and other high-temperature processes using steel.
Indium tin oxide, which does not occur naturally, is a chemical with a low production volume that is a mixture of indium oxide and stannic oxide. It is mainly used in producing transparent conductive films on glass or plastic panels used in electronic devices. Exposure to indium tin oxide occurs mainly in occupational settings, during production and processing, or during recycling of elemental indium. As the use, recycling, and disposal of electronics increases worldwide, exposures to indium in low- and middle-income countries where informal e-recycling occurs are also expected to increase.

Source: http://publications.iarc.fr/569

Occupational exposure to benzene, toluene, xylene and styrene and risk of prostate cancer in a population-based study

Objectives: While several monocyclic aromatic hydrocarbons are classified as definite or possible carcinogens to humans, little data exist on their role in prostate cancer (PCa). We examined occupational exposure to benzene, toluene, xylene (BTX) and styrene and PCa risk in a population-based case–control study in Montreal, Canada.
Methods: Cases aged ≤75 years diagnosed with PCa in 2005–2009 (n=1920) and population controls frequency-matched on age (n=1989) provided detailed work histories. Experts evaluated the certainty, frequency and concentration of exposure to monocyclic aromatic hydrocarbons in each job lasting ≥2 years. Logistic regression estimated OR and 95% CIs for PCa risk, adjusting for potential confounders.
Results: Exposures to BTX were highly intercorrelated, except for durations of exposure at substantial levels. Ever exposure to any BTX was associated with overall PCa (OR 1.27, 95% CI 1.05 to 1.53), while the OR for styrene was 1.19. However, increases in risk were largely confined to low-grade tumours, with ORs of 1.33 (95%CI 1.08 to 1.64) and 1.41 (95% CI 0.85 to 2.31) for ever exposure to any BTX and styrene, respectively, and a duration response pattern for any BTX. Risks for low-grade tumours were elevated among men exposed ≥25 years at substantial levels of benzene (OR 2.32) and styrene (OR 2.44). Some cumulative exposure categories showed increased risks but without clear trends.
Conclusion: Exposure to any BTX was associated with higher risks of overall PCa. Prolonged exposures at the substantial level to benzene and styrene increased risks of low-grade tumours. These novel findings were independent from PCa screening.

Source: Blanc-Lapierre, A., Sauvé, J. F. et Parent, M. E. (2018). Occup Environ Med.
http://dx.doi.org/10.1136/oemed-2018-105058

Development of a Coding and Crosswalk Tool for Occupations and Industries

Introduction: Job coding into a standard occupation or industry classification is commonly performed in occupational epidemiology and occupational health. Sometimes, it is necessary to code jobs into multiple classifications or to convert job codes from one classification to another. We developed a generic tool, called CAPS-Canada (http://www.caps-canada.ca/), that combines a computer-assisted coding tool covering seven International, Canadian and US occupation and industry classifications and an assistant facilitating crosswalks from one classification to another. The objectives of this paper are to present the different functions of the CAPS-Canada tool and to assess their contribution through an inter-rater reliability study.
Method: The crosswalk assistant was built based on a database of >30,000 jobs coded during a previous project. We evaluated to what extent it would allow automatic translation between pairs of classifications. The influence of CAPS-Canada on agreement between coders was assessed through an inter-rater reliability study comparing three approaches: manual coding, coding with CAPS-Canada without the crosswalk assistant, and coding with the complete tool. The material for this trial consisted of a random sample of 1000 jobs extracted from a case–control study and divided into three subgroups of equivalent size.
Results: Across the classification systems, the crosswalk assistant would provide useful information for 83–99% of jobs (median 95%) in a population similar to ours. Eighteen to eighty-one percent of jobs (median 56%) could be entirely automatically recoded. Based on our sample of 1000 jobs, inter-rater reliability in occupation coding ranged from 35.7 to 66.5% (median 53.7%) depending on the combination of classification/resolution. Compared with manual coding, the use of CAPS-Canada substantially improved inter-rater reliability.
Conclusion: CAPS-Canada is an attractive alternative to manual coding and is particularly relevant for coding a job into multiple classifications or for recoding jobs into other classifications.

Source: Rémen, T., Richardson, L., Pilorget, C., Palmer, G., Siemiatycki, J. et Lavoué, J. (2018). Annals of work exposures and health.
https://doi.org/10.1093/annweh/wxy052

Priorisation des zoonoses au Québec dans un contexte d’adaptation aux changements climatiques à l’aide d’un outil d’aide à la décision multicritère

Au Québec comme ailleurs dans le monde, les maladies transmises entre les animaux et les humains (zoonoses) sont en émergence, notamment du fait des changements climatiques. Elles représentent environ 60 % des maladies infectieuses émergentes chez l'humain.
Devant les enjeux zoonotiques qui se multiplient, l'Observatoire multipartite québécois sur les zoonoses et l'adaptation aux changements climatiques (Observatoire) a initié en 2015 une démarche de priorisation des zoonoses, afin d'orienter les besoins en recherche et les actions de surveillance, de prévention et de contrôle au Québec.
Dans le cadre de cette démarche, les membres de l'Observatoire se sont initiés à l'utilisation d'un outil de priorisation des zoonoses basé sur la méthode systématique, rigoureuse et transparente d'aide à la décision multicritères (ADMC).
Ce rapport présente les différentes étapes de cet exercice de priorisation qui ont mené à l'établissement d'une liste consensuelle de 32 zoonoses priorisées, prenant en compte la multiplicité des enjeux présents au Québec notamment leurs impacts en santé publique, en santé animale et environnementale, leurs impacts socio-économiques et leur capacité d'émergence.
De cette liste, neuf zoonoses prioritaires se démarquent : il s'agit du Virus du Nil Occidental, du botulisme, de la rage, de la salmonellose, de la listériose, de l'infection à Escherichia coli, du syndrome pulmonaire à Hantavirus, de l'influenza aviaire et de la maladie de Lyme.
Cette liste de zoonoses priorisées devrait servir de référence pour guider les efforts d'adaptation aux changements climatiques des décideurs (priorisation des actions) et des chercheurs ou organismes subventionnaires (identification de thèmes de recherche).
L'exercice de priorisation à l'aide d'un outil ADMC a également permis de mettre en évidence les manques de connaissances au Québec pour certaines zoonoses. Cela représente bien sûr des défis à relever, mais également de nouvelles opportunités de recherche à exploiter, permettant de façon concrète aux décideurs de cibler où mettre des ressources pour combler ces manques.

Source: https://www.inspq.qc.ca/publications/2432

Exposures to Volatile Organic Compounds among Healthcare Workers

Modeling the Effects of Cleaning Tasks and Product Use
Objectives: Use of cleaning and disinfecting products is associated with work-related asthma among healthcare workers, but the specific levels and factors that affect exposures remain unclear. The objective of this study was to evaluate the determinants of selected volatile organic compound (VOC) exposures in healthcare settings.
Methods: Personal and mobile-area air measurements (n = 143) from 100 healthcare workers at four hospitals were used to model the determinants of ethanol, acetone, 2-propanol, d-limonene, α-pinene, and chloroform exposures. Hierarchical cluster analysis was conducted to partition workers into groups with similar cleaning task/product-use profiles. Linear mixed-effect regression models using log-transformed VOC measurements were applied to evaluate the association of individual VOCs with clusters of task/product use, industrial hygienists' grouping (IH) of tasks, grouping of product application, chemical ingredients of the cleaning products used, amount of product use, and ventilation.
Results: Cluster analysis identified eight task/product-use clusters that were distributed across multiple occupations and hospital units, with the exception of clusters consisting of housekeepers and floor strippers/waxers. Results of the mixed-effect models showed significant associations between selected VOC exposures and several clusters, combinations of IH-generated task groups and chemical ingredients, and product application groups. The patient/personal cleaning task using products containing chlorine was associated with elevated levels of personal chloroform and α-pinene exposures. Tasks associated with instrument sterilizing and disinfecting were significantly associated with personal d-limonene and 2-propanol exposures. Surface and floor cleaning and stripping tasks were predominated by housekeepers and floor strippers/waxers, and use of chlorine-, alcohol-, ethanolamine-, and quaternary ammonium compounds-based products was associated with exposures to chloroform, α-pinene, acetone, 2-propanol, or d-limonene.
Conclusions: Healthcare workers are exposed to a variety of chemicals that vary with tasks and ingredients of products used during cleaning and disinfecting. The combination of product ingredients with cleaning and disinfecting tasks were associated with specific VOCs. Exposure modules for questionnaires used in epidemiologic studies might benefit from seeking information on products used within a task context.

Source: Su, F. C., Friesen, M. C., Stefaniak, A. B., Henneberger, P. K., LeBouf, R. F., Stanton, M. L., ... et Virji, M. A. (2018). Annals of work exposures and health.
https://doi.org/10.1093/annweh/wxy055

Identifying occupational carcinogens: an update from the IARC Monographs

The recognition of occupational carcinogens is important for primary prevention, compensation and surveillance of exposed workers, as well as identifying causes of cancer in the general population. This study updates previously published lists of known occupational carcinogens while providing additional information on cancer type, exposure scenarios and routes, and discussing trends in the identification of carcinogens over time. Data were extracted from International Agency for Research on Cancer (IARC) Monographs covering the years 1971–2017, using specific criteria to ensure occupational relevance and provide high confidence in the causality of observed exposure-disease associations. Selected agents were substances, mixtures or types of radiation classified in IARC Group 1 with ‘sufficient evidence of carcinogenicity' in humans from studies of exposed workers and evidence of occupational exposure documented in the pertinent monograph. The number of known occupational carcinogens has increased over time: 47 agents were identified as known occupational carcinogens in 2017 compared with 28 in 2004. These estimates are conservative and likely underestimate the number of carcinogenic agents present in workplaces. Exposure to these agents causes a wide range of cancers; cancers of the lung and other respiratory sites, followed by skin, account for the largest proportion. The dominant routes of exposure are inhalation and dermal contact. Important progress has been made in identifying occupational carcinogens; nevertheless, there is an ongoing need for research on the causes of work-related cancer. Most workplace exposures have not been evaluated for their carcinogenic potential due to inadequate epidemiologic evidence and a paucity of quantitative exposure data.

Source: Loomis, D., Guha, N., Hall, A. L. et Straif, K. (2018). Occup Environ Med.
http://dx.doi.org/10.1136/oemed-2017-104944

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