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Prevention of COVID-19 in workers: preparation, precaution, and protection. Ann Work Expo Health 2024; 68:1-7. [PMID: 37776568 DOI: 10.1093/annweh/wxad060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 10/02/2023] Open
Abstract
In May 2023 the World Health Organization (WHO) Director General announced the "end" of the COVID-19 Public Health Emergency of International Concern. Although the scale of the pandemic was unprecedented in living memory, it had not been unforeseen. Previous outbreaks of viral respiratory disease have shown important lessons regarding the need to protect healthcare workers (HCW), and research has also been undertaken into the relative effectiveness of control measures and their resource implications. Relevant guidance for worker protection, including HCW protection, which existed at the onset of the COVID-19 pandemic was disregarded both at international and national governmental levels. In many countries there were significant systemic flaws in strategy, culture, and resource availability, and hence in overall preparedness. When the pandemic struck, many experts and organizations advocated a precautionary approach with regard to worker protection, consistent with good occupational hygiene science, practice, and standards. In many Asian countries, protective measures were relatively stringent. However, many workers were left unprotected especially as the WHO, the United States, the United Kingdom, and other governments did not pursue adequate COVID-19 protective measures at work. As the pandemic progressed, improvements in protection were patchy. A notable lack of protection arose from the underestimation of the contribution of aerosol exposure to infection risks, particularly among HCWs providing routine care of potentially infectious patients. A disciplined strategy of source control, pathway control (such as ventilation), and receptor control notably Respiratory Protective Equipment is needed, as well as worldwide vaccination, to contend with this pandemic. Control measures appropriate to the risk of infections transmitted through the air will remain necessary in the longer term, as well as adaptations in the workplace to take account of long-term COVID-19 morbidity and new work practices.
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Learning from the Experience of the COVID-19 Pandemic: A New Paradigm for Occupational Biohazard Assessment and Management. LA MEDICINA DEL LAVORO 2023; 114:e2023056. [PMID: 38060205 PMCID: PMC10731573 DOI: 10.23749/mdl.v114i6.15452] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 12/08/2023]
Abstract
The COVID-19 pandemic has affected workplaces in many different aspects. In this scenario, Occupational Physicians played a crucial role in assessing and managing the risk of SARS-CoV-2 infection and associated diseases to guarantee workers' health and the safety of workplaces. However, the pandemic experience has drawn attention to several critical issues in overall biohazard prevention and management strategies, originating from important knowledge gaps in our scientific understanding. An extensive analysis of the relevant hurdles that have emerged in our medical field can bring valuable lessons for the post pandemic future, not only in preparation for possible new pathogens with pandemic potential but also with principles and concepts applicable to managing all biological agents. In particular, a paradigm shift is needed to properly approach occupational diseases caused by infective agents, accurately define the "case", assess exposure and possible causal relationship with work appropriately, and effectively manage the specific risk through implementing appropriate preventive and protective measures. In this framework, the Occupational Physician should expand his contribution based on his unique expertise and specific competencies, confirming his role as the go-to consultant in all occupational health matters, but also in a multidisciplinary approach, considering different scientific expertise and evidence.
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COVID-19 in Workplace Settings: Lessons Learned for Occupational Medicine in the UK. LA MEDICINA DEL LAVORO 2023; 114:e2023055. [PMID: 38060204 PMCID: PMC10731572 DOI: 10.23749/mdl.v114i6.15461] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 12/08/2023]
Abstract
This paper addresses lessons learned from the COVID-19 pandemic from a UK Occupational Medicine perspective to permit comparison with other national accounts. In spite of good prior research and statute, the necessary resources to protect workers' health were seriously lacking when the pandemic struck. Weak public health guidance, which did not recognise dominant airborne transmission, was applied to workplaces, leaving workers and others unprotected, especially in respect to Respiratory Protective Equipment (RPE). The Health and Safety Executive (HSE) as regulator was lacking, for example, in not producing guidance to protect HealthCare Workers (HCW) who were amongst the most at risk. The UK COVID-19 Public Inquiry should address shortcomings such as these, but recommendations must be accompanied by robust means to ensure appropriate implementation. These should range from substantial measures to improve indoor air quality, to a permanent pandemic management organization with adequate resources. The enforcing authority has to be obliged to publish more specific workplace guidance than the public health authorities. Occupational medicine as a discipline needs to be better prepared, and hence to assert its responsibility towards high standards of workers' health protection. Future research has to include investigating the best means of mitigation against airborne infection and the management of post-acute covid sequelae.
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Evaluation of properties of elastomeric head straps of filtering facepiece respirators. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2023; 29:1294-1300. [PMID: 37711019 DOI: 10.1080/10803548.2023.2257066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
Frequent donning and doffing of filtering facepiece respirators (FFRs) can reduce their effectiveness due to the residual deformation of their elastic head straps. This study investigates the loss of elasticity of head straps during repeated use. Five elastomeric tapes were tested as FFR head straps, and their tensile strength was measured using a DU-100 dynamometer after repeated donning and doffing cycles. After eight consecutive uses, the protection factor drops significantly, requiring strap length adjustments to guarantee the specified level of user protection. The maximum tensile force of the elastomeric head straps causes residual elongation, which remains consistent after eight cycles. The study also establishes how strap elongation depends on the force and number of donning and doffing cycles. This knowledge is vital for designing better FFRs. Additionally, the research explores alternative materials for FFR construction to address strap elongation and its effects on performance and comfort.
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Anaesthetists' current practice and perceptions of aerosol-generating procedures: a mixed-methods study. Anaesthesia 2022; 77:959-970. [PMID: 35864419 PMCID: PMC9543704 DOI: 10.1111/anae.15803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 01/11/2023]
Abstract
The 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.
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Skin and respiratory ill-health attributed to occupational face mask use. Occup Med (Lond) 2022; 72:339-342. [PMID: 35689550 PMCID: PMC9384225 DOI: 10.1093/occmed/kqac031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Face mask use in the workplace has become widespread since the onset of the Covid-19 pandemic and has been anecdotally linked to adverse health consequences. AIMS To examine reports of adverse health consequences of occupational face mask use received by The Health and Occupation Research (THOR) network before and after the pandemic onset. METHODS THOR databases were searched to identify all cases of ill-health attributed to 'face mask' or similar suspected causative agent between 1 January 2010 and 30 June 2021. RESULTS Thirty two cases were identified in total, 18 reported by occupational physicians and 14 by dermatologists. Seventy-five per cent of cases were reported after the pandemic onset and 91% cases were in the health and social care sector. 25 of the 35 (71%) diagnoses were dermatological, the most frequent diagnoses being contact dermatitis (14 cases) and folliculitis/acne (6 cases). Of the seven respiratory diagnoses, four were exacerbation of pre-existing asthma. CONCLUSIONS There is evidence of an abrupt increase in reports of predominantly dermatological ill-health attributed to occupational face mask use since the start of the pandemic. Respiratory presentations have also occurred.
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Changes in skin characteristics after using respiratory protective equipment (medical masks and respirators) in the COVID-19 pandemic among healthcare workers. Contact Dermatitis 2021; 85:225-232. [PMID: 33813749 PMCID: PMC8251455 DOI: 10.1111/cod.13855] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/19/2021] [Accepted: 03/31/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND The coronavirus disease-2019 (COVID-19) outbreak has presented unique dermatologic challenges due to respiratory protective equipment (RPE)-related skin conditions. OBJECTIVE To objectively evaluate the effects of RPE including medical masks and respirators on the skin barrier by measuring various physiological properties of the skin. METHODS A cross-sectional study was designed. Twenty healthy healthcare workers were included in this study. Skin parameters including skin hydration, transepidermal water loss (TEWL), erythema, sebum secretion, pH, and skin temperature were measured in the RPE-covered and RPE-uncovered areas of the face 4 and 8 hours after wearing RPE and 14 hours after not wearing RPE. RESULTS Skin hydration, TEWL, erythema, pH, and skin temperature increased in the RPE-covered areas after wearing RPE for 4 and 8 hours. By contrast, in the RPE-uncovered areas, skin hydration decreased and TEWL, erythema, and pH showed minimal changes over time. Based on the repeated-measure analysis, the changes in skin physiological properties over time were significantly different between RPE-covered and RPE-uncovered areas. CONCLUSION We observed that skin physiological characteristics change with the prolonged use of RPE such as medical masks and respirators. These changes may lead to various adverse skin reactions after long-term use.
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Insecticide Filtration Efficiency of Respiratory Protective Equipment Commonly Worn by Farmers in Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2624. [PMID: 33807896 PMCID: PMC7967504 DOI: 10.3390/ijerph18052624] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/15/2021] [Accepted: 03/02/2021] [Indexed: 11/17/2022]
Abstract
Farmers are at a high risk of inhalation exposure when handling pesticides. Thai farmers usually protect themselves against pesticide exposure by wearing commercial respiratory protective equipment (RPE) available from rural community markets. However, scientific data regarding the pesticide filtration efficiency of RPE commonly worn by farmers is limited. Thus, this study aimed to investigate the efficiency of insecticide filtration of various RPE commonly worn by farmers in Thailand. The half facepiece respirator was used as a control to compare the results with other RPE. Ten types of RPE were selected for testing. The filtration efficiency of each RPE against insecticides was tested in a laboratory. The remarkable findings were that a surgical mask demonstrated the least filtration efficiency of all tested insecticides, with a range of 25.7-61.5%. The RPE available in rural markets of Thailand had a filtration efficiency within a range of 64.9-95.4%, whereas a half facepiece respirator was the most efficient in filtering insecticides, with a range of 96.5-98.9%. Therefore, our results suggest that the RPE most frequently worn by farmers may not provide adequate protection when compared with the respirator. However, considerations around RPE use in low-and middle-income countries and tropical climate conditions should be based on pesticide toxicity and practical use, ensuring balance between the risks from pesticide exposure and acceptance of PPE use.
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Comparative Performance Testing of Respirator versus Surgical Mask Using a Water Droplet Spray Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041599. [PMID: 33567665 PMCID: PMC7915861 DOI: 10.3390/ijerph18041599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/31/2021] [Accepted: 02/04/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND During the SARS-CoV-2 pandemic, there was shortage of the standard respiratory protective equipment (RPE). The aim of this study was to develop a procedure to test the performance of alternative RPEs used in the care of COVID-19 patients. METHODS A laboratory-based test was developed to compare RPEs by total inward leakage (TIL). We used a crossflow nebulizer to produce a jet spray of 1-100 µm water droplets with a fluorescent marker. The RPEs were placed on a dummy head and sprayed at distances of 30 and 60 cm. The outcome was determined as the recovery of the fluorescent marker on a membrane filter placed on the mouth of the dummy head. RESULTS At 30 cm, a type IIR surgical mask gave a 17.7% lower TIL compared with an FFP2 respirator. At 60 cm, this difference was similar, with a 21.7% lower TIL for the surgical mask compared to the respirator. When adding a face shield, the TIL at 30 cm was further reduced by 9.5% for the respirator and 16.6% in the case of the surgical mask. CONCLUSIONS A safe, fast and very sensitive test method was developed to assess the effectiveness of RPE by comparison under controlled conditions.
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What face mask for what use in the context of COVID-19 pandemic? The French guidelines. J Hosp Infect 2020; 105:S0195-6701(20)30211-5. [PMID: 32348833 PMCID: PMC7194956 DOI: 10.1016/j.jhin.2020.04.036] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/23/2020] [Indexed: 11/18/2022]
Abstract
In the context of the COVID-19 pandemic, wearing a face mask has become usual and ubiquitous, in both hospitals and community. However, the general public is consuming surgical or filtering face piece (FFP) masks irrespective of their specificity, leading to global supply shortage for the most exposed persons, which are healthcare workers. This underlines the urgent need to clarify the indications of the different categories of mask, in order to rationalize their use. The study herein specifies the French position for the rational use of respiratory protective equipment for healthcare workers.
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The Effect of a Knowledge-Based Intervention on the Use of Respirators in the Norwegian Smelter Industry. Front Psychol 2020; 11:270. [PMID: 32153476 PMCID: PMC7044339 DOI: 10.3389/fpsyg.2020.00270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 02/04/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction The present study investigated the effect of interventions aiming to improve attitudes toward the use of respiratory protective equipment (RPE), knowledge of RPE and the use of RPE in the Norwegian smelter industry. Method The surveys received 567 respondents to baseline and 240 respondents 2 weeks after the intervention. Participants were invited to either a fit-testing of respirators [Group 1] or a fit-testing combined with a lecture on exposure [Group 2], health effects and RPE. The control group [Group 3] received no training. Questionnaires containing measures of subjective knowledge, attitudes and behavior regarding RPE use were assessed. Results Testing indicated an improvement in knowledge of RPE and a reduction in perceived inconveniences regarding the use of RPE for both intervention groups. Group 1 showed an improvement in attitudes and organizational support, while intervention Group 2 showed an improvement in subjective norms related to RPE use. Intention to use or rate of respirator use was not shown to change significantly for any group using paired testing. Regression analysis indicated that participation in either intervention influenced intention to use respirators. The effect was significant for Group 1 and was marginally significant for intervention Group 2. Conclusion The results indicate that interventions can increase workers’ knowledge and attitudes, and reduce perceived inconvenience regarding the use of respiratory protective equipment. However, even though some variables seemed to positively change, reported respirator use did not improve for either groups participating in the study. It may be that physical barriers with regards to using RPE, such as fogging of protective goggles, sweating, breathing and communication issues outweigh individual attitudes, intentions and social pressure to use respirators. Practical Applications The tailored course and practical training in RPE use in the current intervention can be applied in the smelting industry to provide up to date information on dust exposure, health effects and protective equipment. Some adjustments may be warranted for the content to fit specific risks and exposures of other industries. However, the general pedagogical framework of the educational material regarding health effects and RPE should be useful for most heavy industries.
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Results 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. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3187. [PMID: 31480482 PMCID: PMC6747133 DOI: 10.3390/ijerph16173187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 11/17/2022]
Abstract
Background: Existing evidence shows an urgent need to improve respiratory protective equipment (RPE) use, and more so among migrant workers in small and medium-sized enterprises (SMEs). The study aimed to assess the effectiveness of a behavioral intervention in promoting the appropriate use of RPE among internal migrant workers (IMWs) exposed to organic solvents in SMEs. Methods: A cluster randomized controlled trial was conducted among 1211 IMWs from 60 SMEs in Baiyun district in Guangzhou, China. SMEs were deemed eligible if organic solvents were constantly used in the production process and provided workers with RPE. There were 60 SMEs randomized to three interventions on a 1:1:1 ratio, namely a top-down intervention (TDI), a comprehensive intervention, and a control group which did not receive any intervention. IMWs in the comprehensive intervention received a module encompassing three intervention activities: An occupational health education and training component (lectures and leaflets/posters), an mHealth component in the form of messages illustrative pictures and short videos, and a peer education component. The TDI incorporated two intervention activities, namely the mHealth and occupational health education and training components. The primary outcome was the self-reported appropriate RPE use among IMWs, defined as using an appropriate RPE against organic solvents at all times during the last week before measurement. Secondary outcomes included IMWs' occupational health knowledge, attitude towards RPE use, and participation in occupational health check-ups. Data were collected and assessed at baseline, and three and six months of the intervention. Generalized linear mixed models were performed to evaluate the effectiveness of the trial. Results: Between 3 August 2015 and 29 January 2016, 20 SMEs with 368 IMWs, 20 SMEs with 390 IMWs, and 20 SMEs with 453 IMWs were assigned to the comprehensive intervention, the TDI, and the control group, respectively. At three months, there were no significant differences in the primary and secondary outcomes among the three groups. At six months, IMWs in both intervention groups were more likely to appropriately use RPE than the control group (comprehensive intervention: Adjusted odds ratio: 2.99, 95% CI: 1.75-5.10, p < 0.001; TDI: 1.91, 95% CI: 1.17-3.11, and p = 0.009). Additionally, compared with the control group, the comprehensive intervention also improved all three secondary outcomes. Conclusions: Both comprehensive and top-down interventions were effective in promoting the appropriate use of RPE among IMWs in SMEs. The comprehensive intervention also enhanced IMWs' occupational health knowledge, attitude, and practice. Trial registration: ChiCTR-IOR-15006929. Registered on 15 August 2015.
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Microbial Growth on Dust-Loaded Filtering Materials Used for the Protection of Respiratory Tract as a Factor Affecting Filtration Efficiency. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091902. [PMID: 30200464 PMCID: PMC6164222 DOI: 10.3390/ijerph15091902] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 08/28/2018] [Accepted: 08/29/2018] [Indexed: 11/16/2022]
Abstract
This work aims at understanding the effects of various dust-loading conditions and the type of nonwovens used in the construction of FFRs on the safe use of those protective devices in situations of exposure to biological agents. The survival of microorganisms (Escherichia coli, Candida albicans, and Aspergillus niger) in dust-loaded polypropylene nonwovens (melt-blown, spun-bonded, and needle-punched) was experimentally determined using microbiological quantitative method (AATCC TM 100-2004). Scanning electron microscope was used to assess biofilm formation on dust-loaded filtering nonwovens. The impact of the growth of microorganisms on filtration efficiency of nonwovens was analysed based on the measurements of penetration of sodium chloride particles (size range 7–270 nm). Results showed that tested microorganisms were able to survive on dust-loaded polypropylene filtering nonwovens. The survival rate of microorganisms and penetration of nanoparticles and submicron particles depended on the type of microorganism, as well as the type and the amount of dust, which indicates that both of those factors should be considered for FFR use recommendations.
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Predictors of Respiratory Protective Equipment Use in the Norwegian Smelter Industry: The Role of the Theory of Planned Behavior, Safety Climate, and Work Experience in Understanding Protective Behavior. Front Psychol 2018; 9:1366. [PMID: 30135666 PMCID: PMC6092595 DOI: 10.3389/fpsyg.2018.01366] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 07/16/2018] [Indexed: 11/15/2022] Open
Abstract
Previous research has revealed a higher prevalence of respiratory symptoms in Norwegian smelter workers compared to average population controls. Nevertheless, respiratory protective equipment (RPE) is not always used, even in situations with high exposure risk. A questionnaire was distributed to workers in the Norwegian smelting industry to investigate the relationship between psychological factors and self-reported use of RPEs. Response rate was 567/1,253. A scale measuring attitudes toward behavior (ATT), subjective norms (SN), perceived behavioral control (PBC), and behavioral intention (BI) was constructed based on the Theory of Planned Behavior (TPB). Reliability and Confirmatory Factor Analyses partially supported the theoretical structure of the TPB-based scale, the Work Experience Measurement Scale (WEMS) and the Short Scale for Safety Climate (SC). A model explaining the relationship between observed variables, latent constructs from TPB, WEMS and SC was developed by SEM-analysis. Significant influence on BI from ATT (β = 0.31 p < 0.01), SN (β = 0.36 p < 0.01), and SC (β = 0.19, p < 0.01) emerged. Among the observed variables included, relationship status (β = −0.12 p < 0.05), education level (β = 0.09, p < 0.05), previously completed respirator fit-testing (β = −0.09, p < 0.05) and average hours spent in exposed areas (β = −0.09) p < 0.05) had significant influence on behavioral intention. The model explained 48% of the variance in BI. BI and PBC significantly predicted PB, with β = 0.65 and β = −0.06, respectively. Results of this investigation can help facilitate further work and development of health & safety routines within industrial settings.
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A New Miniature Respirable Sampler for In-mask Sampling: Part 2-Tests Performed Inside the Mask. ANNALS OF OCCUPATIONAL HYGIENE 2016; 60:1084-1091. [PMID: 27630150 DOI: 10.1093/annhyg/mew051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 07/29/2016] [Accepted: 08/08/2016] [Indexed: 12/30/2022]
Abstract
This paper is the second in a series of two describing the performance of a miniature and low-weight respirable sampler designed to fit inside filtering facepiece (FFP) and half-mask type respirators. The first paper described the design of the miniature sampler and evaluated the particle and collection performance of the miniature sampler. This paper assesses its comparability with the traditional inward leakage measurement technique, and its safe use. Simultaneous mass measurements of a respirable sodium chloride aerosol were taken inside a total inward leakage chamber by a miniature sampler and by sodium flame photometry. Direct side-by-side comparison of the two methods yielded excellent correlation (R 2 = 0.99), as did comparison when sampling from inside four different masks when worn by a breathing Sheffield dummy head. In addition, comparison tests were carried out using three models of FFP worn by human volunteers both with and without the miniature sampler, in order to test whether or not the presence of the miniature sampler negatively affected the protection offered. The difference between the tests carried out with the miniature sampler and without the miniature sampler was not statistically significant (P = 0.3). In all cases, the masks performed within their protection class, whether the miniature sampler was fitted or not. We therefore conclude that the miniature sampler does not significantly affect the protection offered by the masks. The miniature sampler may prove a viable option for in-mask measurements of respirable dust where low air concentrations of hazardous material are expected.
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A New Miniature Respirable Sampler for In-mask Sampling: Part 1-Particle Size Selection Performance. ANNALS OF OCCUPATIONAL HYGIENE 2016; 60:1072-1083. [PMID: 27630151 DOI: 10.1093/annhyg/mew053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 07/29/2016] [Accepted: 08/08/2016] [Indexed: 12/30/2022]
Abstract
The Health and Safety Laboratory has developed a miniature respirable sampler to gain a better understanding of the exposure of workers to hazardous substances when they are wearing respiratory protective equipment (RPE) or helmets with visors in the workplace. The study was in two parts and the first part, described herein, was to develop the sampler and test its collection characteristics. Assessment of the impact of the sampler on RPE safety and its comparability with traditional laboratory-based approaches to measure protection factors was discussed in a second article. The miniature sampler (weight-5.4g, length-13mm) was designed to fit into the space available between the nose and chin of an individual inside a filtering facepiece type mask and has a radially omnidirectional inlet with a porous foam particle selector that allows the collection of the respirable fraction on a downstream filter. The sampling efficiency was compared with the respirable convention. A close match with the respirable convention was obtained at a flow rate of 1 l min-1 and the 50% penetration cut off value (d 50) was 4.08 µm. After 3 hours sampling in high humidity (95%), the penetration curve had shifted towards smaller particle sizes (d 50 = 3.81 µm) with 88% of the calculated bias values within 10%. The miniature sampler measured respirable dust and crystalline silica mass concentrations comparable with performance of the Safety In Mines Personal Dust Sampler (SIMPEDS), commonly used in Great Britain, at a flow rate of 0.8 l min-1 The d 50 for the miniature sampler at 0.8 l min-1 (4.4 µm) is within 5% of the d 50 of the SIMPEDS at its prescribed flow rate of 2.2 l min-1 (4.2 µm). These results indicated that the miniature sampler was a good candidate to proceed with tests with RPE described in the second part of this series of two papers.
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Evaluation of RPE-Select: A Web-Based Respiratory Protective Equipment Selector Tool. ANNALS OF OCCUPATIONAL HYGIENE 2016; 60:900-12. [PMID: 27286763 DOI: 10.1093/annhyg/mew035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 04/29/2016] [Indexed: 12/30/2022]
Abstract
This article describes the evaluation of an open-access web-based respiratory protective equipment selector tool (RPE-Select, accessible at http://www.healthyworkinglives.com/rpe-selector). This tool is based on the principles of the COSHH-Essentials (C-E) control banding (CB) tool, which was developed for the exposure risk management of hazardous chemicals in the workplace by small and medium sized enterprises (SMEs) and general practice H&S professionals. RPE-Select can be used for identifying adequate and suitable RPE for dusts, fibres, mist (solvent, water, and oil based), sprays, volatile solids, fumes, gases, vapours, and actual or potential oxygen deficiency. It can be applied for substances and products with safety data sheets as well as for a large number of commonly encountered process-generated substances (PGS), such as poultry house dusts or welding fume. Potential international usability has been built-in by using the Hazard Statements developed for the Globally Harmonised System (GHS) and providing recommended RPE in picture form as well as with a written specification. Illustration helps to compensate for the variabilities in assigned protection factors across the world. RPE-Select uses easily understandable descriptions/explanations and an interactive stepwise flow for providing input/answers at each step. The output of the selection process is a report summarising the user input data and a selection of RPE, including types of filters where applicable, from which the user can select the appropriate one for each wearer. In addition, each report includes 'Dos' and 'Don'ts' for the recommended RPE. RPE-Select outcomes, based on up to 20 hypothetical use scenarios, were evaluated in comparison with other available RPE selection processes and tools, and by 32 independent users with a broad range of familiarities with industrial use scenarios in general and respiratory protection in particular. For scenarios involving substances having safety data sheets, 87% of RPE-Select outcomes resulted in a 'safe' RPE selection, while 98% 'safe' outcomes were achieved for scenarios involving process-generated substances. Reasons for the outliers were examined. User comments and opinions on the mechanics and usability of RPE-Select are also presented.
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Abstract
The Ebola epidemic in West Africa presents a considerable occupational risk to the health personnel involved. The principal mode of virus transmission to health care personnel is through direct contact with the patient, although transmission by aerosols through the air may also occur. Many safety protocols have been suggested relating to personal protection and particularly respiratory protection. It is generally agreed that all health care workers should have easy access to personal protective equipment. However, the degree of respiratory safety escalates from a mask, to an adequate respirator, and finally to a whole body suit with integrated helmet and positive air pressure. Recent publications demonstrate a lack of consensus on the degree of safety necessary. The step from "safe enough" to being "absolutely safe" seems, in most countries, insurmountable because of costs and logistics.
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Clogging of Filtering Material Systems Used for Disposable Respirators. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 1997; 3:191-202. [PMID: 28076725 DOI: 10.1080/10803548.1997.11076375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The article shows the problem of clogging in connection with the parameters of filtering materials used in respiratory protective equipment. The results of investigations of airflow resistance changes during the depositing of dust inside the filtering material are presented. The configuration of layers differing in mass per unit area and the number of layers, were taken into consideration. For each configuration, the clogging abilities and the changes of airflow resistance as a reason of loading with dust were assessed. The analysis of tested materials confirms the hypothesis that there is an important coincidence between the properties of the material used in filtering equipment and the clogging coefficient. The results show that the filter should have a layered structure and that the outer layer should be made of a nonwoven of relatively high surface density.
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