Honoring Eula Bingham: A Memorial Gathering During the Covid-19 Pandemic

Eula Bingham, a toxicologist who invigorated the Occupational Safety and Health Administration as its director and set stringent standards to protect workers from hazardous materials, died on 13 June 2020 in Cincinnati. Throughout Dr. Bingham's long career, she insisted tirelessly that workers had the absolute right to be safe on the job. Her thoughtful and generous wisdom shaped the entire field of occupational safety and health. Her bold and courageous actions prevented countless illnesses and injuries in workers around the world. This article presents the edited transcript from a Virtual Memorial Remembrance of Eula Bingham.

The Occupational Safety and Health Administration at 50: Protecting Workers in a Changing Economy

The passage of the Occupational Safety and Health Act of 1970 brought unprecedented changes in US workplaces, and the activities of the Occupational Safety and Health Administration (OSHA) have contributed to a significant reduction in work-related deaths, injuries, and illnesses. Despite this, millions of workers are injured annually, and thousands killed.To reduce the toll, OSHA needs greater resources, a new standard-setting process, increased civil and criminal penalties, full coverage for all workers, and stronger whistleblower protections. Workers should not be injured or made sick by their jobs. To eliminate work injuries and illnesses, we must remake and modernize OSHA and restructure the relationship of employers and workers with the agency and each other.This includes changing the expectation of what employers must do to protect workers and implementing a requirement that firms have a "duty of care" to protect all people who may be harmed by their activities. Only by making major changes can we ensure that every worker leaves work as healthy as they were when their work shift began.

On site comparison of the OSHA 42, Asset EZ4-NCO, Iso-Chek, DAN and CIP10 methods for measuring toluene diisocyanate (TDI) at a polyurethane foam factory

Because of the semi-volatile nature of diisocyanates (being airborne in both physical vapor and particulate phases), their high reactivity and low occupational exposure limits, diisocyanate exposure evaluation has been challenging for industrial hygienists and laboratories. The objective of this study was to compare the toluene diisocyanate (2,4 and 2,6 isomers, TDI) concentration measured by five methods in a flexible polyurethane foam factory using different collection or derivatization approaches. The methods used were: OSHA 42 modified (filter, 1-(2-pyridyl)piperazine) (OSHA), Asset EZ4-NCO (denuder and filter, dibutylamine) (Asset), Iso-Chek (double-filter, 9-(N-methylaminomethyl) anthracene and 1,2-methoxyphenylpiperazine), DAN (filter, 1,8-diaminonaphthalene), and CIP10 (centrifugation, 1,2-methoxyphenylpiperazine). Particle real-time monitoring for concentration and size distribution was performed in parallel to improve the understanding of the potential bias between methods. The comparison study was performed over 3 days, providing 18 replicates for each of the 5 methods. Isocyanate concentrations collected for each sampling method were compared using linear mixed effect modeling. Compared to OSHA, which yielded the highest concentrations overall, the Asset and DAN methods provided the smallest biases (-29% (95% CI [-52;-6]) and -45% (95% CI [-67;-23]), respectively), while the CIP10 and Iso-Chek methods provided the largest biases (-82% (95% CI [-105;-66]) and -96% (95% CI [-118;-75]), respectively). The substantial bias of Iso-Chek and CIP10 seemed to be explained by the predominance of TDI in the form of sub-micron particles that were inadequately captured by these two methods due to their sampling principle, which are particle filtration without derivatizing agent and centrifugation respectively. Asset and DAN performance seemed to decrease as the sampling time increased. While DAN's bias could be related to a reagent deficiency on the filter, the disparities between OSHA and Asset, both considered as reference methods, highlight the fact that the mechanisms of collection, derivation and extraction do not seem to be completely controlled. Finally, an upward trend has been observed between concentrations of particles below 300 nm in size and concentration levels of TDI. It has also been observed that TDI levels increased with the TDI foam index produced at the facility.

Comparison between OSHA-NIOSH Heat Safety Tool app and WBGT monitor to assess heat stress risk in agriculture

Agricultural workers are exposed to heat stress due to spending significant amount of time outdoors. Risk information from mobile apps is more readily available for timely advice on risk management that is crucial in preventing severe acute illnesses and deaths, but its reliability is unknown. The purpose of this study was to determine the reliability of the OSHA-NIOSH Heat Safety Tool mobile app in providing accurate risk information to prevent heat-related illnesses among agricultural workers in eastern North Carolina. Wet bulb globe temperature (WBGT) indices were datalogged at two agricultural sites using heat stress monitors from April-August 2019 and were assigned to risk levels (minimal, low, moderate, high, extreme) by workload (light, moderate, heavy, very heavy) based on the ACGIH^® Threshold Limit Values (TLVs^®). Hourly heat index (HI) and its corresponding risk level were obtained using the app. Hourly HI-based risk level assignments were time-matched to their corresponding WBGT-based risk level assignments (682 pairs) and analyzed using cross-tabulation by determining the percentage of hourly WBGT-based risk level assignments ("gold standard") with the same hourly HI-based risk level assignments under different workloads, with a higher percentage indicating higher app reliability. Results showed that the app correctly identified 60-100% of minimal risk conditions, depending on workload type, but its reliability decreased as the heat stress risk condition and workload became more severe. The app identified the majority of low risk conditions for a moderate workload (74%) and moderate risk conditions for a light workload (94%) only, indicating limited use in these specific conditions, while the app identified 0% of either the high risk or extreme risk conditions at any workload type. It is concluded that the performance of the OSHA-NIOSH app in assessing occupational risk to heat stress is not protective of workers particularly for heavy and very heavy workloads, and that the use of the app for the assessment of occupational heat stress risk in agricultural settings is not recommended.

Does exposure to bentonite dust during tunnel hyperbaric interventions increase health risks for compressed air workers? A prospective qualitative and quantitative safety assessment

INTRODUCTION

The mining and tunneling industries are historically associated with hazardous exposures that result in significant occupational health concerns. Occupational respiratory exposures causing pneumoconiosis and silicosis are of great concern, silicosis being non-curable. This work demonstrates that compressed-air workers (CAWs) performing tunnel hyperbaric interventions (HIs) may be at risk for hazards related to bentonite exposure, increasing the likelihood of developing harmful illnesses including cancer. Bentonite dust inhalation may result in respiratory levels of silica exceeding acceptable industrial hygiene standards.

METHODS

A qualitative observational exposure assessment was conducted on CAWs while they were performing their HI duties. This was followed by quantitative data collection using personal and area air sample techniques. The results were analyzed and interpreted using standard industrial hygiene principles and guidelines from NIOSH and OSHA.

RESULTS

Our work suggests bentonite dust exposure may be an emerging particulate matter concern among CAWs in the tunneling industry. Aerosolized bentonite particles may have potential deleterious effects that include pneumoconiosis and silicosis. Silicosis can result in the development of pulmonary carcinoma.

CONCLUSIONS

The modern tunneling industry and required hyperbaric interventional tasks represent a potential public health and occupational concern for CAWs. This paper introduces the modern tunneling industry and the duties of CAWs, the hazardous environment in which they perform their duties, and describes the risks and potential harmful health effects associated with these hazardous exposures.

Acoustic trauma from continuous noise: Minimum exposures, issues in clinical trial design, and comments on magnetic resonance imaging exposures

Acoustic trauma (AT) is permanent hearing loss after a single noise exposure. A few human cases resulting from continuous, i.e., nonimpulsive noise, have been reported as reviewed by Ward [(1991). "Hearing loss from noise and music," presented at Audio Engineering Society, New York, October 4-8]. This paper updates that review by examining 11 cases in nine reports, from 1950 to 2006, with the intention of determining minimum exposures that may cause AT, including the potential risk of exposure to noise from magnetic resonance imaging machines. Diffuse-field related levels above 120 dBA for 10 s or more, or above 130 dBA for 2-3 s (values well above OSHA's unprotected exposure limits), can lead to AT. These cases appear to represent a susceptible fraction of the population, because much more intense exposures (e.g., 130 dBA for 32 min) have been tolerated by groups of volunteers who suffered only temporary threshold shifts. AT from continuous noise is unlikely to occur in OSHA-compliant hearing conservation programs, and probably rare enough in the general civilian population that clinical trials of drugs aimed at treating it are unlikely to be practical. AT from impulse noise, such as gunfire, which is specifically not the topic of the current work, is more amenable to clinical trials, especially in military settings.

Assessment of noise in the airplane cabin environment

OBJECTIVE

To measure sound levels in the aircraft cabin during different phases of flight.

METHODS

Sound level was measured on 200 flights, representing six aircraft groups using continuous monitors. A linear mixed-effects model with random intercept was used to test for significant differences in mean sound level by aircraft model and across each flight phase as well as by flight phase, airplane type, measurement location and proximity to engine noise.

RESULTS

Mean sound levels across all flight phases and aircraft groups ranged from 37.6 to >110 dB(A) with a median of 83.5 dB(A). Significant differences in noise levels were also observed based on proximity to the engines and between aircraft with fuselage- and wing mounted engines. Nine flights (4.5%) exceeded the recommended 8-h TWA exposure limit of 85 dB(A) by the NIOSH and ACGIH approach, three flights (1.5%) exceeded the 8-h TWA action level of 85 dB(A) by the OSHA approach, and none of the flights exceeded the 8-h TWA action level of 90 dB(A) by the OSHA PEL approach.

CONCLUSIONS

Additional characterization studies, including personal noise dosimetry, are necessary to document accurate occupational exposures in the aircraft cabin environment and identify appropriate response actions. FAA should consider applying the more health-protective NIOSH/ACGIH occupational noise recommendations to the aircraft cabin environment.

Work-related injuries and fatalities in the geotechnical site works

Geotechnical site works are comprehensive, and they constitute the first step of the construction process. This study performs data mining of geotechnical works and analyzes the database for the root causes of accidents. The Occupational Safety and Health Administration (OSHA) was chosen for the 1984-2013 time frame with 247 cases. Descriptive statistical analyses were performed to discuss variables such as the end use of the work, project type and cost, soil type and condition, type and degree of injury, cause and type of accident, unsafe acts, and occupation and union status of the victim. The results showed that these accidents have a high frequency of recurrence and have a high severity level (54.3% fatalities). In addition, a total of 838 violations were recorded with penalties reaching 5 million US dollars. This study emphasizes that project-specific countermeasures should be taken regarding the root causes of accidents, leading to vigorous strategies to develop safety measures.

Radon in the Workplace: the Occupational Safety and Health Administration (OSHA) Ionizing Radiation Standard

On 29 December 1970, the Occupational Safety and Health Act of 1970 established the Occupational Safety and Health Administration (OSHA). This article on OSHA, Title 29, Part 1910.1096 Ionizing Radiation standard was written to increase awareness of the employer, the workforce, state and federal governments, and those in the radon industry who perform radon testing and radon mitigation of the existence of these regulations, particularly the radon relevant aspect of the regulations. This review paper was also written to try to explain what can sometimes be complicated regulations. As the author works within the Radon Division of the Pennsylvania Department of Environmental Protection, Bureau of Radiation Protection, the exclusive focus of the article is on radon. The 1910.1096 standard obviously covers many other aspects of radiation and radiation safety in the work place.

Updating OSHA Standards Based on National Consensus Standards; Eye and Face Protection. Final rule

On March 13, 2015, OSHA published in the Federal Register a notice of proposed rulemaking (NPRM) to revise its eye and face protection standards for general industry, shipyard employment, marine terminals, longshoring, and construction by updating the references to national consensus standards approved by the American National Standards Institute (ANSI). OSHA received no significant objections from commenters and therefore is adopting the amendments as proposed. This final rule updates the references in OSHA's eye and face standards to reflect the most recent edition of the ANSI/International Safety Equipment Association (ISEA) eye and face protection standard. It removes the oldest-referenced edition of the same ANSI standard. It also amends other provisions of the construction eye and face protection standard to bring them into alignment with OSHA's general industry and maritime standards.

Occupational Exposure to Respirable Crystalline Silica. Final rule

The Occupational Safety and Health Administration (OSHA) is amending its existing standards for occupational exposure to respirable crystalline silica. OSHA has determined that employees exposed to respirable crystalline silica at the previous permissible exposure limits face a significant risk of material impairment to their health. The evidence in the record for this rulemaking indicates that workers exposed to respirable crystalline silica are at increased risk of developing silicosis and other non-malignant respiratory diseases, lung cancer, and kidney disease. This final rule establishes a new permissible exposure limit of 50 micrograms of respirable crystalline silica per cubic meter of air (50 [mu]g/m\3\) as an 8-hour time-weighted average in all industries covered by the rule. It also includes other provisions to protect employees, such as requirements for exposure assessment, methods for controlling exposure, respiratory protection, medical surveillance, hazard communication, and recordkeeping. OSHA is issuing two separate standards--one for general industry and maritime, and the other for construction--in order to tailor requirements to the circumstances found in these sectors.

Comparing written programs and self-reported respiratory protection practices in acute care hospitals

Airborne biological hazards in hospitals require the use of respiratory protection. A well-implemented respiratory protection program can protect health care workers from these exposures. This study examines the relationship between written respiratory programs and reported practices in health care settings. Twenty-eight hospitals in Illinois and Minnesota were recruited to a study of respiratory protection programs and practices in acute care settings. Interviews were conducted with hospital managers, unit managers, and health care workers from departments where respirators are commonly required. Each hospital's written respiratory protection program was scored for the 11 elements required by the Occupational Safety and Health Administration (OSHA), using a standardized tool, for a maximum possible score of 22 (2 pts. per element). Twenty interview questions associated with program practices were also scored by percent correct responses. Written program scores ranged from 2-17 with an average of 9.2. Hospital and unit managers scored on average 82% and 81%, respectively, when compared to the OSHA standard; health care workers scored significantly lower, 71% (p < 0.001). Minnesota written program scores were not significantly higher than Illinois hospitals (p = 0.16), while all Illinois survey respondents scored higher than those in Minnesota (p < 0.001). There was no trend between written programs and interview responses. Written respiratory protection programs in the study sites did not provide the level of detail required OSHA. Interview responses representing hospital practices surrounding respiratory protection indicated that hospitals were aware of and following regulatory guidelines.

Electricity remains a serious workplace hazard

Anyone who works in an industrial environment or is employed in the utility, mass transit, industrial goods manufacturing, or telecommunications industry - as well as many others - may be at risk for electrocution. Electric shock costs workers' lives and results in painful and debilitating injuries every year. Lockout/tagout procedures protect against electrocution, as do rubber insulating gloves, which must be worn any time workers are exposed to energized parts operating at 50 volts or higher. Some newer styles of rubber insulating gloves not only protect against electric shock, but also offer the dexterity and flexibility workers need for hours of comfortable wear.

Occupational and recreational noise exposure from indoor arena hockey games

Occupational and recreational noise exposures were evaluated at two sporting arenas hosting collegiate hockey games (Venue 1) and semi-professional hockey (Venue 2). A total of 54 personal noise dosimetry samples were taken over the course of seven home hockey games: 15 workers and 9 fans at Venue 1, and 19 workers and 11 fans at Venue 2. None of the sampled workers were overexposed to noise based on Occupational Safety and Health Administration criteria. However, 40% and 57% of workers at Venue 1 and 33% and 91% of fans at Venue 2 were overexposed based on ACGIH noise exposure criteria. Noise exposures for fans were significantly different between venues, but worker noise exposures between venues were not significantly different. In addition, extensive area noise monitoring was conducted at each venue to further characterize the stadium noise on a location-by-location basis. Mean equivalent sound pressure levels ranged from 81 to 96 dBA at Venue 1 and from 85 to 97 dBA at Venue 2. Mean noise peak levels ranged from 105 to 124 dBA at Venue 1, and from 110 to 117 dBA at Venue 2. These data reflect the potential for overexposure at indoor hockey events and are useful in characterizing occupational noise exposure of indoor arena support staff and may also provide a foundation for future noise control research in indoor sports arenas.

Are false-positive rates leading to an overestimation of noise-induced hearing loss?

PURPOSE

To estimate false-positive rates for rules proposed to identify early noise-induced hearing loss (NIHL) using the presence of notches in audiograms.

METHOD

Audiograms collected from school-age children in a national survey of health and nutrition (the Third National Health and Nutrition Examination Survey [NHANES III]; National Center for Health Statistics, 1994) were examined using published rules for identifying noise notches at various pass-fail criteria. These results were compared with computer-simulated "flat" audiograms. The proportion of these identified as having a noise notch is an estimate of the false-positive rate for a particular rule.

RESULTS

Audiograms from the NHANES III for children 6-11 years of age yielded notched audiograms at rates consistent with simulations, suggesting that this group does not have significant NIHL. Further, pass-fail criteria for rules suggested by expert clinicians, applied to NHANES III audiometric data, yielded unacceptably high false-positive rates.

CONCLUSIONS

Computer simulations provide an effective method for estimating false-positive rates for protocols used to identify notched audiograms. Audiometric precision could possibly be improved by (a) eliminating systematic calibration errors, including a possible problem with reference levels for TDH-style earphones; (b) repeating and averaging threshold measurements; and (c) using earphones that yield lower variability for 6.0 and 8.0 kHz--2 frequencies critical for identifying noise notches.

A survey of environmental safety issues at 20 medical clinics

In the study described in this article, the authors performed safety walk-throughs or inspections for 20 clinics located both inside a major medical center clinic (onsite) and away from the main clinic site (offsite). A checklist was used to evaluate compliance with institutional, local, state, and federal guidelines and regulations. The results obtained at onsite clinics were compared with the results from offsite clinics. Findings suggested no overall difference in the number of yes (desirable) answers. A marginally significant difference, however, was observed between the onsite and offsite clinics with regard to knowledge of infection control and waste/infection control questions. The walk-throughs helped create an improved working relationship between clinic personnel and environmental safety personnel, allowed for correction of safety issues, enabled an informal training opportunity, and increased institutional compliance with guidelines and regulations.

Views of a Cal/OSHA Inspector

Retiring CAL/OSHA Industrial Hygienist and Senior Safety Engineer Jack Oudiz offers his thoughts in the nature of a voluntary "exit interview" on his years working for the agency and its performance in its mission.

Improving compliance with Occupational Safety and Health Administration standards

Health care facilities can be dangerous places. The mission of the Occupational Safety and Health Administration (OSHA) is to improve the safety of the American workplace by developing and implementing standards that prevent occupational injury, illness, and death. Perioperative services are performed in environments where exposure to bloodborne pathogens is a daily occurrence, making implementation and compliance with OSHA standards very important. Employees and employers must remain current with workplace safety requirements, including use of personal protective equipment. This article presents implications of the OSHA standards for employers, educators, and employees.

Statistical methods for establishing equivalency of several sampling devices

The problem of comparing several alternate sampling devices to the Occupational Safety and Health Administration (OSHA) standard, or the comparison of several sampling devices among themselves, is considered. A test based on the OSHA criterion that states that "90% of the readings of the sampling device should be within +/- 25% of the readings obtained by the standard" is developed. Type I error rates and powers of the test are studied using Monte Carlo simulation. The study indicates that the proposed test is quite satisfactory for applications. The method is illustrated using a simulated data set.