The SARS‐CoV‐2 virus, which causes coronavirus disease 2019 (COVID‐19), has rapidly swept across the world since its identification in December 2019. Otolaryngologists are at unique risk due to the ...close contact with mucus membranes of the upper respiratory tract and have been among the most affected healthcare workers in Wuhan, China. We present information on COVID‐19 management relevant to otolaryngologists on the frontlines of this pandemic and provide preliminary guidance based on practices implemented in China and other countries and practical strategies deployed at Stanford University. Laryngoscope, 130:2537–2543, 2020
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
...a federal court upheld a challenge to the ban. In its risk evaluation for chrysotile asbestos, the EPA concluded that 16 of the 32 conditions of use presented unreasonable risks to human health. ...Maria Neira (WHO, Geneva, Switzerland), pointed out that even if adequate precautions are established for individuals working with asbestos, the mere existence of a market for the material endangers people further down the supply chain. ...products containing asbestos do not last forever.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Exposure to airborne substances such as gases, vapours, and particles remains a relevant health risk in many workplaces. A current topic and cause for discussion is the investigation of the health ...effects of particles containing zinc oxide (ZnO). Among other data, those collected from our study on human exposure data of ZnO in 2018 prompted the National Research Centre for the Working Environment 2021 to formulate a new, sharply lowered proposed occupational exposure limit (OEL) for zinc in workplaces. Since the publication of the Danish report, further studies have been conducted with ZnO. In the following text, all arguments for deriving this new limit value for zinc from the report are discussed, extended with the more recent data since 2018. It should be noted that especially the application of time extrapolation factors needs further discussion and harmonization between regulatory authorities. From our point of view, the data situation can justify a higher OEL for zinc than that proposed by the Danish National Research Centre for the Working Environment.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
There is limited evidence regarding the exposure‐effect relationship between lung‐cancer risk and hexavalent chromium (Cr(VI)) or nickel. We estimated lung‐cancer risks in relation to quantitative ...indices of occupational exposure to Cr(VI) and nickel and their interaction with smoking habits. We pooled 14 case‐control studies from Europe and Canada, including 16 901 lung‐cancer cases and 20 965 control subjects. A measurement‐based job‐exposure‐matrix estimated job‐year‐region specific exposure levels to Cr(VI) and nickel, which were linked to the subjects' occupational histories. Odds ratios (OR) and associated 95% confidence intervals (CI) were calculated by unconditional logistic regression, adjusting for study, age group, smoking habits and exposure to other occupational lung carcinogens. Due to their high correlation, we refrained from mutually adjusting for Cr(VI) and nickel independently. In men, ORs for the highest quartile of cumulative exposure to CR(VI) were 1.32 (95% CI 1.19‐1.47) and 1.29 (95% CI 1.15‐1.45) in relation to nickel. Analogous results among women were: 1.04 (95% CI 0.48‐2.24) and 1.29 (95% CI 0.60‐2.86), respectively. In men, excess lung‐cancer risks due to occupational Cr(VI) and nickel exposure were also observed in each stratum of never, former and current smokers. Joint effects of Cr(VI) and nickel with smoking were in general greater than additive, but not different from multiplicative. In summary, relatively low cumulative levels of occupational exposure to Cr(VI) and nickel were associated with increased ORs for lung cancer, particularly in men. However, we cannot rule out a combined classical measurement and Berkson‐type of error structure, which may cause differential bias of risk estimates.
What's new?
Occupational exposure to hexavalent chromium (Cr(VI)) and nickel is associated with increased lung‐cancer risk. Little is known, however, about quantitative exposure‐effect relationships between lung cancer and Cr(VI) or nickel. Here, quantitative exposure‐effect relationships were investigated using secondary measurement data from different regions and time periods across a wide range of jobs, with adjustment for smoking habits. Lung‐cancer risk was elevated even at low cumulative exposure levels to Cr(VI) or nickel, particularly in men and regardless of smoking habits. The findings warrant ongoing surveillance for carcinogenic risks of occupational metal exposure.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Since reports published in 2015 and 2016 identified 15 probable exposure-outcome associations, there has been an increase in studies in humans of exposure to endocrine-disrupting chemicals (EDCs) and ...a deepened understanding of their effects on human health. In this Series paper, we have reviewed subsequent additions to the literature and identified new exposure-outcome associations with substantial human evidence. Evidence is particularly strong for relations between perfluoroalkyl substances and child and adult obesity, impaired glucose tolerance, gestational diabetes, reduced birthweight, reduced semen quality, polycystic ovarian syndrome, endometriosis, and breast cancer. Evidence also exists for relations between bisphenols and adult diabetes, reduced semen quality, and polycystic ovarian syndrome; phthalates and prematurity, reduced anogenital distance in boys, childhood obesity, and impaired glucose tolerance; organophosphate pesticides and reduced semen quality; and occupational exposure to pesticides and prostate cancer. Greater evidence has accumulated than was previously identified for cognitive deficits and attention-deficit disorder in children following prenatal exposure to bisphenol A, organophosphate pesticides, and polybrominated flame retardants. Although systematic evaluation is needed of the probability and strength of these exposure-outcome relations, the growing evidence supports urgent action to reduce exposure to EDCs.
Background
Workers fabricating engineered stone face high risk for exposure to respirable crystalline silica (RCS) and subsequent development of silicosis. In response, the California Division of ...Occupational Safety and Health (Cal/OSHA) performed targeted enforcement inspections at engineered stone fabrication worksites. We investigated RCS exposures and employer adherence to Cal/OSHA's RCS and respiratory protection standards from these inspections to assess ongoing risk to stone fabrication workers.
Methods
We extracted employee personal air sampling results from Cal/OSHA inspection files and calculated RCS exposures. Standards require that employers continue monitoring employee RCS exposures and perform medical surveillance when exposures are at or above the action level (AL; 25 μg/m3); exposures above the permissible exposure limit (PEL; 50 μg/m3) are prohibited. We obtained RCS and respiratory protection standard violation citations from a federal database.
Results
We analyzed RCS exposures for 152 employees at 47 workplaces. Thirty‐eight (25%) employees had exposures above the PEL (median = 89.7 μg/m3; range = 50.7–670.7 μg/m3); 17 (11%) had exposures between the AL and PEL. Twenty‐four (51%) workplaces had ≥1 exposure above the PEL; 7 (15%) had ≥1 exposure between the AL and PEL. Thirty‐four (72%) workplaces were cited for ≥1 RCS standard violation. Twenty‐seven (57%) workplaces were cited for ≥1 respiratory protection standard violation.
Conclusions
Our investigation demonstrates widespread RCS overexposure among workers and numerous employer Cal/OSHA standard violation citations. More enforcement and educational efforts could improve employer compliance with Cal/OSHA standards and inform employers and employees of the risks for RCS exposure and strategies for reducing exposure.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Significantly lower permissible occupational exposure limits for copper dust are being discussed in Europe and other jurisdictions. However, little data are published on exposures in occupational ...settings and copper-specific effects in humans. Hence, a health surveillance study was performed among workers employed at a copper smelter between 1972 and 2018.
Possible effects of long-term exposures to dust containing copper on lung function were assessed. Specifically, declines in forced expiratory volume in 1 second (FEV1) were compared between a copper-exposed and control group. Cumulative copper exposures were derived from historical airborne monitoring data.
FEV1 declines among exposed and control never smokers were similar to a typical age-dependent decline of 29 mL/y.
The study findings indicate that cumulative inhalable copper dust exposure averaging 4.61 mg/m3-years over an exposure duration of ∼22 years is not associated with adverse effects on lung function.
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