Medical certification of workers for respirator use is an important activity of occupational medicine health professionals. Spirometry is a diagnostic tool to evaluate respiratory distress/insufficiency that may affect respirator use. In this study, we analyzed the pulmonary function data of 337 workers from different occupations which required medical evaluation to wear a respirator. The American Thoracic Society and National Fire Protection Association criteria were used to evaluate employees. Of 337 workers who were cleared for respiratory use on the basis of medical questionnaires for respirator compliance, 14 (4.15%) failed to pass respirator compliance on the basis of NFPA criteria and 5 (1.48%) failed to pass respirator compliance criteria on the basis of ATS criteria. We compared the use of different Spirometric equations to evaluate these criteria and we found the Crapo equation cleared more workers for respirator use as compared to the Knudson and NHANES III equations. We also measured repeated Forced Expiratory Volume in 1st Second (FEV1) and Forced Vital Capacity (FVC) and compared the results longitudinally over time. Age was the only significant factor affecting the reduction in the lung function in longitudinal analysis. Longitudinal spirometry results suggested that workers were protected while using a respirator in the workplace, but age is the significant factor in reducing their lung function. As some workers were able to qualify for respirator use based on questionnaire alone but failed respirator clearance subsequent to pulmonary function testing, it is recommended that spirometry be used to evaluate clearance for all workers who will use a respirator in the workplace. As well, using different Spirometric equations can affect the outcome on passing or failing clearance for respirator use, and this should be considered in a respiratory medical certification program.

Background: Since 1965, there have not been any major revisions of the healthcare laws in the United States, until the recent implementation of the Affordable Care Act (ACA). However, ACA is not well understood and is often controversial. The purpose of this study is to: (1) evaluate the relationship between the employers’ and the employees’ perceptions regarding the ACA mandates for small businesses, (2) evaluate the relationship between the self-reported and the tested knowledge of individuals regarding the ACA mandates for small businesses, and (3) determine if socio-demographic factors influence individual’s perception of the law. Based on the gathered information, we aim to develop a socio-ecological model of ACA acceptance to address the barriers and facilitators to implementing the new law and recommend changes to address any deficits. Method: An online questionnaire was distributed anonymously to employees and employers of small businesses. The data gathered included information on the participants' knowledge and perceptions on the law and their socio-demographic information. Kendall correlation test, generalized linear regression models and bootstrapping resampling method were employed to detect differences in the perceptions & knowledge of employees and employers, to evaluate the association between self-reported and tested knowledge, and to generate a SEM model of ACA perception and acceptance. Results: Based on the analysis, we found that job status significantly affects the individual perception of the law (p = 0.004). The study showed a statistically significant negative association between the self-reported knowledge and the actual-tested knowledge of individuals (r= -0.4174, p-value of 0.01159). We found that interpersonal level had the highest impact on perception (coefficient of 5.67, p-value0.05). Conclusion: Individual perception is a key factor in adoption of new policies. A socio-ecological model of ACA acceptance can be a powerful tool in addressing the barriers and facilitators to the successful implementation of the new law and to modify the policies to address any deficits in the law.

Mold is a type of fungus present in nearly all environments. Mold thrives under several environmental parameters such as high humidity and an adequate food source. A professional, such as an industrial hygienist, can measure mold in indoor and outdoor environments. Industrial hygienists commonly use a cascade impactor with a culture plate to capture air within a sampling area. While collecting air samples, environmental parameters such as temperature, humidity, and carbon dioxide are recorded. A laboratory then cultures and analyzes the samples, identifying the types and amounts of viable mold found in the sampling area. In this study, a data analysis method is used to interpret lab results and compare those results to the environmental parameters measured during collection. The study aims to show the relationship between the environmental parameters (temperature, humidity, carbon dioxide) and the types and amounts of mold that were measured in both indoor built environments and their surrounding outdoor areas. Among all 170 different sampling locations, the outdoor areas had higher counts and concentrations of mold. In addition, both indoor and outdoor areas saw Penicillium, Aspergillus, and Cladosporium as the most prevalent molds, with Cladosporium having the highest counts. Lower temperatures and humidity had a very small influence on mold growth and thus, yielded the lowest counts. Furthermore, the highest concentrations of mold were found within the same temperature and humidity ranges for both indoor and outdoor environments.

Formaldehyde is a colorless gas that is found naturally in the environment. It is a popular additive in many consumer products including composite wood products. Composite wood products are engineered wood panels produced from pressing pieces, chips, particles, or fibers of wood together at high temperatures held together with a bonding agent. This bonding agent is often formaldehyde-containing resins that are known to release formaldehyde over time. This is concerning because of the carcinogenic classification of formaldehyde, the wide spread application of composite wood products, and the increasing amount of time spent in the indoor environment. In a controlled 0.53 m3 chamber, a panel of medium density fiberboard (MDF) with a surface area of 4.49 m2 was subjected to multiple temperatures to measure formaldehyde emissions. The panels were allowed to acclimate for 48 hours followed by a 72 hour sample period using passive diffusive monitors at temperatures: 26.1, 29.3, 34.1, and 38.9 °C. The results of the study found a strong relationship (R2 = 0.9954) between the emission rate of formaldehyde from MDF and temperature. The emission rate increased 192% between 26.1 °C and 38.9 °C. The results of the study indicate that as temperature increases, the amount of formaldehyde emitted from a panel of MDF also increases. This results in higher airborne concentrations of formaldehyde in environments where the panels are present.

Introduction: Assessment of heat strain is an alternative approach to assessing heat stress exposures. Two common measures of heat strain are body core temperature (TC) and heart rate (HR). In this study TC was assessed by rectal temperature (Tre). Physiological Strain Index (PSI) was developed to combine both Tre and HR into one metric. Data collected from progressive heat stress trials were used to (1) demonstrate that PSI can distinguish between Sustainable and Unsustainable heat stress; (2) suggest values for PSI that demonstrate a sustainable level of heat stress; and (3) determine if clothing or metabolic rate were effect modifiers. Methods: Two previous progressive heat stress studies included 494 trials with 988 pairs of Sustainable and Unsustainable exposures over a range of relative humidity (rh), metabolic rates (M) and clothing using 29 participants. To assess the discrimination ability of PSI, conditional logistic regression and logistic regression were used. The accuracy of PSI was assessed using Receiver Operating Characteristic curves (ROC). Results: The present study found that primary (Tre, HR, and Tsk) and derived (PSI and ΔTre-sk) HSMs can accurately predict Unsustainable heat stress exposures based on AUCs that ranged from 0.73 to 0.86. Skin temperature had the highest AUC (0.86) with PSI in the mid-range (0.79). The values of the HSMs associated with a predicted probability of 0.25 were considered as screening values (PSI < 2.6, ΔTre-sk > 1.9 °C, Tre < 37.5, HR < 109, and Tsk < 35.8). The value of using any one of these individual indicators is that they act as a screening tool to decide if an exposure assessment is needed. Metabolic rate was found to be a confounder for all the HSMs except for RTsk. It was not statistically significant for HSMs derived models (PSI and ΔTre-sk). And its effect modification was not significant in any model. Conclusions: Based on the ROC curve, PSI can accurately predict Unsustainable heat stress exposures (AUC 0.79). HR alone has a similar capacity to distinguish Unsustainable exposures (AUC 0.78) under relatively constant exposure (metabolic rate and environment) for an hour or so. Screening limits with high sensitivity, however, have low thresholds. This limits the utility of these heat strain metrics. To the extent that the observed strain is low, there is good evidence that the exposure is Sustainable.

Noise-related hearing loss has been listed as one of the most prevalent occupational health concerns in the United States for more than 25 years with approximately 30 million people in the US alone occupationally exposed to hazardous noise according to the Occupational Safety and Health Organization. Many people are aware of some risks the military members take every day being at war, but very few think about the risks of the members on a base located stateside. To this point, not much research has been done on these risks, and even less has been done on the hazardous noise risks these service members are subjected to. These workers typically work many days a week as well as long hours while being around loud noises for extended periods of time. The purpose of this research study was to collect data on personal noise exposure for security forces at multiple locations at MacDill Air Force Base (AFB) to compare the results with the Air Force Occupational and Environmental Exposure Limit (OEEL) of 85 dBA for an 8-hour time weighted average (TWA) and the Occupational Safety and Health Administration’s (OSHA) Permissible Exposure Limit (PEL) of 90 dBA for an 8-hour TWA. Personal noise dosimeters were used for collecting personal noise exposure, and sound level meters were used for collecting area noise exposure. A Lieutenant at MacDill offered the data she was at liberty to divulge on the security forces for this study. Dosimetry testing was done at four locations, and sound level surveys were done at two locations, with one of the locations being tested by both, dosimeters and a sound level meter. The results from this study show that the highest area noise is on the 26 ft Aluminum Boat at the helm with the sirens on while the boat moves at 25 knots with a noise level at 101.2 dBA, and the highest personal noise exposure was at the CATM section with an 8-hour TWA of 108.9 dBA. When taking the Air Force OEEL (>85 dBA) into account, three of the four locations were overexposed to noise hazards using personal noise dosimetry, but only one of the four locations were overexposed to noise hazards using personal noise dosimetry when using the OSHA PEL (>90 dBA).

Major changes have occurred in the workplace in the past decades. Technology has changed dramatically, innovative ways of utilising nuclear power have been developed, new chemicals have been introduced to the market and the adverse effects of other chemicals on both human health and safety and the environment have been discovered. This has influenced the nature of the workforce itself. Regulators in the different jurisdictions were required to react to the challenges that these changes represent. This thesis explores the responses in the United Kingdom, the United States of America and the Republic of South Africa by identifying the occupational safety and health (OSH) regulations, administration, enforcement and penalties which have been put in place to address the above mentioned challenges. It is impossible to mention all the changes in the workforce and workplace that have occurred in the recent years, and this thesis therefore focuses on the possibilities that different types of regulation offer to address some of these changes. Alterations to existing approaches are proposed to ensure that enforcement is improved and better targeted. The utilisation of third parties as surrogate regulators is also addressed. The central theme of this thesis is how the law can stimulate self-regulation by adopting a Safety Management System (SMS) within enterprises to encourage “self-critical reflection about their OHS performance”. The purpose of criminal sanctions in occupational safety and health regulation, the role of the prosecution in the enforcement of OSH strategies and the possibility of combining prosecutions of corporations with prosecutions of individual managers and directors who are responsible for non-compliance with OSH standards are also addressed. Although it is most important to ensure that workers are not injured or do not contract occupational diseases, in practice this does unfortunately happen. Therefore this thesis also discusses the compensation of injured workers. / Professor D. S. de Villiers

A variety of paint products are used for their aesthetic and anti-corrosive properties. Isocyanates are consistently found in automobile paint products, particularly in clear coat polyurethane products. Clear coat is typically sprayed via pressurized air by means of an auto-spray robot. In clear coat repair situations, manual, air-powered spray guns are used, and manual spray Operators administer the clear coat material. The isocyanates are a primary anti-corrosive agent in polyurethane products. The Occupational Safety and Health Administration (OSHA) has not established a Permissible Exposure Limit (PEL). The National Institute for Occupational Safety and Health (NIOSH) and American Conference of Governmental Industrial Hygienists (ACGIH) have set Recommended Exposure Limit (REL) and Threshold Limit Value (TLV), respectively. NIOSH recommends a 0.005 parts per million (ppm), 10-hour Time Weighted Average (TWA), and a ceiling exposure of 0.020 ppm in a 10 minute period. Similarly, ACGIH recommends a 0.005 ppm, 8 hour TWA. Automobile manufacturers use clear coats in a variety of ways. Some may use clear coats with blocked isocyanates, or isocyanates that are completely reacted, and others may use clear coat products that allow isocyanates to be liberated during an application, baking, and curing process. The research objective of this study was to characterize exposure, focusing on a single manufacturer’s use of isocyanate-containing clear coats in their Paint Department. A newly evaluated medium (ISO 17734) using di-n-butylamine as a derivative agent, in a denuder tube, was selected instead of NIOSH methods 5521, 5522, and 5525. The ISO evaluated medium was selected to reduce secondary hazard exposure to toluene in impingers. Second, a medium developed by SKC, Inc., called ISO-CHEK®, was not selected because of the short collection time, sensitivity of the medium after collection, and storage and shipping requirements for analysis. Sampling took place over two days, one day for manual spray operations with 2 personal samples from Operators, and 4 area samples collected, and the second day for auto-sprayer Inspectors with 4 personal samples collected. The samples were then analyzed for hexamethylene diisocyanates (HDI) monomer and homopolymer species. The 0.005 ppm, 10 hour TWA; the 0.020 ppm ceiling limit (10 minutes); and the 0.005 ppm 8-hour TWA TLV were not exceeded on either day of sampling. Neither the area nor the personal samples exceeded the 10 hour TWA, ceiling limit, or TLV. In fact, the results had to be recalculated in to parts per billion (ppb). The average exposure for manual spray Operators was 0.052 ppb for the homopolymer, and 0.024 ppb for the monomer species. For auto-spray Inspectors, the average was 0.053 ppb for the homopolymer component and 0.021 ppb for the monomer species. Though the average isocyanate concentration was similar for both Operators and Inspectors, the averages are still below REL and TLV recommendations. These data provided preliminary information regarding the exposure to isocyanates from clear coat use, and also provide context for future evaluation of isocyanate use at this automobile manufacturer. The low concentration of isocyanates could indicate working ventilation systems, liberation of isocyanate species to non-hazardous forms, or low volatilization of isocyanates from the clear coat.

Every year, twenty-two million workers are exposed to potentially damaging noise at work. Last year, U.S. businesses paid more than $1.5 million in penalties for not protecting workers from noise. (OSHA, 2016). In the United States ten million people have some kind of noise related hearing loss (CDC, 2016) and noise damage to the ear may not be detected until it is great enough to cause hearing impairment. Grounds keeper’s functions consist of a variety of activities that require the use of powered tools such as mowers, riding mowers, leaf blowers, pressure washers, trimmers/edgers and chainsaws. OSHA has stated that “noise is a potential hazard for most jobs that involve abrasive or high-power machinery, impact of rapidly moving parts (product or machinery), or power tools”. (OSHA, 2016) in addition to this, their job is mostly outdoors exposing them to the added noise of traffic, construction and people. The purpose of this research study was to obtain occupational noise exposure data for groundskeepers who use powered equipment to do their job. The groundskeepers who participated in this research study were volunteers and worked in a University campus in the State of Florida. Personal noise dosimeters were used to collect the data in this study. Exposure information was collected over 6 days for 8-hour work shifts during the summer months of the year. Dosimetry was done on a maximum of five groundskeepers per monitoring day, ranging from 1 to 5 employees per day depending on availability. Results of this study indicate that the highest noise exposures occurred on groundskeepers in charge of mowing by means of a riding mower. Results of this study indicate that the highest 8-hr TWA noise exposure for the groundskeepers (GK) 1 and 2 occurred the first day of testing which was a Monday. Using the OSHA PEL measurement method GK1 exposure was 98.5 dBA, GK2 was 97.6 dBA. Using the same measurement method the highest exposure to GK3: 89.2 dBA, occurred on day five of the assessment. For GK4 the highest exposure occurred on the third day of testing with an exposure measurement of 86.1 dBA. GK5 was only assessed one day and his exposure measured at 84.5 dBA. GK6 AND GK7 were evaluated two days and their highest exposures measured at GK6: 89.3 dBA and GK7: 85.7 dBA. Using the OSHA Hearing Conversation Act measurement method, GK1 was exposed to excessive noise levels (>85 dBA as an 8-hr TWA) on five days of the six day assessment period. GK2 was exposed to hazardous noise levels on all four days he was assessed. GK3 and GK4 exceeded the OSHA HCA standard one of the two days they were monitored. GK 5 did not have noise exposure levels above 85 dBA on the day he volunteered for monitoring. GK6 had exposures over 85 dBA on both days he volunteered to be monitored. Finally, GK7 exceeded the 85 dBA limit on one of the two days they volunteered for this study.

Introduction: Non-compliance with respiratory protection programs among firefighters may put them at increased risk of injury and illness from occupational exposures during fire extinguishing activities. This research aims to characterize respiratory protection practices among Florida firefighters. This information will allow better understanding of factors that are associated with non-compliance with respiratory protection guidelines. Methods: Survey questionnaire was used to characterize Florida fire departments in this cross sectional study. Four hundred and seventy-seven surveys were administered to Florida firefighters both in person and electronically to collect information regarding firefighter knowledge and participation in their respective respiratory protection programs during the past twelve months. Survey questions were developed from the model set by the National Fire Protection Association which provides standards and regulations regarding firefighter protections. Collected data were used to produce summary statistics regarding firefighter department size, coverage area, and firefighter employment type. Further data analysis used Statistical Analysis Software to compute multinomial logistic regression analysis. Results: The 477 respondents were 91% male with a mean age 39 years old (range 21-65 years). The majority of respondents, 76%, were non-smokers, 21% former smokers, and 3% current smokers. In regards to ethnicity, respondents were 77% Caucasian, 13% Hispanic, 3% African-American, and 4% other. Most respondents were career firefighters, 97%, with less than ten years of experience, 44%, working in a fire department with at least 21 firefighters, 98%. Most respondents, 80%, had a written respiratory program in place. The most cited reason for not having implemented a written respiratory program was lack of knowledge related to the program. Multinomial logistic regression analysis of departments with response areas of at least 250,000 square miles produced a statistically significant 0.44 odds ratio for having a written respiratory program as compared to those with a less than 10,000 square miles response area. Conclusion: Additional resources need to be given to Florida fire departments to ensure that all firefighters receive adequate respiratory protection in accordance with National Fire Protection Association guidelines. There is an association between fire departments with large response areas and non-compliance with respiratory protection guidelines in regards to: having a written respiratory program, the frequency of respiratory fit testing, and the frequency of medical fitness testing. This suggests that rural fire departments need additional resources to ensure fire fighters are adequately protected. Additional research should focus on why these differences exist in the rural fire departments. Respondents stating a lack of knowledge or no requirement for a written respiratory program suggest that future efforts should focus on respiratory protection education and training.