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Risk Factors Associated with Non-compliance with the Respiratory Protection Program among FirefightersDawkins, Brandon 20 May 2016 (has links)
<p><b>Introduction</b>: 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. </p><p> <b>Methods</b>: 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. </p><p> <b>Results</b>: 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. </p><p> <b>Conclusion</b>: 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. </p>
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An Exposure Assessment of Paper Dust in a Coupon Manufacturing FacilityFink, Danny C. 15 April 2017 (has links)
<p> <i><b>Purpose</b></i>. Exposures to paper dust, classified as Particulates Not Otherwise Regulated (PNOR), in an industrial setting can cause irritation to the eyes, skin, throat and upper respiratory tract. An exposure assessment was conducted to evaluate the paper dust exposures in the coupon manufacturing facility during a normal production working period. <i><b> Methods.</b></i> Total and respirable personal dust sampling was performed according to NIOSH 0500 and 0600 methods. Six total dust samples and seven respirable dust samples were taken within the sampling areas where airborne paper dust was produced to evaluate the Time Weighted Average (TWA) of the exposed employees. <i><b>Results.</b></i> Results showed that the TWAs for total dust within the three sampling areas ranged from 0.4% to 4.7% of the Occupational Safety and Health Administration (OSHA) Permissible Exposure Limit (PEL) and 0.5% to 7.1% of the American Conference of Governmental Industrial Hygienists (ACGIH) Threshold Limit Value (TLV), except sample RD-4 in the Baler Room. TWAs for respirable dust within the Press Room and Collation Area ranged from 0.8% to 0.9% of the OSHA PEL for all samples and 1.4% to 1.5% of the ACGIH TLV. Descriptive statistics showed the sample standard deviation for both total and respirable dust to be below 1.0. The coefficient of variation for TWAs of total dust in the Press Room was 32.7% while all other total dust and respirable dust coefficient of variations for TWA ranged from 1.3% to 3.4%. <i><b>Conclusion.</b></i> Exposures to paper dust ranged from 0.4% to 7.1% of either the OSHA PEL or ACGIH TLV with an exception of sample RD-4 in the Baler Room which was 34% of the OSHA PEL and 56.7% of the ACGIH TLV. Identical respirable dust data and variable total dust data in the Press Room and Collation Area suggest that the dust being generated is of a larger particle size and therefore affects the nose, throat, and upper lungs. The engineering and administrative controls present appeared to be adequate based on the sampling data. Respiratory Personal Protective Equipment (PPE) was not considered a requirement but should be permitted if requested. Present workplace practices also appeared adequate based on the sampling data. </p>
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Injuries among the Double Disaster Cohort of Persons in the WTC Health Registry Exposed to Superstorm SandyBaumet, Krishna 08 August 2017 (has links)
<p> Introduction: In double disaster cohorts responders are exposed to two potentially hazardous situations. Experience with one disaster may affect how responders behave in the second. We evaluate associations of injuries and exposures, with rescue work performed by WTC responders enrolled in the WTCHR who responded 11 years later to Superstorm Sandy. </p><p> Methods: An 84 question Sandy survey was given to 8870 WTCHR enrollees. Outcome measures included total number of injuries, extremity sprains and lacerations and the exposures encountered. A "home danger" variable includes all the reparation and clean- up activities. All analyses were conducted with SAS 9.4. Using multivariable logistic regression, unadjusted and adjusted odds ratios were calculated to estimate association strength between work and volunteer status, age, race, gender, education and 9/11 rescue worker status. </p><p> Results: A total of 4558 (51%) of enrollees participated. 56% were male, 45-64 years of age (62.9%), non-Hispanic white (71.1%) and 44.28% had 2010 income > $75,000. Among 1,044 Sandy responders, 64% of paid workers and 42% of volunteers were also 9/11 workers. Volunteers had increased odds ratios for >1 injury: adjusted odds ratio (aOR) 2.42(95% CI: 1.60-3.64), compared to non-rescue workers. Exposure to Home Danger hazards had an adjusted odds ratio of 7.53 (5.16-10.99) for multiple injuries, suggesting the importance of evacuation and hazard education </p><p> Discussion: Our study shows that volunteers exposed to Sandy have increased odds of having more than one injury and for extremity injury.</p><p>
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A critical look at measurement of work outcomes for people with arthritisAlHeresh, Rawan 29 October 2015 (has links)
STUDY ONE
Objective. To evaluate the methodological quality of studies examining psychometric properties of work outcome assessments for people with arthritis to guide instrument selection use based on quality of literature.
Methods. A systematic review was conducted through a structured search to identify articles describing studies of assessment development and studies of their psychometric properties. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used to appraise the included studies. Finally, an evidence synthesis was performed to combine findings.
Results. Nine arthritis specific work outcome assessments were identified; 17 articles examining the psychometric properties of these instruments were identified and reviewed. Quality of studies reporting psychometrics of each instrument was highly variable. The evidence synthesis showed that the Work Limitations Questionnaire had the strongest quality evidence of internal consistency and content validity (including structural validity and hypothesis testing), followed by the Work Instability Scale. None of the instruments had strong quality evidence of criterion validity or responsiveness.
Conclusion. Considering the high variability and the low quality of the literature, we recommend that instrument developers integrate studying full psychometric assessment of their instruments, including responsiveness and criterion validity, and consult guidelines (i.e. COSMIN) in reporting their findings.
STUDY TWO
Background. The World Health Organization – Health and Work Performance Questionnaire (HPQ) was developed to ascertain absence from work and reduced work performance in the workplace due to health problems. The purpose of this study is to evaluate the construct validity and scoring methods of the work performance subscale of the HPQ for people with arthritis.
Methods. Cross-sectional data from a randomized clinical trial on preventing work limitations was used. Construct validity of work performance was examined through hypothesis testing using convergence and divergence based on established risk factors from the literature. Pearson’s correlations were used for continuous data, and Spearman’s Ranked correlations for categorical data were used to test the hypotheses. Both scoring methods of the HPQ (absolute and relative) were evaluated.
Results. Data from 287 participants showed that the sample had moderate levels of limitations in work performance. The HPQ showed acceptable construct validity through convergence and divergence. The absolute scoring method had more significant and stronger associations than the relative scoring method.
Conclusion. This study was the first exploring the construct validity of the HPQ for people with arthritis, and since construct validity is a continuing process, more research is needed to further assess the ability of the HPQ to measure work performance. One scoring method (i.e. absolute) was more informative that the other. More research is needed to explore other psychometric properties of the HPQ such as responsiveness and test-retest reliability.
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An occupational epidemiology study on the acute irritant effects due to exposure to borax particulateHu, Xiaohan 01 January 1991 (has links)
Acute irritant symptoms can be caused by a variety of airborne environmental agents. Earlier studies on the acute irritant effects by comparison of symptom events at the beginning and end of the work shift or between groups at different exposure levels have been inadequate. This research examines the acute irritant effects of occupational exposure to sodium borate dusts (borax) using the repeated measurement design. The study population was composed of 79 exposed and 29 unexposed employees. The subjects were queried about irritant symptoms at hourly intervals for the first six hours of the shift and four days in a row. They were also provided a means to record the timing of the symptom by pressing an event marker. Acute pulmonary function change measured by peak expiratory flow rate (PEFR) was obtained. Dose-response relationships were examined by computing incidence rates of specific symptoms at increasing exposure levels. Both ordinary and two-stage logistic regression analysis were used in symptom analysis. L-th autoregressive models were applied in the assessment of acute change in PEFR in relation to exposure concentrations. The major findings showed that dose-response relationships were present for each of five acute irritant symptoms. Increased symptom responses were associated with measured exposure across entire exposure range; no clear threshold was indicated. On the other hand, analysis of acute change in PEFR revealed that only a temporary drop of PEFR was associated with an exposure level above 2 mg/m$\sp3$. Although this change in PEFR was of no clinical importance, it provided an objective measurement that was consistent with findings for acute symptoms. The event marker was found to be useful in allowing more precise estimation of the time of symptoms in relation to prior short-term peak exposures. It showed that the symptom response to exposure peaks was very quick, if not nearly instantaneous. It also provided validation that the recalled symptom onset time was satisfactory. However, inconsistent marker use with respect to symptom and marker use recall were not infrequent, suggesting that this event marker may not replace the traditional interview in obtaining subjective symptom events in future epidemiologic studies.
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Assessment of Prolonged Occupational Exposure to Heat StressGarzon-Villalba, Ximena Patricia 03 August 2016 (has links)
<p> Heat stress is a recognized occupational hazard present in many work environments. Its effects increase with increasing environmental heat loads. There is good evidence that exertional heat illness is associated with ambient thermal conditions in outdoor environments. Further, there is reason to believe that risk of acute injury may also increase with the ambient environment. For these reasons, the assessment of heat stress, which can be done through the characterization of the wet bulb globe temperature (WBGT), is designed to limit exposures to those that could be sustained for an 8-h day. The ACGIH Threshold Limit Value (TLV) for heat stress was based on limited data from Lind in the 1960s. Because there are practical limitations of using thermal indices, measurement of physiological parameters, such as body temperature and heart rate are used with environmental indices or as their alternative. </p><p> The illness and injury records from the Deepwater Horizon cleanup effort provided an opportunity to examine the effects of ambient thermal conditions on exertional heat illness and acute injury, and also the cumulative effect of the previous day’s environmental conditions. The ability of the current WBGT-based occupational exposure limits to discriminate unsustainable heat exposures, and the proposal of alternative occupational limits was performed on data from two progressive heat stress protocol trials performed at USF. The USF studies also provided the opportunity to explore physiological strain indicators (rectal temperature, heart rate, skin temperature and the Physiological Strain Index) to determine the threshold between unsustainable and sustainable heat exposures. Analysis were performed using Poisson models, conditional logistic regressions, logistic regressions, and receiver operator curves (ROC curves).</p><p> It was found that the odds to present an acute event, either exertional heat illness or acute injuries increased significantly with rising environmental conditions above 20 °C (RR 1.40 and RR 1.06, respectively). There was evidence of the cumulative effect from the prior day’s temperature and increased risk of exertional heat illness (RRs from 1.0–10.4). Regarding the accuracy of the current TLV, the results of the present investigation showed that this occupational exposure limit is extremely sensitive to predict cases associated with unsustainable heat exposures, its area under the curve (AUC) was 0.85; however its specificity was very low (specificity=0.05), with a huge percentage of false positives (95%). The suggested alternative models improved the specificity of the occupational exposure limits (specificities from 0.36 to 0.50), maintaining large AUCs (between 0.84 and 0.89). Nevertheless, any decision in trading sensitivity for specificity must be taken with extreme caution because of the steeped increment risk of heat related illness associated with small increments in environmental heat found also in the present study. Physiologic heat strain indices were found as accurate predictors for unsustainable heat stress exposures (AUCs from 0.74 to 0.89), especially when measurements of heart rate and skin temperature are combined (AUC=0.89 with a specificity of 0.56 at a sensitivity=0.95). Their implementation in industrial settings seems to be practical to prevent unsustainable heat stress conditions.</p>
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Is the "grass| greener? Occupational wellness in the Colorado cannabis industryWalters, Kevin M. 19 July 2016 (has links)
<p> This study is the first occupational safety and health evaluation of the cannabis industry of Colorado from an Occupational Health Psychology (OHP) perspective. Qualitative pilot data and common OHP theories provide a framework for project development, design, and rationale. This study investigated the following among cannabis industry workers: potential stressors, perceptions and awareness of physical safety hazards, strain outcomes, and organizational supports that might buffer relations between stressors and strain outcomes. Study results provide a first glimpse at the demographics of the cannabis industry and suggest that workers generally experience low strain and high levels of organizational supports in the presence of various physical and psychological stressors and hazards. However, results also suggest heterogeneous health and safety training, awareness, and regulation in the cannabis industry. Future research directions and practical implications for cannabis industry workers are provided.</p>
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Hexamethylene Diisocyanate Homopolymer and Monomer Exposure Assessment and Characterization at an Automobile Manufacturer in the United StatesSivaraman, Karthik R. 18 August 2016 (has links)
<p> 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. </p><p> 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. </p><p> 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.</p>
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Assessing the Occupational Noise Exposure of BartendersWoltman, Adrianna J. 12 August 2015 (has links)
<p> The Occupational Safety and Health Administration estimates that each year, approximately 30 million people are occupationally exposed to hazardous noise. While many are aware of the noise exposure associated with industrial occupations, there has been little research conducted on bartenders who often work in environments that have high levels of noise. The majority of current published research on occupational noise exposure of bartenders has only evaluated noise levels on one night of business. Bartenders often work multiple days per week, which vary in the amount of patrons and entertainment provided, this variation in business leads to variation in the amount of noise to which they are exposed. </p><p> The purpose of this research study was to gather occupational noise exposure data for bartenders during a workweek at a Tampa Bay bar establishment that hosts live music on weekends. Personal noise dosimeters were used to collect personal noise exposure data. Area noise level data were collected using a sound level meter. While several bar establishments were approached, one bar establishment part pated as the study site and noise data were collected for seven consecutive days (Thursday-Wednesday). Personal noise exposure data were collected for an entire 8-hour work shift for the Thursday-Sunday portion of the study, and for 6 hours for the Monday-Wednesday portion of the study. Area noise data were collected for the Thursday-Saturday portion of the study. </p><p> Results of this study indicate that the highest noise exposure for either bartender occurred on Saturday (Bartender 1: 93.1 dBA; Bartender 2: 83.6 dBA) when a live band was performing in the establishment. Using the OSHA Hearing Conversation and OSHA PEL measurement methods, Bartender 1 was exposed to excessive noise levels (>85 dBA) on four (4) nights of the study, while Bartender 2 had no exposures over 85 dBA. However, using the ACGIH measurement method, Bartender 1 was exposed to excessive noise levels six (6) nights of the study, while Bartender 2 was exposed to excessive noise levels two (2) nights of the study.</p>
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Effectiveness of a worksite health promotion program to improve health-related quality of life indicatorsCasirnano, Tara 18 July 2015 (has links)
<p> Health and wellness is essential to each individual's quality of life. The importance of health and wellness is not only of an individual concern but also a population-based societal concern. Currently there is growing epidemic or obesity as 65% of American adults are either overweight or obese. The work setting is an ideal location to foster healthy behaviors as most adults spend the majority of their day there. The need for health-related activities is supported in many different types of workplaces, especially in higher education settings. This study aimed to explore the relationship of a health promotion program using pedometers on the health-related indicators of the SF-36v2 and vital functioning of the participants in a college setting. The association of participant's health promotion level to changes in health-related indicators and vital functioning was also explored.</p><p> A pre-test post-test experimental design was conducted with a convenience sample of 29 participants. All 29 participants completed the pre-test, the 6 week health promotion program using pedometers, and the first post-test (post-test 1). Only 15 individuals completed the second post-test (post-test 2) which was administered six months after the completion of the health promotion program. Paired sample t tests analyzed the difference in scores of each participant from pre-test (baseline) to post-test 1. The paired sample t tests reported a significant improvement in the component summary and subtests of the SF 36v2 such as the mental health component summary (<i>p</i> = .013), physical functioning (<i>p</i> = .015), vitality (<i>p</i> = .033), and mental health (<i>p</i> = .005). The linear regression analysis revealed mental health component summary scores were a highly significant predictor of vitality (β = 1.075, <i>p</i> = .001), accounting for 50.5% of the variance in vitality. Vitality is unique to each individual. This construct can affects one's ability to activity engage in their roles and occupations.</p><p> Health and wellness support role performance. The roles of most adults consist of worker, friend, and family member. Fulfillment of roles and meaningful activities supports balance and quality of life. Having the physical and mental capability to perform one's roles in a variety of contexts leads to engagement and satisfaction. Sustenance of a healthy lifestyle via physical activity is also an integral component of wellness. Utilizing technology and support within the social, virtual, and physical environments have all been shown by this study to improve quality of life indicators. Improvements were noted to statistically support the use of pedometers, points of decision prompts, and email correspondence to increase physical activity levels as well as stages of health promotion.</p>
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