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<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&rsquo;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 &deg;C (RR 1.40 and RR 1.06, respectively). There was evidence of the cumulative effect from the prior day&rsquo;s temperature and increased risk of exertional heat illness (RRs from 1.0&ndash;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>

<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&rsquo;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&reg;, 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>

BACKGROUND: Formalized risk management (RM) is an internationally accepted process for reducing hazards in the workplace, with defined steps including hazard scoping, risk assessment, and implementation of controls, all within an iterative process. While required for all industry in the European Union and widely used elsewhere, the United States maintains a compliance-based regulatory structure, rather than one based on systematic, risk-based methodologies. Firefighting is a hazardous profession, with high injury, illness, and fatality rates compared with other occupations, and implementation of RM programs has the potential to greatly improve firefighter safety and health; however, no descriptions of RM implementation are in the peer-reviewed literature for the North American fire service. METHODS: In this paper we describe the steps used to design and implement the RM process in a moderately-sized fire department, with particular focus on prioritizing and managing injury hazards during patient transport, fireground, and physical exercise procedures. Hazard scoping and formalized risk assessments are described, in addition to the identification of participatory-led injury control strategies. Process evaluation methods were conducted to primarily assess the feasibility of voluntarily instituting the RM approach within the fire service setting. RESULTS: The RM process was well accepted by the fire department and led to development of 45 hazard specific-interventions. Qualitative data documenting the implementation of the RM process revealed that participants emphasized the: value of the RM process, especially the participatory bottom-up approach; usefulness of the RM process for breaking down tasks to identify potential risks; and potential of RM for reducing firefighter injury. CONCLUSIONS: As implemented, this risk-based approach used to identify and manage occupational hazards and risks was successful and is deemed feasible for U.S. (and other) fire services. While several barriers and challenges do exist in the implementation of any intervention such as this, recommendations for adopting the process are provided. Additional work will be performed to determine the effectiveness of select controls strategies that were implemented; however participants throughout the organizational structure perceived the RM process to be of high utility while researchers also found the process improved the awareness and engagement in actively enhancing worker safety and health.

<p>Firefighters and asphalt pavers are exposed to polycyclic aromatic hydrocarbons (PAHs) during various work activities. The purpose of this study was to evaluate urinary PAH levels and compare these bio-monitoring levels among firefighters, asphalt pavers, and non-occupationally exposed individuals. The National Institute of Standards and Technology (NIST) urinary PAH levels were used for non-occupationally exposed controls. When compared to the NIST standard for smokers and non-smokers, firefighters demonstrated statistically significant differences in urinary concentration differences for the following metabolites: 2-OH-fluorene, 3-OH-fluorene and 1-OH-pyrene, which were lower in firefighters than the NIST mean for smokers. 1-OHphenanthrene, 2-OH-phenanthrene and 3-OH-phenanthrene were higher among world trade center exposed firefighters than the NIST mean for smokers. When firefighters were compared to the NIST non-smoker standard, firefighters demonstrated elevated levels in all tested PAH biomarkers due to a mixture of smokers and non-smokers in the firefighter cohort. </p><p> Asphalt workers had statistically significant higher urinary concentration elevations in 2OH-fluorene, 1-OH-phenanthrene and 3-OH-phenanthrene as compared to the NIST smoker mean. When asphalt pavers were compared to the NIST non-smoker mean, asphalt pavers had statistically significant increases in all tested PAH biomarkers, with the exception of 2-OHphenanthrene. While firefighters did not demonstrate a substantial change in urinary PAH metabolite levels compared to control populations of smokers and non-smokers, asphalt pavers experienced concentrations that were in some cases increased by orders of magnitude compare to NIST controls. Future research may be needed to evaluate any potential health risk posted to occupational exposed asphalt pavers. </p>

<p> This study explores the pervasiveness of job fatigue in Emergency Room nurses. It identifies factors that contribute to nurse burnout, including job dissatisfaction and workplace bullying, and explores strategies for assessing and reducing fatigue syndrome. As the literature suggests, there is a link between nurse burnout and patient safety. These findings are expected to help organizations develop strategies to reduce stress in the workplace and develop wellness programs. Upon using an interviewing process, the study found several themes that pointed to the key factors of increased ER nurse burnout, and provided several implications as to the changes that need to be made to improve the ER department environment. Some of the key findings included the need to hire more staff, make supervisors and management more approachable and available, and increasing support to ER nurses. Doing so will clearly help mitigate the problem of high stress levels among ER nurses and help to prevent the likelihood of burnout.</p>

Improvements to construction health and safety were driven by primary legislation promulgated in the 1970s and by subsequent regulations, codes and official guidance. In parallel social psychology, management and leadership theories were developing practical means for achieving health and safety objectives and reducing accidents and incidents of ill health. Despite the notable improvements that were achieved in countries with strong legislatives bases, the reduction in the rate of accidents has been significant but at the same time substantially falling short of providing safe and healthy workplaces. Construction sites remain places of high hazard and high risk activities for workers. Acknowledging the gains made by the compliance approach whilst challenging the underpinning assumptions on the causes of accidents and ill health, a critical theory methodology was developed to explore different perceptions and arrive at a new understanding of workplace culture within which safe practices take place. The purpose was to determine the degree of cultural maturity within and readiness of companies for the attainment of preventative workplace safety cultures, and this was achieved through the development of two projects, 1) the development of a cultural maturity index and 2) the development of an ethics reasoning pedagogy for construction professionals. Utilising a set of criteria deemed necessary for achieving success and sustainability the first project is a metric based on behavioural objectives and rational planning was designed and developed to ascertain the intangibles that would be indicative of a company’s culture. This was field tested and substantial revisions made to the original criteria resulting in a shift of focus from Corporate Social Responsibility, innovation and resourcefulness to moral agency, ethics reasoning and leadership, all of which were subject to critical evaluation and redefining on a priori principles. The resulting model, Organisation Cultural Maturing Index, is designed to develop a greater understanding of the social relationships that underpin workplace cultures and explain the many factors that come into play when health and safety programmes and practices are developed and implemented on construction sites. The model allows for the development of and flexibility in company and site specific approaches to achieving safe outcomes through respect for autonomous thought and support for collective action by all workplace employees. The model distinguished between concepts of leadership that are associated with managing operations and originates a new concept of leadership which initiates and supports agency and advocates a restructuring of workplace relationships in order to achieve safe, healthy and sustainable construction projects and contributes to a humanising ethos in work relationships. The second project is the development of under-graduate and post-graduate modules on ethics reasoning designed to facilitate moral agency through the development of critical thinking and reasoning skills and fill a gap in construction professional education. It integrates with the OCMI model through the provision of under-graduate and post-graduate programmes of study which develop the ethics reasoning skills of construction professionals facilitating their abilities to make design and operational judgements based on human and societal benefit. This project further integrates with the ethics standards required by Joint Board of Moderators and Engineering Council in respect of professionalism, and professional code of ethics such as the RICS’s. The review will further identify from both projects those elements of innovation and originality in the methodology adopted and applied to occupational health and safety and the insights and perspectives arrived at as a consequence.

Agriculture challenges health and safety professionals as it continues to be one of the most dangerous occupations despite the considerable attention that has been paid to it. Researchers have struggled to obtain the information necessary to challenge the cultural, economic and family dynamics that seem resistant to change. To add to this difficulty, attention has not been paid to the concerns of the farm women who work off the farm while taking care of children and supporting their husbands. This research process has resulted in viewing the women as women, not as wives. This qualitative research proposal used feminist methodology to study the perspectives of farm women through the focus group process. Data was collected and an analysis performed using the transcripts. Ultimately, meaning emerged from the collective lived experience of these farm women. The farming community hopefully will benefit from this research through the creation of better safety interventions targeted to the farm wife in the future.

<p> Personnel who work on the flight deck of an aircraft carrier are exposed to extreme levels of jet engine noise often in excess of 140 decibels (dB). The current circumaural hearing protective devices (CAHPD) employed by flight deck crewmen are inadequate for the level of protection required for these extreme levels of noise. Fiber-reinforced thermoset polymer composite (FRPC) materials such as aramid fibers used in body armor, have high theoretical values of acoustic impedance due to a fundamentally high modulus of elasticity and may offer a superior level of hearing protection over original equipment (OE) thermoplastic CAHPDs. The objective of this project was to measure and evaluate the attenuation of CAHPD&rsquo;s constructed from FRPC materials. FRPC CAHPD ear cups were paired with OE thermoplastic CAHPD ear cups of equal shape and thickness, and the protected and unprotected A-weighted sound pressure level (SPL) was measured in continuous and impulse noise environments >80 dBA using a JOLENE manikin. These data were evaluated for paired differences between the protected and unprotected mean SPL, and OE protected and FRPC protected mean SPL and indicates that OE thermoplastic CAHPDs provide greater sound attenuation of continuous noise >80 dBA and aramid FRPC CAHPDs provide greater sound attenuation of impulse noise >80 dBA.</p>

<p> The purpose of this case study was to explore the perceptions and experiences of hospital emergency preparedness coordinators of preparing for and responding to incidents. Stakeholder and protection motivation theories provided the theoretical framework for the study. The nonprobability sampling technique of purposive sample was used to identify 10 hospital preparedness coordinators employed at acute care hospitals with emergency departments located in Connecticut and Massachusetts. A field-tested researcher developed 20-question interview questionnaire guided data collection. This qualitative case study answers the questions: What are hospital emergency preparedness coordinators perspectives of hospital preparedness? How do hospital emergency preparedness coordinators prepare for a hospital incident? How do hospital emergency preparedness coordinators respond to a hospital incident? What factors do hospital emergency preparedness coordinators believe best prepares a hospital for incidents? Ranked in order of replication, the researcher identified three themes using first and second cycle coding techniques with pattern coding: (a) planning, (b) training, and (c) communication. Control and motivation emerged as subthemes. Results of the study provide detail rich data for hospital emergency preparedness coordinators, and provide insight and information for stakeholders from all types of private and public organizations to improve hospital emergency preparedness programs. </p>