Measuring the effects of respiratory protective equipment and other protectors in preventing the scattering of vocalization droplets.

This study was conducted to quantitatively examine the effects of respiratory protective equipment (respirators) and various other types of protectors in preventing the scattering of vocalization droplets. Each of 12 adult male volunteers was asked to vocalize intermittently for 1 min at a target intensity of approximately 100 dBA in an experimental room adjusted to a humidity of approximately 60-70%. The subjects vocalized while wearing respirators, other types of protectors, or no protectors at all. The droplet concentration in a particle size range of 0.3 to 10 µm was measured under each experimental condition, and the transmitted particle concentration and penetration were calculated. The concentration and penetration of particles transmitted from the respirators were lower than those transmitted from the other protectors examined. The probability of infection reduction through the use of the protectors was estimated from the data obtained on the effectiveness of the protectors in preventing the scattering of droplets. We concluded that there is no need for additional droplet scattering prevention in various work settings when appropriate respirators are used under optimal conditions.

Literature review to integrate information to assist workers to select masks even at workplaces without occupational health personnel.

BACKGROUND: With the COVID-19 pandemic, the idea of universal mask wearing to prevent infecting others when one becomes infected has prevailed among people. In general, any workplace is not exempt and workers are required to wear a mask while working at the sites. OBJECTIVES: This study aims to integrate information to assist workers to select effective protectors for the prevention of droplet infection even at workplaces without occupational health personnel. METHODS: A total of 94 studies were included in this study: 91 studies were identified in MEDLINE, which was used for the literature search, and an additional three studies were identified from other information sources. The studies were checked to eliminate duplication and narrowed down to 31 based on the titles and abstracts. The contents of the 31 studies were read through and then 19 studies were extracted for careful reading. RESULTS AND CONCLUSIONS: Regarding the protectors used at workplaces, it was suggested that (1) workers continue to use respiratory protectors as needed at sites where respiratory protectors such as an N95 respirator had to be used even before the spread of COVID-19 and (2) wear surgical masks, multi-layer cloth masks, or hybrid fabric masks made of several types of fabrics that are recommended in terms of preventing dissemination of droplets and protecting against inhalation of droplets, selected according to the working conditions, taking account of air permeability, breathability, and durability.

Efficacy of ice slurry and carbohydrate-electrolyte solutions for firefighters.

OBJECTIVES: To examine the thermoregulatory and fluid-electrolyte responses of firefighters ingesting ice slurry and carbohydrate-electrolyte solutions before and after firefighting operations. METHODS: Twelve volunteer firefighters put on fireproof clothing and ingested 5 g/kg of beverage in an anteroom at 25°C and 50% relative humidity (RH; pre-ingestion), and then performed 30 minutes of exercise on a cycle ergometer (at 125 W for 10 minutes and then 75 W for 20 minutes) in a room at 35℃ and 50% RH. The participants then returned to the anteroom, removed their fireproof clothing, ingested 20 g/kg of beverage (post-ingestion), and rested for 90 minutes. Three combinations of pre-ingestion and post-ingestion beverages were provided: a 25℃ carbohydrate-electrolyte solution for both (CH condition); 25℃ water for both (W condition); and a -1.7℃ ice slurry pre-exercise and 25℃ carbohydrate-electrolyte solution post-exercise (ICE condition). RESULTS: The elevation of body temperature during exercise was lower in the ICE condition than in the other conditions. The sweat volume during exercise was lower in the ICE condition than in the other conditions. The serum sodium concentration and serum osmolality were lower in the W condition than in the CH condition. CONCLUSIONS: The ingestion of ice slurry while firefighters were wearing fireproof clothing before exercise suppressed the elevation of body temperature during exercise. Moreover, the ingestion of carbohydrate-electrolyte solution by firefighters after exercise was useful for recovery from dehydration.

Development of a method for estimating oesophageal temperature by multi-locational temperature measurement inside the external auditory canal.

We aimed to develop a practical method to estimate oesophageal temperature by measuring multi-locational auditory canal temperatures. This method can be applied to prevent heatstroke by simultaneously and continuously monitoring the core temperatures of people working under hot environments. We asked 11 healthy male volunteers to exercise, generating 80 W for 45 min in a climatic chamber set at 24, 32 and 40 °C, at 50% relative humidity. We also exposed the participants to radiation at 32 °C. We continuously measured temperatures at the oesophagus, rectum and three different locations along the external auditory canal. We developed equations for estimating oesophageal temperatures from auditory canal temperatures and compared their fitness and errors. The rectal temperature increased or decreased faster than oesophageal temperature at the start or end of exercise in all conditions. Estimated temperature showed good similarity with oesophageal temperature, and the square of the correlation coefficient of the best fitting model reached 0.904. We observed intermediate values between rectal and oesophageal temperatures during the rest phase. Even under the condition with radiation, estimated oesophageal temperature demonstrated concordant movement with oesophageal temperature at around 0.1 °C overestimation. Our method measured temperatures at three different locations along the external auditory canal. We confirmed that the approach can credibly estimate the oesophageal temperature from 24 to 40 °C for people performing exercise in the same place in a windless environment.

Urinary 1-hydroxypyrene levels among office workers living in industrial areas.

We examined exposure to polycyclic aromatic hydrocarbons (PAHs) among non-smoking office workers in 2 countries living in the vicinity of a coke-oven factory by measuring their levels of urinary 1-OHP, a known metabolite of PAHs. Subjects included 10 non-smoking office workers in Kitakyushu city (Japan) and 20 workers in Thai Nguyen city (Vietnam). Measurement was optimized by using the high-performance liquid chromatography (HPLC) method developed by Jongeneelen et al. This method required only a small amount of urine and had a short incubation time, and its detection limit was very low (0.00448 ng/ml), which was practical and highly sensitive.The median urinary 1-OHP concentration in the Vietnamese subjects (0.417 ng/mg creatinine) was six times as high as that in the Japanese subjects (0.069 ng/mg creatinine) (P < 0.001). However, both concentrations were significantly below the guideline level, below which there is no genotoxic effect, implying a low probability of any adverse health effects.Our measurements from both countries showed higher urinary 1-OHP concentrations than in previous studies from locations without factories, indicating that ambient air pollution from industrial emissions is an important source of PAH exposure. Finally, the urinary 1-OHP concentrations did not correlate with gender or lifestyle factors.

Urinary 1-hydroxypyrene and 8-hydroxydeoxyguanosine levels among coke-oven workers for 2 consecutive days.

OBJECTIVES: This study evaluated the levels of exposure to polycyclic aromatic hydrocarbons (PAHs) and their relationship with oxidative DNA damage among Vietnamese coke-oven workers. METHODS: We collected urine from 36 coke-oven workers (exposed group) at the beginning and end of the shift on 2 consecutive days. We also collected urine from 78 medical staff (control group). Information was collected by questionnaire about smoking status, drinking habit, and working position. Urinary 1-hydroxypyrene (1-OHP) and 8-hydroxydeoxyguanosine (8-OH-dG) were measured using HPLC. All statistical analyses were performed with SPSS version 19. RESULTS: Urinary 1-OHP was significantly higher in the coke-oven workers than in the control group (p<0.05). Top-oven workers had the highest levels of internal exposure to PAHs, followed by side-oven and then bottom-oven workers (5.41, 4.41 and 1.35 ng/mg creatinine, respectively, at the end of the shift on day 2). Urinary 8-OH-dG was significantly higher in top- and side-oven workers at the end of the shift on day 2 (4.63 and 5.88 ng/mg creatinine, respectively) than in the control group (3.85 ng/mg creatinine). Based on a multi-regression analysis, smoking status had a significant effect on urinary 8-OH-dG (p=0.049). Urinary 1-OHP tended to have a positive correlation with urinary 8-OH-dG (p=0.070). CONCLUSIONS: Vietnamese coke-oven workers were exposed to PAHs during their work shift. Urinary 1-OHP exceeded the recommended limit, and elevated oxidative DNA damage occurred in top- and side-oven workers on the second day of work. A tendency for positive correlation was found between urinary 1-OHP and urinary 8-OH-dG.

Urine temperature as an index for the core temperature of industrial workers in hot or cold environments.

Workers working in hot or cold environments are at risk for heat stroke and hypothermia. In Japan, 1718 people including 47 workers died of heat stroke in 2010 (Ministry of Health Labour and Welfare, Japan 2011). While the American Conference of Governmental Industrial Hygienists (ACGIH) recommendation lists the abnormal core temperature of workers as a criterion for halting work, no method has been established for reliably measuring core temperatures at workplaces. ISO 9886 (Ergonomics-evaluation of thermal strain by physiological measurements. ISO copyright office, Geneva, pp 3-14; 2004) recognizes urine temperature as an index of core temperature only at normal temperature. In this study we ascertained whether or not urine temperature could serve as an index for core temperature at temperatures above and below the ISO range. We measured urine temperature of 31 subjects (29.8 ± 11.9 years) using a thermocouple sensor placed in the toilet bowl at ambient temperature settings of 40, 20, and 5˚C, and compared them with rectal temperature. At all ambient temperature settings, urine temperature correlated closely with rectal temperature exhibiting small mean bias. Urine temperature changed in a synchronized manner with rectal temperature at 40˚C. A Bland and Altman analysis showed that the limits of agreement (mean bias ± 2SD) between rectal and urine temperatures were -0.39 to +0.15˚C at 40˚C (95%CI -0.44 to +0.20˚C) and -0.79 to +0.29˚C at 5˚C (-0.89 to +0.39˚C). Hence, urine temperature as measured by the present method is a practical surrogate index for rectal temperature and represents a highly reliable biological monitoring index for assessing hot and cold stresses of workers at actual workplaces.

Effort-reward imbalance and depression among private practice physicians.

PURPOSE: Current private practice physicians provide medical services in a harsh economic situation. The effort-reward imbalance (ERI) model puts its emphasis on an imbalance between high efforts spent and low rewards received in occupational life. ERI model includes three different reward factors from task to organizational levels. We examined whether ERI in terms of low organizational reward (poor prospective and job insecurity) could be the most relevant and strongly associated with depression among private practice physicians. METHODS: This is a cross-sectional questionnaire study of 1,103 private practice physicians who were currently working in clinical settings and completed the data of exposure and outcome. The study questionnaire was mailed to all the physicians listed as members of a local branch of the Japan Medical Association (n = 3,441) between November and December 2008. Outcomes were prevalence of depression as measured by the Center for Epidemiologic Studies Depression Scale and adjusted odds ratios (OR) of depression with respect to ERI. RESULTS: Fifty-seven percent of physicians were exposed to ERI, and 18% of the physicians were depressed. Logistic regression analyses revealed that ERI was significantly associated with depression (OR and 95% confidence interval = 3.57; 2.43-5.26). ERI with regard to organizational reward was most prevalent (60%) and had the strongest association with depression (5.14; 3.36-7.92). CONCLUSION: Predominant prevalence of ERI in terms of organizational level low reward and strong associations between the ERI component and depression suggests that countermeasures from social perspective are crucial.

[Assessment of telephone operators' exposure to sound through headphones].

We estimated the level of noise that telephone operators were exposed to through headphones by a two-step method using an artificial ear technique and a manikin technique. In the artificial ear technique, the sound pressure level (Leq) of the total work hours was 81.5 dB, whereas the Leq of the total duration of phone calls was 89.3 dB. Therefore, we conducted a more accurate measurement by the manikin technique (ISO11904-2). By this method, we could simulate the headphone-wearing condition of the workers and convert the measurements to a diffuse-field related L(Aeq). By this manikin technique, the corrected L(Aeq) of the total work hours was 68.3 dB, whereas the corrected L(Aeq) of the total duration of call was 76.6 dB, which was below the standard of the Occupational Exposure Limits of the Japan Society of Occupational Health. We confirmed that in a workplace where the background noise is low (51.3 dBA), a good signal-noise ratio is maintained so that operators don't have to listen to loud sounds through headphones. Neither the gender nor the type of the telephone equipment of the callers affected the sound pressure levels.

Assessments by HR and %HRR of occupational work exertion for alternating periods of rest and manual labor.

OBJECTIVES: Metabolic equivalents (METs) and relative metabolic rate (RMR) as calculated by oxygen uptake (VO(2)) are often used to assess physical exertion. In practice, accurate measurements of VO(2) are difficult; heart rate (HR) values represent an alternate index of physical exertion. We investigated whether one can assess physical exertion based on HR in the workplace, even if the physical task in question involves alternating periods of strenuous anaerobic activity and rest. We also examined the potential usefulness of assessments based on percentage of heart rate reserve (%HRR) and percentage of oxygen uptake reserve (% VO(2)R). METHODS: Six healthy men were asked to perform several physical movements. HR and VO(2) were recorded in real time. RESULTS: HR and VO(2) are significantly correlated even under conditions of various repeated intermittent movements including anaerobic exertion. Cumulative fatigue results in inadequate recovery in various parameters indicating sufficient rest times, whereas VO(2) values recover immediately. One movement may generate large differences in HR among individuals, but not in VO(2). We found no significant differences between dispersion for %HRR and VO(2)R. However, as with HR, %HRR values indicated insufficient recovery after strenuous exertion. CONCLUSIONS: VO(2) alone does not adequately reflect the exertion entailed by certain physical activities. HR is more useful than VO(2) in evaluating the exertion required by physical labor in individual workers. While we can use %HRR and % VO(2)R to compare physical exertion from individual to individual, %HRR is more valuable, since % VO(2)R can underestimate physical exertion in recovery periods for the same reasons as VO(2).

Expression of heme oxygenase-1 in the lungs of rats exposed to potassium octatitanate whiskers.

OBJECTIVES: Oxidative stress is thought to be the pathogenesis of pulmonary fibrosis induced by asbestos, and heme oxygenase-1 (HO-1) protects lung tissue against oxidative stress. We hypothesized that HO-1 is also associated with oxidative lung injury caused by exposure to potassium octatitanate whiskers (PT1), which is one of the asbestos substitutes. METHODS: Male Wistar rats were administered 1 mg or 2 mg PT1 suspended in saline by a single intratracheal instillation and were sacrificed after recovery for 3 days, 1 wk, 1 mo, 3 mo or 6 mo. Gene expression of HO-1 protein and mRNA and immunostaining were investigated in rat lungs. RESULTS: HO-1 protein expression was increased from 3 days to 1 mo and at 6 mo in the 1 or 2 mg PT1-exposed groups, and the gene expression of HO-1 mRNA was also increased at 3 days and from 1 mo to 6 mo. HO-1-positive cells were mainly found in the alveolar macrophages and the bronchial epithelial cells in immunostaining. CONCLUSIONS: These findings suggest that HO-1 is involved in lung damage caused by PT1.