NIOSH Risk-Based Model to Resume Field Research and Public Health Service in 2020 During the COVID-19 Pandemic.

In the early months of the COVID-19 pandemic, field research and public health service work conducted by the National Institute for Occupational Safety and Health (NIOSH) was put on hold. During this time, NIOSH developed a risk-based model to resume fieldwork, balancing the public health benefit of such fieldwork with the risks of severe acute respiratory syndrome coronavirus 2 exposure and transmission. We describe our experiences with this model, along with the broader public health significance of the methods used to inform risk management decisions. (Am J Public Health. 2022;112(8):1138-1141. https://doi.org/10.2105/AJPH.2022.306882).

Addressing Infection Prevention and Control in the First U.S. Community Hospital to Care for Patients With Ebola Virus Disease: Context for National Recommendations and Future Strategies.

Health care personnel (HCP) caring for patients with Ebola virus disease (EVD) are at increased risk for infection with the virus. In 2014, a Texas hospital became the first U.S. community hospital to care for a patient with EVD; 2 nurses were infected while providing care. This article describes infection control measures developed to strengthen the hospital's capacity to safely diagnose and treat patients with EVD. After admission of the first patient with EVD, a multidisciplinary team from the Centers for Disease Control and Prevention (CDC) joined the hospital's infection preventionists to implement a system of occupational safety and health controls for direct patient care, handling of clinical specimens, and managing regulated medical waste. Existing engineering and administrative controls were strengthened. The personal protective equipment (PPE) ensemble was standardized, HCP were trained on donning and doffing PPE, and a system of trained observers supervising PPE donning and doffing was implemented. Caring for patients with EVD placed substantial demands on a community hospital. The experiences of the authors and others informed national policies for the care of patients with EVD and protection of HCP, including new guidance for PPE, a rapid system for deploying CDC staff to assist hospitals ("Ebola Response Team"), and a framework for a tiered approach to hospital preparedness. The designation of regional Ebola treatment centers and the establishment of the National Ebola Training and Education Center address the need for HCP to be prepared to safely care for patients with EVD and other high-consequence emerging infectious diseases.

Styrene-associated health outcomes at a windblade manufacturing plant.

BACKGROUND: Health risks of using styrene to manufacture windblades for the green energy sector are unknown. METHODS: Using data collected from 355 (73%) current windblade workers and regression analysis, we investigated associations between health outcomes and styrene exposure estimates derived from urinary styrene metabolites. RESULTS: The median current styrene exposure was 53.6 mg/g creatinine (interquartile range: 19.5-94.4). Color blindness in men and women (standardized morbidity ratios 2.3 and 16.6, respectively) was not associated with exposure estimates, but was the type previously reported with styrene. Visual contrast sensitivity decreased and chest tightness increased (odds ratio 2.9) with increasing current exposure. Decreases in spirometric parameters and FeNO, and increases in the odds of wheeze and asthma-like symptoms (odds ratios 1.3 and 1.2, respectively) occurred with increasing cumulative exposure. CONCLUSIONS: Despite styrene exposures below the recommended 400 mg/g creatinine, visual and respiratory effects indicate the need for additional preventative measures in this industry.

Evaluation of the NIOSH MWF total particulate matter: thoracic particulate matter conversion factor in a machining environment.

Worker exposures to metalworking fluids were characterized at a plant that produced air compressors. Full-shift, side-by-side air samples (n = 147) were collected and analyzed for total particulate matter, extractable total particulate matter, thoracic particulate matter, and extractable thoracic particulate matter. The thoracic particulate matter geometric mean of 0.32 m/m (3)was below the National Institute for Occupational Safety and Health (NIOSH) recommended exposure limit (REL) of 0.4 mg/m (3). The total particulate matter geometric mean of 0.52 mg/m (3), however, was above 0.5 mg/m (3), the total particulate matter concentration offered as a surrogate REL in the NIOSHCriteria for a Recommended Standard for Occupational Exposure to Metalworking Fluids.[1]Of the 83 total particulate matter results that were at or above smash 0.5 mg/m (3), only 50 (60%) of the corresponding thoracic particulate matter results were at or above 0.4 mg/m (3). These data indicated a conversion factor of 1.65 between thoracic particulate matter and total particulate matter concentrations and 1.40 between thoracic extractable particulate matter and total extractable concentrations. These factors were significantly different from the 1.25 used to compare total particulate matter with thoracic particulate matter concentrations in the NIOSHCriteria Document[1](p < 0.01) and call into question the validity of a universal conversion factor. The authors conclude that thoracic particulate matter exposure assessment should be done directly. In terms of protecting the worker, however, the 1.25 conversion factor appeared to be conservative since each time a total particulate matter result was below 0.5 mg/m (3), its paired thoracic particulate matter measurement was below 0.4 mg/m (3).