Evaluation of the exposure prediction component of Control of Substances Hazardous to Health Essentials.

The exposure prediction component of the Control of Substances Hazardous to Health (COSHH) Essentials model (paper version) was evaluated using field measurements from National Institute of Occupational Safety and Health (NIOSH) Health Hazard Evaluation (HHE) reports. Overall 757 measured exposures for 94 similar exposure groups (SEGs) were compared with the COSHH Essentials predicted exposure range (PER). The SEGs were stratified based on the magnitude of measured exposures (high, medium, or low) and physical state of the substance (vapor or particulate). The majority of measured exposures observed involved low-level exposure to vapors; thus, overall findings from the current study are limited to low-level vapor exposure scenarios. Overall, the exposure prediction component of COSHH Essentials vastly overestimated low-level exposures to vapors. This study went beyond the scope of previous studies and investigated which model components led to the overestimation. It was concluded that COSHH Essential's tendency to overestimate was due to multiple complex interactions among model components. Overall, the magnitude of overestimation seems to increase exponentially as values for predictor variables increase. This is likely due to the log-based scale used by the model to allocate concentration ranges. In addition, the current banding scheme used to allocate volatility appears to play a role in the overestimation of low-level exposures to vapors.

Asbestos in public hospitals: are employees at risk?

Asbestos is an established human carcinogen. Asbestos-containing building materials (ACBM) are used in surfacing materials, thermal system insulation (TSI), and miscellaneous materials, and they have been used in buildings in Jamaica in the past. The objective of the study described here was to identify ACBM, its characteristics, and its determinants in Jamaican hospitals. A walk-through survey of all hospitals was undertaken and 152 bulk samples were collected from 26 public and private hospitals. The samples were analyzed using polarized light microscopy. Sixteen (61.5%) hospitals had ACBM used mainly as TSI. The ACBM in most cases was friable and in a poor condition indicative of fiber release and contained the fibers chrysotile, amosite, and crocidolite. The age of hospitals was not associated with the presence of ACBM. Results indicated potential risk of asbestos exposure in hospitals. The hospital authorities should formulate and implement an asbestos policy for hospitals and undertake proper management of asbestos in all hospitals.

The practice of the 10 essential services and abilities in the 14 core competencies of Alabama environmental health practitioners.

Leading public health agencies have developed guidelines for essential services and core competencies. The study described here was conducted to determine the level of practice of the 10 essential services and abilities in the 14 core competencies among environmental public health practitioners in Alabama. Questionnaires about the practice of the essential services, abilities in the core competencies, and demographics were collected from 255 (88%) practitioners and analyzed by statistical methods. According to the results of this study, these practitioners spent most of their time diagnosing, investigating, enforcing, educating, and linking people to public health services. They had increasing levels of practice as they were promoted to higher-level jobs, and the level of practice was greater in rural counties than in urban. They rated their skill in all of the core competencies to be at least pretty good. Practitioners with high school degrees had lower abilities than those with college degrees. Overall, these professionals were better educated, younger, and had better skills than expected.

The effect of gender and respirator brand on the association of respirator fit with facial dimensions.

This study examined the association of facial dimensions with respirator fit considering the effect of gender and respirator brand. Forty-one subjects (20 white females and 21 white males) participated in the study. Each subject was measured for 12 facial dimensions using anthropometric sliding and spreading calipers and a steel measuring tape. Three quantitative fit tests were conducted with the same subject wearing one size of three different brands of half-mask respirators resulting in a total of nine fit tests. Linear mixed model analysis was used to model respirator fit as a function of gender and respirator brand while controlling for facial dimensions. Results indicated that the gender by respirator brand interaction was not statistically significant (p = 0.794), and there was no significant difference in respirator fit between males and females (p = 0.356). There was a significant difference in respirator fit among respirator brands (p < 0.001). Because correlations between facial dimensions and respirator fit differed across gender and respirator brand, six separate linear mixed models were fit to assess which facial dimensions most strongly relate to respirator fit using a "one variable at a step" backward elimination procedure. None of the 12 facial dimensions were significantly associated with respirator fit in all six models. However, bigonial breadth and menton-nasion length were significantly associated with respirator fit in five of the six models, and biectoorbitale breadth, bizygomatic breadth, and lip width were significantly associated with respirator fit in four of the six models. Although this study resulted in significant findings related to the correlation of respirator fit with menton-nasion length and lip width (the dimensions currently used to define the half-mask respirator test panel), other facial dimensions were also shown to be significantly associated with respirator fit. Based on these findings and findings from previous studies, it is suggested that other facial dimensions including bigonial breadth, biectoorbitale breadth, and bizygomatic breadth be considered when designing half-mask respirators, and that face length and lip width alone may not be appropriate in defining test groups whose fit is intended to be representative of worker populations.

Evaluation of the predictive abilities of a qualitative exposure assessment model.

Various qualitative exposure assessment models based on different underlying assumptions requiring distinct inputs and providing diverse outputs are used by occupational hygienists and risk managers to evaluate the magnitude of occupational exposures. Although a wide variety of exposure assessment models are available, most models have not been validated. This study compared the inhalation risk factor of a qualitative exposure assessment model with quantitative exposure data collected at a manufacturing facility for more than 9 years for 12 worker groups involving 24 chemical agents. A Spearman's rho correlation found no significant correlation between the model's risk factor and the maximum measured exposure (rs=0.119, p=0.496). A Fisher exact test found that the maximum measured exposure was independent of the model's inhalation risk factor (chi2=0.203, p=0.653). The model accurately classified measured exposures in 18 out of 35 cases (51%), 53% of the measured exposures classified as acceptable were correctly classified by the model (sensitivity), whereas 33% of the measured exposures classified as uncertain/unacceptable were correctly classified by the model (specificity). There was a 67% probability that the model would result in a false low classification and a 47% probability that the model would result in a false high classification. Although the model was simple to apply, the overall predictive ability for the low level exposures seen in the study were poor and inconsistent among worker groups compared.

Assuring public health professionals are prepared for the future: the UAB public health integrated core curriculum.

In response to calls to improve public health education and our own desire to provide a more relevant educational experience to our Master of Public Health students, the University of Alabama at Birmingham (UAB) School of Public Health designed, developed, and instituted a fully integrated public health core curriculum in the fall of 2001. This curriculum combines content from discipline-specific courses in biostatistics, environmental health, epidemiology, health administration, and the social and behavioral sciences, and delivers it in a 15 credit hour, team-taught course designed in modules covering such topics as tobacco, infectious diseases, and emergency preparedness. Weekly skills-building sessions increase student competence in data analysis and interpretation, communication, ethical decision-making, community-based interventions, and policy and program planning. Evaluations affirm that the integrated core is functioning as intended: as a means to provide critical content in the core disciplines in their applied context. As public health education continues to be debated, the UAB public health integrated core curriculum can serve as one model for providing quality instruction that is highly relevant to professional practice.