Occupational exposure to respirable crystalline silica among US metal and nonmetal miners, 2000-2019.

BACKGROUND: In metal and nonmetal (M/NM) mines in the United States, respirable crystalline silica (RCS) exposures are a recognized health hazard and a leading indicator of respiratory disease. This study describes hazardous exposures that exceed occupational exposure limits and examines patterns of hazardous RCS exposure over time among M/NM miners to better inform the need for interventions. METHODS: Data for this study were obtained from the Mine Safety and Health Administration (MSHA) Open Government Initiative Portal for the years 2000-2019, examining respirable dust samples with MSHA-measured quartz concentration >1%. Descriptive statistics for RCS were analyzed for M/NM miners by year, mine type, sector, commodity, occupation, and location in a mine. RESULTS: This study found the overall geometric mean (GM) for personal exposures to RCS was 28.9 µg/m3 (geometric standard deviation: 2.5). Exposures varied significantly by year, mine type, sector, commodity, occupation, and location in a mine. Overall, the percentages of exposures above the MSHA permissible exposure limit (PEL for respirable dust with >1% quartz, approximately 100 µg/m3 RCS) and the National Institute for Occupational Safety and Health RCS recommended exposure limit (REL, 50 µg/m3 ) were 11.8% and 27.3%, respectively. GM exposures to RCS in 2018 (45.9 µg/m3 ) and 2019 (52.9 µg/m3 ) were significantly higher than the GM for all years prior. The overall 95th percentile of RCS exposures from 2000 to 2019 was 148.9 µg/m3 , suggesting a substantial risk of hazardous exposures above the PEL and REL during the entire period analyzed. CONCLUSIONS: The prevalence of high exposures to RCS among M/NM miners continues in the past 20 years and may be increasing in certain settings and occupations. Further research and intervention of the highest exposures are needed to minimize the risks of acquiring silica-induced respiratory diseases.

Tdap Vaccination Among Healthcare Personnel-21 States, 2013.

INTRODUCTION: Outbreaks of pertussis can occur in healthcare settings. Vaccinating healthcare personnel may be helpful in protecting healthcare personnel from pertussis and potentially limiting spread to others in healthcare settings. METHODS: Data from 21 states using the 2013 Behavioral Risk Factor Surveillance System industry/occupation module were analyzed in 2016. Tetanus, diphtheria, and acellular pertussis (Tdap) vaccination status was self-reported by healthcare personnel along with their occupation, healthcare setting/industry, demographics, and access to care factors. To compare groups, t-tests were used. The median state response rate was 44.0%. RESULTS: Among all healthcare personnel, 47.2% were vaccinated for Tdap. Physicians had higher Tdap coverage (66.8%) compared with all other healthcare personnel except nurse practitioners and registered nurses (59.5%), whose coverage did not statistically differ from that of physicians. Tdap vaccination coverage was higher among workers in hospitals (53.3%) than in long-term care facilities (33.3%) and other clinical settings, such as dentist, chiropractor, and optometrist offices (39.3%). Healthcare personnel who were younger, who had higher education, higher annual household income, a personal healthcare provider, and health insurance had higher Tdap vaccination coverage compared with reference groups. Tdap vaccination coverage among healthcare personnel in 21 states ranged from 30.6% in Mississippi to 65.9% in Washington. CONCLUSIONS: Improvement in Tdap vaccination among healthcare personnel is needed to potentially reduce opportunities for spread of pertussis in healthcare settings. On-site workplace vaccination, offering vaccines free of charge, and promoting vaccination may increase vaccination among healthcare personnel.

Prevalence of Obesity, No Leisure-Time Physical Activity, and Short Sleep Duration Among Occupational Groups in 29 States.

OBJECTIVE: The aim of this study was to examine prevalence of obesity (body mass index of 30 or higher), no leisure-time physical activity in the past 30 days (no LTPA), and short sleep duration (averaging less than 7 hours of sleep per 24-hour period) among 22 occupational groups. METHODS: We analyzed 2013 and 2014 Behavioral Risk Factor Surveillance System (BRFSS) data from 29 states, controlling for sex, age, race/ethnicity, and education. RESULTS: By occupation, prevalence ranged from 16.1% to 35.8% for obesity, 11.3% to 28.7% for no LTPA, and 31.4% to 42.9% for short sleep. Only Transportation & Material Moving ranked among the top five occupations for all three risk factors. Obesity and no LTPA varied significantly by sex for several occupations. CONCLUSION: Prevalence of obesity, no LTPA, and short sleep varied by occupation and affected more than one in five U.S. workers.

Cardiovascular Health Status by Occupational Group - 21 States, 2013.

Cardiovascular disease (CVD) accounts for one of every three deaths in the United States, making it the leading cause of mortality in the country (1). The American Heart Association established seven ideal cardiovascular health behaviors or modifiable factors to improve CVD outcomes in the United States. These cardiovascular health metrics (CHMs) are 1) not smoking, 2) being physically active, 3) having normal blood pressure, 4) having normal blood glucose, 5) being of normal weight, 6) having normal cholesterol levels, and 7) eating a healthy diet (2). Meeting six or all seven CHMs is associated with a lower risk for all-cause, CVD, and ischemic heart disease mortalities compared with the risk to persons who meet none or only one CHM (3). Fewer than 2% of U.S. adults meet all seven of the American Heart Association's CHMs (4). Cardiovascular morbidity and mortality account for an estimated annual $120 billion in lost productivity in the workplace; thus, workplaces are viable settings for effective health promotion programs (5). With over 130 million employed persons in the United States, accounting for about 55% of all U.S. adults, the working population is an important demographic group to evaluate with regard to cardiovascular health status. To determine if an association between occupation and CHM score exists, CDC analyzed data from the 2013 Behavioral Risk Factor Surveillance System (BRFSS) industry and occupation module, which was implemented in 21 states. Among all occupational groups, community and social services employees (14.6%), transportation and material moving employees (14.3%), and architecture and engineering employees (11.6%) had the highest adjusted prevalence of meeting two or fewer CHMs. Transportation and material moving employees also had the highest prevalence of "not ideal" ("0" [i.e., no CHMs met]) scores for three of the seven CHMs: physical activity (54.1%), blood pressure (31.9%), and weight (body mass index [BMI]; 75.5%). Disparities in cardiovascular health status exist among U.S. occupational groups, making occupation an important consideration in employer-sponsored health promotion activities and allocation of prevention resources.

Occupational carbon monoxide fatalities in the US from unintentional non-fire related exposures, 1992-2008.

OBJECTIVE: To analyze characteristics of, and trends in, work-related carbon monoxide (CO) fatalities in the US. METHODS: Records of unintentional, non-fire related fatalities from CO exposure were extracted from the Bureau of Labor Statistics' Census of Fatal Occupational Injuries and the Occupational Safety and Health Administration's Integrated Management Information System for years 1992-2008 and analyzed separately. RESULTS: The average number of annual CO fatalities was 22 (standard deviation=8). Fatality rates were highest among workers aged≥65, males, Hispanics, winter months, the Midwest, and the Fishing, Hunting, and Trapping industry subsector. Self-employed workers accounted for 28% of all fatalities. Motor vehicles were the most frequent source of fatal CO exposure, followed by heating systems and generators. CONCLUSIONS: CO has been the most frequent cause of occupational fatality due to acute inhalation, and has shown no significant decreasing trend since 1992. The high number of fatalities from motor vehicles warrants further investigation.

Prevalence of dermatitis in the working population, United States, 2010 National Health Interview Survey.

BACKGROUND: Prevalence patterns of dermatitis among workers offer clues about risk factors and targets for prevention, but population-based estimates of the burden of dermatitis among US workers are lacking. METHODS: Data from an occupational health supplement to the 2010 National Health Interview Survey (NHIS-OHS) were used to estimate the prevalence of dermatitis overall and by demographic characteristics and industry and occupation (I&O) of current/recent employment. RESULTS: Data were available for 27,157 adults, including 17,524 current/recent workers. The overall prevalence rate of dermatitis among current/recent workers was 9.8% (range among I&O groups: 5.5-15.4%), representing approximately 15.2 million workers with dermatitis. The highest prevalence rates were among I&O groups related to health care. Overall, 5.6% of dermatitis cases among workers (9.2% among healthcare workers) were attributed to work by health professionals. CONCLUSIONS: Dermatitis affected over 15 million US workers in 2010, and its prevalence varied by demographic characteristics and industry and occupation of employment. The prevalence rate of work-related dermatitis based on the NHIS-OHS was approximately 100-fold higher than incidence rates based on the Bureau of Labor Statistics' Survey of Occupational Illness and Injury.

Characterization of lead in US workplaces using data from OSHA's integrated management information system.

BACKGROUND: Lead hazards continue to be encountered in the workplace. OSHA's Integrated Management Information System (IMIS) is the largest available database containing sampling results in US workplaces. METHODS: Personal airborne lead sampling results in IMIS were extracted for years 1979-2008. Descriptive analyses, geographical mapping, and regression modeling of results were performed. RESULTS: Seventy-nine percent of lead samples were in the manufacturing sector. Lead sample results were highest in the construction sector (median = 0.03 mg/m(3) ). NORA sector, year, OSHA region, number of employees at the worksite, federal/state OSHA plan, unionization, advance notification, and presence of an employee representative were statistically associated with having a lead sample result exceed the PEL. CONCLUSIONS: Lead concentrations within construction have been higher than any other industry. Lead hazards have been most prevalent in the north and northeastern US. IMIS data can be useful as a surveillance tool and for targeting prevention efforts toward hazardous industries.

Characteristics of US workers whose blood lead levels trigger the medical removal protection provision, and conformity with biological monitoring requirements, 2003-2005.

BACKGROUND: Workers with blood lead levels (BLL) > or =60 microg/dl (50 microg/dl for construction workers) or with three or more consecutive BLLs over at least 6 months that average 50 microg/dl or greater are required to be removed from work involving lead exposure that exceeds the OSHA action level. This study estimates the proportion of workers with BLLs that trigger the medical removal provision by industry sector, and examines whether workers received appropriate follow-up blood lead testing. METHODS: Three years (2003-2005) of data from the Adult Blood Lead Epidemiology and Surveillance program were analyzed to identify those industries with a high percentage of workers with BLLs that trigger the medical removal provision. Adjusted rate ratios (RR) of adults with such BLLs were estimated by industry sector compared to the battery manufacturing industry using Poisson regression models. RESULTS: Out of 13,724 adults with BLLs > or =25 microg/dl, a total of 533 adults had BLLs that triggered the medical removal provision. RRs of adults with BLLs triggering medical removal were highest for "painting and wall covering contractors" (RR = 22.1) followed by "highway, street and bridge construction" (RR = 14.7), "amusement, gambling, and recreation" (RR = 11.4), and "glass product manufacturing" (RR = 10.1). Overall, 29% of adults with BLLs triggering medical removal received appropriate follow-up blood lead tests and met the eligibility to return to lead work. CONCLUSIONS: These findings suggest that additional efforts are needed to prevent occupational overexposure to lead in adults, and to ensure proper medical management of those workers who meet medical removal criteria.

Evaluation of two portable lead-monitoring methods at mining sites.

Two methods for measuring airborne lead using field-portable instruments have been developed by the National Institute for Occupational Safety and Health (NIOSH): Method 7702 uses X-ray fluorescence (XRF), and Method 7701 employs ultrasonic extraction (UE) followed by anodic stripping voltammetry (ASV). The two portable methods were evaluated at mining sites. Area air samples were collected throughout two mills where ore from nearby mines was processed; the primary constituent of the ore was lead sulfide (galena). The air samples were collected on 37 mm mixed cellulose ester membrane filters housed within plastic filter cassettes. At the end of the work shift, the cassettes were collected and taken to a room off-site for analysis by the two portable methods. The filter samples were first analyzed by XRF and then by UE/ASV. Calibration was verified on both instruments according to standard procedures. The samples were then sent for confirmatory analysis via flame atomic absorption spectrometry (FAAS) according to NIOSH Method 7082. Pairwise comparisons between the methods using the paired t-test showed no statistically significant differences between ASV and FAAS (P>0.05); however, the comparison between XRF and FAAS was statistically significant (P<0.05). The elevated lead concentrations reported by XRF relative to FAAS were likely the result of the ability of XRF to report total lead, including lead silicates. This form of lead is not liberated in the digestion process prior to FAAS analysis, and is therefore not detected by this method. Despite this discrepancy, lead concentrations measured by both portable technologies were found to be highly correlated with the laboratory method (R2>0.96), suggesting that they are suitable as screening methods for airborne lead at mining sites.