Maternal occupation as a nail technician or hairdresser during pregnancy and birth defects, National Birth Defects Prevention Study, 1997-2011.

OBJECTIVE: Nail technicians and hairdressers may be exposed to chemicals with potential reproductive effects. While studies have examined birth defects in children of hairdressers, those in children of nail technicians have not been evaluated. We investigated associations between selected birth defects and maternal occupation as a nail technician or hairdresser versus a non-cosmetology occupation during pregnancy. METHODS: We analysed population-based case-control data from the multisite National Birth Defects Prevention Study, 1997-2011. Cases were fetuses or infants with major structural birth defects; controls were live-born infants without major birth defects. Expert raters classified self-reported maternal jobs as nail technician, combination nail technician-hairdresser, hairdresser, other cosmetology work or non-cosmetology work. We used logistic regression to calculate adjusted ORs and 95% CIs for associations between occupation during pregnancy and birth defects, controlling for age, smoking, education and race/ethnicity. RESULTS: Sixty-one mothers worked as nail technicians, 196 as hairdressers, 39 as combination nail technician-hairdressers and 42 810 as non-cosmetologists. The strongest associations among nail technicians included seven congenital heart defect (CHD) groups (ORs ranging from 2.7 to 3.5) and neural tube defects (OR=2.6, CI=0.8 to 8.4). Birth defects most strongly associated with hairdressing included anotia/microtia (OR=2.1, CI=0.6 to 6.9) and cleft lip with cleft palate (OR=2.0, CI=1.1 to 3.7). All oral cleft groups were associated with combination nail technician-hairdresser work (ORs ranging from 4.2 to 5.3). CONCLUSIONS: Small samples resulted in wide CIs. Still, results suggest associations between maternal nail technician work during pregnancy and CHDs and between hairdressing work and oral clefts.

COVID-19 Among Workers in Meat and Poultry Processing Facilities - 19 States, April 2020.

Congregate work and residential locations are at increased risk for infectious disease transmission including respiratory illness outbreaks. SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is primarily spread person to person through respiratory droplets. Nationwide, the meat and poultry processing industry, an essential component of the U.S. food infrastructure, employs approximately 500,000 persons, many of whom work in proximity to other workers (1). Because of reports of initial cases of COVID-19, in some meat processing facilities, states were asked to provide aggregated data concerning the number of meat and poultry processing facilities affected by COVID-19 and the number of workers with COVID-19 in these facilities, including COVID-19-related deaths. Qualitative data gathered by CDC during on-site and remote assessments were analyzed and summarized. During April 9-27, aggregate data on COVID-19 cases among 115 meat or poultry processing facilities in 19 states were reported to CDC. Among these facilities, COVID-19 was diagnosed in 4,913 (approximately 3%) workers, and 20 COVID-19-related deaths were reported. Facility barriers to effective prevention and control of COVID-19 included difficulty distancing workers at least 6 feet (2 meters) from one another (2) and in implementing COVID-19-specific disinfection guidelines.* Among workers, socioeconomic challenges might contribute to working while feeling ill, particularly if there are management practices such as bonuses that incentivize attendance. Methods to decrease transmission within the facility include worker symptom screening programs, policies to discourage working while experiencing symptoms compatible with COVID-19, and social distancing by workers. Source control measures (e.g., the use of cloth face covers) as well as increased disinfection of high-touch surfaces are also important means of preventing SARS-CoV-2 exposure. Mitigation efforts to reduce transmission in the community should also be considered. Many of these measures might also reduce asymptomatic and presymptomatic transmission (3). Implementation of these public health strategies will help protect workers from COVID-19 in this industry and assist in preserving the critical meat and poultry production infrastructure (4).

Occupational exposures to new dry cleaning solvents: High-flashpoint hydrocarbons and butylal.

The dry cleaning industry is moving away from using perchloroethylene. Occupational exposures to two alternative dry cleaning solvents, butylal and high-flashpoint hydrocarbons, have not been well characterized. We evaluated four dry cleaning shops that used these alternative solvents. The shops were staffed by Korean- and Cantonese-speaking owners, and Korean-, Cantonese-, and Spanish-speaking employees. Because most workers had limited English proficiency we used language services in our evaluations. In two shops we collected personal and area air samples for butylal. We also collected air samples for formaldehyde and butanol, potential hydrolysis products of butylal. Because there are no occupational exposure limits for butylal, we assessed employee health risks using control banding tools. In the remaining two shops we collected personal and area air samples for high-flashpoint hydrocarbon solvents. In all shops the highest personal airborne exposures occurred when workers loaded and unloaded the dry cleaning machines and pressed dry cleaned fabrics. The air concentrations of formaldehyde and butanol in the butylal shops were well below occupational exposure limits. Likewise, the air concentrations of high-flashpoint hydrocarbons were also well below occupational exposure limits. However, we saw potential skin exposures to these chemicals. We provided recommendations on appropriate work practices and the selection and use of personal protective equipment. These recommendations were consistent with those derived using control banding tools for butylal. However, there is insufficient toxicological and health information to determine the safety of butylal in occupational settings. Independent evaluation of the toxicological properties of these alternative dry cleaning solvents, especially butylal, is urgently needed.

Investigating a persistent odor at an aircraft seat manufacturer.

An aircraft seat manufacturing company requested a NIOSH health hazard evaluation to help identify a strong odor that had persisted throughout the facility for over a year. Employees reported experiencing health effects thought to be related to the odor. We collected and analyzed area air samples for volatile organic compounds, endotoxin, bacterial and fungal metagenome, and metalworking fluid aerosol. Bulk metalworking fluid samples were analyzed for endotoxin, bacterial and fungal metagenome, and viable bacteria and fungus. We also evaluated the building ventilation systems and water diversion systems. Employees underwent confidential medical interviews about work practices, medical history, and health concerns. Based on our analyses, the odor was likely 2-methoxy-3,5-dimethylpyrazine. This pyrazine was found in air samples across the facility and originated from bacteria in the metalworking fluid. We did not identify bacteria known to produce the compound but bacteria from the same Proteobacteria order were found as well as bacteria from orders known to produce other pyrazines. Chemical and biological contaminants and odors could have contributed to health symptoms reported by employees, but it is likely that the symptoms were caused by several factors. We provided several recommendations to eliminate the odor including washing and disinfecting the metalworking machines and metalworking fluid recycling equipment, discarding all used metalworking fluid, instituting a metalworking fluid maintenance program at the site, and physically isolating the metalworking department from other departments.

Testing of glove efficacy against sprayed isocyanate coatings utilizing a reciprocating permeation panel.

OBJECTIVES: Modify a permeation panel to evaluate dermal protective clothing for resistance to sprayed coatings with minimal variability in spray paint loading across the test panel. Determine isocyanate protection effectiveness of natural rubber latex (5 mil or 0.13mm), nitrile rubber (5 mil or 0.13mm), and butyl rubber (13 mil or 0.33mm) glove materials against a commonly used automotive clear coat formulation. The latex and nitrile gloves were the type used by the local autobody spray painters. METHODS: Glove materials were tested by spraying paint onto an automated reciprocating permeation panel (permeation panel II). Temperature, relative humidity, and spray conditions were controlled to optimize paint loading homogeneity as evaluated by gravimetric analysis. Isocyanate permeation was measured using 1-(2-pyridyl)-piperazine-coated fiber-glass filters analyzed by a modified version of the OSHA 42/PV2034 methods. RESULTS: Latex exhibited a higher permeation rate compared with nitrile for isocyanates (1,6-hexamethylene diisocyanate (HDI) and isophorone diisocyanate monomers) and both materials presented permeation at all of the time points suggesting a fast isocyanate breakthrough. Butyl material exhibited no permeation or breakthrough for isocyanates under the tested conditions. The spray application at 69±8°F was optimally homogeneous at 45±0.5mg weight of dry clear coat per 5cm(2). CONCLUSIONS: The permeation panel II is a reliable method to assess dermal protective clothing performance against polymerizing coatings. Commonly used 5-mil (0.13-mm) latex and nitrile gloves were determined to be ineffective barriers against the isocyanates found in a commonly used clear-coat formulation while butyl gloves were protective.

Occupational Safety and Health and Illicit Opioids: State of the Research on Protecting Against the Threat of Occupational Exposure.

The nationwide opioid crisis continues to affect not only people who use opioids but also communities at large by increasing the risk of accidental occupational exposure to illicit opioids. In addition, the emergence of highly potent synthetic opioids such as fentanyl and carfentanil increases the need to protect workers who may encounter unknown drug substances during job activities. To support the National Institute for Occupational Safety and Health Opioids Research Gaps Working Group, we examined the state of the literature concerning methods to protect workers against accidental occupational exposure to illicit opioids, and have identified unmet research needs concerning personal protective equipment, decontamination methods, and engineering controls. Additional studies are needed to overcome gaps in technical knowledge about personal protective equipment, decontamination, and control methods, and gaps in understanding how these measures are utilized by workers. Increasing our knowledge of how to protect against exposure to illicit opioids has the potential to improve occupational health across communities.

Occupational exposure to polybrominated diphenyl ethers (PBDEs) and other flame retardant foam additives at gymnastics studios: Before, during and after the replacement of pit foam with PBDE-free foams.

Coaches spend long hours training gymnasts of all ages aided by polyurethane foam used in loose blocks, mats, and other padded equipment. Polyurethane foam can contain flame retardant additives such as polybrominated diphenyl ethers (PBDEs), to delay the spread of fires. However, flame retardants have been associated with endocrine disruption and carcinogenicity. The National Institute for Occupational Safety and Health (NIOSH) evaluated employee exposure to flame retardants in four gymnastics studios utilized by recreational and competitive gymnasts. We evaluated flame retardant exposure at the gymnastics studios before, during, and after the replacement of foam blocks used in safety pits with foam blocks certified not to contain several flame retardants, including PBDEs. We collected hand wipes on coaches to measure levels of flame retardants on skin before and after their work shift. We measured flame retardant levels in the dust on window glass in the gymnastics areas and office areas, and in the old and new foam blocks used throughout the gymnastics studios. We found statistically higher levels of 9 out of 13 flame retardants on employees' hands after work than before, and this difference was reduced after the foam replacement. Windows in the gymnastics areas had higher levels of 3 of the 13 flame retardants than windows outside the gymnastics areas, suggesting that dust and vapor containing flame retardants became airborne. Mats and other padded equipment contained levels of bromine consistent with the amount of brominated flame retardants in foam samples analyzed in the laboratory. New blocks did not contain PBDEs, but did contain the flame retardants 2-ethylhexyl 2,3,4,5-tetrabromobenzoate and 2-ethylhexyl 2,3,4,5-tetrabromophthalate. We conclude that replacing the pit foam blocks eliminated a source of PBDEs, but not 2-ethylhexyl 2,3,4,5-tetrabromobenzoate and 2-ethylhexyl 2,3,4,5-tetrabromophthalate. We recommend ways to further minimize employee exposure to flame retardants at work and acknowledge the challenges consumers have identifying chemical contents of new products.

Serum concentrations of polychlorinated dibenzo-p-dioxins among ceramicists.

Polychlorinated dibenzo-p-dioxins (PCDDs) occur naturally in ball clay at elevated concentrations. Thus, persons who habitually work with clay may be at risk for exposure to PCDDs. An earlier case report provided some evidence of elevated PCDD levels in serum for long-term hobby ceramicists; however, no previous study has measured serum dioxin concentrations among ceramicists. This study measured PCDD serum levels for 27 individuals involved in ceramics making. The average residual, defined as the average of the [log measured serum lipid concentration ­ log background serum lipid concentration], was calculated and then tested to determine whether it was significantly different from zero. The p-values for the average residuals indicated that the serum lipid concentrations for several PCDD congeners were elevated relative to background. The number of significant residuals increased dramatically if the background concentrations were adjusted to account for the fact that they were not contemporaneous with the measurements for the ceramicists. The ratio of the 1,2,3,6,7,8-HxCDD concentration to the 1,2,3,7,8,9-HxCDD concentration was greater than 1.0, unlike in ball clay, suggesting that although long-term working with ball clay elevates the PCDD levels in serum somewhat, it is not the predominant source of the PCDD body burden for ceramicists.

Evaluation of the release of dioxins and PCBs during kiln-firing of ball clay.

Ball clay is known to be naturally contaminated with high levels of polychlorinated di-benzo-p-dioxins (PCDDs). This study evaluated the potential for PCDD, polychlorinated dibenzofuran (PCDF) and polychlorinated biphenyl (PCB) release during the kiln firing of ball clay in an art studio. Toxic equivalence (TEQ) were calculated using World Health Organization (WHO) 2005 toxic equivalence factors (TEF) and congener concentrations. Ten bags of commercial ball clay were found to have an average TEQ of 1,370 nanograms/kilogram (ng kg(-1)) dry weight (dw), almost exclusively due to PCDDs (99.98% of TEQ). After firing, none of the 29 dioxin-like analytes was measured above the limits of detection (LOD) in the clay samples. Air samples were taken during firings using both low-flow and high-flow air samplers. Few low-flow air samples contained measurable levels of dioxin congeners above the LOD. The mean TEQ in the high volume air samples ranged from 0.07 pg m(-3) to 0.21 pg m(-3) when firing ball clay, and was 0.11 pg m(-3) when no clay was fired. These concentrations are within the range measured in typical residences and well-controlled industrial settings. The congener profiles in the high-flow air samples differed from the unfired clay; the air samples had a considerable contribution to the TEQ from PCDFs and PCBs. Given that the TEQs of all air samples were very low and the profiles differed from the unfired clay, it is likely that the PCDDs in dry ball clay were destroyed during kiln firing. These results suggest that inhalation of volatilized dioxins during kiln firing of dry ball clay is an unlikely source of exposure for vocational and art ceramicists.