Characterizing Asbestos Hazard Emergency Response Act (AHERA) Compliance in New Jersey: 2008-2017.

CONTEXT: The Asbestos Hazard Emergency Response Act (AHERA) became a law in 1986, and the US Environmental Protection Agency (USEPA) was mandated to promulgate rules to regulate the inspection, management, and abatement of asbestos-containing building materials (ACBM) in schools. This study describes 10 years (2008-2017) of AHERA compliance site inspection data conducted by the New Jersey Department of Health (NJDOH). OBJECTIVES: To establish the level to which inspected NJ schools comply with AHERA regulations, to characterize compliance deficiencies including those that may lead to increased asbestos exposure risk to students and school employees, and to determine whether age, type, and geographic location of school impacted the likelihood of noncompliance. DESIGN: Information collected during 456 unique inspections between 2008 and 2017 was analyzed. SETTING AND PARTICIPANTS: Inspections were conducted at public and private schools in New Jersey. These included elementary, middle, and high schools, as well as charter and vocational/technical schools. MAIN OUTCOME MEASURES: Descriptive statistics and multiple logistic regression modeling of 3 factors, school type, geographical region, and school age. RESULTS: NJDOH inspectors found damage to friable ACBM in 50% (n = 229) of the schools and fiber release episodes in 27% of inspections (n = 121). The case of schools failing to attach warning labels on or immediately adjacent to ACBM was the most frequently noted compliance deficiency over the 10-year period. The modeling output showed that compliance was associated with the type of school and geographical region. CONCLUSIONS: Inspected schools during the 10-year period were in serious noncompliance with AHERA regulations. This included deficiencies that demonstrate a potential exposure to asbestos such as missing ACBM in management plans, damaged ACBM, lack of protection of short-term workers and custodial staff, and the identification of fiber release episodes. Modeling results of specific school characteristics can help direct limited resources to mitigate potential asbestos exposures.

Tree-Related Injuries Associated With Response and Recovery From Hurricane Sandy, New Jersey, 2011-2014.

OBJECTIVES: Extreme weather events require extensive tree removal and disposal, tasks associated with severe injury risks among workers and residents. To help understand the risks of such activities, we evaluated the impact of a large and destructive storm (Hurricane Sandy in 2012) on the incidence of tree-related injuries. METHODS: We searched chief-complaint text fields for patients aged 18-65 from 2011-2014 emergency department visit records submitted by New Jersey hospitals through the state-based syndromic surveillance system. Tree-related keywords (eg, saw, branch, wood chip, woodchip, tree) identified possible injuries that we then reviewed to exclude unrelated cases and classify mechanisms of tree-related injury. We used Poisson regression analysis to evaluate changes in the rates of probable tree-related injuries, adjusting for total emergency department visits and seasonal variation. RESULTS: We identified 698 probable tree-related injuries from 2011-2014 among patients aged 18-65, including 104 (14.9%) falls, 241 (34.5%) machine-related injuries, 311 (44.6%) struck-by injuries, and 42 (6.0%) other tree-related injuries. Tree-related injuries increased significantly in the quarter immediately after Hurricane Sandy (November 2012-January 2013) compared with the same quarter the year before (rate ratio [RR] = 1.67; 95% confidence interval [CI], 1.13-2.47) and the year after (RR = 2.47; 95% CI, 1.62-3.78) Hurricane Sandy, especially for struck-by injuries compared with the year before (RR = 2.74; 95% CI, 1.47-5.12) and the year after (RR = 4.17; 95% CI, 2.09-8.32) Hurricane Sandy. More than one-third of the injuries (33.4%) involved chainsaws. CONCLUSIONS: A major hurricane was associated with an increase in tree-related injuries in emergency departments, especially for mechanisms consistent with handling downed and damaged trees. Further research should confirm these findings and evaluate opportunities for preventing tree-related injuries.

Trees down, hazards abound: Observations and lessons from Hurricane Sandy.

BACKGROUND: Given predictions that climate change will lead to an increase in severe storms, it is important to more fully understand the risks experienced by workers charged with the cleanup and removal of storm damaged trees. These hazards have received little attention in the occupational safety and health literature. METHODS: This paper is based on semi-structured interviews with 23 stakeholders involved in the Hurricane Sandy cleanup effort. RESULTS: Interview participants identified at risk sectors, gaps in training and preparedness, and raised particular concerns about storm downed trees, electrical hazards, and fatigue and suggested steps to reduce these hazards. CONCLUSIONS: Stakeholders' observations about storm response suggest directions for improving the health and safety of this critical workforce.

Assessing Barriers to the Use of Fall Protection in Small Residential Construction Companies in New Jersey.

Three focus groups were conducted with residential construction workers from local New Jersey labor organizations to characterize barriers to fall protection use among residential construction contractors who work for companies with fewer than ten employees. Thirty-six residential construction workers volunteered to participate, the average age was thirty-nine years, and twenty-four (67%) were of Hispanic origin. Twelve (33%) of the participants reported having fallen from greater than 6 ft at work and twenty (56%) of the participants had known someone who has fallen from greater than 6 ft. Sixteen (44%) had not been provided with fall protection equipment by their employer and eighteen (50%) reported their current employer had not provided workplace safety training. Factors that created barriers to use of fall protection equipment such as equipment availability, employee/employer relationships, cultural differences, and company size were identified. Results from this study confirm that falls remain a concern among residential construction workers in small companies.

Isocyanates and work-related asthma: Findings from California, Massachusetts, Michigan, and New Jersey, 1993-2008.

BACKGROUND: Isocyanates remain a leading cause of work-related asthma (WRA). METHODS: Two independent data systems were analyzed for the period 1993-2008: (1) State-based WRA case surveillance data on persons with isocyanate-induced WRA from four states, and (2) Occupational Safety and Health Administration (OSHA) Integrated Management Information System (IMIS) isocyanate air sampling results. RESULTS: We identified 368 cases of isocyanate-induced WRA from 32 industries and 678 OSHA isocyanate air samples with detectable levels from 31 industries. Seventeen industries were unique to one or the other dataset. CONCLUSION: Isocyanate-induced WRA continues to occur in a wide variety of industries. Two data systems uncovered industries with isocyanate exposures and/or illness. Improved control measures and standards, including medical surveillance, are needed. More emphasis is needed on task-specific guidance, spill clean-up procedures, skin and respiratory protection, and targeted medical monitoring to mitigate the hazards of isocyanate use.

Effects of demographic factors on survival time after a diagnosis of amyotrophic lateral sclerosis.

BACKGROUND: The Agency for Toxic Substances and Disease Registry established surveillance projects to determine the incidence, prevalence, and demographic characteristics of persons with Amyotrophic Lateral Sclerosis (ALS) in defined geographic areas. There is a need to characterize and account for the survival and prognostic factors among a population-based cohort of ALS cases in the United States. METHODS: A cohort of incident cases diagnosed from 2009-2011 in New Jersey was followed until death or December 31, 2013, whichever happened first. Survival was assessed using Kaplan-Meier curves and Cox proportional hazards regression was used to identify prognostic factors. RESULTS: Sixty-four percent of incident cases died between 2009 and 2013, 93.7% specifically from ALS. Among the 456 cases studied in the survival analysis, the median survival from diagnosis was 21 months; 46% of cases survived longer than two years from diagnosis. Older age predicted shorter survival. While there is some indication of differences because of sex, race, and ethnicity, these differences were not statistically significant when accounting for age. CONCLUSIONS: New Jersey mortality data were queried to determine the vital status of a cohort of incident ALS cases and used to investigate relationships between demographic factors and survival. Results are consistent with other population-based studies. Older age was a strong predictor of shorter survival time. Additional follow-up time is needed to characterize longer-term survival.

Population-based surveillance of amyotrophic lateral sclerosis in New Jersey, 2009-2011.

BACKGROUND: Limited epidemiological data exist about amyotrophic lateral sclerosis (ALS) in the United States (US). The Agency for Toxic Substances and Disease Registry maintains the National ALS Registry and funded state and metropolitan surveillance projects to obtain reliable, timely information about ALS in defined geographic areas. METHODS: Neurologists submitted case reports for ALS patients under their care between January 1, 2009 and December 31, 2011 who were New Jersey residents. A medical record verification form and electromyogram (EMG) report were requested for a sample of case reports. Incidence rates were standardized to the 2000 US Standard Population. RESULTS: The average crude annual incidence rate was 1.87 per 100,000 person-years, the average age-adjusted annual incidence rate was 1.67 per 100,000 person-years, and the point prevalence rate on December 31, 2011 was 4.40 per 100,000 persons. Average annual incidence rates and point prevalence rates were statistically higher for men compared with women; Whites compared with Blacks/African Americans and Asians; and non-Hispanics compared with Hispanics. CONCLUSIONS: The project findings contribute new, population-based, state-specific information to epidemiological data regarding ALS. The findings are generally consistent with previously published surveillance studies conducted in the US and abroad.

Lead-based paint awareness, work practices, and compliance during residential construction and renovation.

The U.S. Environmental Protection Agency recently implemented the Renovation, Repair and Painting (RRP) rule that applies to pre-1978 residences because of the potential presence of lead-based paint. Enforcement of this rule may be difficult and therefore it is crucial to understand the awareness and beliefs of contractors and the general public because these will likely be major determinants of exposures resulting from residential renovation work. The study described in this article utilized two mailed surveys: one directed to the general public and the other directed to contractors. The surveys were conducted in New Jersey and Virginia. Field observations were also recorded for work sites in New Jersey. Results indicated a high awareness among the general public about the hazards of lead, a low level of screening by children's doctors for lead exposure, frequent use of work practices that generate lots of dust, poor hygiene among contractors, and the potential for low compliance of contractors with the RRP rule. In particular, contractors who do not believe lead is a serious health hazard are expected to have the lowest compliance with the RRP rule. These findings serve as targets for effective public health interventions through education and outreach.

Utilizing United States Coast Guard data to calculate incidence rates and identify risk factors for occupational fishing injuries in New Jersey.

Commercial fishing has high rates of work-related injury and death and needs preventive strategies. Work-related fatal and nonfatal injury rates for New Jersey (NJ) commercial fishermen who suffered unintentional traumatic injuries from 2001 to 2007 are calculated using data from the United States Coast Guard (USCG) Marine Safety and Pollution Database and estimated denominator data. Fatalities were compared to those ascertained by the NJ Fatality Assessment Control and Evaluation (FACE) surveillance system. For the study years, 225 nonfatal injuries and 31 fatal injuries were reported. Among nonfatal injuries, the causes by frequency were fall onto surface, crushed between objects, struck by moving object, line handling/caught in lines, collision with fixed objects, fall into water, and other noncontact injuries. The distribution of fatal injuries differed, with the most frequent cause as crushed between objects. Falls into water and several noncontact injuries accounted for most of the other fatalities. The large majority (96%) of nonfatal injuries were contact injuries, whereas only 68% of fatalities were classified as contact. The overall incidence rate of nonfatal injuries was 1188 per 100,000 full-time equivalents (FTEs) per year. The rate varied considerably by year, from a low of 286 per 100,000 FTEs in 2001 and 2007 to 3806 per 100,000 FTEs in 2003. The overall occupational fatality rate over the period 2001-2007 was 164 per 100,000 FTEs per year. These results can aid in targeting the commercial fishing industry for injury prevention strategies and interventions, especially for falls, crushing injuries, and drownings.

Engineering control technologies to reduce occupational silica exposures in masonry cutting and tuckpointing.

OBJECTIVES: A number of tasks in construction generate worker overexposures to respirable crystalline silica dust, which is a significant contributor to occupational mortality and morbidity. This study evaluated the performance of commercially available engineering controls used in dusty construction tasks commonly performed by bricklayers. METHODS: Local exhaust ventilation (LEV) controls for a portable abrasive cutter and for tuckpointing grinders were examined at a bricklayers' training center, as were two stationary wet saws. Personal breathing zone air samples were collected with and without the use of LEV or water suppression during simulated concrete block cutting, brick cutting, and tuckpointing. RESULTS: Compared with the use of no exposure control during block and brick cutting, the portable LEV unit significantly reduced mean respirable quartz exposures by 96% for block cutting and 91% for brick cutting (p < 0.01). The use of stationary wet saws was also associated with 91% reductions in exposure (p < 0.01). For tuckpointing, the reductions in mean respirable quartz concentrations were between 91% and 93% with the LEV controls (p < 0.05). CONCLUSIONS: Reductions of up to 96% in mean respirable quartz concentration were observed between control and no-control scenarios. These reductions with commercially available off-the-shelf tools demonstrate the effectiveness of engineering control interventions to reduce crystalline silica exposures in construction. Strategies to further improve control performance and approaches for increasing control interventions in construction are needed.

Survey of current lead use, handling, hygiene, and contaminant controls among New Jersey industries.

In 2003, a chemical handling and use survey was mailed to New Jersey employers identified as currently using lead in their industrial processes. This survey was used to ascertain characteristics about lead use, handling, and protection of employees during manufacturing operations. The survey included a diverse group of current lead users with a total lead use range from less than 1 pound to more than 63 million pounds of lead per year. The survey allowed for a comprehensive characterization of hazards and protective measures associated with this metal, still commonly used in many products and industrial processes. Forty-five surveys were returned by companies that are listed in the New Jersey Adult Blood Lead Registry, which is part of the New Jersey Adult Blood Lead Epidemiology and Surveillance (ABLES) program. This program records and investigates cases of adults with greater than 25 mu g/dL of lead in their blood; most cases are related to occupational exposures. This survey found that greater than 25% of these surveyed companies with significant potential for lead exposure did not employ commonly used and basic industrial hygiene practices. In addition, the survey found that 24% of these companies had not conducted air sampling within the last 3 years. Air sampling is the primary trigger for compliance with the Occupational Safety and Health Administration (OSHA) general industry lead standard. Only 17% of the companies have ever been cited for a violation of the OSHA lead standard, and only 46% of these companies have ever had an OSHA inspection. State-based surveillance can be a useful tool for OSHA enforcement activities. Elevated blood lead values in adults should be considered as a trigger for required compliance with an OSHA general industry lead standard.

Soil contamination from PCB-containing buildings.

BACKGROUND: Polychlorinated biphenyls (PCBs) in construction materials, such as caulking used around windows and expansion joints, may constitute a source of PCB contamination in the building interiors and in surrounding soil. Several studies of soil contamination have been conducted around buildings where the caulking has been removed by grinding or scraping. The PCBs in soil may have been generated in the process of removing the caulking, but natural weathering and deterioration of the caulking may have also been a source. OBJECTIVES: The objectives of this study were to measure PCB levels in soil surrounding buildings where PCB-containing caulk was still in place, and to evaluate the mobility of the PCBs from caulking using the Toxicity Characteristic Leaching Procedure (U.S. Environmental Protection Agency Method 1311). DISCUSSION: We found soil PCB contamination ranging from 3.3 to 34 mg/kg around buildings with undisturbed caulking that contained 10,000-36,200 mg/kg PCBs. The results of the Toxicity Characteristic Leaching Procedure (leachate concentrations of 76-288 mg PCB/L) suggest that PCBs in caulking can be mobilized, apparently as complexes with dissolved organic matter that also leach off the caulking material. CONCLUSIONS AND RECOMMENDATIONS: Although these new findings are based on a small sample size, they demonstrate the need for a national survey of PCBs in building materials and in soil surrounding these buildings. Because the buildings constructed during the time the PCB caulking was in use (1960s and 1970s) include schools, hospitals, and apartment buildings, the potential for exposure of children is a particular concern. It is necessary to reconsider the practice of disposing of old PCB caulking removed during building renovations in conventional landfills, given the apparent mobility of PCBs from the caulking material. Disposal of some caulking material in nonhazardous landfills might lead to high PCB levels in landfill leachate.