Characterization of Environmental Levels of Pesticide Residues in Household Air and Dust Samples near a Bioenergy Plant Using Treated Seed as Feedstock.

Exposure to neonicotinoid insecticides is associated with adverse human health outcomes. There is environmental contamination in Saunders County, Nebraska, due to the accumulation of fungicides and insecticides from a now-closed ethanol plant using seed corn as stock. A pilot study quantified environmental contamination in nearby houses from residual pesticides by measuring dust and air (indoor/outdoor) concentrations of neonicotinoids and fungicides at the study site (households within two miles of the plant) and control towns (20-30 miles away). Air (SASS® 2300 Wetted-Wall Air Sampler) and surface dust (GHOST wipes with 4 × 4-inch template) samples were collected from eleven study households and six controls. Targeted analysis quantified 13 neonicotinoids, their transformation products and seven fungicides. Sample extracts were concentrated using solid phase extraction (SPE) cartridges, eluted with methanol and evaporated. Residues were re-dissolved in methanol-water (1:4) prior to analysis, with an Acquity H-Class ultraperformance liquid chromatograph (UPLC) and a Xevo triple quadrupole mass spectrometer. We compared differences across chemicals in air and surface dust samples at the study and control sites by dichotomizing concentrations above or below the detection limit, using Fisher's exact test. A relatively higher detection frequency was observed for clothianidin and thiamethoxam at the study site for the surface dust samples, similarly for thiamethoxam in the air samples. Our results suggest airborne contamination (neonicotinoids and fungicides) from the ethanol facility at houses near the pesticide contamination.

Exploring First Responders' Use and Perceptions on Continuous Health and Environmental Monitoring.

First responders lose their lives in the line of duty each year, and many of these deaths result from strenuous physical exertion and exposure to harmful environmental agents. Continuous health monitoring may detect diseases and alert the first responder when vital signs are reaching critical levels. However, continuous monitoring must be acceptable to first responders. The purpose of this study was to discover first responders' current use of wearable technology, their perceptions of what health and environmental indicators should be monitored, and who should be permitted to monitor them. The survey was sent to 645 first responders employed by 24 local fire department stations. A total of 115 (17.8%) first responders answered the survey and 112 were used for analysis. Results found first responders perceived a need for health and environmental monitoring. The health and environmental indicators that respondents perceived as most important for monitoring in the field were heart rate (98.2%) and carbon monoxide (100%), respectively. Overall, using and wearing monitoring devices was not age-dependent and health and environmental concerns were important for first responders at any stage of their career. However, current wearable technology does not seem to be a viable solution for first responders due to device expense and durability issues.

Coexposure to Solvents and Noise as a Risk Factor for Hearing Loss in Agricultural Workers.

OBJECTIVE: This study addressed the relationship of hearing loss and coexposure to solvents and noise among farmers and ranchers in central United States. METHODS: The surveillance study included surveys to stratified random samples of operations in 2018 and 2020 (n = 34,146), requesting information on injuries, illnesses, exposures, and preventive measures. Responses (n = 7495) were analyzed using hierarchical multinomial logistic regression, adjusting for personal and work characteristics. RESULTS: Nearly 60% of respondents exposed to both solvents and noise reported hearing loss. The exposures increased the adjusted odds of moderate/severe hearing loss as follows: solvents alone, (odds ratio [OR], 1.49; 95% confidence interval [CI], 0.93-2.38), noise alone (OR, 4.42; 95% CI, 3.39-5.76), and coexposure to both noise and solvents (OR, 6.03; 95% CI, 4.67-7.78). CONCLUSIONS: Solvent exposure, along with noise, should be considered in hearing conservation programs among farmers and ranchers.

Exposure to Toxicants Associated With Use and Transitions Between Cigarettes, e-Cigarettes, and No Tobacco.

Importance: Transitions between e-cigarettes and cigarettes are common among tobacco users, but empirical evidence on the health outcomes of switching tobacco products is scarce. Objectives: To examine changes in urinary biomarkers between baseline and 1-year follow-up among adult tobacco users switching between e-cigarettes and cigarettes. Design, Setting, and Participants: This cohort study used data from wave 1 (baseline, September 2013 to December 2014) and wave 2 (1-year follow-up, October 2014 to October 2015) of the Population Assessment of Tobacco and Health Study. A subset of the probability sample of US adults who voluntarily provided biospecimens at 2 waves was analyzed. Participants were divided into 3 mutually exclusive groups at baseline: exclusive cigarette smokers, exclusive e-cigarette users, and dual users. Data analysis was performed in 2021. Exposures: Harmful and potentially harmful constituents included nicotine metabolites, tobacco-specific nitrosamines (TSNAs; including 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol [NNAL]), metals, polycyclic aromatic hydrocarbons (PAHs), and volatile organic compounds (VOCs). Main Outcomes and Measures: Within-participant changes in 55 urinary biomarkers of exposure (BOEs) to harmful and potentially harmful constituents were examined using multivariable regression models. Results: Among 3211 participants (55.6% women, 68.3% White, 13.2% Black, and 11.8% Hispanic) at baseline, 21.9% of exclusive cigarette users, 42.8% of exclusive e-cigarette users, and 62.1% of dual users changed product use at follow-up (all percentages are weighted). There was a significant reduction in urine concentrations of TSNAs, PAHs, and VOCs when users transitioned from exclusive cigarette to exclusive e-cigarette use, with a 92% decrease in NNAL, from a mean of 168.4 pg/mg creatinine (95% CI, 102.3-277.1 pg/mg creatinine) to 12.9 pg/mg creatinine (95% CI, 6.4-25.7 pg/mg creatinine; P < .001). A similar panel of BOEs decreased when dual users transitioned to exclusive e-cigarette use; NNAL levels decreased by 96%, from a mean of 143.4 pg/mg creatinine (95% CI, 86.7-237.0 pg/mg creatinine) to 6.3 pg/mg creatinine (95% CI, 3.5-11.4 pg/mg creatinine; P < .001). Nicotine metabolites, TSNAs, PAHs, and VOCs significantly increased when baseline exclusive e-cigarette users transitioned to exclusive cigarette use or dual use. Switching from exclusive cigarette use to dual use was not associated with significant decreases in BOEs. Conclusions and Relevance: This national cohort study provides evidence on the potential harm reduction associated with transitioning from exclusive cigarette use or dual use to exclusive e-cigarette use. e-Cigarettes tend to supplement cigarettes through dual use instead of cessation at the population level. Continuous monitoring of BOE at the population level and assessment of BOE change by product transition are warranted, as well as defined adverse health outcomes.

Exposure Assessment at a Pullet Barn - A Case Study.

Poultry production is an integral part of agriculture and of the U.S. economy, accounting for millions of eggs and chicken products consumed annually. Most ubiquitous to the poultry industry from farm production to research are broiler and layer poultry operations, with pullet operations at the forefront. Although essential to the cycles of production, there is a dearth of evidence regarding the occupational exposure risks of pullet production. The aim of this case study was to measure total dust and ammonia levels during the growth cycle of pullets. Ammonia and total dust concentrations were measured as single day measurements at three different points of time during the 16.5-week growth cycle of pullet flocks using two fixed sampling stations configured to represent the breathing zone height of poultry workers. As birds grew from chicks to hens, concentrations of total dust and ammonia increased. Notably, from 3 weeks-of-age to 9 weeks-of-age concentrations of total dust increased from 1.1-1.2 mg/m3 to 16.0-18.0 mg/m3; and from 9 weeks-of-age to 15 weeks-of-age, dust concentrations reached 43.0-50.0 mg/m3. Concentrations of ammonia also increased from 9 weeks to 15 weeks from 1.1-2.7 ppm to 22.0-30.0 ppm. Both levels of ammonia and total dust reached levels that have the potential to induce adverse health effects among farmers raising pullets.

Agricultural Injuries among Farmers and Ranchers in the Central United States during 2011-2015.

The high risk of occupational fatalities in agriculture is well documented, but information on non-fatal injuries is lacking due to challenges in injury surveillance. This surveillance study explored the frequency, characteristics, and risk factors for non-fatal injuries among farmers and ranchers in the central United States. The Central States Center for Agricultural Safety and Health (CS-CASH), in collaboration with the USDA National Agricultural Statistics Service (NASS), conducted annual surveys (n = 34,777 sent) during 2011-2015 covering a seven-state region (Iowa, Kansas, Minnesota, Missouri, North Dakota, Nebraska, and South Dakota). The average response rate was 32% in the five consecutive annual surveys. The average injury incidence rate was 7.0 injuries/100 operators per year. Most injuries (89%) occurred during agricultural work. The most frequent sources of injury were livestock (22%), machinery (13%), and hand tools (12%). Risk factors for injury included: male gender, younger age (vs. 65+ years), farming as the primary occupation, greater work time, greater land area, ranch (vs. farm), organic farming, internet access, and production of several types of crops and animals. Most injuries (56%) required a doctor visit, and 12% required hospitalization. The average medical costs were $1,936 out of pocket and $8,043 paid by insurance. The combined average costs for most serious injuries were $7,858. Most injuries (66%) resulted in some lost time from agricultural work, and 13% were serious, resulting in more than 30 days of lost work time. The non-fatal injury rate for self-employed farmers and ranchers was higher than that of hired agricultural workers reported by the Bureau of Labor Statistics. This result reaffirms farming/ranching as a dangerous occupation and emphasizes the need for efforts to prevent agricultural injuries, especially those associated with identified injury sources and risk factors.

Review of Literature for Air Medical Evacuation High-Level Containment Transport.

INTRODUCTION: Aeromedical evacuation (AE) is a challenging process, further complicated when a patient has a highly hazardous communicable disease (HHCD). We conducted a review of the literature to evaluate the processes and procedures utilized for safe AE high-level containment transport (AE-HLCT) of patients with HHCDs. METHODS: A literature search was performed in PubMed/MEDLINE (from 1966 through January 2019). Authors screened abstracts for inclusion criteria and full articles were reviewed if the abstract was deemed to contain information related to the aim. RESULTS: Our search criteria yielded 14 publications and were separated based upon publication dates, with the natural break point being the beginning of the 2013-2016 Ebola virus disease epidemic. Best practices and recommendations from identified articles are subdivided into pre-flight preparations, inflight operations, and post-flight procedures. CONCLUSIONS: Limited peer-reviewed literature exists on AE-HLCT, including important aspects related to healthcare worker fatigue, alertness, shift scheduling, and clinical care performance. This hinders the sharing of best practices to inform evacuations and equip teams for future outbreaks. Despite the successful use of different aircraft and technologies, the unique nature of the mission opens the opportunity for greater coordination and development of consensus standards for AE-HLCT operations.

Need for Aeromedical Evacuation High-Level Containment Transport Guidelines.

Circumstances exist that call for the aeromedical evacuation high-level containment transport (AE-HLCT) of patients with highly hazardous communicable diseases. A small number of organizations maintain AE-HLCT capabilities, and little is publicly available regarding the practices. The time is ripe for the development of standards and consensus guidelines involving AE-HLCT.

Injury risk factors to farm and ranch operators in the Central United States.

BACKGROUND: This study focused on risk factors for serious injuries in farm and ranch operators in the central United States. METHODS: The Central States Center for Agricultural Safety and Health, in collaboration with the National Agricultural Statistics Service, sent mail surveys to 6953, 6912, and 6912 farms/ranches in 2011-2013, respectively, covering seven Midwestern states. RESULTS: The average survey response rate was 35%. The average annual incidence rate (injuries/100 workers) was 6.91 for all injuries and 2.40 for serious injuries. Univariate analyses determined several demographic and farm production-related risk factors for serious injury. Adjusted analysis showed a greater risk of serious injury for operators of age 45-54 years (vs. 65 and higher), those who worked 75-99% of their time (vs. less time), and those who operated larger land areas (vs. smaller). CONCLUSION: The identified risk factors should be considered when targeting injury prevention programs.

Knowledge, Attitudes, and Practices for Respiratory and Hearing Health among Midwestern Farmers.

OBJECTIVE: The purpose of this study was to assess knowledge, attitudes, and practices for hearing and respiratory health/safety among farmers in seven Midwestern states served by a federally funded Agricultural Center. Findings provided a baseline to longitudinally track the Agricultural Center's program outcomes and to design community education to improve safety and health among farmers. DESIGN AND SAMPLE: This was a cross-sectional study using a 30 item mailed survey to describe farmers' operations, demographics, health conditions, related information sources, and knowledge/attitude/practices for personal protective equipment (PPE) (i.e., ear plugs/muffs and dust masks/respirators). MEASURES: Frequencies and percentages were calculated for each item and according to responses from younger versus older farmers. The unit of study was farm operators (N = 280) randomly selected from a publicly available database of corn/soybean and hog farmers in seven Midwestern states. RESULTS: Findings revealed important knowledge gaps among respondents regarding (1) hazardous exposure sources; (2) long-term health consequences of noise/dust exposure; (3) proper selection/fitting of PPE. CONCLUSIONS: Public health nurses and primary care providers in rural communities should address specific knowledge gaps in order to enhance farmers' perceived understanding of their susceptibility to hazardous exposures. Increasing farmers' knowledge through preferred venues may help to improve PPE effectiveness.

Evaluation and control of isoflurane during experimental dental procedures on rodents.

The purpose of this study was to assess exposures to isoflurane to employees performing an experimental dental procedure on rodents. Isoflurane was used as an anesthetic for rodents during injections and placement of dental apparatus into the mouth. We collected eight full-shift samples using passive badges over a three-week period. The procedure was performed once a week for approximately 45 min each day. Results showed that employees were being exposed to isoflurane above the National Institute for Occupational Safety and Health recommended exposure level for halogenated anesthetic gases of two parts per million. The employer installed a ventilation system in the procedure room after the initial sampling and results. We collected 12 full-shift samples after the ventilation system was in place. Results showed an approximate 86% decrease in isoflurane concentration.

Review and Meta-analysis of Emerging Risk Factors for Agricultural Injury.

Agricultural injury is a significant public health problem globally. Extensive research has addressed this problem, and a growing number of risk factors have been reported. The authors evaluated the evidence for frequently reported risk factors earlier. The objective in the current study was to identify emerging risk factors for agricultural injury and calculate pooled estimates for factors that were assessed in two or more studies. A total of 441 (PubMed) and 285 (Google Scholar) studies were identified focusing on occupational injuries in agriculture. From these, 39 studies reported point estimates of risk factors for injury; 38 of them passed the Newcastle-Ottawa criteria for quality and were selected for the systematic review and meta-analysis. Several risk factors were significantly associated with injury in the meta-analysis. These included older age (vs. younger), education up to high school or higher (vs. lower), non-Caucasian race (vs. Caucasian), Finnish language (vs. Swedish), residence on-farm (vs. off-farm), sleeping less than 7-7.5 hours (vs. more), high perceived injury risk (vs. low), challenging social conditions (vs. normal), greater farm sales, size, income, and number of employees on the farm (vs. smaller), animal production (vs. other production), unsafe practices conducted (vs. not), computer use (vs. not), dermal exposure to pesticides and/or chemicals (vs. not), high cooperation between farms (vs. not), and machinery condition fair/poor (vs. excellent/good). Eighteen of the 25 risk factors were significant in the meta-analysis. The identified risk factors should be considered when designing interventions and selecting populations at high risk of injury.

Risk Factors for Agricultural Injury: A Systematic Review and Meta-analysis.

The objective of this study was to identify significant risk factors for agricultural injury based on the literature. The authors conducted a systematic review of commonly reported risk factors. Studies that reported adjusted odds ratio (OR) or relative risk (RR) estimates for the selected risk factors were identified from PubMed and Google Scholar. Pooled risk factor estimates were calculated using meta-analysis. A total of 441 (PubMed) and 285 (Google Scholar) studies were found in the initial searches; of these, 132 and 78 studies, respectively, met the selection criteria for injury outcomes, and 32 of these reported adjusted OR or RR estimates. One study was excluded because it did not meet the set Newcastle-Ottawa Scale quality criteria. Finally, 31 studies were used for meta-analysis. The pooled ORs for the risk factors were as follows: male gender (vs. female) 1.68, full-time farmer (vs. part-time) 2.17, owner/operator (vs. family member or hired worker) 1.64, regular medication use (vs. no regular medication use) 1.57, prior injury (vs. no prior injury) 1.75, health problems (vs. no health problems) 1.21, stress or depression (vs. no stress or depression) 1.86, and hearing loss (vs. no hearing loss) 2.01. All selected factors except health problems significantly increased the risk of injury, and they should be (a) considered when selecting high-risk populations for interventions, and (b) considered as potential confounders in intervention studies.

Estimates of community exposure and health risk to sulfur dioxide from power plant emissions using short-term mobile and stationary ambient air monitoring.

UNLABELLED: To estimate plausible health effects associated with peak sulfur dioxide (SO2) levels from three coal-fired power plants in the Baltimore, Maryland, area, air monitoring was conducted between June and September 2013. Historically, the summer months are periods when emissions are highest. Monitoring included a 5-day mobile and a subsequent 61-day stationary monitoring study. In the stationary monitoring study, equipment was set up at four sites where models predicted and mobile monitoring data measured the highest average concentrations of SO2. Continuous monitors recorded ambient concentrations each minute. The 1-min data were used to calculate 5-min and 1-hr moving averages for comparison with concentrations from clinical studies that elicited lung function decrement and respiratory symptoms among asthmatics. Maximum daily 5-min moving average concentrations from the mobile monitoring study ranged from 70 to 84 ppb (183-220 µg/m³), and maximum daily 1-hr moving average concentrations from the mobile monitoring study ranged from 15 to 24 ppb (39-63 µg/m³). Maximum 5-min moving average concentrations from stationary monitoring ranged from 39 to 229 ppb (102-600 µg/m³), and maximum daily 1-hr average concentrations ranged from 15 to 134 ppb (40-351 µg/m³). Estimated exposure concentrations measured in the vicinity of monitors were below the lowest levels that have demonstrated respiratory symptoms in human clinical studies for healthy exercising asthmatics. Based on 5-min and 1-hr monitoring, the exposure levels of SO2 in the vicinity of the C.P. Crane, Brandon Shores, and H.A. Wagner power plants were not likely to elicit respiratory symptoms in healthy asthmatics. IMPLICATIONS: Mobile and stationary air monitoring for SO2 were conducted to quantify short-term exposure risk, to the surrounding community, from peak emissions of three coal-fired power plants in the Baltimore area. Concentrations were typically low, with only a few 5-min averages higher than levels indicated during clinical trials to induce changes in lung capacity for healthy asthmatics engaged in exercise outdoors.

Environmental tobacco smoke exposure among casino dealers.

OBJECTIVE: This study quantified casino dealers' occupational exposure to environmental tobacco smoke (ETS). METHODS: We measured casino dealers' exposure to ETS components by analyzing full-shift air and preshift and postshift urine samples. RESULTS: Casino dealers were exposed to nicotine, 4-vinyl pyridine, benzene, toluene, naphthalene, formaldehyde, acetaldehyde, solanesol, and respirable suspended particulates. Levels of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) in urine increased significantly during an 8-hour work shift both with and without adjustment for creatinine clearance. Creatinine-unadjusted cotinine significantly increased during the 8-hour shift, but creatinine-adjusted cotinine did not increase significantly. CONCLUSIONS: Casino dealers at the three casinos were exposed to airborne ETS components and absorbed an ETS-specific component into their bodies, as demonstrated by detectable levels of urinary NNAL. The casinos should ban smoking on their premises and offer employee smoking cessation programs.

Assessment of noise exposure in a hospital kitchen.

In March 2007, the National Institute for Occupational Safety and Health (NIOSH) was asked to evaluate the noise exposure of employees in the Nutrition and Food Services Department of a large hospital, because of noise concerns raised after the installation of the PowerSoak dishwashing system. Eleven employees (two cooks, eight food service workers, and a materials handler) contributed 13 full-shift and two task-based personal noise dosimetry measures over two days. The noise levels for two food service workers assigned to the pots and pans room (85.1 and 85.2dBA), a cook working in the food preparation area (85.9 dBA), and a food service worker assigned to the dishwashing room (89.5 dBA) exceeded the NIOSH Recommended Exposure Limit (REL); however, none of the measures exceeded the Occupational Safety and Health Administration (OSHA) Permissible Exposure Limit (PEL). The noise level from the PowerSoak dishwashing system alone was not excessive, but additional noise from the food preparation area (primarily from blenders and utensils), and from metal-to-metal contact between stainless steel pots and pans and metal racks, may explain exposures above the NIOSH REL for employees in the pots and pans room. The cooks were exposed to many intermittent impact noise sources, such as, metal-to-metal contact between utensils and the use of industrial-size blenders. We recommended that metal-to-metal contact be reduced as much as possible throughout the Nutrition and Food Services Department, and hearing protectors be provided to employees in the dishwashing room until engineering controls were in place.

A task-based assessment of noise levels at a swine confinement.

This study describes a task-based noise evaluation conducted at a community college that operated a small swine confinement for training and profit. Seven full-shift dosimeter samples and area noise data were collected during the evaluation. The time weighted average noise levels were all well below the Occupational Safety and Health Administration's (OSHA) Permissible Exposure Limit, but exceeded the National Institute for Occupational Safety and Health's Recommended Exposure Limit on three of seven occasions. The potential for high noise exposures is evidenced in the noise dose measured for specific activities such as power washing, ear clipping, and snout snaring. When the data were extrapolated to depict exposures where specific tasks were carried out over a full shift, tasks such as power washing and snout snaring would exceed the OSHA Action Level (AL). Employees who exceed the OSHA AL are required to be enrolled in a hearing conservation program.