Wildfire, Smoke Exposure, Human Health, and Environmental Justice Need to be Integrated into Forest Restoration and Management.

PURPOSE OF REVIEW: Increasing wildfire size and severity across the western United States has created an environmental and social crisis that must be approached from a transdisciplinary perspective. Climate change and more than a century of fire exclusion and wildfire suppression have led to contemporary wildfires with more severe environmental impacts and human smoke exposure. Wildfires increase smoke exposure for broad swaths of the US population, though outdoor workers and socially disadvantaged groups with limited adaptive capacity can be disproportionally exposed. Exposure to wildfire smoke is associated with a range of health impacts in children and adults, including exacerbation of existing respiratory diseases such as asthma and chronic obstructive pulmonary disease, worse birth outcomes, and cardiovascular events. Seasonally dry forests in Washington, Oregon, and California can benefit from ecological restoration as a way to adapt forests to climate change and reduce smoke impacts on affected communities. RECENT FINDINGS: Each wildfire season, large smoke events, and their adverse impacts on human health receive considerable attention from both the public and policymakers. The severity of recent wildfire seasons has state and federal governments outlining budgets and prioritizing policies to combat the worsening crisis. This surging attention provides an opportunity to outline the actions needed now to advance research and practice on conservation, economic, environmental justice, and public health interests, as well as the trade-offs that must be considered. Scientists, planners, foresters and fire managers, fire safety, air quality, and public health practitioners must collaboratively work together. This article is the result of a series of transdisciplinary conversations to find common ground and subsequently provide a holistic view of how forest and fire management intersect with human health through the impacts of smoke and articulate the need for an integrated approach to both planning and practice.

Surveillance of work-related asthma including the emergence of a cannabis-associated case series in Washington State.

OBJECTIVE: We conducted surveillance for work-related asthma (WRA) in Washington State to identify the industry sectors and asthma exposures most commonly affecting injured workers and in need of prevention activities. METHODS: Using workers' compensation data as the primary data source, valid cases were classified as work-aggravated asthma (WAA) or new onset asthma that includes occupational asthma (OA) and reactive airways dysfunction syndrome (RADS). The source of exposure that caused the worker's asthma, their industry and occupation were determined. RESULTS: There were 784 valid work-related asthma cases identified for the period 2009-2016, WAA (n = 529) was most common followed by occupational asthma (n = 127) and RADS (n = 12). The Health Care and Social Assistance industry had the highest number of cases (n = 170) with 82% classified as WAA. The highest overall proportions of new onset asthma are occurring in Agriculture, Forestry, Fishing and Hunting (33% of work related asthma cases), Manufacturing (31%) and Construction (30%). The leading substances associated with new onset asthma across all industries include hop plant dust, wood and cedar dust, mineral and inorganic dust, mold, and cleaning materials. We describe ten cases of cannabis-associated asthma including seven from workers in the legalized cannabis industry, four of whom had OA. CONCLUSION: State-based work-related asthma surveillance is critical in identifying the workers and exposures associated with this occupational disease, including the detection of a case-series in the cannabis industry.

Work-related asthma surveillance in Washington State: time trends, industry rates, and workers' compensation costs, 2002-2016.

Objective: Washington State's work-related asthma (WRA) surveillance program utilizes workers' compensation (WC) data as its primary data source and has spanned a 15-year time period. This study analyses trends for WRA claim incidence rates compared to all WC claim incidence rates. WRA claim incidence rates and WC costs are analyzed by industry. Methods: Potential WRA cases were identified through the WC system and through direct provider report and classified by industry, age, and year of illness onset. WRA claim rates by industry and year were calculated using total work hours reported by employers covered by the WC system. Claim costs for accepted claims were compared by industry and year. Results: WRA claim incidence rates decreased 8.9% (95% CI: -10.6, -7.2) annually for the time period 2002-2016. The decline in WRA claim incidence rate is slightly faster than the incidence rate for all WC claims which had its steepest decrease from 2007 to 2010 at an estimated annual 8.4% decrease (95% CI: -11.8, -5.0). WRA claim rates were highest for workers in Public Administration, Manufacturing, and the Agricultural, Forestry, Fishing and Hunting industries. Median claim costs for WRA did not change significantly by year (p = 0.2, range $595-$1442) and the distribution of WRA WC claim costs by industry were highest in Manufacturing (21.3%) and Construction (16.4%) industries. Conclusion: WRA claim incidence rates are declining in Washington State. The cause for the decline is unclear. Workers across all industries in Washington remain at risk for WRA.

Severe Silicosis in Engineered Stone Fabrication Workers - California, Colorado, Texas, and Washington, 2017-2019.

Silicosis is an incurable occupational lung disease caused by inhaling particles of respirable crystalline silica. These particles trigger inflammation and fibrosis in the lungs, leading to progressive, irreversible, and potentially disabling disease. Silica exposure is also associated with increased risk for lung infection (notably, tuberculosis), lung cancer, emphysema, autoimmune diseases, and kidney disease (1). Because quartz, a type of crystalline silica, is commonly found in stone, workers who cut, polish, or grind stone materials can be exposed to silica dust. Recently, silicosis outbreaks have been reported in several countries among workers who cut and finish stone slabs for countertops, a process known as stone fabrication (2-5). Most worked with engineered stone, a manufactured, quartz-based composite material that can contain >90% crystalline silica (6). This report describes 18 cases of silicosis, including the first two fatalities reported in the United States, among workers in the stone fabrication industry in California, Colorado, Texas, and Washington. Several patients had severe progressive disease, and some had associated autoimmune diseases and latent tuberculosis infection. Cases were identified through independent investigations in each state and confirmed based on computed tomography (CT) scan of the chest or lung biopsy findings. Silica dust exposure reduction and effective regulatory enforcement, along with enhanced workplace medical and public health surveillance, are urgently needed to address the emerging public health threat of silicosis in the stone fabrication industry.

Isocyanate Exposure Below Analytical Detection When a Paint Brush and Roller Are Used to Apply Moisture-Cure Polyurethane Paint.

Isocyanate exposure is known to be hazardous when polyurethane paints are applied with a spray gun, but less is known of exposure when paint is applied with a paint brush and roller. Concentrations of 1,6-hexamethylene diisocyanate (HDI) monomer and three HDI polymers were assessed when two moisture-cure polyurethane paints containing 31-35% isocyanates were applied with a paint roller and brush. Short-term 15-min samples were taken during paint application in an indoor test environment with no ventilation (n= 12); in an outdoor test environment (n= 11); and in an outdoor in-situ assessment (n= 22). The outdoor in-situ assessment involved the painting of a bus shelter and light poles at a public transit station over two night shifts. All isocyanate samples were below analytical detection. The analytical limits of detection for HDI monomer, HDI biuret, HDI isocyanurate, and HDI uretdione were 0.005, 0.84, 0.87, and 0.88 µg, respectively. The finding that isocyanate concentrations were below detection is attributed to the use of paint roller and brush which minimize paint aerosolization and the paint formulation itself which contained <1% of volatile HDI monomer.

Occupational Hydrofluoric Acid Injury from Car and Truck Washing--Washington State, 2001-2013.

Exposure to hydrofluoric acid (HF) causes corrosive chemical burns and potentially fatal systemic toxicity. Car and truck wash cleaning products, rust removers, and aluminum brighteners often contain HF because it is efficient in breaking down roadway matter. The death of a truck wash worker from ingestion of an HF-based wash product and 48 occupational HF burn cases associated with car and truck washing in Washington State during 2001-2013 are summarized in this report. Among seven hospitalized workers, two required surgery, and all but one worker returned to the job. Among 48 injured workers, job titles were primarily auto detailer, car wash worker, truck wash worker, and truck driver. Because HF exposure can result in potentially severe health outcomes, efforts to identify less hazardous alternatives to HF-based industrial wash products are warranted.

Protection efficacy of gloves against components of the solvent in a sprayed isocyanate coating utilizing a reciprocating permeation panel.

OBJECTIVES: Determine protection effectiveness of 5-mil natural rubber latex (0.13-mm), 5-mil nitrile rubber (0.13-mm), and 13-mil butyl rubber (0.33-mm) glove materials against solvents present in a commonly used automotive clear coat formulation using a novel permeation panel. The latex and nitrile gloves were the type commonly used by local autobody spray painters. METHODS: Glove materials were tested by spraying an automotive clear coat onto an automated reciprocating permeation panel (permeation panel II). Temperature, relative humidity, and spray conditions were controlled to optimize clear coat loading homogeneity as evaluated by gravimetric analysis. Solvent permeation was measured using charcoal cloth analyzed by the National Institute for Occupational Safety and Health 1501 method. RESULTS: Natural rubber latex allowed 3-5 times the permeation of solvents relative to nitrile rubber for all 10 solvents evaluated: ethyl benzene, 2-heptanone, 1-methoxy-2-propyl acetate, o-xylene, m-xylene, p-xylene, n-butyl acetate, methyl isobutyl ketone, petroleum distillates, and toluene. There is a distinct behavior in solvent permeation before and after the coating dry time. Solvent permeation increased steadily before coating dry time and remained fairly constant after coating dry time. Butyl was not permeated by any of the solvents under the conditions tested. CONCLUSIONS: Commonly used 5-mil thick (0.13-mm) latex and nitrile gloves were ineffective barriers to solvents found in a commonly used clear coat formulation. Conversely, 13-mil (0.33-mm) butyl gloves were found to be protective against all solvents in the clear coat formulation.

Respiratory disease associated with occupational inhalation to hop (Humulus lupulus) during harvest and processing.

BACKGROUND: There is little published evidence for occupational respiratory disease caused by hop dust inhalation. In the United States, hops are commercially produced in the Pacific Northwest region. OBJECTIVE: To describe occupational respiratory disease in hop workers. METHODS: Washington State workers' compensation claims filed by hop workers for respiratory disease were systematically identified and reviewed. Incidence rates of respiratory disease in hop workers were compared with rates in field vegetable crop farm workers. RESULTS: Fifty-seven cases of respiratory disease associated with hop dust inhalation were reported from 1995 to 2011. Most cases (61%) were diagnosed by the attending health care practitioner as having work-related asthma. Seven percent of cases were diagnosed as chronic obstructive pulmonary disease, and the remaining cases were diagnosed as allergic respiratory disorders (eg, allergic rhinitis) or asthma-associated symptoms (eg, dyspnea). Cases were associated with hop harvesting, secondary hop processing, and indirect exposure. The incidence rate of respiratory disease in hop workers was 15 cases per 10,000 full-time workers, which was 30 times greater than the incidence rate for field vegetable crop workers. A strong temporal association between hop dust exposure and respiratory symptoms and a clear association between an increase in hop dust concentrations and the clinical onset of symptoms were apparent in 3 cases. CONCLUSION: Occupational exposure to hop dust is associated with respiratory disease. Respiratory disease rates were higher in hop workers than in a comparison group of agricultural workers. Additional research is needed before hop dust can be confirmed as a causative agent for occupational asthma.

Distribution of asthma by occupation: Washington State behavioral risk factor surveillance system data, 2006-2009.

OBJECTIVE: To estimate the prevalence of asthma in workers by occupation in Washington State. METHODS: Data from the 2006-2009 Behavioral Risk Factor Surveillance System (BRFSS) and the BRFSS Asthma Call-Back Survey (ACBS) in Washington State (WA) were analyzed. Using state-added and coded Industry and Occupation questions, we calculated prevalence ratios (PRs) for 19 occupational groups. RESULTS: Of the 41,935 respondents who were currently employed during 2006-2009, the prevalence of current asthma was 8.1% [95% confidence interval (CI) 7.8-8.5%] When compared with the reference group of executive, administration and managerial occupations, three occupational groups had significantly (p < 0.05) higher PRs of current asthma: "Teachers, all levels, and Counselors' (PR 1.3, 95% CI 1.1-1. 6%); 'Administrative Support, including Clerical" (PR 1. 5, 95% CI 1.2-1.9%); and "Other Health Services" (PR 1.5, 95% CI 1.2-1.9). Half of the 2511 ACBS respondent workers (55.1%) indicated that they believed exposure at work had caused or worsened their asthma, but only 10.7% had ever spoken with a health care professional about their asthma being work related. CONCLUSIONS: Some occupations have a higher prevalence of current asthma than other occupations. The systematic collection of industry and occupation data can help identify worker populations with a high burden of asthma and can be used to target disease prevention efforts as well as to aid clinician recognition and treatment. Workers indicated that work-related asthma exposures are not discussed with their health care provider and this communication gap has implications for asthma management.

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.

Understanding factors that influence protective glove use among automotive spray painters.

Dermal contact with isocyanate-based coatings may lead to systemic respiratory sensitization. The most common isocyanates found in sprayed automotive coatings are monomeric and oligomeric 1,6-hexamethylene diisocyanate (HDI) and isophorone diisocyanate (IPDI). Most spray painters use thin (4-5 mil) latex gloves that are not effective at preventing dermal exposures when spraying isocyanate paints. Personal interviews with collision repair industry personnel and focus groups with spray painters were held to characterize risk awareness, to examine perceptions and challenges concerning protective glove use and selection, and to generate ideas for protective glove use interventions. The most popular gloves among spray painters were thin (4-5 mil) and thick (14 mil) latex. We found that medium to thick (6-8 mil) nitrile were not always perceived as comfortable and were expected to be more expensive than thin (4-5 mil) latex gloves. Of concern is the user's difficulty in distinguishing between nitrile and latex gloves; latex gloves are now sold in different colors including blue, which has traditionally been associated with nitrile gloves. Even though spray painters were familiar with the health hazards related to working with isocyanate paints, most were not always aware that dermal exposure to isocyanates could contribute to the development of occupational asthma. There is a need for more research to identify dermal materials that are protective against sprayed automotive coatings. Automotive spray painters and their employers need to be educated in the selection and use of protective gloves, specifically on attributes such as glove material, color, and thickness.

Prevention guidance for isocyanate-induced asthma using occupational surveillance data.

Data from Washington State's work-related asthma surveillance system were used to characterize isocyanate-induced asthma cases occurring from 1999 through 2010. Injured worker interviews and medical records were used to describe the industry, job title, work process, workers' compensation cost, and exposure trends associated with 27 cases of isocyanate-induced asthma. The majority (81%) of cases were classified within the surveillance system as new-onset asthma while 19% were classified as work-aggravated asthma. The workers' compensation cost for isocyanate-induced asthma cases was $1.7 million; this was 14% of the total claims cost for all claims in the asthma surveillance system. The majority of cases (48%) occurred from paint processes, followed by foam application or foam manufacturing (22%). Nine of the asthma cases associated with spray application occurred during application to large or awkward-shaped objects. Six workers who did not directly handle isocyanates (indirect exposure) developed new-onset asthma. Two cases suggest that skin contact and processes secondary to the isocyanate spray application, such as cleanup, contributed to immune sensitization. Surveillance data provide insight for the prevention of isocyanate-induced respiratory disease. Key observations are made regarding the development of work-related asthma in association with a) paint application on large objects difficult to ventilate, b) indirect exposure to isocyanates, c) exposure during secondary or cleanup processes, and d) reports of dermal exposure.

Airborne isocyanate exposures in the collision repair industry and a comparison to occupational exposure limits.

Isocyanate exposure was evaluated in 33 spray painters from 25 Washington State autobody shops. Personal breathing zone samples (n = 228) were analyzed for isophorone diisocyanate (IPDI) monomer, 1,6-hexamethylene diisocyanate (HDI) monomer, IPDI polyisocyanate, and three polyisocyanate forms of HDI. The objective was to describe exposures to isocyanates while spray painting, compare them with short-term exposure limits (STELs), and describe the isocyanate composition in the samples. The composition of polyisocyanates (IPDI and HDI) in the samples varied greatly, with maximum amounts ranging from up to 58% for HDI biuret to 96% for HDI isocyanurate. There was a significant inverse relationship between the percentage composition of HDI isocyanurate to IPDI and to HDI uretdione. Two 15-min STELs were compared: (1) Oregon's Occupational Safety and Health Administration (OR-OSHA) STEL of 1000 µg/m(3) for HDI polyisocyanate, and (2) the United Kingdom's Health and Safety Executive (UK-HSE) STEL of 70 µg NCO/m(3) for all isocyanates. Eighty percent of samples containing HDI polyisocyanate exceeded the OR-OSHA STEL while 98% of samples exceeded the UK-HSE STEL. The majority of painters (67%) wore half-face air-purifying respirators while spray painting. Using the OR-OSHA and the UK-HSE STELs as benchmarks, 21% and 67% of painters, respectively, had at least one exposure that exceeded the respirator's OSHA-assigned protection factor. A critical review of the STELs revealed the following limitations: (1) the OR-OSHA STEL does not include all polyisocyanates, and (2) the UK-HSE STEL is derived from monomeric isocyanates, whereas the species present in typical spray coatings are polyisocyanates. In conclusion, the variable mixtures of isocyanates used by autobody painters suggest that an occupational exposure limit is required that includes all polyisocyanates. Despite the limitations of the STELs, we determined that a respirator with an assigned protection factor of 25 or greater is required to protect against isocyanate exposures during spray painting. Consequently, half-face air-purifying respirators, which are most commonly used and have an assigned protection factor of 10, do not afford adequate respiratory protection.

Work-related asthma in Washington State.

OBJECTIVE: Asthma is a common and costly public health problem. Occupational exposures contribute to the burden of asthma. Identifying workplace exposures and industries and occupations at risk can lead to more effective prevention measures. METHODS: Data from Washington State's work-related asthma (WRA) surveillance program from October 2001 to December 2008 were analyzed. Workers' compensation records, physician reports, and telephone interviews were used to describe the occurrence of WRA during this time, in order to identify contributing exposure sources and industries and occupations that are associated with WRA in Washington. RESULTS: There were 1343 identified WRA cases in Washington State during this time. Of these, 1285 were workers' compensation claims, with a total medical cost for State Fund claims of approximately $3 million dollars. The top three sources identified were miscellaneous chemicals and materials, mineral and inorganic dusts, and plant material. Plant material claims proved to be widespread throughout various industries, were largely classified as new-onset asthma cases, and had higher median medical cost and higher median time loss days than cases associated with other exposure sources. CONCLUSIONS: Washington State has an abundance of plant-material-related WRA cases among US states conducting WRA surveillance. Washington State's industry mix might explain the higher prevalence of cases, particularly its logging and wood processing industries and as a world leader in hops production. In Washington, further WRA prevention efforts should emphasize workplaces working with plant materials.

Survey of dermal protection in Washington State collision repair industry.

Substantial exposure to isocyanates may occur during spray painting in autobody shops, yet information is lacking on the efficacy of the protective clothing used during spray painting. We investigated the personal and workplace factors associated with painters' dermal protection use during a large-scale exposure assessment study. Survey data indicated that 69% of painters always used gloves, with latex gloves (47%) and nitrile gloves (34%) used most frequently. Among latex glove users, 53% used thin latex (0.05-0.13 mm), 6% used medium latex (0.15-0.20 mm), and 12% used thick latex (> 0.20 mm). Among nitrile glove users, 27% used thin nitrile and 45% used medium nitrile. Sixty-three percent of painters always used coveralls, 44% preferring one particular brand. Although overspray presents an opportunity for dermal exposure to the neck and face, only 19% of painters protected these areas with personal protective equipment. Painters who always used coveralls were more likely to use gloves (odds ratio = 7.9, p = 0.061). Painters who reported ever having smoked cigarettes used gloves (p = 0.05) and coveralls (p = 0.04) more frequently. Painters who sprayed more than 34 clear coat jobs per month used coveralls most frequently (p = 0.038). Exact logistic regressions along with random sample calculations indicated that the survey results were independent of the shops. Because of the small sample size in this study, future research is warranted to corroborate these results. Studying the effectiveness of gloves and coveralls against polyurethane paints and understanding the underlying motivators and preferences for painters and business owners is needed for the development of best practices for the selection and use of dermal protection.

Field comparison of air sampling methods for monomeric and polymeric 1,6-hexamethylene diisocyanate.

This study was to critically compared 13 different air samplers for their ability to monitor air exposures to monomeric and polymeric 1,6-hexamethylene diisocyanate (HDI) in the automotive refinishing industry. Using both fast- and slow-drying clearcoat, we tested the following types of samplers: single- and dual-stage 37-mm polypropylene (PP) and polystyrene (PS) samplers (open- and closed-face), IOM (with plastic and stainless steel inserts), OSHA42, IsoChek, and WA-DOSH samplers. Midget impingers with frit were used as reference samplers. We observed the PP, PS, and IOM samplers to measure greater levels of HDI monomer and biuret when a fast-drying clearcoat was applied compared with a slow-drying clearcoat. When a slow-drying clearcoat was applied, the open-face PP and PS samplers measured significantly more monomeric and polymeric HDI (2-fold; p < 0.003) than the closed-face PP and PS samplers. We determined that significantly more monomeric and polymeric HDI were measured by impingers (1.3-1.9-fold) compared with single-stage PP/PS (N = 59), dual-stage PP/PS (N = 59), or IOM (N = 24) samplers. However, when stratified by cassette characteristics, the open-face single-stage PP and PS samplers performed equally to the impingers for HDI monomer when a fast-drying clearcoat was applied, and for all analytes when a slow-drying clearcoat was applied. Significantly higher HDI monomer concentrations (1.2-3.1-fold; p = 0.001) were measured with OSHA42 compared with the impinger. The IsoChek did not detect HDI monomer, and of the three samplers analyzed by laboratories other than UNC (i.e., OSHA42, IsoChek, and WA-DOSH), the WA-DOSH was in the best agreement with the impingers. The influence of clearcoat drying time on the sampler's ability to measure monomeric and polymeric HDI emphasizes the importance of the speciation of diisocyanates in chemical analysis and the careful consideration for the selection of the air sampler to be used when measuring exposures during automotive spray painting.

Development of a permeation panel to test dermal protective clothing against sprayed coatings.

OBJECTIVES: Design, construct, and characterize an apparatus to evaluate dermal protective clothing for resistance to polymerizing materials. Specifically, we evaluated the permeation of the most common glove material used in automotive collision repair (0.10-0.13 mm or 4-5 mil latex) with representative isocyanate-containing clear coats. Our ultimate goal is to make informed recommendations on dermal protective materials to prevent isocyanate exposures and reduce the likelihood of occupational illness in automotive collision repair and other industries. METHODS: A novel permeation panel was developed to assess dermal protective clothing. With this apparatus, up to eight test materials may be evaluated under typical-spray application conditions. Solid collection media comprised of 1-(2-pyridyl)-piperazine (2-PP)-coated fiberglass filters or colorimetric SWYPE™ pads were placed behind test materials to capture permeants. The 2-PP-coated filters were subsequently analyzed using a modified OSHA42/PV2034 method. Color change in the SWYPEs provided an immediate field estimate of breakthrough time. In addition, Teflon filters were mounted proximal to the permeation cells to measure the mass of clear coat applied to the panel and to evaluate loading homogeneity. This study evaluated the permeation of isocyanates through 0.10-0.13 mm latex glove material at a fixed time (30 min post-spraying) and over a time course (6-91 min post-spraying). RESULTS: Monomers 1,6-hexamethylene diisocyanate (HDI) and isophorone diisocyanate (IPDI) permeated through (0.10-0.13 mm) latex glove material under typical glove use conditions (30 min). The latex glove material exhibited immediate breakthrough, with a permeation rate of 2.9 ng min(-1) cm(-2). The oligomeric forms of HDI and IPDI did not permeate the latex glove material. The spray application at 71 ± 5 °F was fairly homogeneous (33.7 ± 8 mg weight of dry clear coat per 5 cm(2)). CONCLUSIONS: The permeation panel is a viable method to assess dermal protective clothing performance against polymerizing materials. Thin (0.10-0.13 mm) latex gloves were determined to be ineffective barriers to the isocyanates commonly found in clear coats. Because this type of glove is used frequently in auto body shops, the potential for isocyanate exposure is of concern. Permeation tests with other dermal protective clothing materials and other clear coat formulations are needed to make recommendations about alternative materials.

Occupational carbon monoxide poisoning in Washington State, 2000-2005.

Washington State workers' compensation data can be used to guide prevention efforts focused on occupational carbon monoxide (CO) poisoning. Between 2000 and 2005, a total of 345 individual claims comprising 221 different exposure incidents were identified for the 6-year time period. The construction industry had 43 (20%) CO incidents, followed by wholesale trade with 32 (15%), and agriculture with 27 (12%) incidents. Fuel-powered forklifts caused 29% of all incidents, while autos/trucks/buses were responsible for 26%. The number of forklift incidents in fruit packing and cold storage companies declined significantly from 1994 through 2007 (Spearman's rho = 0.6659, p < 0.01). While this study used multiple medical records from workers' compensation claims to identify CO poisoning, a surveillance system that lacks extensive medical records may rely principally on carboxyhemoglobin (COHb) tests. This study demonstrated that 71% of the identified workers' compensation claims had associated COHb tests. The recurrence and timing of CO poisoning as well as control of the CO-generating source were determined. Approximately 8% of all work sites had recurring CO poisoning incidents. Two percent experienced a recurrent incident within 16 days of the initial incident, and 6% experienced a recurrent incident between 16 days and 3 years after the initial incident. Sixty-seven percent of claimants exposed to CO were not in direct control of the CO-generating source; this has implications for CO prevention and underscores the need for all employees to be trained on CO hazards.

Surveillance of Washington OSHA exposure data to identify uncharacterized or emerging occupational health hazards.

Chemical substance exposure data from the Washington State Occupational Safety and Health Administration (OSHA) program were reviewed to determine if inspections conducted as a result of a report of a hazard from a complainant or referent may alert the agency to uncharacterized or emerging health hazards. Exposure and other electronically stored data from 6890 health inspection reports conducted between April 2003 and August 2008 were extracted from agency records. A total of 515 (7%) inspections with one or more personal airborne chemical substance samples were identified for further study. Inspections by report of a hazard and by targeting were compared for the following: number of inspections, number and percentage of inspections with workers exposed to substances above an agency's permissible exposure limit, types of industries inspected, and number and type of chemical substances assessed. Report of a hazard inspections documented work sites with worker overexposure at the same rate as agency targeted inspections (approximately 35% of the time), suggesting that complainants and referents are a credible pool of observers capable of directing the agency to airborne chemical substance hazards. Report of a hazard inspections were associated with significantly broader distribution of industries as well as a greater variety of chemical substance exposures than were targeted inspections. Narrative text that described business type and processes inspected was more useful than NAICS codes alone and critical in identifying processes and industries that may be associated with new hazards. Finally, previously identified emerging hazards were found among the report of a hazard data. These findings indicate that surveillance of OSHA inspection data can be a valid tool to identify uncharacterized and emerging health hazards. Additional research is needed to develop criteria for objective review and prioritization of the data for intervention. Federal OSHA and other state OSHA agencies will need to add electronic data entry fields more descriptive of industry, process, and substance to fully use agency exposure data for hazard surveillance.

Characterizing the health and safety needs of the collision repair industry.

Production workers in the collision repair industry are potentially exposed to many harmful chemicals, including isocyanates. Of particular concern is the burden of work-related asthma in this industry that likely reflects exposures to the isocyanates in two-part paints. The main objectives of this study were to gather information about: (i) the collision repair industry business model, (ii) the number of collision repair production workers potentially exposed to isocyanates, (iii) additional chemical and physical exposures of concern, (iv) current health and safety practices in the industry, (v) the health and safety perceptions and needs of business owners and managers, and (vi) strategies to reduce exposure and increase employer and worker awareness. Data were gathered using a combination of key informant interviews, field investigations, and a statewide needs assessment survey. Although a response bias cannot be excluded, the 69% response rate suggests that the survey results are likely representative of Washington State's collision repair industry. Collision repair was determined to be a male-dominated industry chiefly comprising small, nonunionized, family-run businesses. Many shops face numerous safety and health challenges resulting from a combination of misinformation within the industry, insufficient funds to address workplace health and safety concerns, and social barriers to enforcing best practices within the shops. Most notably, inappropriate selection and use of respirators and gloves likely contribute significantly to isocyanate exposures. Collision repair workers are potentially exposed to a variety of additional chemical and physical hazards that deserve attention. This industry requires health and safety intervention of both an educational campaign and technical assistance. Any such intervention must account for the financial, demographic, and social characteristics of this industry.