Comparison of the near field/far field model and the advanced reach tool (ART) model V1.5: exposure estimates to benzene during parts washing with mineral spirits.

The Advanced Reach Tool V1.5 (ART) is a mathematical model for occupational exposures conceptually based on, but implemented differently than, the "classic" Near Field/Far Field (NF/FF) exposure model. The NF/FF model conceptualizes two distinct exposure "zones"; the near field, within approximately 1m of the breathing zone, and the far field, consisting of the rest of the room in which the exposure occurs. ART has been reported to provide "realistic and reasonable worst case" estimates of the exposure distribution. In this study, benzene exposure during the use of a metal parts washer was modeled using ART V1.5, and compared to actual measured workers samples and to NF/FF model results from three previous studies. Next, the exposure concentrations expected to be exceeded 25%, 10% and 5% of the time for the exposure scenario were calculated using ART. Lastly, ART exposure estimates were compared with and without Bayesian adjustment. The modeled parts washing benzene exposure scenario included distinct tasks, e.g. spraying, brushing, rinsing and soaking/drying. Because ART can directly incorporate specific types of tasks that are part of the exposure scenario, the present analysis identified each task's determinants of exposure and performance time, thus extending the work of the previous three studies where the process of parts washing was modeled as one event. The ART 50th percentile exposure estimate for benzene (0.425ppm) more closely approximated the reported measured mean value of 0.50ppm than the NF/FF model estimates of 0.33ppm, 0.070ppm or 0.2ppm obtained from other modeling studies of this exposure scenario. The ART model with the Bayesian analysis provided the closest estimate to the measured value (0.50ppm). ART (with Bayesian adjustment) was then used to assess the 75th, the 90th and 95th percentile exposures, predicting that on randomly selected days during this parts washing exposure scenario, 25% of the benzene exposures would be above 0.70ppm; 10% above 0.95ppm; and 5% above 1.15ppm. These exposure estimates at the three different percentiles of the ART exposure distribution refer to the modeled exposure scenario not a specific workplace or worker. This study provides a detailed comparison of modeling tools currently available to occupational hygienists and other exposure assessors. Possible applications are considered.

Flavoring Chemicals in E-Cigarettes: Diacetyl, 2,3-Pentanedione, and Acetoin in a Sample of 51 Products, Including Fruit-, Candy-, and Cocktail-Flavored E-Cigarettes.

BACKGROUND: There are > 7,000 e-cigarette flavors currently marketed. Flavoring chemicals gained notoriety in the early 2000s when inhalation exposure of the flavoring chemical diacetyl was found to be associated with a disease that became known as "popcorn lung." There has been limited research on flavoring chemicals in e-cigarettes. OBJECTIVE: We aimed to determine if the flavoring chemical diacetyl and two other high-priority flavoring chemicals, 2,3-pentanedione and acetoin, are present in a convenience sample of flavored e-cigarettes. METHODS: We selected 51 types of flavored e-cigarettes sold by leading e-cigarette brands and flavors we deemed were appealing to youth. E-cigarette contents were fully discharged and the air stream was captured and analyzed for total mass of diacetyl, 2,3-pentanedione, and acetoin, according to OSHA method 1012. RESULTS: At least one flavoring chemical was detected in 47 of 51 unique flavors tested. Diacetyl was detected above the laboratory limit of detection in 39 of the 51 flavors tested, ranging from below the limit of quantification to 239 µg/e-cigarette. 2,3-Pentanedione and acetoin were detected in 23 and 46 of the 51 flavors tested at concentrations up to 64 and 529 µg/e-cigarette, respectively. CONCLUSION: Because of the associations between diacetyl and bronchiolitis obliterans and other severe respiratory diseases observed in workers, urgent action is recommended to further evaluate this potentially widespread exposure via flavored e-cigarettes. CITATION: Allen JG, Flanigan SS, LeBlanc M, Vallarino J, MacNaughton P, Stewart JH, Christiani DC. 2016. Flavoring chemicals in e-cigarettes: diacetyl, 2,3-pentanedione, and acetoin in a sample of 51 products, including fruit-, candy-, and cocktail-flavored e-cigarettes. Environ Health Perspect 124:733-739; http://dx.doi.org/10.1289/ehp.1510185.

Review of PCBs in US schools: a brief history, an estimate of the number of impacted schools, and an approach for evaluating indoor air samples.

PCBs in building materials such as caulks and sealants are a largely unrecognized source of contamination in the building environment. Schools are of particular interest, as the period of extensive school construction (about 1950 to 1980) coincides with the time of greatest use of PCBs as plasticizers in building materials. In the USA, we estimate that the number of schools with PCB in building caulk ranges from 12,960 to 25,920 based upon the number of schools built in the time of PCB use and the proportion of buildings found to contain PCB caulk and sealants. Field and laboratory studies have demonstrated that PCBs from both interior and exterior caulking can be the source of elevated PCB air concentrations in these buildings, at levels that exceed health-based PCB exposure guidelines for building occupants. Air sampling in buildings containing PCB caulk has shown that the airborne PCB concentrations can be highly variable, even in repeat samples collected within a room. Sampling and data analysis strategies that recognize this variability can provide the basis for informed decision making about compliance with health-based exposure limits, even in cases where small numbers of samples are taken. The health risks posed by PCB exposures, particularly among children, mandate precautionary approaches to managing PCBs in building materials.

Indoor air quality survey of nail salons in Boston.

Employees in nail salons, largely Vietnamese immigrant women in Boston, are exposed to a range of volatile organic chemicals from the products used in salons, including solvents, glues and polishes. Some of these chemicals have the potential to cause short and long-term adverse health effects. Only limited research has been performed on assessing occupational exposures. This project aimed to characterize total volatile organic compound (TVOC) and PM2.5 concentrations in nail salons as a function of ventilation, building characteristics, customer and employee occupancy, and type of services being performed. Students conducted sampling in 21 salons in Boston, MA from September to December, 2011. Study visits included: indoor environmental quality measurements (TVOCs, PM2.5 and carbon dioxide), site observations, and an interview. CO2 levels in 15 of 21 salons exceeded 800 ppm, suggesting that these salons may have insufficient ventilation. Higher TVOC and PM2.5 levels were found in salons with less ventilation (as estimated using CO2 concentrations). Contrary to our a priori hypothesis, average levels of TVOCs, CO2 and PM2.5 were consistent throughout salons, indicating that exposures may not be restricted to areas in the salon where work is being performed (e.g., at the manicure table). Higher TVOC concentrations were observed when tasks were being performed, yet were not dependent upon the number of tasks being performed. Improving ventilation conditions in salons to meet minimum outdoor air delivery requirements can reduce exposures to TVOCs.

Assessing risk of health care-acquired Legionnaires' disease from environmental sampling: the limits of using a strict percent positivity approach.

BACKGROUND: Elevated percent positivity (≥30%) of Legionella in hospital domestic water systems has been suggested as a metric for assessing the risk of health care-acquired Legionnaires' disease (LD). METHODS: We examined the validity of this metric by analyzing data from peer-reviewed studies containing reports of Legionella prevalence in hospital water (ie, percent positivity) and temporally matched reports of patients with health care-acquired LD. RESULTS: Our literature review identified 31 peer-reviewed publications reporting matched data. We abstracted a total of 206 data points, representing 119 hospitals, from these articles. We determined that the proposed 30% positivity metric has 59% sensitivity and 74% specificity (ie, a 41% false-negative rate and a 26% false-positive rate). These notable error rates could have significant implications, given that we identified 16 peer-reviewed articles and 6 government guidance documents that referenced the 30% positivity metric as a risk assessment tool. CONCLUSIONS: Environmental sampling of hospital water distribution systems for Legionella can be an important component of risk management for LD. However, the possible consequence of using a percent positivity metric with low sensitivity and specificity is that many hospitals might fail to mitigate when a true risk is present, or might unnecessarily allocate limited resources to deal with a negligible risk.

Mitigation of building-related polychlorinated biphenyls in indoor air of a school.

BACKGROUND: Sealants and other building materials sold in the U.S. from 1958 - 1971 were commonly manufactured with polychlorinated biphenyls (PCBs) at percent quantities by weight. Volatilization of PCBs from construction materials has been reported to produce PCB levels in indoor air that exceed health protective guideline values. The discovery of PCBs in indoor air of schools can produce numerous complications including disruption of normal operations and potential risks to health. Understanding the dynamics of building-related PCBs in indoor air is needed to identify effective strategies for managing potential exposures and risks. This paper reports on the efficacy of selected engineering controls implemented to mitigate concentrations of PCBs in indoor air. METHODS: Three interventions (ventilation, contact encapsulation, and physical barriers) were evaluated in an elementary school with PCB-containing caulk and elevated PCB concentrations in indoor air. Fluorescent light ballasts did not contain PCBs. Following implementation of the final intervention, measurements obtained over 14 months were used to assess the efficacy of the mitigation methods over time as well as temporal variability of PCBs in indoor air. RESULTS: Controlling for air exchange rates and temperature, the interventions produced statistically significant (p < 0.05) reductions in concentrations of PCBs in indoor air of the school. The mitigation measures remained effective over the course of the entire follow-up period. After all interventions were implemented, PCB levels in indoor air were associated with indoor temperature. In a "broken-stick" regression model with a node at 20 °C, temperature explained 79% of the variability of indoor PCB concentrations over time (p < 0.001). CONCLUSIONS: Increasing outdoor air ventilation, encapsulating caulk, and constructing a physical barrier over the encapsulated material were shown to be effective at reducing exposure concentrations of PCBs in indoor air of a school and also preventing direct contact with PCB caulk. In-place management methods such as these avoid the disruption and higher costs of demolition, disposal and reconstruction required when PCB-containing building materials are removed from a school. Because of the influence of temperature on indoor air PCB levels, risk assessment results based on short-term measurements, e.g., a single day or season, may be erroneous and could lead to sub-optimal allocation of resources.

Elevated corrosion rates and hydrogen sulfide in homes with 'Chinese Drywall'.

In December 2008, the U.S. Consumer Product Safety Commission (CPSC) began receiving reports about odors, corrosion, and health concerns related to drywall originating from China. In response, a detailed environmental health and engineering evaluation was conducted of 41 complaint and 10 non-complaint homes in the Southeast U.S. Each home investigation included characterization of: 1) drywall composition; 2) indoor and outdoor air quality; 3) temperature, moisture, and building ventilation; and 4) copper and silver corrosion rates. Complaint homes had significantly higher hydrogen sulfide concentrations (mean 0.82 vs.

Assessing exposure to granite countertops--Part 1: Radiation.

Humans are continuously exposed to low levels of ionizing radiation. Known sources include radon, soil, cosmic rays, medical treatment, food, and building products such as gypsum board and concrete. Little information exists about radiation emissions and associated doses from natural stone finish materials such as granite countertops in homes. To address this knowledge gap, gross radioactivity, gamma ray activity, and dose rate were determined for slabs of granite marketed for use as countertops. Annual effective radiation doses were estimated from measured dose rates and human activity patterns while accounting for the geometry of granite countertops in a model kitchen. Gross radioactivity, gamma activity, and dose rate varied significantly among and within slabs of granite with ranges for median levels at the slab surface of ND to 3000 cpm, ND to 98,000 cpm, and ND to 1.5E-4 mSv/h, respectively. The maximum activity concentrations of the (40)K, (232)Th, and (226)Ra series were 2715, 231, and 450 Bq/kg, respectively. The estimated annual radiation dose from spending 4 h/day in a hypothetical kitchen ranged from 0.005 to 0.18 mSv/a depending on the type of granite. In summary, our results show that the types of granite characterized in this study contain varying levels of radioactive isotopes and that their observed emissions are consistent with those reported in the scientific literature. We also conclude from our analyses that these emissions are likely to be a minor source of external radiation dose when used as countertop material within the home and present a negligible risk to human health.

Assessing exposure to granite countertops--Part 2: Radon.

Radon gas ((222)Rn) is a natural constituent of the environment and a risk factor for lung cancer that we are exposed to as a result of radioactive decay of radium ((226)Ra) in stone and soil. Granite countertops, in particular, have received recent media attention regarding their potential to emit radon. Radon flux was measured on 39 full slabs of granite from 27 different varieties to evaluate the potential for exposure and examine determinants of radon flux. Flux was measured at up to six pre-selected locations on each slab and also at areas identified as potentially enriched after a full-slab scan using a Geiger-Muller detector. Predicted indoor radon concentrations were estimated from the measured radon flux using the CONTAM indoor air quality model. Whole-slab average emissions ranged from less than limit of detection to 79.4 Bq/m(2)/h (median 3.9 Bq/m(2)/h), similar to the range reported in the literature for convenience samples of small granite pieces. Modeled indoor radon concentrations were less than the average outdoor radon concentration (14.8 Bq/m(3); 0.4 pCi/l) and average indoor radon concentrations (48 Bq/m(3); 1.3 pCi/l) found in the United States. Significant within-slab variability was observed for stones on the higher end of whole slab radon emissions, underscoring the limitations of drawing conclusions from discrete samples.

Airborne fungal spores in a cross-sectional study of office buildings.

Airborne fungal spores were measured in 44 office buildings in the summer and winter throughout the continental United States, as part of the Building Assessment, Survey and Evaluation (BASE) program. Six indoor air and two outdoor air samples were collected on a single day from each building. The cross-sectional and repeated measure design afforded evaluation of between-building and within-building variability of fungal spore levels in buildings. Total fungal spore concentrations in indoor air ranged from < 24 to 1000 spores/m3, except for one building with natural ventilation where indoor levels were approximately 9000 spores/m3. Indoor air concentrations of total spores did not vary significantly between winter and summer or morning and afternoon monitoring periods or among climate zones or locations within a test area. Indoor-outdoor ratios of total spore concentrations typically ranged between 0.01 and 0.1 and were approximately seven times greater in winter than summer because of relatively low outdoor levels in the winter. The indoor-outdoor ratio of total spore concentrations for a building was consistent (reliability coefficient = 0.91) among repeated measures. Distributions of rank correlation coefficients for spore types in pairs of individual indoor-outdoor and indoor-indoor samples were weakly correlated (Spearman correlation = 0.2 on average). When spore type data were aggregated among samples from the same building, the central tendency of the rank correlation coefficients increased to 0.45. Rank correlation coefficients were also proportional to the number of spore types present in the samples that were compared. The BASE study provides normative data on concentrations of fungal spores that can aid in identification of problematic levels of mold in buildings.

Methodologic issues in follow-up studies of cancer incidence among occupational groups in the United States.

PURPOSE: Incidence studies of occupational factors and cancer in the United States are problematic because the use of population-based registries to identify cases requires development of historical data on subjects' residences and often severely restricts the time period of follow up. This article describes procedures for addressing these challenges. METHODS: We used data from studies of cancer incidence and mortality among microelectronics industry employees to assess various methods for developing residential histories and the relative informativeness of the two studies. RESULTS: We developed residential histories for 98% of 99,229 mortality study subjects. Analyses making alternative assumptions about residential histories yielded standardized incidence ratios varying by at most 6%. Use of postemployment residential histories increased person-years by up to 62% and increased the observed number of cancers by up to 28%. The proportion of mortality study person-years included in the cancer incidence study ranged from 40% to 77% among work activity subcohorts. The number of observed cancer cases in the incidence study was 60% higher than the number of observed cancer deaths in the mortality study. CONCLUSIONS: Assumptions about residential history had little impact on validity. Use of information sources with national coverage to develop residential histories increased the incidence study's precision. Despite geographic and temporal restrictions, incidence studies provide more data than mortality studies on cancers with good survival. However, the potential for selection bias in incidence studies may vary considerably among subcohorts, indicating the need for cautious interpretation of such research.

Exposure assessment for retrospective follow-up studies of semiconductor- and storage device-manufacturing workers.

OBJECTIVE: This exposure assessment was conducted in the first large study of mortality and cancer incidence in semiconductor and storage device manufacturing. METHODS: Unique combinations of division, department and job codes and names (DDJ) from work history records were assigned to work groups and exposure categories. Agent exposure matrices assessed differences in potential exposures between groups. Changes in exposure over time were tracked by dividing the production history into manufacturing eras. RESULTS: Nineteen work groups were developed to capture 310,351 unique DDJs from 1965-1999. Agent exposure matrices contrasted exposure potential to solvents, metals, and work in cleanrooms between groups, and three manufacturing eras were identified for each site. CONCLUSIONS: The work groups, manufacturing eras and agent matrices have been used to classify workers in the study of cancer incidence and mortality.

Hypnosis in contemporary medicine.

Hypnosis became popular as a treatment for medical conditions in the late 1700s when effective pharmaceutical and surgical treatment options were limited. To determine whether hypnosis has a role in contemporary medicine, relevant trials and a few case reports are reviewed. Despite substantial variation in techniques among the numerous reports, patients treated with hypnosis experienced substantial benefits for many different medical conditions. An expanded role for hypnosis and a larger study of techniques appear to be indicated.

Assessing dental caries prevalence in African-American youth and adults.

It has been well documented that dental caries affect millions of children in the USA with the majority experiencing decay by the late teens. This is especially true for low-income minorities. The objective of this descriptive study was to determine dental caries prevalence in a sample of low-income African-American youth and adults. A total of 1034 individuals were examined. They were divided into two age groups: youth, 9-19 years and adults, 20-39 years. Females comprised approximately 65 percent (64.5) of the study group. The DMFT Index was used to determine caries prevalence in this study population. The DMFT findings showed that approximately 73 percent (72.9 percent) of the youth had either decayed, missing or filled teeth. Male youth had slightly higher DMFT mean scores than female youth: male mean = 7.93, standard error = 0.77, female mean = 7.52, standard error = 0.36; however, as females reached adulthood their DMFT scores increased substantially, mean = 15.18, standard error = 0.36. Caries prevalence was much lower in male adults, DMFT, mean = 7.22, standard error of 0.33. The decayed component for female adults mean score was 6.81, a slight increase over adult males, mean = 6.58. Although there were few filled teeth in both age groups, female adults had slightly more filled teeth than male adults, females mean = 2.91 vs. males; however, adult males experienced slightly more missing teeth, mean = 5.62 as compared to adult females, mean = 5.46. n = 2.20. Both female and male adults had an increase in missing teeth. As age increased there was a significant correlation among decayed, missing and filled teeth as tested by Analysis of Variance (ANOVA), p < 0.01. A significant correlation was found between filled teeth by sex, p < .005. We conclude that caries prevalence was higher in female and male youth, but dental caries increased more rapidly in females as they reached adulthood.

Streptococcus mutans levels and caries prevalence in low-income schoolchildren.

Previous studies have shown that persons having high Streptococcus mutans levels in the saliva are "at risk" for dental caries. Most investigators agree, that if high levels of S. mutans were identified early in the life of at-risk children, dental decay could be reduced or eliminated through intervention. The purpose of this study is to show an association between S. mutans levels and caries prevalence in a sample of elementary school children. The study group consisted of 242 school children, ages 5-13 years. The subjects were divided into two age groups, 5-8 years and 9-13 years. Approximately 59 percent were African Americans. The sample of 242 children were equally females and males, 50 percent in each group. The Dentocult SM Test was used to make S. mutans determinations. The df-t index was used to determine the number of decayed and filled teeth of children ages 5-8 years; the DMF-T Index estimated the number of decayed, missing or filled teeth of children ages 9-13 years. Dental caries were found in 58 percent of the children (mean = 2.67, and range of 1-11). Approximately 47 percent of the children with caries had high S. mutans levels (100K-1M). Females had higher S. mutans levels than males in the 9-13 age group, p < .05. Analysis of Variance Test indicated that S. mutans levels for older females (ages 9-13) were significantly higher than those observed in males the same age (p < .01). This trend was not observed in younger children, ages 5-8 years. In addition, no significant difference or interaction was noted by sex for S. mutans levels and decayed or filled teeth (df-t) for younger children. We conclude that high levels of Streptococcus mutans are related to increased number of decayed teeth and conversely, low Streptococcus mutans levels are related to fewer dental caries. This study was supported in part by Colgate-Palmolive Company and the National Dental Association Foundation, Inc.