How Sharp Objects Injuries Impact our Healthcare Workers: Unveiling Perspective and Preventive Imperatives.

Introduction Sharp object injuries in the medical field present a considerable occupational hazard for healthcare workers (HCWs), encompassing a spectrum of consequences from immediate discomfort to enduring health consequences. These injuries may expose HCWs to potential infections. Despite efforts to control sharp object injuries in healthcare environments, they are present at every stage involving using or disposing of medical sharp instruments. In Jordan, limited research has focused on sharp object injuries, with most data included from studies concentrating on practicing nurses or nursing students. Consequently, further research is necessary to comprehend the causes behind the high sharp object injury rate and the insufficient knowledge of safety practices and preventive guidelines. Objectives This study was conducted to investigate the impact of sharp object injuries on HCWs, underlying causes, and potential consequences causes of needlestick injuries. To highlight perspective and preventive imperatives. Methods and patients This retrospective institutional-based cross-sectional chart analysis was conducted by reviewing all sharp object injuries report sheets and extracting data directly from these reports for analysis. The study encompassed all reported cases occurring between 2018 and 2023. All the participants' data handling was accomplished according to the Declaration of Helsinki (2013) and the Health Insurance Portability and Accountability (HIPAA) Acts.  Results A total of 146 self-reported hospital workers were included in the study. Within the final cohort, 52.73% of the participants were male (77/146), with an average age at diagnosis of 38.6±7.87 years (ranging from 20 to 52 years). Conversely, females comprised 47.27% of the cohort population (69/146) and had an average age at diagnosis of 34.73±6.73 years (ranging from 19 to 47 years). The age group 20-29 years was the most prominent age group, statistical analysis of age and gender data revealed significant differences. The overall prevalence of sharp object injuries was 11.83%, indicating that a sizable portion of HCWs is at risk of exposure to bloodborne pathogens. Among the different professional categories, Physicians constituted the majority of sharp object injuries reported victims in 41 cases (28.08%), followed by nurses in 38 cases (26.02%). Statistical analysis of the profession's data revealed significant differences (P<0.001). Notably, sharp object injuries were most reported in wards. The leading procedures that caused sharp object injuries were identified as during needle recapping in 53 instances (36.30%), then followed by medical waste treatment in 32 cases (21.92%). The left hand was the most affected body part, reported in 83 cases (56.84%). All injured individuals reported the incident promptly. No seroconversions were documented within the reviewed cases during the study period. Conclusion Injuries caused by sharp objects persist as a significant danger for hospital employees, posing immediate harm and long-term health risks linked to bloodborne pathogens. The findings stress the continuous responsibility of healthcare institutions to prioritize staff safety by addressing the root causes of sharp object injuries and fostering reporting and prevention cultures. Underreporting reasons are diverse, encompassing factors like time constraints, fear of consequences, and the misconception of injury insignificance.

Comprehensive radiation shield minimizes operator radiation exposure in coronary and structural heart procedures.

OBJECTIVES: This study evaluated the efficacy of a novel comprehensive shield designed to minimize radiation exposure (RE) to Physicians performing coronary and structural heart procedures. BACKGROUND: The Protego™ radiation shielding system (Image Diagnostics Inc., Fitchburg, Ma) is designed to provide comprehensive protection from RE and has been State certified sufficient to allow operators to perform procedures without orthopedically burdensome lead aprons. METHODS: This single center two-group cohort study assessed the efficacy of this shield in a large number of cardiac procedures (coronary and structural), comparing operator RE compared to standard protection methods (personal lead apparel and "drop down" shield). RESULTS: The Protego™ system reduced operator RE by 99 % compared to Standard Protection. RE was significantly lower at both "Head" level by thyroid median dose 0.0 (0.0, 0,0) vs 5.7 (2.9, 8.2) µSv (p < 0.001), as well as waist dose 0.0 (0.0, 0.0) vs 10.0 (5.0, 16.6) µSv (p < 0.001). ("Zero" Total RE was documented by Raysafe™ in 64 % (n = 32) of TAVR cases and 73.2 % (n = 183) of the coronary cases utilizing Protego™. In contrast, standard protection did not achieve "Zero" exposure in a single case. These dramatic differences in RE were achieved despite higher fluoroscopy times in the Protego™ arm (11.9 ± 8.6 vs 14.3 ± 12.5 min, p = 0.015). Per case procedural exposure measured by Dose Area Product was higher in the Protego™ group compared to standard protection (115.4 ± 139.2 vs 74.9 ± 69.3, p < 0.001). CONCLUSION: The Protego™ shield provides total body RE protection for operators performing both coronary and structural heart procedures. This shield allows procedural performance without the need for personal lead aprons and has potential to reduce catheterization laboratory occupational health hazards.

Health Hazard Among Shrimp Cultivators in India: A Quantitative Burden of Disease Study.

Background: The lack of focus on the health status of shrimp cultivators by previous studies while the production of shrimp has been rising over the years after the introduction of the blue revolution in India. The present study estimated the burden of diseases among shrimp cultivators in India. Methods: Primary data were collected by using simple random sampling. The sample size was 357. The classification of diseases were made by using the international classification of diseases, tenth revision (ICD-10), version 2019. Disability-adjusted life years (DALY) were used to measure the health status of shrimp cultivators. DALY is the summation of the burden of disease from mortality and morbidity. Sensitive and uncertainty analysis was used by changing the value of the parameter and method, respectively. Results: The burden of disease among shrimp cultivators in 2020 ranges from 101.03 DALY based on equal age weightage, without discount rate, and potential life expectancy (DALY0,0,PLE) to 84.02 DALY based on unequal age weightage, discount rate, and standardized life expectancy (DALY1,0.03,SLE). The burden of disease per 100,000 shrimp cultivators was 28,477.74 DALY and 23,600.84 DALY when calculated by using DALY0,0,PLE and DALY1,0.03,SLE method, respectively. The higher burden of diseases from non-communicable diseases was followed by injury and communicable diseases for both methods. The disease burden from mortality was more than two-thirds of the total burden of disease and the rest from morbidity. The burden of disease among shrimp cultivators was sensitive to parameter changes because it changes between 92.10 DALY and 63.03 DALY with the change in the parameter. Uncertainty in the burden of disease among them was due to method variation, which ranges from 120.03 DALY to 74.06 DALY. Conclusion: The higher burden of non-communicable diseases, and the lower burden of communicable, and injuries per 100,000 shrimp cultivators compared to the national level in India.

Association between occupational noise exposure level and pure-tone audiometry abnormalities among Metropolitan Manila Development Authority employees: A cross-sectional study.

Traffic enforcers are exposed to various occupational health and safety hazards, including noise pollution, which may lead to occupational hearing loss. This cross-sectional study aimed to estimate the prevalence of hearing loss and to assess the relationship between occupational noise exposure level (ONEL) and abnormalities in air conduction thresholds among Metropolitan Manila Development Authority (MMDA) employees along Epifanio delos Santos Avenue, Philippines. Eight-hour ONELs were measured among 108 participants working with greater than 5 years of service. Participants had hearing evaluations using pure tone audiometry (PTA) to calculate the prevalence of hearing loss. Generalized linear models with a Poisson distribution were fitted to estimate the association between ONEL and audiologic abnormalities, controlling for confounding factors. Approximately 16% of employees had hearing loss. The prevalence of hearing loss was higher with ONEL exposures greater than 85 A-weighted decibels (dBA), with traffic enforcers exposed to higher ONELs than office workers. ONELs greater than 85 dBA were related to audiologic abnormalities at different frequencies in PTA. The prevalence of audiologic abnormalities at 4000 Hz and 6000 Hz was 48% higher (adjusted prevalence ratio [aPR], 1.48; 95% CI, 1.12-1.96) and 25% higher (aPR, 1.25; 95% CI, 1.00-1.55), respectively, among participants with ONELs greater than 85 dBA than with ONELs less than or equal to 85 dBA. Participants exposed to ONELs greater than 85 dBA, more likely traffic enforcers, may have increased risk of audiologic abnormalities. Regular ONEL monitoring is warranted for occupational risk assessment of traffic enforcers. A hearing conservation program may need to be considered for this population. Additional studies are needed to determine trends in hearing deterioration among traffic enforcers.

Occupational risk perception of construction workers: a cross sectional study.

Introduction: Construction workers are often exposed to significant injury risk. The aim of our study is to assess their occupational hazards and injury risk perception. Methods: We administered 256 questionnaires to construction workers. The survey was aimed at collecting information regarding occupational risk and hazard exposure perception, risk control and behavioral self-assessment. We analyzed the data obtained in order to highlight any associations between injury risk perception and anamnestic, occupational, behavioral or perceptual factors. Results: Participants were prevalently males (92.37%) aged 21-60 years (94%). They showed a job seniority level of 21.3 (11.51) on average and, ranging from a 1 to 10 score, a danger awareness of 6.8 (2.9), a lack of prevention measures 6.0 (3.3), an improper behavior of 7.3 (2.7), an unpredictable fate of 6.0 (2.9). These factors resulted significantly associated with the injury risk perception. Multivariable analysis highlighted that the injury risk perception was associated with the lack of prevention measure and unpredictable fate. On the other hand, we found a negative association with the workers' improper behaviors. Conclusion: Workers' perception showed fairly uniform average values even when occupational risk was demonstrated. Our analysis suggests a positive correlation between injury risk perception and the idea that injuries are due both to fate and to chance; it also shows a negative correlation between injury risk perception and the idea that injuries are due to improper behavior. A lack of fully comparable studies confirms the need for further studies on the injury risk perception of construction workers.

Knowledge, Attitude, and Practices Regarding Radiation and its Hazards Among Orthopaedic Surgeons in India: A Questionnaire-Based Study.

Introduction: Orthopaedic surgeons are among the most frequent users of radiation and are often exposed to X-Ray radiation regularly. There is an overall unsatisfactory level of knowledge, attitude, and practices regarding the same among surgeons. This study aimed to assess the practices among orthopaedic surgeons regarding radiation and its hazards in India. Methodology: This questionnaire-based survey was conducted between March and September 2022. The questionnaire broadly assessed the knowledge, awareness, and practices among orthopaedic surgeons regularly exposed to X-ray radiation. The questionnaire consisted of objective and Likert scale questions which were distributed to the respondents electronically using publicly available contact information. A qualitative review of interpretations obtained from the responses and available evidence in the literature was then performed. Results: The response rate for the survey was 36.4%. 65.9% reported using trunk protection all the time during procedures. 57.1% of respondents reported not using thyroid protection during procedures. 92.3% reported not using protective goggles and 100% did not use appropriate gloves. 76.9% were not issued dosimeters, and only 5.5% of those who had been issued one wore it during radiation procedures. 58.2% reported having a dedicated employee to operate the machine. 86.8% of respondents did not have formal training and 81.3% were not aware of institutes offering formal training. Conclusion: There is very high compliance with the use of protection aprons among the respondents however, the use of other apparel like thyroid shields, protection goggles and gloves was poor. The awareness regarding radiation exposure was also poor as most respondents were not issued dosimeters, however, those issued with one were well aware of their exposure. It is imperative to prioritize both surgeons' and patients' safety where radiation exposure is concerned.

Risk of noise-induced hearing loss in the spine surgeon.

Background: Occupation-related noise-induced hearing loss (NIHL) has both negative economic and quality of life implications. The risk spine surgeons undertake in regards to NIHL during operative intervention is unknown. Governing bodies, including the National Institute for Occupational Safety and Health, have recommended exposure limits not to exceed 85 decibels (dB) over 8 hours. The purpose of this study is to characterize noise exposure to spine surgeons in the operating room (OR). Methods: Prospective collection of intraoperative recordings of spinal surgeries (cervical and thoracic/lumbar) was undertaken. Data gathered included procedure, operative duration, presence of background music, and noise information. Noise information included maximum decibel level (MDL), Peak level (LCPeak), Equivalent continuous sound pressure level, time weighted average (TWA), dose, and projected dose. Noise measurements were compared with baseline controls with and without music (empty ORs). Results: Two hundred seven noise recordings were analyzed. One hundred eighteen of those being spinal surgeries, 49 baseline recordings without music, and 40 with music. Maximum decibel level reached a maximum value of 111.5 dBA, with an average amongst surgical recordings of 103 dBA. Maximum decibel level exceeded 85 dBA in 100% of cases and was greater than 100 dBA in 78%. The maximum LCPeak recorded was 132.9 dBC with an average of 120 dBC. Furthermore, the average dose was 7.8% with an average projected dose of 26.5%. The highest dose occurred during a laminectomy at 72.9% of daily allowable noise. Maximum projected dose yielded 156% during a 3-level anterior cervical discectomy and fusion. Conclusions: Spine surgeons are routinely exposed to damaging noise levels (>85 dBA) during operative intervention. With spine surgeons often performing multiple surgeries a day, the cumulative risk of noise exposure cannot be ignored. The synergistic effects of continuous and impact noise places spine surgeons at risk for the development of occupation-related NIHL.

Firefighters' exposure to per-and polyfluoroalkyl substances (PFAS) as an occupational hazard: A review.

The term "firefighter" and "cancer" have become so intertwined in the past decade that they are now nearly inseparable. Occupational exposure of firefighters to carcinogenic chemicals may increase their risk of developing different types of cancer. PFAS are one of the major classes of carcinogenic chemicals that firefighters are exposed to as occupational hazard. Elevated levels of PFAS have been observed in firefighters' blood serum in recent studies. Possible sources of occupational exposure to PFAS include turnout gear, aqueous film-forming foam, and air and dust at both the fire scene and fire station. Preliminary discussion on PFAS includes definition, classification, and chemical structure. The review is then followed by identifying the sources of PFAS that firefighters may encounter as an occupational hazard. The structural properties of the PFAS used in identified sources, their degradation, and exposure pathways are reviewed. The elevated level of PFAS in the blood serum and how this might associate with an increased risk of cancer is discussed. Our review shows a significant amount of PFAS on turnout gear and their migration to untreated layers, and how turnout gear itself might be a potential source of PFAS exposure. PFAS from aqueous film-forming foams (AFFF), air, and dust of fire stations have been already established as potential exposure sources. Studies on firefighters' cancer suggest that firefighters have a higher cancer risk compared to the general population. This review suggests that increased exposure to PFAS as an occupational hazard could be a potential cancer risk for firefighters.

Comprehensive interventions to reduce occupational hazards among medical staff in the pathology department of five primary hospitals.

OBJECTIVE: To explore comprehensive interventions to reduce occupational hazards among medical staff in the pathology department of five primary hospitals. METHODS: The indoor air quality in the pathology department of five primary hospitals and the health status of staff were investigated and analyzed. Formaldehyde and benzene concentrations in the technical and diagnostic rooms of the pathology departments were analyzed before and after comprehensive interventions. The Environmental Protection Agency risk assessment paradigm was used to assess the health risks from occupational exposure to benzene and formaldehyde. Consequently, considering the local environment, targeted comprehensive intervention measures were developed, including optimizing management, raising awareness, updating equipment, and replacing reagents. RESULTS: Eye discomfort was higher among technicians in the pathology department than among clinical medical staff (P < 0.05). Before comprehensive interventions, formaldehyde concentrations were higher in the technical room than in the diagnostic room at the five primary hospitals (P < 0.05). However, compared to before interventions, formaldehyde and benzene concentrations in both rooms were significantly lower after comprehensive interventions. Furthermore, although medium risks of occupational exposure to benzene and formaldehyde remained in both rooms before and after comprehensive interventions, the risk values before interventions were higher than after comprehensive interventions. The staff of the technical rooms showed higher risk values that those of the diagnostic rooms before and after comprehensive interventions. Similarly, although hazard quotient (HQ) values for occupational exposure to benzene and formaldehyde were < 1 in both the technical and diagnostic rooms before and after comprehensive interventions, with lower noncarcinogenic risks, the values were higher before than after comprehensive interventions. Moreover, staff in the technical room had higher HQ values before and after comprehensive interventions than those in the diagnostic room. The use of environmentally friendly reagents for the preparation of frozen sections was effective. CONCLUSION: Comprehensive interventions significantly reduced occupational hazards among staff at the pathology department of five primary hospitals, which is of great practical significance to protect the health of staff.

Nanoparticle Concentration in Surgical Plume During Tonsillectomy: A Comparison of Four Techniques.

OBJECTIVE: Surgical plume has known potential occupational health hazards. This study compares nanoparticle concentrations in surgical plumes generated between different pediatric tonsillectomy surgical techniques and assesses the efficacy of mitigation measures. METHODS: This is a cross-sectional study performed at a tertiary care academic center. Extracapsular or intracapsular tonsillectomy was performed in 60 patients using four techniques and in 10 additional patients using mitigation measures. Two nanoparticle counters were used to measure particulate concentrations: CPC™ and DiSCmini™. Tonsillectomy techniques included: (1) microdebrider (MD), (2) Bovie with manual suctioning by an assistant (B), (3) Bovie with built-in smoke evacuation system (BS), and (4) Coblator™ (CB). An additional Yankauer suction was used in the mitigation groups (BSY) and (CBY). Comparative analysis was performed using one-way ANOVA on ranks and pairwise comparisons between the groups. RESULTS: The mean concentrations (particles/cm3 ) and coefficient of variants for the DiSCmini particulate counter were MD: 5140 (1.6), B: 30700 (1.5), BS: 25001 (0.8), CB: 54814 (1.7), CBY: 2395 (1.3) and BSY: 11552 (1.0). Mean concentrations for the CPC particulate counter were MD: 1223 (1.4), B: 3405 (0.7), BS: 5002 (0.9), CB: 13273 (1.0), CBY: 1048 (1.2) and BSY: 3046 (0.6). The lowest mean concentrations were noted in cases using MD and the highest in cases using CB. However, after mitigation, CBY had the lowest overall levels. CONCLUSION: Tonsillectomy technique does impact the levels of nanoparticles emitted within the surgical plume, which may present an occupational hazard for operating room personnel. LEVEL OF EVIDENCE: 3 Laryngoscope, 2023.

Diagnostic value of a logistic model of occupational lead poisoning using hematological parameters.

OBJECTIVE: We investigated the predictive value of a logistic model utilizing hematological parameters in diagnosing occupational lead poisoning. METHODS: This retrospective study (September 2020-December 2022) included patients with occupational lead poisoning. Differences in hematological parameters were compared between individuals with occupational blood lead poisoning and healthy individuals. We used logistic regression analysis to develop a diagnostic prediction model for occupational blood lead poisoning. Receiver operating characteristic (ROC) curves and corresponding area under the ROC curve values were used to assess the diagnostic value of hematological parameters and logistic models. RESULTS: Compared with controls, several indicators were significantly higher in the group with blood lead poisoning, but others were significantly lower. Logistic regression analysis showed that the red blood cell distribution width coefficient of variation (RDW-CV), neutrophil/lymphocyte ratio (NLR), and percentage of small red blood cells (Micro%) were independent factors in diagnosing occupational blood lead poisoning. The logistic regression model constructed based on these three parameters had sensitivity 78.7% and specificity 83.8% for diagnosing occupational lead poisoning. CONCLUSION: We identified RDW-CV, NLR, and Micro% as independent predictors in the diagnosis of occupational lead poisoning. A logistic regression model that includes these may contribute to better detection of occupational lead poisoning.

[The facility design and operation effect of control vehicle emissions hazard in test section of automobile assembly workshop].

The hazard of vehicle emissions mainly come from the four wheel positioning, drum test and vehicle emissions test sections in automobile assembly workshop, which can lead to abnormal hemoglobin and hepatic insufficiency in workers. We researched on preventing toxic gases technologies for the vehicle emissions generated by these three sections, designed the ventilation facilities, and then detected and evaluated the operation effect, thereby improving the working environment, ensuring the occupational health of workers, and providing scientific basis for the control of vehicle emissions hazards.

Knowledge and practice of radiation safety in Brazilian equine veterinarians are less than optimal: An online survey.

Exposure to ionizing radiation is an occupational risk for veterinarians due to the potential for carcinogenesis, reproductive disorders, cataracts, and hereditary genetic changes. This survey study aimed to identify the radiological protection practices routinely used by veterinarians who work with portable digital X-ray equipment in horses in Brazil and assess their knowledge regarding current legislation. A total of 120 voluntary participation questionnaires were sent to veterinarians who used portable digital radiographic equipment in horses nationwide. The frequencies of the answers were analyzed using the chi-square test and logistic regression models. Thirty-five veterinarians responded (29% response rate). Of these, there was a greater participation of professionals in public institutions (40%, 14/35, p < .001), with 69% from the southeast region (24/35, p < .001) and 69% (24/35, p = .028) being male. We found that self-employed veterinarians had a higher odds ratio (OR) (9.00; 95% confidence interval (CI) [1.39-58.44]; p = .021) of not using personal protective equipment compared with those in professional public institutions. In addition, not knowing the current legislation Collegiate Directorate Resolution 611/22 was a potential risk factor for lower radiological protection (OR, 8.00; 95% CI, [0.79-81.33]; p = 0.079). In conclusion, findings indicated that Brazilian equine veterinarians generally do not adopt adequate radiological protection against ionizing radiation during radiographic examinations and have low knowledge of the current legislation. Results can be used as background for the formulation of specific radiation protection guidelines for veterinarians and incentive educational and training strategies to reduce risks inherent to occupational exposure.

Needlestick and sharps injuries among healthcare workers in an oncology setting: a retrospective 7-year cross-sectional study.

OBJECTIVE: To assess the prevalence of needlestick and sharps injuries (NSSIs) and associated factors among healthcare workers (HCWs) at King Hussein Cancer Centre (KHCC), Amman, Jordan. METHODS: This retrospective cross-sectional study undertook a chart review of all HCWs that reported an NSSI between January 2015 and December 2021. Data collected included sociodemographic factors including age, sex, qualifications, and predictors of NSSIs such as working hours, work shift, and specific job roles within the oncology setting, work experience in KHCC, overall work experience and occupational category. RESULTS: A total of 355 NSSIs were included in this study with a peak prevalence in 2019 (81 of 355; 22.8%). Nurses (220 of 355; 62.0%), housekeeping staff (59of 355; 16.6%) and physicians (45 of 355; 12.7%) were the most affected occupations. NSSIs were most common in the surgical floor (65 of 355; 18.3%) and operating rooms (56 of 355; 15.8%). Blood collection (94 of 355; 26.5%) and waste collection (65 of 355; 18.3%) were the two primary procedures resulting in NSSIs. The risk of injury was significantly associated with the locations of NSSIs, procedure that caused NSSIs, shift and overall experience. CONCLUSION: NSSIs remain common among HCWs, which highlights the need for targeted education.

[Design for online monitoring of occupational hazard factors based on internet of things].

At present, there are disadvantages with the detection for occupational hazard factors, such as insufficient monitoring data, poor timeliness, weak representativeness, long detection cycles, and inability to continuously monitor. Taking advantages of internet of things technology, an online monitoring platform for occupational hazard factors has been designed. The platform collects the concentration (intensity) of hazard factors through sensors, transmits the occupational hazards data collected online in realtime. The online monitoring cloud center for occupational hazard factors processes and analyzes online monitoring data in realtime, stores the hazard factors data to form database management, and provides user application services to form an intelligent online monitoring service model for occupational hazard factors. Based on the online monitoring platform of occupational hazard factors, multi-level government health supervision departments and employers can grasp the status of hazard factors in real time, which is conducive to improving the level of occupational hazard supervision.

Indian Perspective of Burnout Among Plastic Surgeons.

Introduction Over the last decade, the term "Burnout" has become familiar term in all walks of life, particularly medicine. Emotional exhaustion, depersonalization, and a low sense of personal accomplishment make up the triad. At least a third of plastic surgeons are having burnout according to the western literature. Data on burnout in Indian plastic surgeons is lacking. We have made an attempt to analyze the incidence and factors responsible for burnout among plastic surgeons in India. Materials and Methods An online survey was conducted in India to assess burnout among plastic surgeons from June to November 2019. Consent, demographic information, stress-related factors, the abbreviated Maslach Burnout Inventory (aMBI), and Satisfaction with Medicine were all included section wise in the survey. Both used scales were validated. Data were gathered using Google forms, then uploaded to an Excel file and analyzed. A multivariable and univariable analysis of factors associated with burnout was carried out. Results Twenty-two percent of 330 plastic surgeons who responded were assessed to have moderate to high emotional exhaustion, 5% had moderate to high depersonalization, and 3% had low personal accomplishment. The overall burnout rate was 8.2%. Seventy-three percent of plastic surgeons enjoyed a good to very good quality of life. Great over-volume of work, mid-career practicing plastic surgeons and professional satisfaction with work were found to have a significant association with burnout on multivariate analysis. Conclusions Plastic surgeons in India suffer an overall burnout rate of 8.2% with a multifactorial etiology. This occupational hazard is preventable and reversible. Plastic surgeons need to be vigilant about this and seek help whenever required.

Community kitchen tandoors (CKT)-a potential candidate for air pollution mitigation strategies?

Community kitchen tandoor (CKT) is a clay-based hollow cylindrical device commonly used in South Asian and Middle Eastern countries for baking flatbreads and cooking meat. These CKTs, generally fuelled by charcoal or wood, contribute significantly to the pollution loads in ambient air along with occupational exposure hazards. CKTs, being a part of the informal sector, lack emissions and safety guidelines. This study surveys 139 restaurants in CKT hotspots of New Delhi, India, to understand tandoor design and operational parameters and to assess PM2.5 and CO exposure concentrations at representative field restaurants. PM2.5 and CO exposure concentrations from traditional CKT was found to be several-folds higher than safe indoor air quality levels. Further, the traditional CKT was evaluated for different improved fuels (like briquettes and pellets) in the laboratory for PM2.5 and CO microenvironment concentrations. It was found that the fuel improvements in traditional CKT could not improve microenvironment concentrations to the desired levels; hence, an automated pellet-fed forced-draft improved tandoor with an improved combustion chamber design is demonstrated. The results of the laboratory trial of improved tandoor were compared with traditional tandoor (using pellets) and have shown 84% and 94% reductions in PM2.5 and CO concentrations, respectively, indicating significant benefits to the environment and health. We recommend implementing such improved CKT, on a large scale, combined with other identified control options, as a potential candidate under air pollution mitigation strategies in cities' action plans under National Clean Air Programme (NCAP).

Intraoperative Neck Angles in Endoscopic and Microscopic Otologic Surgeries.

OBJECTIVE: To quantitatively compare the ergonomic risk of otologic surgeries performed with endoscopes and microscopes. STUDY DESIGN: Observational cross-sectional study. SETTING: Operating room of a tertiary academic medical center. METHODS: Intraoperative neck angles of otolaryngology attendings, fellows, and residents were assessed during 17 otologic surgeries using inertial measurement unit sensors. Sensors were attached midline between the shoulder blades and on the posterior scalp of participants and were calibrated just prior to beginning each case. Quaternion data were used to calculate neck angles during periods of active surgery. RESULTS: Endoscopic and microscopic cases included similar percentages of time in high-risk neck positions, 75% and 73%, respectively, according to a validated ergonomic risk assessment tool, the Rapid Upper Limb Assessment. However, microscopic cases included a higher percentage of time spent in extension (25%) compared to endoscopic cases (12%) (p < .001). When examining the magnitude of average flexion and extension angles, endoscopic and microscopic cases were not significantly different. CONCLUSION: Utilizing intraoperative sensor data, we found that both endoscopic and microscopic approaches in otologic surgery were associated with high-risk neck angles, which can result in sustained neck strain. These results suggest that optimal ergonomics may be better achieved by the consistent application of basic ergonomic principles than by changing the technology in the operating room.

Impact of differential occupational LPG exposure on cardiopulmonary indices, liver function, and oxidative stress in Northwestern city of Nigeria.

Exposure to hydrocarbon products has been associated with numerous health risks and toxicities. Outdoor or indoor occupational exposure to highly volatile and lipid-soluble hydrocarbons has been linked to impairment of respiratory, cardiovascular, and liver functions. This study is aimed at determining the potential impact of occupational exposure to liquefied petroleum gas (LPG) in varying work environments. Respiratory symptoms, oxidative stress, cardio-pulmonary, and liver function parameters were assessed among LPG workers in the Kano metropolis, Nigeria. Study subjects were recruited from LPG filling stations and street LPG retail shops. Results of the study showed that the forced vital capacity (FVC) of LPG station workers was significantly lower (2.81 L/min; H = 22.473, p < 0.001) relative to the values recorded among LPG retail shop workers and the controls (3.54 L/min and 4.24 L/min respectively). A similar reduction was seen in the forced expiratory volume in the first second (FEV1) and the forced expiratory flow in 25-75 % of forced vital capacity (FEF25-75) obtained from the filling station workers (H = 32.722, p < 0.001 & H = 15.655, p <0.001 respectively). Furthermore, exposure to non-combusted LPG increased systolic blood pressure, mean arterial pressure, and serum liver enzymes. Findings from this study revealed that despite the high amount of coarse particulate matter in LPG retail shops, the filling station workers are more susceptible to the impairment of lung function possibly due to the high quantity of total volatile organic compounds (TVOCs) in the filling station environment.