A review of the effectiveness of respirators in reducing exposure to polycyclic aromatic hydrocarbons for coke oven workers.

OBJECTIVES: In 2011 recommendations for the prescription of lung cancer in coke oven workers were made in the UK. In the 1970s, a powered helmet respirator, the Airstream helmet, was introduced to the UK coking industry with the aim of reducing exposure to polycyclic aromatic hydrocarbons (PAH) aerosols and consequent lung cancer risks for workers on the coke oven tops. This review set out to identify the level of protection afforded by the Airstream helmet, when the helmets could be considered to have provided effective protection and whether the levels of protection have been maintained to the current time. METHODS: Five approaches were taken to identify review material, including searching the peer-reviewed and grey literature; searching material held in the National Archive; using a Freedom of Information to the Health and Safety Executive; interviews with employees involved in the introduction of the Airstream helmet; and acquisition of company reports. RESULTS: The two principal companies involved in coke production in the UK took different approaches to the introduction of the Airstream helmets. Because of this, it can only be considered that effective wearing occurred in the industry as a whole from 1982 onwards. Exposure measurements made by British Steel in the late 1970s suggested that the mean protection factor of the Airstream helmet was ~10 (5th percentile~2.5), regardless of whether exposure was assessed as the inhalable aerosol or other measures more specific to aerosol of PAH. More recent data collected using biological monitoring has identified that average urinary levels of 1-hydroxypyrene (1-HP) generally correspond with the inhalation occupational exposure limit for benzene soluble material. Although on occasions, relatively high air concentrations in-mask and urinary 1-HP concentrations have been identified, underlining the necessity to maintain close supervision of workers wearing respirators. CONCLUSIONS: Overall, we concluded that the wearing of helmet respirators has effectively controlled long-term average exposure to PAH for most workers on coke ovens since 1982.

Indoor Exposure to Selected Air Pollutants in the Home Environment: A Systematic Review.

(1) Background: There is increasing awareness that the quality of the indoor environment affects our health and well-being. Indoor air quality (IAQ) in particular has an impact on multiple health outcomes, including respiratory and cardiovascular illness, allergic symptoms, cancers, and premature mortality. (2) Methods: We carried out a global systematic literature review on indoor exposure to selected air pollutants associated with adverse health effects, and related household characteristics, seasonal influences and occupancy patterns. We screened records from six bibliographic databases: ABI/INFORM, Environment Abstracts, Pollution Abstracts, PubMed, ProQuest Biological and Health Professional, and Scopus. (3) Results: Information on indoor exposure levels and determinants, emission sources, and associated health effects was extracted from 141 studies from 29 countries. The most-studied pollutants were particulate matter (PM2.5 and PM10); nitrogen dioxide (NO2); volatile organic compounds (VOCs) including benzene, toluene, xylenes and formaldehyde; and polycyclic aromatic hydrocarbons (PAHs) including naphthalene. Identified indoor PM2.5 sources include smoking, cooking, heating, use of incense, candles, and insecticides, while cleaning, housework, presence of pets and movement of people were the main sources of coarse particles. Outdoor air is a major PM2.5 source in rooms with natural ventilation in roadside households. Major sources of NO2 indoors are unvented gas heaters and cookers. Predictors of indoor NO2 are ventilation, season, and outdoor NO2 levels. VOCs are emitted from a wide range of indoor and outdoor sources, including smoking, solvent use, renovations, and household products. Formaldehyde levels are higher in newer houses and in the presence of new furniture, while PAH levels are higher in smoking households. High indoor particulate matter, NO2 and VOC levels were typically associated with respiratory symptoms, particularly asthma symptoms in children. (4) Conclusions: Household characteristics and occupant activities play a large role in indoor exposure, particularly cigarette smoking for PM2.5, gas appliances for NO2, and household products for VOCs and PAHs. Home location near high-traffic-density roads, redecoration, and small house size contribute to high indoor air pollution. In most studies, air exchange rates are negatively associated with indoor air pollution. These findings can inform interventions aiming to improve IAQ in residential properties in a variety of settings.

Musculoskeletal health in the workplace.

Musculoskeletal (MSK) problems remain the most frequent reason why individuals are absent from work, including those with work-related musculoskeletal disorders (WRMSDs or MSDs) and those with chronic MSK problems. This paper aims to examine changes in work and the workforce since 2000; how work impacts on chronic MSK conditions and how we can help people with these conditions to stay at work. While our knowledge of the causes of WRMSDs has increased since 2000, there has been limited workplace action in reducing exposure to hazards. A life course approach is needed as individuals of all ages are reporting MSK problems. How people work has also changed and informalisation of work contracts has increased with a perceived concurrent reduction in occupational safety and health (OSH) protection. Retaining people at work with MSK problems requires compliance with relevant safety, health and diversity legislation and a risk management approach. Good and open communication within the workplace and identification of other sources of support is also necessary. Considerations must be made at the individual level (internal motivation), organisational level (a supportive manager) and self-management of symptoms. Simple case examples are provided in the paper of what works in practice as well as a proposed research agenda. Increased awareness at all levels of society of MSK health is essential.

Is pesticide exposure a cause of obstructive airways disease?

A systematic review was performed to identify any associations between pesticide exposure and the occurrence (both prevalence and incidence) of airways disease (asthma and chronic obstructive pulmonary disease) and wheezing symptoms. PubMed, MEDLINE, Embase, Scopus, CINAHL, Google Scholar and the Cochrane Database of Systematic Reviews were searched between September 2010 and October 2010 for papers with the inclusion criteria of English language, published after 1990, peer-reviewed and nondietary exposure. From a total of 4390 papers identified, 42 were included after initial assessment of content. After evaluating the included studies for quality, those considered to be at high risk of bias were excluded, leaving a total of 23 relevant papers. Results suggest that exposure to pesticides may be associated with prevalent asthma, but methodological issues, such as cross-sectional/case-control design, measurements of exposure and limited adjustment for confounders, limit the strength of the evidence base in this area. The association between pesticide exposure and asthma appears to be more evident and consistent in children than in adults. Exposure to pesticides may be associated with COPD; however, the strength of evidence for an association with COPD is weaker than for asthma. As the exposure metrics within each health end-point varied across studies, no meta-analyses were carried out.

Conservative treatment of work-related upper limb disorders: a review.

AIM: The literature review was carried out to identify and summarize the evidence-base for conservative clinical management of upper limb disorders (ULDs) including specific disorders and non-specific ULDs. METHOD: Keywords were identified through a scoping study and guidance from the project sponsor. A number of databases were searched including Web of Knowledge, Pub Med, Medline, Ergonomics Online, the Cochrane Library and BMJ Clinical Evidence for the years 1993-2004. Abstracts were obtained for papers identified in the search and full papers were obtained for literature, which included diagnostic methods, conservative treatments, new data or results or systematic reviews. RESULTS: The review identified that there is evidence for the efficacy of conservative treatments for the management of carpal tunnel syndrome, epicondylitis, rotator cuff tendonitis and bicipital tendonitis and tension neck syndrome. There was no evidence found to support or refute conservative treatment of tenosynovitis, tendonitis, de Quervain's disease or diffuse non-specific ULDs. CONCLUSION: The evidence reviewed was not always of good quality and data gaps including methodological design issues need to be addressed by future research.

The interaction between lid diameter, height and shape on wrist torque exertion in younger and older adults.

The following study investigated wrist torque strength measurements of a group of younger and older adults. The aim of the study was to examine the impact of shape, diameter and height of lid on wrist torque opening strength. Forty participants took part in the study in four groups, younger males and females and older males and females. Data were collected for 12 test pieces. Anthropometric data were also obtained for stature, weight, hand breadth, hand length, chuck grip force, grip force, lateral grip force and pinch grip force. The analysis of the wrist torque strength measurements found that participants could exert greater force with square test pieces compared to circular test pieces of the same diameter. Examination of the circular test pieces found that as diameter and height increased, so did torque exertion data for the test pieces between 20 mm and 50 mm diameter. The surface area of the test pieces was found to be highly correlated with the level of torque exertion, thus a linear model was developed to describe this relationship. The model could be used to predict maximal torque closure levels for use in the packaging industry. The anthropometric data revealed that as height, weight, hand length and hand breadth increased, there was a correlation with the levels of torque exerted. Future research needs to further examine the relationship between surface area and torque exerted and the design of spherical lids to increase the contact area between the hand and the lid.