BackgroundIn recent years, cleaning has been identified as an occupational risk because of an increased incidence of reported respiratory effects, such as asthma and asthma-like symptoms among cleaning workers. Due to the lack of systematic occupational hygiene analyses and workplace exposure data, it is not clear which cleaning-related exposures induce or aggravate asthma and other respiratory effects. Currently, there is a need for systematic evaluation of cleaning products ingredients and their exposures in the workplace. The objectives of this work were to: a) identify cleaning products' ingredients of concern with respect to respiratory and skin irritation and sensitization; and b) assess the potential for inhalation and dermal exposures to these ingredients during common cleaning tasks.MethodsWe prioritized ingredients of concern in cleaning products commonly used in several hospitals in Massachusetts. Methods included workplace interviews, reviews of product Materials Safety Data Sheets and the scientific literature on adverse health effects to humans, reviews of physico-chemical properties of cleaning ingredients, and occupational hygiene observational analyses. Furthermore, the potential for exposure in the workplace was assessed by conducting qualitative assessment of airborne exposures and semi-quantitative assessment of dermal exposures.ResultsCleaning products used for common cleaning tasks were mixtures of many chemicals, including respiratory and dermal irritants and sensitizers. Examples of ingredients of concern include quaternary ammonium compounds, 2-butoxyethanol, and ethanolamines. Cleaning workers are at risk of acute and chronic inhalation exposures to volatile organic compounds (VOC) vapors and aerosols generated from product spraying, and dermal exposures mostly through hands.ConclusionCleaning products are mixtures of many chemical ingredients that may impact workers' health through air and dermal exposures. Because cleaning exposures are a function of product formulations and product application procedures, a combination of product evaluation with workplace exposure assessment is critical in developing strategies for protecting workers from cleaning hazards. Our task based assessment methods allowed classification of tasks in different exposure categories, a strategy that can be employed by epidemiological investigations related to cleaning. The methods presented here can be used by occupational and environmental health practitioners to identify intervention strategies.

BackgroundA growing body of epidemiologic evidence suggests an association between exposure to cleaning products with asthma and other respiratory disorders. Thus far, these studies have conducted only limited quantitative exposure assessments. Exposures from cleaning products are difficult to measure because they are complex mixtures of chemicals with a range of physicochemical properties, thus requiring multiple measurement techniques. We conducted a pilot exposure assessment study to identify methods for assessing short term, task-based airborne exposures and to quantitatively evaluate airborne exposures associated with cleaning tasks simulated under controlled work environment conditions.MethodsSink, mirror, and toilet bowl cleaning tasks were simulated in a large ventilated bathroom and a small unventilated bathroom using a general purpose, a glass, and a bathroom cleaner. All tasks were performed for 10 minutes. Airborne total volatile organic compounds (TVOC) generated during the tasks were measured using a direct reading instrument (DRI) with a photo ionization detector. Volatile organic ingredients of the cleaning mixtures were assessed utilizing an integrated sampling and analytic method, EPA TO-17. Ammonia air concentrations were also measured with an electrochemical sensor embedded in the DRI.ResultsAverage TVOC concentrations calculated for 10 minute tasks ranged 0.02 - 6.49 ppm and the highest peak concentrations observed ranged 0.14-11 ppm. TVOC time concentration profiles indicated that exposures above background level remained present for about 20 minutes after cessation of the tasks. Among several targeted VOC compounds from cleaning mixtures, only 2-BE was detectable with the EPA method. The ten minute average 2- BE concentrations ranged 0.30 -21 ppm between tasks. The DRI underestimated 2-BE exposures compared to the results from the integrated method. The highest concentration of ammonia of 2.8 ppm occurred during mirror cleaning.ConclusionsOur results indicate that airborne exposures from short-term cleaning tasks can remain in the air even after tasks' cessation, suggesting potential exposures to anyone entering the room shortly after cleaning. Additionally, 2-BE concentrations from cleaning could approach occupational exposure limits and warrant further investigation. Measurement methods applied in this study can be useful for workplace assessment of airborne exposures during cleaning, if the limitations identified here are addressed.

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Background: Several recent studies have linked emissions from printing equipment with upper airway inflammation and systemic oxidative stress in healthy humans, lung inflammation in mice, and cytotoxicity, induction of inflammatory markers and epigenetic changes in human cell lines. Acute exposures have lead to upper airway inflammation and systemic oxidative stress, which for certain markers took longer than 24-36 h post-exposure to clear. Objective: In this follow-up work, we determined: i) whether chronic exposures to nanoparticles from copiers lead to chronic upper airway inflammation and systemic oxidative stress; and ii) whether expression patterns of biomarkers for such stresses change during transition from acute to chronic exposures. Methods: Six permanent employees from three copy centers and eleven controls participated in the study. Nasal lavage and urine samples were collected on Monday morning (pre-shift, Mo-AM) and evening (post-shift, Mo-PM), as well as at the end of the workweek (Fr-PM), over three random weeks. The matched controls were sampled over one week. Nasal lavage samples were analyzed for a panel of 14 pro-inflammatory cytokines/chemokines, inflammatory cells, and total protein. Urine samples were analyzed for 8-OH-dG, a biomarker of systemic oxidative stress. Detailed quantitative exposure assessment to airborne nanoparticles was conducted for a whole week, and included size distribution, size-fractionated aerosol collection, extensive chemical analysis, and lung burden estimates. Results:The daily geometric mean total particle number concentration varied between 14,600-21,860 particles/cm 3 , 1.7-12.1 times greater than background, with maxima up to 143,000 particles/cm 3 . Mass concentration of the nanoscale fraction was in the 1-10 µg/m 3 range.Chemical composition of the nanoparticle fraction was comprised mostly of organic compounds, mixed with several engineered nanoparticles, which contributed a metal content ranging from 2-8% of the total particulate mass.Five out of the 14 inflammatory cytokines, namely IL-6, IL-8, TNFα, IL-1β and Eotaxin, were significantly elevated in the nasal lavage samples of the chronically exposed copier operators (p < 0.0001) relative to controls. One cytokine, G-CSF, was significantly down regulated (p < 0.0001) in copier operators (p <0.05). The level of all six cytokines did not change significantly across days (i.e. Mo-AM vs. Mo-PM, and Mo-AM vs. Fr-PM) and across weeks in chronically exposed individuals. In addition, there were significant (p < 0.0001) increases in inflammatory cell infiltration (2.7 fold) in nasal lavage samples and 8-OH-dG in (4.3 fold) in urine samples. Conclusion:Chronic upper airway inflammation and systemic oxidative stress were documented in photocopier operators chronically exposed to nanoparticles. These findings agree with the recent toxicological literature on printer-emitted particles and medical case reports, and call for an industry-wide study of the health effects resulting from exposure to printer-emitted particles...

In this female group, treadmill workstations had serious design problems for workers with not enough control of their jobs. The early identification and removal of barriers likely needs to be considered when offering these workstations to workers with low job autonomy.

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An integrated pollution prevention (P(2)) and occupational safety and health (OSH) worksite intervention and alternatives assessment strategy was developed in hospitals. It was called the Pollution Prevention-Occupational Safety and Health (P(2)OSH) assessment for the "Sustainable Hospitals Project." Methods included (a) developing a participatory intervention model for introducing more environmentally sound, healthy, and safe materials and work practices for specific hospital procedures; (b) developing an integrated P(2)OSH survey to evaluate environmental and occupational impacts of the intervention; and (c) conducting and evaluating interventions by applying the P(2)OSH assessment pre- and post-intervention. Eleven interventions were performed in six hospitals: an aliphatic fixative replaced xylene in three histology laboratories; a mercury reduction plan was implemented in three clinical laboratories; digital imaging replaced wet chemical film processing in three radiology departments; a less toxic aldehyde replaced formaldehyde in one hospital histopathology laboratory; and conventional mopping was replaced by microfiber mopping in one hospital. Occupational and environmental health and safety impacts were observed for all interventions. The alternatives generally were beneficial, although each had limitations that resulted in process and task changes with potentially negative P(2) and/or OSH impacts. When these were identified in the pilot phase they could be addressed before full-scale implementation. The P(2)OSH method shifts the focus of occupational and environmental hygiene from hazard control to substitution. Because few ideal alternatives exist, the emphasis is on a continuous process to identify, implement, and evaluate alternatives, rather than on a particular alternative. Occupational and environmental health and safety professionals have an important role as agents in hospital organizational change and in the search for healthier and safer alternatives. Through these activities they can become involved in the design/redesign of products, materials, and processes, thus expanding their traditional role.

Home health care (HHC) is growing rapidly and yet health and safety conditions of HHC clinicians are poorly understood. Study of this workforce presents unique challenges because it is decentralised, often part-time and mobile. As part of a larger project on sharps injuries and blood exposures in HHC, this paper addresses the challenges of recruiting a large cohort of HHC nurses and aides and describes novel cross-sectional survey methodology. Recruitment was conducted with cooperation from eight HHC agencies and two labour unions. Intensive personal contacts and a financial incentive ($25) were employed. Some groups of HHC clinicians could be contacted only by mail, while others were contacted during a promotional “mini-fair” at their agency. A total of 1772, 18-page health and safety surveys were distributed and 1225 usable surveys were collected. This 69% overall response rate is better than that in many recent health surveys. Survey returns were highest (67—91%) where promotional events were held. The mailing-only strategy generated lower response rates (53—55%), despite the same financial incentive. Despite the challenges of reaching out to the decentralised HHC workforce, adequate response to a detailed health survey is possible, using appropriate techniques and with the close cooperation of employers and labour unions.