OCCUCON 2023 Abstracts

The proceedings contain 32 papers. The topics discussed include: assessment of workplace indoor fine particle exposure and pulmonary function parameters among ceramic tile industry workers of West India;respiratory morbidities in school children of critically polluted industrial area of Gujarat - a prospective observational study;morbidities among workers of an organochlorine pesticide industry;identifying interventions to reduce NCDs in workplaces in India: a stakeholder's assessment;examining toxic metals in biological samples and residential PM2.5 to evaluate their risk in adolescent children;ergonomics hazard assessment reduction in large scale petrochemical complex, Vadodara;factors associated with work related quality of life among garment factory employees in South India;factors associated with work related quality of life among garment factory employees in South India;and screening for COVID-19 among workers attending medical examinations under occupational health service of an open cast iron ore mine in Jharkhand: a cross-sectional study.

Community disaster resilience using multi-hazard assessment during Covid-19: The case of Denpasar, Indonesia

As tourism and its related sectors have flourished in Bali Province, Denpasar Municipality, as the capital, has attracted significant urbanization. As a result of this development tendency, the city has become the densest location in the Bali Area. Denpasar Municipality is suffering with urban issues such as waste, land-use changing, housing bubble, and cultural asset loss as a result of the negative effects of urbanization. Not only from the degradation of urban livelihood threat, but Denpasar is also at risk from multi-hazard disasters such as earthquakes, tsunami, floods, extreme weather, forest and land fire, extreme waves, and beach erosion. Currently, the outbreak of the COVID-19 pandemic, as well as the decline of the tourism business, have forced Denpasar Municipality's resilience to the edge.In addition, to address the threat of disaster and urban issues in Denpasar, this research was conducted to analyze the resilience in the city. Yet, the previous studies have not been addressed the resilience of the urban crisis and disaster in a holistic approach. First, the semi-qualitative research by CDRI (Climate Disaster Resilience Index) Framework was conducted to measure the urban resilience in Denpasar. The result of five parameters (physical, social, institutional, economic, and environment) reveals that West Denpasar has the highest resilience score, followed by South, North, and East Denpasar. In addition, to assess the supporting and restricting resilience factors in Denpasar, a qualitative approach using semi-structured interviews with different responsible institutions for disaster management in Denpasar was undertaken. The result shows that sufficient infrastructure and facilities, bonus demographic, collaboration with the private sector, sufficient information access, and control from the government are the supporting factors of resilience while urbanization challenge, budget shifting, the management of the problem, the ownership of the asset, collaboration with the community and focus on physical loss and damage are the restraining factors of resilience in Denpasar Municipality.

An Application of the DHI Methodology for a Comparison of SARS-CoV-2 Epidemic Hazards in Customer Delivery Services of Smart Cities

Current awareness of epidemic threats and critical experiences of the COVID-19 pandemic require extension of the management model in the smart city, especially in the field of mobility and transport services, with monitoring of epidemic hazards. This paper addresses the issue of epidemic hazards, a new challenge in smart cities, and customer delivery services. The novel DHI methodology for epidemic hazards assessment is presented and applied to compare customer delivery services in aspects of SARS-CoV-2 epidemic hazards. The case studies presented a detailed analysis of epidemic hazards on the basis of process algorithms and dedicated quantitative scales to assess factors influencing the mechanisms of virus transmission. The developed DHI methodology and the results obtained for transport services constitute important cognitive knowledge for the administrative personnel in smart city.

Disposable face masks release micro particles to the aqueous environment after simulating sunlight aging: Microplastics or non-microplastics?

This study focuses on characterizing microplastics and non-microplastics released from surgical masks (SMs), N95 masks (N95), KN95 masks (KN95), and children's masks (CMs) after simulating sunlight aging. Based on micro-Raman spectrum analysis, it was found that the dominant particles released from masks were non-microplastics (66.76–98.85%). Unfortunately, CMs released the most microplastics, which is 8.92 times more than SMs. The predominant size range of microplastics was 30–500 µm, and the main polymer types were PP and PET. Compared with the whole SMs, the microplastic particles released from the cutting-SMs increased conspicuously, which is 12.15 times that of the whole SMs. The main components of non-microplastics include β-carotene, microcrystalline cellulose 102, and eight types of minerals. Furthermore, non-microplastics were mainly fibrous and fragmented in appearance, similar to the morphology of microplastics. After 15 days of UVA-aging, the fibers of the face layers had cracks to varying degrees. It was estimated that these four types of masks can release at least 31.5 trillion microplastics annually in China. Overall, this study demonstrated that the masks could release a large quantity of microplastics and non-microplastics to the environment after sunlight aging, deserving urgent attention in the future study. © 2022 Elsevier B.V.

Expanding Vulnerability Indices for Pandemic Effects

In this study, our goal is to identify potentially vulnerable communities that could be subject to ongoing or compounding impacts from the pandemic and/or that may experience a slower recovery due to sociodemographic factors. For this purpose, we compiled information from multiple databases related to sociodemographic and health variables. We used a ranking-based method to integrate them and develop new combined indices. We also investigated a time-dependent correlation between vulnerability components and COVID-19 statistics to understand their time-dependent relationship. We ultimately developed pandemic vulnerability indices by combining CDC's social vulnerability index, our newly developed composite health vulnerability index, and COVID-19 impact indices. We also considered additional assessments include expected annual loss due to natural hazards and community resilience. Potential hot spots (at the county level) were identified throughout the United States, and some general trends were noted. Counties with high COVID-19 impact indices and higher values of the pandemic vulnerability indices were primarily located in the southern United States or coastal areas in the Eastern and Southwestern United States at the beginning of the COVID-19 pandemic. Over time, the computed pandemic vulnerability indices shifted to higher values for counties in the southern and north-central United States, while values calculated for the northwestern and northeastern communities tended to decrease.

Expanding Vulnerability Indices for Pandemic Effects

In this study, our goal is to identify potentially vulnerable communities that could be subject to ongoing or compounding impacts from the pandemic and/or that may experience a slower recovery due to sociodemographic factors. For this purpose, we compiled information from multiple databases related to sociodemographic and health variables. We used a ranking-based method to integrate them and develop new combined indices. We also investigated a time-dependent correlation between vulnerability components and COVID-19 statistics to understand their time-dependent relationship. We ultimately developed pandemic vulnerability indices by combining CDC's social vulnerability index, our newly developed composite health vulnerability index, and COVID-19 impact indices. We also considered additional assessments include expected annual loss due to natural hazards and community resilience. Potential hot spots (at the county level) were identified throughout the United States, and some general trends were noted. Counties with high COVID-19 impact indices and higher values of the pandemic vulnerability indices were primarily located in the southern United States or coastal areas in the Eastern and Southwestern United States at the beginning of the COVID-19 pandemic. Over time, the computed pandemic vulnerability indices shifted to higher values for counties in the southern and north-central United States, while values calculated for the northwestern and northeastern communities tended to decrease.

Hurricanes Laura and Sally: A Case Study of Evacuation Decision-Making in the Age of COVID-19

This study examines risk perceptions and evacuation planning for those residents affected by Hurricane Laura}the first major hurricane evacuation during the COVID-19 pandemic}and Hurricane Sally, prior to the wide-spread availability of vaccines. Research on hurricane evacuation behavior and risk perceptions during a pandemic is critical for quantifying the intersect of these compounding threats. Analyses captured how people perceive public shelters and whether evacuation choices changed in light of the pandemic. Many study participants considered themselves vulnerable to COVID-19 (39.4%), and two-thirds believed it would be “very serious” if they or their loved ones contracted COVID-19, but this had no impact on their actual evacuation decision-making. Approximately 75% of the sample stayed at home during Hurricanes Laura or Sally, and, of these, just over 80% indicated that COVID-19 was a somewhat important deciding factor. This reflects the partial role that COVID-19 played in balancing individual and household protective action decision-making during complex disasters, whereas 15.5% wanted to evacuate but waited until it was too late. For those who evacuated to a hotel, many found that staff and guests wore masks and socially distanced in common spaces. Of particular interest is that individuals have a continued negative perception of public shelters’ ability to safeguard against COVID-19 that was coupled with a significant decrease in the number of respondents that would potentially use shelters in 2020 as compared with before the COVID-19 pandemic. These results have informed and will inform future hazard mitigation planning during the current pandemic or future pandemics or infectious disease outbreaks. © 2022 American Meteorological Society.

Utilizing Google Street View for Rapid Seismic Vulnerability Assessment: Case Study in the City of Manila, Philippines

Earthquake Impact Reduction Study for Metro Manila (MMEIRS) estimated that around 40% of the total number of residential buildings within Metro Manila will either collapse or be affected by the M7.2 generated by the West Valley Fault. Need arises to evaluate the seismic vulnerability of structures in the area to enhance the city’s resilience to seismic hazards. Rapid seismic vulnerability assessments are typically conducted by means of sidewalk surveys. However, advances in digital technologies such as Google Street View (GSV) provide the potential to do remote assessments, particularly amid mobility restrictions brought about by the COVID-19 pandemic. This paper aims to demonstrate the usefulness of GSV in collecting data needed for rapid seismic vulnerability assessments through the case of buildings in the City of Manila. Six 300 m x 300 m blocks were evaluated using GSV for identifying seismic-related building parameters. Results show the ease of use of GSV in data collection on areas encompassing commercial and residential zones within the city and poses difficulty for blocks dominated by informal settlements. Among the challenges observed in formal zones include blockages in views due to fences, trees, and/or vehicles parked in front. For informal settlements, much of the buildings are not visible in GSV for evaluation thereby necessitating supplemental data collection. Overall, GSV demonstrates usefulness, and has the potential to speed up seismic vulnerability assessments in urban areas in conjunction with existing in situ assessments currently conducted.

Six-Month Outcomes Among Lung Transplant Patients with COVID-19

Purpose: There is limited data on the outcomes beyond the acute illness among lung transplant (LT) patients with Coronavirus disease 2019 (COVID-19). The current study sought to describe the predictors of 6-month survival among a single center cohort of LT. *Methods: We included all the LT patients diagnosed with COVID-19 during a one-year period (March 2020 to Feb 2021;n=54;median age: 60, 20-73 years;M:F 37:17). All patients completed at least 6-month follow up from COVID-19 diagnosis. We reviewed patient characteristics, presenting features, clinical course, and laboratory abnormalities at presentation and during the acute illness. We reviewed the hospital course and post-discharge outcomes including lung function loss among COVID-19 survivors. Median follow-up duration was 304 days. Six-month survival after COVID-19 was analyzed as the primary outcome variable. Result(s): Restrictive lung disease was the most common LT indication (n=41, 75.9%) and most had undergone bilateral LT (n=43, 79.6%). Patients were a median of 48 months (range <1-139 months) from their transplant. Majority of the patients required hospitalization (n=48) and significant proportion of patients developed respiratory failure (n=26). One month survival was 90.7% (n=49) while the survival dropped to 81.5% (n=44) by 6-month follow-up. On univariate analysis, females (35.3% vs 10.8%) and those with pre-existing chronic lung allograft dysfunction (CLAD, 33.3% vs 11.1%) experienced worse 6-month survival. Peak lactate dehydrogenase (LD) levels had the strongest association with 6-month survival on Mann Whitney U comparisons. On receiver operator characteristic curve analysis, the peak LD levels had an area under the curve of 82.9% (69.1-96.7%, p=0.002) with 400 U/L identified as the best cut-off. A peak LD level >400 U/L during the acute illness from COVID-19 was significantly associated with worse 6-month survival (OR, 95% CI: 4.38, 1.31-14.65, p=0.02).On Cox proportion hazard analysis, female gender (adjusted HR: 5.38, 1.13-25.64;p=0.035), pre-infection CLAD (5.63, 1.24-25.57;p=0.025) and peak LD levels >400 U/L (7.49, 1.72-35.53;p=0.007, see Figure for the Kaplan-Meier survival analysis) were independently associated with survival after COVID-19 among LT patients. Conclusion(s): COVID-19 is associated with significant mortality among LT patients with several patients succumbing beyond the period of acute illness. Female gender, established CLAD prior to COVID-19 and an LD>400 U/L at any time during the acute illness are adverse prognostic markers and may form the basis of customized management strategies. (Table Presented).

Lung Transplantation Promotes Survival In Patients with COVID-19 ARDS Who Require Extended Duration of VV ECMO support

Background: Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) is increasingly being utilized to manage critical COVID-19 associated ARDS (CCAA) in patients who fail medical optimization and mechanical ventilatory support. The aim of this study was to determine the probability of weaning patients from ECMO over time and whether a subset of patients should be considered for lung transplantation. Additionally, we investigated when lung transplant should be considered after VV ECMO support. Methods: 49 patients with CCAA who required ECMO between January 2020 and September 2021 were investigated. Baseline patient demographics, clinical, laboratory, and follow-up data were compared. The change in probability of ECMO weaning based on duration of ECMO support was studied using a univariate analysis. Additionally, patients who received lung transplantation following VV ECMO for COVID-19 during this same period were studied to compare outcomes to those of patients with only VV ECMO support. Cox proportion hazard analysis was performed to determine predictors of survival in patients who required greater than 28 days of ECMO support. Yuden index was used to determine change in probability of survival with time on ECMO. Results: Of 49 patients, 17 (35%) received lung transplants and 32 (65%) remained on ECMO for >28 days. The probability of weaning patients from ECMO was highest within the first 10 days (60%);beyond 40 days, it was 5.1% (Fig. A). The probability of successfully weaning patients from ECMO significantly decreased over time and ECMO support greater than 28 days (Yuden index, Hazard ratio: 1.09, 95% CI;1.00-1.03) was associated with a significantly increased risk of mortality. Additionally, both survival to hospital discharge (p<0.001, Fig. B) and post-discharge survival (p<0.001, Fig. C) were significantly greater in those who were weaned from ECMO prior to 28 days than those who were weaned after 28 days. In those who could not be weaned from ECMO, lung transplantation (HR:0.47, p<0.01, 95% CI 0.17-0.94), ECMO duration (HR:1.09, p=0.01, 95% CI 1.00-1.03) and higher BUN levels (HR:1.02, p<0.01, 95% CI 1.01- 1.46) prior to ECMO initiation were independent predictors of survival. ECMO support of greater than 8 days was associated with a statistically significant increase in mortality compared to those who received fewer than 8 days of support (Yuden index, HR 1.96, CI 1.06-5.51). Furthermore, the projected survival of patients on ECMO support for greater than 8 days was substantially worse than those requiring fewer than 8 days of support (Fig. C and D). Conclusion: This study suggests that survival and accompanying lung recovery is more probable in patients who require a short duration of ECMO support whereas those who require longer durations, particularly exceeding 28 days, is associated with a lower rate of survival. (Figure Presented).

Occupational Risk Assessment for Flight Schools: A 3,4-Quasirung Fuzzy Multi-Criteria Decision Making-Based Approach

The concept of occupational risk assessment is related to the analysis and prioritization of the hazards arising in a production or service facility and the risks associated with these hazards;risk assessment considers occupational health and safety (OHS). Elimination or reduction to an acceptable level of analyzed risks, which is a systematic and proactive process, is then put into action. Although fuzzy logic-related decision models related to the assessment of these risks have been developed and applied a lot in the literature, there is an opportunity to develop novel occupational risk assessment models depending on the development of new fuzzy logic extensions. The 3,4-quasirung fuzzy set (3,4-QFS) is a new type of fuzzy set theory emerged as an extension of the Pythagorean fuzzy sets and Fermatean fuzzy sets. In this approach, the sum of the cube of the degree of membership and the fourth power of the degree of non-membership must be less than or equal to 1. Since this new approach has a wider space, it can express uncertain information in a more flexible and exhaustive way. This makes this type of fuzzy set applicable in addressing many problems in multi-criteria decision making (MCDM). In this study, an occupational risk assessment approach based on 3,4-quasirung fuzzy MCDM is presented. Within the scope of the study, the hazards pertaining to the flight and ground training, training management, administrative and facilities in a flight school were assessed and prioritized. The results of existing studies were tested, and we considered both Pythagorean and Fermatean fuzzy aggregation operators. In addition, by an innovative sensitivity analysis, the effect of major changes in the weight of each risk parameter on the final priority score and ranking of the hazards was evaluated. The outcomes of this study are beneficial for OHS decision-makers by highlighting the most prioritized hazards causing serious occupational accidents in flights schools as part of aviation industry. The approach can also be suggested and adapted for production and service science environments where their occupational health & safety are highly required.

UPDATING WORKPLACE FIRST AID KITS

To the Revised ANSI/ISEA Z308.1 Standard While the number of workplace nonfatal injuries reported by private industry employers ticked down in 2020 to 2.1 million from 2.7 million in 2019, according to the statistics released by the U.S. Bureau of Labor Statistics (BLS) in November 2021, accidents can happen at any time in any type of work environment. Revised Standard ANSI/ISEA Z308.1-2021 was developed by the International Safety Equipment Association (ISEA) First Aid Product Group and approved by key stakeholders representing construction groups, technology corporations, testing laboratories, utility companies and others. Included in the updated standard is a more robust discussion to assist the employer in assessing risks, identifying potential hazards and selecting additional first-aid supplies relevant to a particular application or work environment, including mobile workstations or field offices.

The COVID-19 Pandemic, a Risk Management Approach

The coronavirus disease-2019 pandemic, one of many global threats to human health, provides an opportunity to analyze how to detect, minimize, and even prevent the spread of future viral zoonotic agents with pandemic potential. Such analysis can utilize existing risk assessment techniques that seek formally to define the hazard, assess the health risk, characterize the health threat, and estimate the probability of occurrence. © 2021 by Turkish Neurological Society.

The Application of Hospital Safety Index for Analyzing Primary Healthcare Center (PHC) Disaster and Emergency Preparedness

The World Health Organization (WHO) defines the primary healthcare center (PHC) as a whole-of-society approach to health that aims at ensuring the highest possible level of health and well-being and their equitable distribution by focusing on people’s needs as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation, and palliative care, and as close as feasibly possible to people’s everyday environment. PHCs are expected to remain operational when disasters occur. This study aimed to assess the PHC disaster preparedness level in Indonesia using The Hospital Safety Index (HSI) from WHO/PAHO. Eleven PHCs located in four provinces in Indonesia, i.e., Jakarta, Yogyakarta, North Sumatera, and West Java, were selected. Data were collected through interviews, focus-group discussions (FGDs), observations, and document reviews. The parameters assessed were all types of hazards, structural or construction safety, nonstructural safety, and functional attributes. The results show that the overall score of HSI for PHCs in Jakarta (0.674) and North Sumatera (0.752) fell into the “A” category, meaning that these PHCs would likely remain operational in the case of disasters. Meanwhile, the overall HSI scores for PHCs in West Java (0.601) and Yogyakarta (0.602) were between 0.36 and 0.65, or in “B” category, meaning that these PHCs would be able to recover during disasters but several services would be exposed to danger. The results suggested that there are several gaps that need urgent interventions to be applied for the structural safety of buildings, water supply systems, fuel storage, disaster committee organization, furniture and fittings, offices and storage equipment, as well as increasing the capacity of workers through a structured and systematic training framework for disaster readiness. The results from this study can be used for prioritizing budgets and resource allocation, cost planning, providing specific solutions for local and national government, and efforts to achieve disaster risk reduction.