Knowledge, attitudes and practices regarding respirable silica exposure and personal protective equipment use among brick kiln workers in Nepal.

OBJECTIVES: Brick kiln workers in Nepal are a neglected population who are exposed to high respirable silica concentrations, and few use interventions to reduce exposure. We aimed to characterise the prevalence of respiratory personal protective equipment (PPE) use, understand knowledge and attitudes towards kiln dust and respiratory PPE and identify factors associated with respiratory PPE use. METHODS: We conducted a cross-sectional study in Bhaktapur, Nepal. We used simple random selection to identify 10 out of 64 total kilns and stratified random sampling of 30 households to enrol workers aged ≥14 years within selected kilns. Field workers surveyed participants using structured questionnaires. Our primary outcome was to characterise the prevalence of current respiratory PPE use and secondary outcomes were summaries of knowledge, attitudes and practice of PPE use. RESULTS: We surveyed 83 workers (mean age 30.8 years, 77.1% male). Of these, 28.9% reported current respiratory PPE use at work, 3.6% heard of silicosis prior to the survey and 24.1% correctly identified the best respiratory PPE (N95, compared with surgical masks and barrier face coverings) for reducing dust exposure. Respiratory PPE users had higher income (mean monthly household income US$206 vs US$145; p=0.04) and education levels (25% vs 5.1% completed more than primary school; p=0.02) compared with non-users. CONCLUSIONS: Respiratory PPE use was low. Workers had poor knowledge of kiln dust health effects and proper respiratory PPE. We highlight important barriers to PPE use, particularly knowledge gaps, which can guide future investigations to reduce the silicosis burden among brick kiln workers.

Brick kiln pollution and its impact on health: A systematic review and meta-analysis.

Brick kiln emissions adversely affect air pollution and the health of workers and individuals living near the kilns; however, evidence of their impacts remains limited. We conducted a systematic review of brick kiln pollution (emissions, source contributions and personal exposures) and its effects on health. We extracted articles from electronic databases and through manual citation searching. We estimated pooled, sample-size-weighted means and standard deviations for personal exposures by job type; computed mean emission factors and pollutant concentrations by brick kiln design; and meta-analyzed differences in means or proportions for health outcomes between brick kiln workers and controls or for participants living near or far away from kilns. We identified 104 studies; 74 were conducted in South Asia. The most evaluated pollutants were particulate matter (PM; n = 48), sulfur dioxide (SO2; n = 24) and carbon monoxide (CO; n = 22), and the most evaluated health outcomes were respiratory health (n = 34) and musculoskeletal disorders (n = 9). PM and CO emissions were higher among traditional than improved brick kilns. Mean respirable silica exposures were only measured in 4 (4%) studies and were as high as 620 µg/m3, exceeding the NIOSH recommended exposure limit by a factor of over 12. Brick kiln workers had consistently worse lung function, more respiratory symptoms, more musculoskeletal complaints, and more inflammation when compared to unexposed participants across studies; however, most studies had a small sample size and did not fully describe methods used for sampling or data collection. On average, brick kiln workers had worse health outcomes when compared to unexposed controls but study quality supporting the evidence was low. Few studies reported silica concentrations or personal exposures, but the few that did suggest that exposures are high. Further research is needed to better understand the relationship between brick kiln pollution and health among workers, and to evaluate exposure mitigation strategies.

Application and demonstration of meso-activity exposure factors to advance estimates of incidental soil ingestion among agricultural workers.

BACKGROUND: Soil is an understudied and underregulated pathway of chemical exposure, particularly for agricultural workers who cultivate food in soils. Little is known about how agricultural workers spend their time and how they may contact soil while growing food. Exposure factors are behavioral and environmental variables used in exposure estimation. OBJECTIVES: Our study aimed to derive exposure factors describing how growers engage in different tasks and use those factors to advance the use of time-activity data to estimate soil ingestion exposures among agricultural workers. METHODS: We administered a meso-activity-based, season-specific soil contact activity questionnaire to 38 fruit and vegetable growers. We asked growers to estimate the frequency and duration of six meso-activities and describe how they completed them. We used questionnaire data to derive exposure factors and estimate empirical and simulated exposures to a hypothetical contaminant in soil via incidental ingestion using daily, hourly, and hourly-task-specific ingestion rates. RESULTS: We generated exposure factors characterizing the frequency and duration of six meso-activities by season, and self-reported soil contact, glove use, and handwashing practices by meso-activity and season. Seasonal average daily doses (ADDs) were similar across all three forms of ingestion rates. No consistent patterns regarding task-specific contributions to seasonal or annual ADDs were observed.

Subchronic exposure to ambient PM 2.5 impairs novelty recognition and spatial memory.

Air pollution remains a great challenge for public health, with the detrimental effects of air pollution on cardiovascular, rhinosinusitis, and pulmonary health increasingly well understood. Recent epidemiological associations point to the adverse effects of air pollution on cognitive decline and neurodegenerative diseases. Mouse models of subchronic exposure to PM 2.5 (ambient air particulate matter < 2.5 µm) provide an opportunity to demonstrate the causality of target diseases. Here, we subchronically exposed mice to concentrated ambient PM 2.5 for 7 weeks (5 days/week; 8h/day) and assessed its effect on behavior using standard tests measuring cognition or anxiety-like behaviors. Average daily PM 2.5 concentration was 200 µg/m 3 in the PM 2.5 group and 10 µg/m 3 in the filtered air group. The novel object recognition (NOR) test was used to assess the effect of PM 2.5 exposure on recognition memory. The increase in exploration time for a novel object versus a familiarized object was lower for PM 2.5 -exposed mice (42% increase) compared to the filtered air (FA) control group (110% increase). In addition, the calculated discrimination index for novel object recognition was significantly higher in FA mice (67 %) compared to PM 2.5 exposed mice (57.3%). The object location test (OLT) was used to examine the effect of PM 2.5 exposure on spatial memory. In contrast to the FA-exposed control mice, the PM 2.5 exposed mice exhibited no significant increase in their exploration time between novel location versus familiarized location indicating their deficit in spatial memory. Furthermore, the discrimination index for novel location was significantly higher in FA mice (62.6%) compared to PM 2.5 exposed mice (51%). Overall, our results demonstrate that subchronic exposure to higher levels of PM 2.5 in mice causes impairment of novelty recognition and spatial memory.

Reliability of low mass toenail samples as biomarkers of chronic metal exposure.

BACKGROUND: Toenails are a promising matrix for chronic metal exposure assessment, but there are currently no standard methods for collection and analysis. Questions remain about sample mass requirements and the extent to which metals measured in this matrix are representative of chronic body burden. OBJECTIVE: This study proposes a method to maximize sample conservation for toenail metals analysis using inductively coupled plasma mass spectrometry (ICP-MS). We demonstrate the reliability of an ~25 mg toenail sample (typically 1-2 clippings) for metals analysis and evaluate the intra-individual variability of multiple metals in this matrix over time in men from the Gulf Long-term Follow-up (GuLF) Study. METHODS: Toenail samples from 123 GuLF Study participants were collected at two visits 3 years apart and analyzed for 18 elements using ICP-MS. Participants with samples exceeding 200 mg at the first visit (n = 29) were selected for triplicate sub-sample analysis. Kendall's coefficient of concordance (W) was used to assess sub-sample reliability and Spearman's correlation coefficients (ρ) were used to evaluate fluctuations in elemental concentrations over time. RESULTS: Results were not reported for Cd, Co, Mo, Sb, and V (detected in <60% of the samples). There was strong agreement among triplicate samples (Kendall's W: 0.72 (Cu)-0.90 (Cu)) across all elements evaluated, moderate correlations of elemental concentrations (Spearman's ρ: 0.21-0.42) over 3 years for As, Ca, Cr, Fe, Pb, Mn, and Zn, and strong correlations (>0.50) for Se, Cu, and Hg. IMPACT STATEMENT: This toenail reliability study found that a low-mass (~25 mg) toenail sample (1-2 clippings) is suitable for the determination of most elements using ICP-MS and helps to increase the analytical capacity of limited toenail biospecimens collected in cohort studies. The results highlight differences in the suitability of toenails for chronic metal exposure assessment by element and underscore the need to consider intra-person variability, especially when comparing results across studies. We also provide recommendations for analytical standardization and the partitioning of the total collected toenail sample into multiple analytic sub-samples for future studies using toenail biospecimen for multiple assays.

Volatile Hydrocarbon Exposures and Incident Coronary Heart Disease Events: Up to Ten Years of Follow-up among Deepwater Horizon Oil Spill Workers.

BACKGROUND: During the 2010 Deepwater Horizon (DWH) disaster, response and cleanup workers were potentially exposed to toxic volatile components of crude oil. However, to our knowledge, no study has examined exposure to individual oil spill-related chemicals in relation to cardiovascular outcomes among oil spill workers. OBJECTIVES: Our aim was to investigate the association of several spill-related chemicals [benzene, toluene, ethylbenzene, xylene, n-hexane (BTEX-H)] and total hydrocarbons (THC) with incident coronary heart disease (CHD) events among workers enrolled in a prospective cohort. METHODS: Cumulative exposures to THC and BTEX-H across the cleanup period were estimated via a job-exposure matrix that linked air measurement data with self-reported DWH spill work histories. We ascertained CHD events following each worker's last day of cleanup work as the first self-reported physician-diagnosed myocardial infarction (MI) or a fatal CHD event. We estimated hazard ratios (HR) and 95% confidence intervals for the associations of exposure quintiles (Q) with risk of CHD. We applied inverse probability weights to account for bias due to confounding and loss to follow-up. We used quantile g-computation to assess the joint effect of the BTEX-H mixture. RESULTS: Among 22,655 workers with no previous MI diagnoses, 509 experienced an incident CHD event through December 2019. Workers in higher quintiles of each exposure agent had increased CHD risks in comparison with the referent group (Q1) of that agent, with the strongest associations observed in Q5 (range of HR=1.14-1.44). However, most associations were nonsignificant, and there was no evidence of exposure-response trends. We observed stronger associations among ever smokers, workers with ≤high school education, and workers with body mass index <30 kg/m2. No apparent positive association was observed for the BTEX-H mixture. CONCLUSIONS: Higher exposures to volatile components of crude oil were associated with modest increases in risk of CHD among oil spill workers, although we did not observe exposure-response trends. https://doi.org/10.1289/EHP11859.

Exposure to volatile hydrocarbons and neurologic function among oil spill workers up to 6 years after the Deepwater Horizon disaster.

BACKGROUND: During the 2010 Deepwater Horizon (DWH) disaster, oil spill response and cleanup (OSRC) workers were exposed to toxic volatile components of crude oil. Few studies have examined exposure to individual volatile hydrocarbon chemicals below occupational exposure limits in relation to neurologic function among OSRC workers. OBJECTIVES: To investigate the association of several spill-related chemicals (benzene, toluene, ethylbenzene, xylene, n-hexane, i.e., BTEX-H) and total petroleum hydrocarbons (THC) with neurologic function among DWH spill workers enrolled in the Gulf Long-term Follow-up Study. METHODS: Cumulative exposure to THC and BTEX-H across the oil spill cleanup period were estimated using a job-exposure matrix that linked air measurement data to detailed self-reported DWH OSRC work histories. We ascertained quantitative neurologic function data via a comprehensive test battery at a clinical examination that occurred 4-6 years after the DWH disaster. We used multivariable linear regression and modified Poisson regression to evaluate relationships of exposures (quartiles (Q)) with 4 neurologic function measures. We examined modification of the associations by age at enrollment (<50 vs. ≥50 years). RESULTS: We did not find evidence of adverse neurologic effects from crude oil exposures among the overall study population. However, among workers ≥50 years of age, several individual chemical exposures were associated with poorer vibrotactile acuity of the great toe, with statistically significant effects observed in Q3 or Q4 of exposures (range of log mean difference in Q4 across exposures: 0.13-0.26 µm). We also observed suggestive adverse associations among those ≥ age 50 years for tests of postural stability and single-leg stance, although most effect estimates did not reach thresholds of statistical significance (p < 0.05). CONCLUSIONS: Higher exposures to volatile components of crude oil were associated with modest deficits in neurologic function among OSRC workers who were age 50 years or older at study enrollment.

Efficacy of Grignard Pure to Inactivate Airborne Phage MS2, a Common SARS-CoV-2 Surrogate.

Grignard Pure (GP) is a unique and proprietary blend of triethylene glycol (TEG) and inert ingredients designed for continuous antimicrobial treatment of air. TEG has been designated as a ″Safer Chemical" by the US EPA. GP has already received approval from the US EPA under its Section 18 Public Health Emergency Exemption program for use in seven states. This study characterizes the efficacy of GP for inactivating MS2 bacteriophage─a nonenveloped virus widely used as a surrogate for SARS-CoV-2. Experiments measured the decrease in airborne viable MS2 concentration in the presence of different concentrations of GP from 60 to 90 min, accounting for both natural die-off and settling of MS2. Experiments were conducted both by introducing GP aerosol into air containing MS2 and by introducing airborne MS2 into air containing GP aerosol. GP is consistently able to rapidly reduce viable MS2 bacteriophage concentration by 2-3 logs at GP concentrations of 0.04-0.5 mg/m3 (corresponding to TEG concentrations of 0.025 to 0.287 mg/m3). Related GP efficacy experiments by the US EPA, as well as GP (TEG) safety and toxicology, are also discussed.

Accuracy of professional judgments for dermal exposure assessment using deterministic models.

The accuracy of exposure judgments, particularly for scenarios where only qualitative information is available or a systematic approach is not used, has been evaluated and shown to have a relatively low level of accuracy. This is particularly true for dermal exposures, where less information is generally available compared to inhalation exposures. Relatively few quantitative validation efforts have been performed for scenarios where dermal exposures are of interest. In this study, a series of dermal exposure judgments were collected from 90 volunteer U.S. occupational health practitioners in a workshop format to assess the accuracy of their judgments for three specific scenarios. Accuracy was defined as the ability of the participants to identify the correct reference exposure category, as defined by the quantitative exposure banding categories utilized by the American Industrial Hygiene Association (AIHA®). The participants received progressively additional information and training regarding dermal exposure assessments and scenario-specific information during the workshop, and the relative accuracy of their category judgments over time was compared. The results of the study indicated that despite substantial education and training in exposure assessment generally, the practitioners had very little experience in performing dermal exposure assessments and a low level of comfort in performing these assessments. Further, contrary to studies of practitioners performing inhalation exposure assessments demonstrating a trend toward underestimating exposures, participants in this study consistently overestimated the potential for dermal exposure without quantitative data specific to the scenario of interest. Finally, it was found that participants were able to identify the reference or "true" category of dermal exposure acceptability when provided with relevant, scenario-specific dermal and/or surface-loading data for use in the assessment process. These results support the need for additional training and education of practitioners in performing dermal exposure assessments. A closer analysis of default loading values used in dermal exposure assessments to evaluate their accuracy relative to real-world or measured dermal loading values, along with consistent improvements in current dermal models, is also needed.

A qualitative characterization of meso-activity factors to estimate soil exposure for agricultural workers.

BACKGROUND: Agricultural workers' exposure to soil contaminants is not well characterized. Activity pattern data are a useful exposure assessment tool to estimate extent of soil contact, though existing data do not sufficiently capture the range and magnitude of soil contact in the agricultural context. OBJECTIVE: We introduce meso-activity, or specific tasks, to improve traditional activity pattern methodology. We propose a conceptual framework to organize the factors that may modify soil exposure and impact soil contact estimates within each meso-activity in agriculture. We build upon models from the US EPA to demonstrate an application of this framework to dose estimation. METHODS: We conducted in-depth interviews with sixteen fruit and vegetable growers in Maryland to characterize factors that influence soil exposure in agriculture. For illustrative purposes, we demonstrate the application of the framework to translate our qualitative data into quantitative estimates of soil contact using US EPA models for ingestion and dermal exposure. RESULTS: Growers discussed six tasks, or meso-activities, involving interaction with soil and described ten factors that may impact the frequency, duration and intensity of soil contact. We organized these factors into four categories (i.e., Environmental, Activity, Timing and Receptor; EAT-R) and developed a framework to improve agricultural exposure estimation and guide future research. Using information from the interviews, we estimated average daily doses for several agricultural exposure scenarios. We demonstrated how the integration of EAT-R qualitative factors into quantitative tools for exposure assessment produce more rigorous estimates of exposure that better capture the true variability in agricultural work. SIGNIFICANCE: Our study demonstrates how a meso-activity-centered framework can be used to refine estimates of exposure for agricultural workers. This framework will support the improvement of indirect exposure assessment tools (e.g., surveys and questionnaires) and inform more comprehensive and appropriate direct observation approaches to derive quantitative estimations of soil exposure. IMPACT STATEMENT: We propose a novel classification of activity pattern data that links macro and micro-activities through the quantification and characterization of meso-activities and demonstrate how the application of our qualitative framework improves soil exposure estimation for agricultural workers. These methodological advances may inform a more rigorous approach to the evaluation of pesticide and other chemical and biological exposures incurred by persons engaged in the cultivation of agricultural commodities in soil.

Experimental studies of particle removal and probability of COVID-19 infection in passenger railcars.

A series of experiments in stationary and moving passenger railcars was conducted to measure the removal rates of particles in the size ranges of SARS-CoV-2 viral aerosols, and the air changes per hour provided by the existing and modified air handling systems. The effect of ventilation and air filtration systems on removal rates and their effects on estimated probability (i.e., risk) of infection was evaluated in a range of representative conditions: (1) for two different ratios of recirculated air (RA) to outdoor air (OA) (90:10 RA:OA and 67:33 RA:OA); (2) using minimum efficiency reporting value (MERV) filters with standard (MERV-8) and increased (MERV-13) filtration ratings; and (3) in the presence and absence of a portable high-efficiency particulate-air (HEPA) room air purifier system operated at clean air delivery rate (CADR) of 150 and 550 cfm. The higher-efficiency MERV-13 filters significantly increased particle removal rates on average by 3.8 to 8.4 hr-1 across particle sizes ranging from 0.3 to 10 µm (p < 0.01) compared to MERV-8 filters. The different RA:OA ratios and the use of a portable HEPA air purifier system had little effect on particle removal rates. MERV-13 filters reduced the estimated probability of infection by 42% compared to the MERV-8 filter. The use of a HEPA-air purifier with a MERV-13 filter causes a 50% reduction in the estimated probability of infection. Upgrading the efficiency of HVAC filters from MERV-8 to MERV-13 in public transit vehicles is the most effective exposure control method resulting in a clear reduction in the removal rates of aerosol particles and the estimated probability of infection.

Associations between airborne crude oil chemicals and symptom-based asthma.

RATIONALE: The 2010 Deepwater Horizon (DWH) oil spill response and cleanup (OSRC) workers were exposed to airborne total hydrocarbons (THC), benzene, toluene, ethylbenzene, o-, m-, and p-xylenes and n-hexane (BTEX-H) from crude oil and PM2.5 from burning/flaring oil and natural gas. Little is known about asthma risk among oil spill cleanup workers. OBJECTIVES: We assessed the relationship between asthma and several oil spill-related exposures including job classes, THC, individual BTEX-H chemicals, the BTEX-H mixture, and PM2.5 using data from the Gulf Long-Term Follow-up (GuLF) Study, a prospective cohort of 24,937 cleanup workers and 7,671 nonworkers following the DWH disaster. METHODS: Our analysis largely focused on the 19,018 workers without asthma before the spill who had complete exposure, outcome, and covariate information. We defined incident asthma 1-3 years following exposure using both self-reported wheeze and self-reported physician diagnosis of asthma. THC and BTEX-H were assigned to participants based on measurement data and work histories, while PM2.5 used modeled estimates. We used modified Poisson regression to estimate risk ratios (RR) and 95% confidence intervals (CIs) for associations between spill-related exposures and asthma and a quantile-based g-computation approach to explore the joint effect of the BTEX-H mixture on asthma risk. RESULTS: OSRC workers had greater asthma risk than nonworkers (RR: 1.60, 95% CI: 1.38, 1.85). Higher estimated THC exposure levels were associated with increased risk in an exposure-dependent manner (linear trend test p < 0.0001). Asthma risk also increased with increasing exposure to individual BTEX-H chemicals and the chemical mixture: A simultaneous quartile increase in the BTEX-H mixture was associated with an increased asthma risk of 1.45 (95% CI: 1.35,1.55). With fewer cases, associations were less apparent for physician-diagnosed asthma alone. CONCLUSIONS: THC and BTEX-H were associated with increased asthma risk defined using wheeze symptoms as well as a physician diagnosis.

Potential Influence of Skin Hydration and Transepidermal Water Loss on the Dermal Transfer and Loading of Elemental Metallic Lead.

The factors influencing transfer of chemicals or other contaminants to and from the surface of the skin are often poorly understood. Previous research has indicated that environmental conditions, skin hydration, and repeated contacts may all influence the quantity of dermal transfer. The aim of this analysis was to evaluate the influence of skin hydration and condition on quantitative chemical transfer in a series of systematic measurements using human subjects for 5 and 10 repeated contacts. Elemental metallic lead was used as the exemplar test substance for the measurements collected. Skin hydration index (HI) was assessed using a corneometer and skin condition and barrier function were measured using an open-chamber transepidermal water loss (TEWL) instrument. Results indicated that for the palmar surface of the index finger where sampling was conducted, the relative hydration level of the skin was higher for males (n = 6) versus females (n = 4) (mean HI = 4.0 for females; mean HI = 5.5 for males) but this difference was not statistically significant. Overall, the skin hydration level was not significantly associated with dermal loading for either the 5 contact scenario (Pearson correlation = 0.27; R2 = 0.07; P = 0.45) or the 10 contact scenario (Pearson correlation = 0.26; R2 = 0.07; P = 0.47). When the results were stratified by higher versus lower hydration levels (HI = 1-5 versus HI = 5-10), for the higher hydration levels (HI = 5-10; mean HI = 7), there was a moderately positive association between skin hydration and loading, but this was not statistically significant for either the 5 contact scenario (Pearson correlation = 0.75; R2 = 0.56; P = 0.15) or the 10 contact scenario (Pearson correlation = 0.6; R2 = 0.36; P = 0.28). No clear relationship was observed between the lower hydration levels (HI = 1-5) and dermal loading. For the palmar index finger, there was a negative correlation between the TEWL measurements and both the 5 contact (Pearson correlation = -0.45; R2 = 0.2; P = 0.19) and 10 contact (Pearson correlation = -0.3; R2 = 0.09; P = 0.4) scenarios, but this was not statistically significant. The results of this study are consistent with the limited results of other analyses, which have suggested that there may be nuances with respect to the effects of skin hydration on the quantitative dermal transfer to and from the skin, although additional data are needed to better understand these potential differences.

Exposure Group Development in Support of the NIEHS GuLF Study.

In the GuLF Study, a study investigating possible adverse health effects associated with work on the oil spill response and clean-up (OSRC) following the Deepwater Horizon disaster in the Gulf of Mexico, we used a job-exposure matrix (JEM) approach to estimate exposures. The JEM linked interview responses of study participants to measurement data through exposure groups (EGs). Here we describe a systematic process used to develop transparent and precise EGs that allowed characterization of exposure levels among the large number of OSRC activities performed across the Gulf of Mexico over time and space. EGs were identified by exposure determinants available to us in our measurement database, from a substantial body of other spill-related information, and from responses provided by study participants in a detailed interview. These determinants included: job/activity/task, vessel and type of vessel, weathering of the released oil, area of the Gulf of Mexico, Gulf coast state, and time period. Over 3000 EGs were developed for inhalation exposure and applied to each of 6 JEMs of oil-related substances (total hydrocarbons, benzene, toluene, ethylbenzene, total xylene, and n-hexane). Subsets of those EGs were used for characterization of exposures to dispersants, particulate matter, and oil mist. The EGs allowed assignment to study participants of exposure estimates developed from measurement data or from estimation models through linkage in the JEM for the investigation of exposure-response relationships.

Estimation of Aerosol Concentrations of Oil Dispersants COREXIT™ EC9527A and EC9500A during the Deepwater Horizon Oil Spill Response and Clean-up Operations.

The April 2010 Deepwater Horizon drilling unit explosion at the Macondo oil well resulted in the release of approximately 779 million l of oil into the Gulf of Mexico. As part of the response effort to break up oil slicks on the water's surface, 6.81 million l of chemical dispersants COREXIT™ EC9500A and COREXIT™ EC9527A were applied by plane or vessel or injected near the seabed. The GuLF Long-term Follow-up Study is investigating possible adverse health effects of workers involved in the oil spill response and clean-up (OSRC). In this paper, we describe potential dispersant-related air concentrations generated from aerial spraying of dispersants to provide insight as to what concentrations OSRC workers may have been exposed under worst-case conditions. Personal exposure measurement data were not collected. Modeling, therefore, was conducted to estimate airborne concentrations of total aerosol to COREXIT™ EC9527A and EC9500A. Using the AgDISP model, we estimated air concentrations to dispersant total aerosols, defined as all components of the dispersant including active ingredients, surfactants, and water, resulting from aerial and vessel applications, as average 1-h and 2-min concentrations. For comparison, 1-h air concentrations associated with aerial spraying were estimated using another model, AERMOD. At 152 m horizontal to the flight path, average 1-h total aerosol concentrations associated with aerial applications were estimated to be as high as 49.3 µg m-3 (9527A) and 45.4 µg m-3 (9500A), and both decreased with increased distance from the flight line. The estimates for spraying 9500A from vessels indicated that total aerosol concentrations were potentially as high as 0.33 µg m-3 at 10 m from the nozzles. These results suggest that personal exposures to dispersant aerosols were negligible.

Assessing Exposures from the Deepwater Horizon Oil Spill Response and Clean-up.

The GuLF Study is investigating adverse health effects from work on the response and clean-up after the Deepwater Horizon explosion and oil release. An essential and necessary component of that study was the exposure assessment. Bayesian statistical methods and over 135 000 measurements of total hydrocarbons (THC), benzene, ethylbenzene, toluene, xylene, and n-hexane (BTEX-H) were used to estimate inhalation exposures to these chemicals for >3400 exposure groups (EGs) formed from three exposure determinants: job/activity/task, location, and time period. Recognized deterministic models were used to estimate airborne exposures to particulate matter sized 2.5 µm or less (PM2.5) and dispersant aerosols and vapors. Dermal exposures were estimated for these same oil-related substances using a model modified especially for this study from a previously published model. Exposures to oil mist were assessed using professional judgment. Estimated daily THC arithmetic means (AMs) were in the low ppm range (<25 ppm), whereas BTEX-H exposures estimates were generally <1000 ppb. Potential 1-h PM2.5 air concentrations experienced by some workers may have been as high as 550 µg m-3. Dispersant aerosol air concentrations were very low (maximum predicted 1-h concentrations were generally <50 µg m-3), but vapor concentrations may have exceeded occupational exposure excursion guidelines for 2-butoxyethanol under certain circumstances. The daily AMs of dermal exposure estimates showed large contrasts among the study participants. The estimates are being used to evaluate exposure-response relationships in the GuLF Study.

Assessing variability of aerosols generated from e-Cigarettes.

While some in vitro and in vivo experiments have studied the toxic effects of e-cigarette (e-cig) components, the typical aerosol properties released from e-cigarettes have not been well characterized. In the present study, we characterized the variability in mass concentration and particle size distribution associated with the aerosol generation of different devices and e-liquid compositions in an experimental setup. The findings of this study indicate a large inter-day variability in the experiments, likely due to poor quality control in some e-cig devices, pointing to the need for a better understanding of all the factors affecting exposures in in vitro and in vivo experiments, and the development of standardized protocols for generation and measurement of e-cig aerosols.

Association of Deepwater Horizon Oil Spill Response and Cleanup Work With Risk of Developing Hypertension.

Importance: Exposure to hydrocarbons, fine particulate matter (PM2.5), and other chemicals from the April 20, 2010, Deepwater Horizon disaster may be associated with increased blood pressure and newly detected hypertension among oil spill response and cleanup workers. Objective: To determine whether participation in cleanup activities following the disaster was associated with increased risk of developing hypertension. Design, Setting, and Participants: This cohort study was conducted via telephone interviews and in-person home exams. Participants were 6846 adults who had worked on the oil spill cleanup (workers) and 1505 others who had completed required safety training but did not do cleanup work (nonworkers). Eligible participants did not have diagnosed hypertension at the time of the oil spill. Statistical analyses were performed from June 2018 to December 2021. Exposures: Engagement in cleanup activities following the Deepwater Horizon oil spill disaster, job classes, quintiles of cumulative total hydrocarbons exposure level, potential exposure to burning or flaring oil, and estimated PM2.5 were examined. Main Outcomes and Measures: Systolic and diastolic blood pressure measurements were collected during home exams from 2011 to 2013 using automated oscillometric monitors. Newly detected hypertension was defined as antihypertensive medication use or elevated blood pressure since the spill. Log binomial regression was used to calculate prevalence ratios (PR) and 95% CIs for associations between cleanup exposures and hypertension. Multivariable linear regression was used to estimate exposure effects on continuous blood pressure levels. Results: Of 8351 participants included in this study, 6484 (77.6%) were male, 517 (6.2%) were Hispanic, 2859 (34.2%) were non-Hispanic Black, and 4418 (52.9%) were non-Hispanic White; the mean (SD) age was 41.9 (12.5) years at enrollment. Among workers, the prevalence of newly detected hypertension was elevated in all quintiles (Q) of cumulative total hydrocarbons above the first quintile (PR for Q3, 1.29 [95% CI, 1.13-1.46], PR for Q4, 1.25 [95% CI, 1.10-1.43], and PR for Q5, 1.31 [95% CI, 1.15-1.50]). Both exposure to burning and/or flaring oil and gas (PR, 1.16 [95% CI, 1.02-1.33]) and PM2.5 from burning (PR, 1.26 [95% CI, 0.89-1.71]) for the highest exposure category were associated with increased risk of newly detected hypertension, as were several types of oil spill work including cleanup on water (PR, 1.34 [95% CI, 1.08-1.66]) and response work (PR, 1.51 [95% CI, 1.20-1.90]). Conclusions and Relevance: Oil spill exposures were associated with newly detected hypertension after the Deepwater Horizon disaster. These findings suggest that blood pressure screening should be considered for workers with occupational hydrocarbon exposures.

Application of Markov models to predict changes in nasal carriage of Staphylococcus aureus among industrial hog operations workers.

Industrial hog operation (IHO) workers can be occupationally exposed to Staphylococcus aureus and may carry the bacteria in their nares. Workers may persistently carry S. aureus or transition between different states of nasal carriage over time: no nasal carriage, nasal carriage of a human-associated strain, and nasal carriage of a livestock-associated strain. We developed a mathematical model to predict the proportion of IHO workers in each nasal carriage state over time, accounting for IHO worker mask use. We also examined data sufficiency requirements to inform development of models that produce reliable predictions. We used nasal carriage data from a cohort of 101 IHO workers in North Carolina, sampled every 2 weeks for 4 months, to develop a three-state Markov model that describes the transition dynamics of IHO worker nasal carriage status over the study period and at steady state. We also stratified models by mask use to examine their impact on worker transition dynamics. If conditions remain the same, our models predicted that 49.1% of workers will have no nasal carriage of S. aureus, 28.2% will carry livestock-associated S. aureus, and 22.7% will carry human-associated S. aureus at steady state. In stratified models, at steady state, workers who reported only occasional mask (<80% of the time) use had a higher predicted proportion of individuals with livestock-associated S. aureus nasal carriage (39.2%) compared to workers who consistently (≥80% of the time) wore a mask (15.5%). We evaluated the amount of longitudinal data that is sufficient to create a Markov model that accurately predicts future nasal carriage states by creating multiple models that withheld portions of the collected data and compared the model predictions to observed data. Our data sufficiency analysis indicated that models created with a small subset of the dataset (approximately 1/3 of observed data) perform similarly to models created using all observed data points. Markov models may have utility in predicting worker health status over time, even when limited longitudinal data are available.