Since 1997, nine cases of severe pneumonia, caused by species within the B. cereus group and with a presentation similar to that of inhalation anthrax, were reported in seemingly immunocompetent metalworkers, with most being welders. In seven of the cases, isolates were found to harbor a plasmid similar to the B. anthracis pXO1 that encodes anthrax toxins. In this paper, we review the literature on the B. cereus group spp. pneumonia among welders and other metalworkers, which we term welder’s anthrax. We describe the epidemiology, including more information on two cases of welder’s anthrax in 2020. We also describe the health risks associated with welding, potential mechanisms of infection and pathological damage, prevention measures according to the hierarchy of controls, and clinical and public health considerations. Considering occupational risk factors and controlling exposure to welding fumes and gases among workers, according to the hierarchy of controls, should help prevent disease transmission in the workplace. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

Patient care and public health require timely, reliable laboratory testing. However, clinical laboratory professionals rarely know whether patient specimens contain infectious agents, making ensuring biosafety while performing testing procedures challenging. The importance of biosafety in clinical laboratories was highlighted during the 2014 Ebola outbreak, where concerns about biosafety resulted in delayed diagnoses and contributed to patient deaths. This review is a collaboration between subject matter experts from large and small laboratories and the federal government to evaluate the capability of clinical laboratories to manage biosafety risks and safely test patient specimens. We discuss the complexity of clinical laboratories, including anatomic pathology, and describe how applying current biosafety guidance may be difficult as these guidelines, largely based on practices in research laboratories, do not always correspond to the unique clinical laboratory environments and their specialized equipment and processes. We retrospectively describe the biosafety gaps and opportunities for improvement in the areas of risk assessment and management; automated and manual laboratory disciplines; specimen collection, processing, and storage; test utilization; equipment and instrumentation safety; disinfection practices; personal protective equipment; waste management; laboratory personnel training and competency assessment; accreditation processes; and ethical guidance. Also addressed are the unique biosafety challenges successfully handled by a Texas community hospital clinical laboratory that performed testing for patients with Ebola without a formal biocontainment unit. The gaps in knowledge and practices identified in previous and ongoing outbreaks demonstrate the need for collaborative, comprehensive solutions to improve clinical laboratory biosafety and to better combat future emerging infectious disease outbreaks.

The global Coronavirus Disease (COVID-19) pandemic caused by the SARS-CoV-2 virus has raised many urgent questions about the transmission of this disease, including the possible roles of aerosols containing SARS-CoV-2. This is particularly true in workplace settings where workers may encounter customers and coworkers who are infected with COVID-19 and where aerosols can be produced in a variety of ways. Research by the aerosol science community is needed to learn more about whether SARS-CoV-2 can spread by infectious aerosols and about the effectiveness of different protective measures. The purpose of this commentary is to present some of the questions surrounding aerosols containing SARS-CoV-2 and to provide suggestions for future research topics.

Legalization of medicinal and recreational cannabis use in numerous states within the USA has resulted in the increased commercial cultivation of cannabis. Outdoor cannabis farming operations present a variety of potential physical, chemical, and biological hazards that currently remain uncharacterized. Worker exposures to endotoxins were evaluated at an outdoor US cannabis farm during harvesting and processing activities. Endotoxin area air sample concentrations ranged from below the limit of detection to 15 endotoxin units per cubic meter (EU/m3). Endotoxin breathing zone measurements (2.8–37 EU/m3) were below the Dutch Expert Committee on Occupational Safety occupational exposure limit of 90 /m3. During confidential medical interviews, no adverse health effects were reported by workers while harvesting or processing cannabis. Further endotoxin exposure assessments should be performed especially in larger, indoor cannabis operations where a confined environment may result in higher endotoxin exposures than observed in this outdoor environment.

Cannabis cultivation is an emerging industry within the United States. Organic dust derived in part from naturally occurring microorganisms is known to cause byssinosis in the hemp industry. In this pilot study, bacteria and fungi encountered by workers at an outdoor cannabis farm that utilized organic practices were elucidated by 1625% shaded blockS ribosomal RNA (rRNA) and Internal Transcribed Spacer (ITS) region sequencing, respectively. Area (n = 14) and personal air samples (n = 12) were collected during harvesting and processing activities. 1625% shaded blockS rRNA and ITS regions of extracted bacterial and fungal genomic DNA were amplified and sequenced using Sanger sequencing. Bacterial sequencing resolved 1077 sequences that were clustered into 639 operational taxonomic units (OTUs) and predominantly placed in the phylum, Actinobacteria (46%). Personal air samples revealed higher bacterial and Actinobacteria diversity compared to outdoor area samples collected within the facility (p<0.05). A high degree of dissimilarity between bacteria was identified within and between samples. Fungal sequences (n = 985) were identified and predominantly clustered in the phylum Ascomycota (53%). Of the 216 fungal OTUs elucidated, the cannabis plant pathogenic species, Botrytis cinerea, was the most prevalent and accounted for 34% of all fungal sequences. The relative abundance of B. cinerea was highest in personal air samples (59%) compared to area samples collected in the drying room (19%), greenhouse (18%) and outdoor environment (6%). There was 49% sample similarity between fungi identified within personal air samples, but higher dissimilarity coefficients were observed within and between greenhouse, drying room, and outdoor area air samples. The results of this pilot study suggest that the cannabis farm workers are potentially exposed to Actinobacteria as well as the cannabis plant pathogen, B. cinerea during harvesting, bud stripping, and hand trimming processes.

In July 2015, a municipal health department in Ohio received complaints of respiratory and ocular symptoms from patrons of an indoor waterpark resort. In response, the health department conducted an online survey in August 2015 through which 19 (68%) patron and employee respondents reported eye burning, nose irritation, difficulty breathing, and vomiting. On August 11, 2015, the health department requested a health hazard evaluation by CDC's National Institute for Occupational Safety and Health to characterize the prevalence of symptoms among employees and determine the etiology of work-related symptoms. In January 2016, CDC investigators performed a cross-sectional epidemiologic study, environmental sampling, and ventilation system assessment (1). Findings suggested that chlorine disinfection byproducts and environmental conditions contributed to a higher prevalence of work-related respiratory and ocular symptoms among employees in the waterpark compared with employees in other resort areas. Recommendations included servicing the ventilation system, changing work practices to decrease the amount of disinfection byproduct precursors, and responding promptly to employee reports of symptoms.

An aircraft seat manufacturing company requested a NIOSH health hazard evaluation to help identify a strong odor that had persisted throughout the facility for over a year. Employees reported experiencing health effects thought to be related to the odor. We collected and analyzed area air samples for volatile organic compounds, endotoxin, bacterial and fungal metagenome, and metalworking fluid aerosol. Bulk metalworking fluid samples were analyzed for endotoxin, bacterial and fungal metagenome, and viable bacteria and fungus. We also evaluated the building ventilation systems and water diversion systems. Employees underwent confidential medical interviews about work practices, medical history, and health concerns. Based on our analyses, the odor was likely 2-methoxy-3,5-dimethylpyrazine. This pyrazine was found in air samples across the facility and originated from bacteria in the metalworking fluid. We did not identify bacteria known to produce the compound but bacteria from the same Proteobacteria order were found as well as bacteria from orders known to produce other pyrazines. Chemical and biological contaminants and odors could have contributed to health symptoms reported by employees, but it is likely that the symptoms were caused by several factors. We provided several recommendations to eliminate the odor including washing and disinfecting the metalworking machines and metalworking fluid recycling equipment, discarding all used metalworking fluid, instituting a metalworking fluid maintenance program at the site, and physically isolating the metalworking department from other departments.

BACKGROUND: The National Institute for Occupational Safety and Health (NIOSH) conducted a health hazard evaluation (HHE) of a water-damaged school in New Orleans (NO), Louisiana. Our aim in this evaluation was to document employee health effects related to exposure to the water-damaged school, and to determine if VCS testing could serve as a biomarker of effect for occupants who experienced adverse health effects in a water-damaged building. METHODS: NIOSH physicians and staff administered a work history and medical questionnaire, conducted visual contrast sensitivity (VCS) testing, and collected sticky-tape, air, and dust samples at the school. Counting, culturing, and/or a DNA-based technology, called mold-specific quantitative PCR (MSQPCR), were also used to quantify the molds. A similar health and environmental evaluation was performed at a comparable school in Cincinnati, Ohio which was not water-damaged. RESULTS: Extensive mold contamination was documented in the water-damaged school and employees (n = 95) had higher prevalences of work-related rashes and nasal, lower respiratory, and constitutional symptoms than those at the comparison school (n = 110). VCS values across all spatial frequencies were lower among employees at the water-damaged school. CONCLUSIONS: Employees exposed to an extensively water-damaged environment reported adverse health effects, including rashes and nasal, lower respiratory, and constitutional symptoms. VCS values were lower in the employees at the water-damaged school, but we do not recommend using it in evaluation of people exposed to mold. (Am. J. Ind. Med. Published 2012. This article is a U.S. Government work and is in the public domain in the USA.)

Humans are constantly exposed to fungi, or moulds, usually without suffering harm to health. However, in some instances inhalation of sufficient numbers of mould spores can trigger symptoms of asthma, rhinitis or bronchitis. Respiratory ill health associated with the built environment is often referred to either as Sick Building Syndrome [SBS] (i.e. building related symptoms) or building related illness. For many, the difference between SBS and building related illness is unclear and the two overlap. This review examines the differences between the two and describes in more detail the role of moulds in building related illness. Using as examples the after-effects of flooding in the UK in 2007, and Hurricane Katrina in USA in 2005, methods used to investigate exposure to indoor mould contamination are described, together with strategies for remediating mould contaminated buildings.