Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-16 (of 16 Records) |
Query Trace: Niemeier R[original query] |
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Rapid review of dermal penetration and absorption of inorganic lead compounds for occupational risk assessment
Niemeier RT , Maier A , Reichard JF . Ann Work Expo Health 2022 66 (3) 291-311 Lead (Pb) exposure continues to be a significant public health issue in both occupational and non-occupational settings. The vast majority of exposure and toxicological studies have focused on effects related to inhalation and gastrointestinal exposure routes. Exposure to inorganic Pb compounds through dermal absorption has been less well studied, perhaps due to the assumption that the dermal pathway is a minor contributor to aggregate exposures to Pb compounds. The aim of this rapid review was to identify and evaluate published literature on dermal exposures to support the estimation of key percutaneous absorption parameters (Kp, flux, diffusion rate) for use in occupational risk assessment. Eleven articles were identified containing information from both in vitro and in vivo systems relevant to percutaneous absorption kinetics. These articles provided 24 individual study summaries and information for seven inorganic Pb compounds. The vast majority of study summaries evaluated (n = 22, 92%) reported detectable amounts of dermal absorption of inorganic Pb. Data were identified for four Pb compounds (Pb acetate, Pb nitrate, Pb oxide, and Pb metal) that may be sufficient to use in evaluating physiologically based pharmacokinetic models. Average calculated diffusion rates for the pool of animal and human skin data ranged from 10-7 to 10-4 mg cm-2 h-1, and Kp values ranged from 10-7 to 10-5 cm h-1. Study design and documentation were highly variable, and only one of the studies identified was conducted using standard test guideline-compliant methodologies. Two studies provided quality estimates on the impacts of dermal absorption from water-insoluble Pb compounds on blood Pb levels. These two studies reported that exposures via dermal routes could elevate blood Pb by over 6 µg dl-1. This estimation could represent over 100% of 5 µg dl-1, the blood Pb associated with adverse health effects in adults. The utility of these estimates to occupational dermal exposures is limited, because the confidence in the estimates is not high. The literature, while of limited quality, overall strongly suggests inorganic Pb has the potential for dermal uptake in meaningful amounts associated with negative health outcomes based on upper bound diffusion rate estimates. Future standard test guideline-compliant studies are needed to provide high-confidence estimates of dermal uptake. Such data are needed to allow for improved evaluation of Pb exposures in an occupational risk assessment context. |
Occupational Histoplasmosis: Epidemiology and Prevention Measures
de Perio MA , Benedict K , Williams SL , Niemeier-Walsh C , Green BJ , Coffey C , Di Giuseppe M , Toda M , Park JH , Bailey RL , Nett RJ . J Fungi (Basel) 2021 7 (7) In areas where Histoplasma is endemic in the environment, occupations involving activities exposing workers to soil that contains bird or bat droppings may pose a risk for histoplasmosis. Occupational exposures are frequently implicated in histoplasmosis outbreaks. In this paper, we review the literature on occupationally acquired histoplasmosis. We describe the epidemiology, occupational risk factors, and prevention measures according to the hierarchy of controls. |
Cumulative Risks from Stressor Exposures and Personal Risk Factors in the Workplace: Examples from a Scoping Review.
Fox MA , Niemeier RT , Hudson N , Siegel MR , Dotson GS . Int J Environ Res Public Health 2021 18 (11) Protecting worker and public health involves an understanding of multiple determinants, including exposures to biological, chemical, or physical agents or stressors in combination with other determinants including type of employment, health status, and individual behaviors. This has been illustrated during the COVID-19 pandemic by increased exposure and health risks for essential workers and those with pre-existing conditions, and mask-wearing behavior. Health risk assessment practices for environmental and occupational health typically do not incorporate multiple stressors in combination with personal risk factors. While conceptual developments in cumulative risk assessment to inform a more holistic approach to these real-life conditions have progressed, gaps remain, and practical methods and applications are rare. This scoping review characterizes existing evidence of combined stressor exposures and personal factors and risk to foster methods for occupational cumulative risk assessment. The review found examples from many workplaces, such as manufacturing, offices, and health care; exposures to chemical, physical, and psychosocial stressors combined with modifiable and unmodifiable determinants of health; and outcomes including respiratory function and disease, cancers, cardio-metabolic diseases, and hearing loss, as well as increased fertility, menstrual dysfunction and worsened mental health. To protect workers, workplace exposures and modifiable and unmodifiable characteristics should be considered in risk assessment and management. Data on combination exposures can improve assessments and risk estimates and inform protective exposure limits and management strategies. |
A cumulative risk perspective for occupational health and safety (OHS) professionals
Niemeier RT , Williams PRD , Rossner A , Clougherty JE , Rice GE . Int J Environ Res Public Health 2020 17 (17) Cumulative risk assessment (CRA) addresses the combined risk associated with chemical and non-chemical exposures. Although CRA approaches are utilized in environmental and ecological contexts, they are rarely applied in workplaces. In this perspectives article, we strive to raise awareness among occupational health and safety (OHS) professionals and foster the greater adoption of a CRA perspective in practice. Specifically, we provide an overview of CRA literature as well as preliminary guidance on when to consider a CRA approach in occupational settings and how to establish reasonable boundaries. Examples of possible workplace co-exposures and voluntary risk management actions are discussed. We also highlight important implications for workplace CRA research and practice. In particular, future needs include simple tools for identifying combinations of chemical and non-chemical exposures, uniform risk management guidelines, and risk communication materials. Further development of practical CRA methods and tools are essential to meet the needs of complex and changing work environments. |
Planning for epidemics and pandemics: assessing the potential impact of extended use and reuse strategies on respirator usage rates to support supply-and-demand planning efforts
Yorio PL , Fisher EM , Kilinc-Balci FS , Rottach D , Harney J , Seaton M , Dahm MM , Niemeier T . J Int Soc Respir Prot 2020 37 (1) 52-60 During epidemics and pandemics healthcare personnel (HCP) are on the front line of disease containment and mitigation. Personal protective equipment (PPE), such as NIOSH-approved N95 filtering facepiece respirators (FFRs), serve an important role in minimizing HCP risks and are in high demand during public health emergencies. Because PPE demand can exceed supply, various public health strategies have been developed to reduce the rate of PPE consumption as supply dwindles. Extended use and limited reuse of N95 FFRs are strategies advocated by many governmental agencies used to increase the number of times a device can be used. Increased use of respirators designed for reuse-such as powered air-purifying respirators (PAPRs) and elastomeric half-mask and full facepiece air-purifying respirators- is another option designed to reduce the continuous need for new devices as the daily need for respirator use increases. Together, these strategies are designed to reduce the number of PPE units that must be discarded daily and, therefore, extend the longevity of available supply. The purpose of this paper is to theoretically estimate the impact of extended use and limited reuse strategies for N95 FFRs and the increased use of reusable respirator options on PPE consumed. The results suggest that a considerable reduction in PPE consumption would result from extended use and limited reuse of N95 FFRs and the increased use of respirators designed for reuse; however, the practical benefits must be balanced with the risks and economic costs. In addition, extended use and reuse strategies must be accompanied by proper procedures to reduce risk. The study is designed to support epidemic and pandemic PPE supply and demand planning efforts. |
Ten questions concerning the implications of carpet on indoor chemistry and microbiology
Haines SR , Adams RI , Boor BE , Bruton TA , Downey J , Ferro AR , Gall E , Green BJ , Hegarty B , Horner E , Jacobs DE , Lemieux P , Misztal PK , Morrison G , Perzanowski M , Reponen T , Rush RE , Virgo T , Alkhayri C , Bope A , Cochran S , Cox J , Donohue A , May AA , Nastasi N , Nishioka M , Renninger N , Tian Y , Uebel-Niemeier C , Wilkinson D , Wu T , Zambrana J , Dannemiller KC . Build Environ 2020 170 1-16 Carpet and rugs currently represent about half of the United States flooring market and offer many benefits as a flooring type. How carpets influence our exposure to both microorganisms and chemicals in indoor environments has important health implications but is not well understood. The goal of this manuscript is to consolidate what is known about how carpet impacts indoor chemistry and microbiology, as well as to identify the important research gaps that remain. After describing the current use of carpet indoors, questions focus on five specific areas: 1) indoor chemistry, 2) indoor microbiology, 3) resuspension and exposure, 4) current practices and future needs, and 5) sustainability. Overall, it is clear that carpet can influence our exposures to particles and volatile compounds in the indoor environment by acting as a direct source, as a reservoir of environmental contaminants, and as a surface supporting chemical and biological transformations. However, the health implications of these processes are not well known, nor how cleaning practices could be optimized to minimize potential negative impacts. Current standards and recommendations focus largely on carpets as a primary source of chemicals and on limiting moisture that would support microbial growth. Future research should consider enhancing knowledge related to the impact of carpet in the indoor environment and how we might improve the design and maintenance of this common material to reduce our exposure to harmful contaminants while retaining the benefits to consumers. |
The global landscape of occupational exposure limits-implementation of harmonization principles to guide limit selection
Deveau M , Chen CP , Johanson G , Krewski D , Maier A , Niven KJ , Ripple S , Schulte PA , Silk J , Urbanus JH , Zalk DM , Niemeier RW . J Occup Environ Hyg 2015 12 Suppl 1 0 Occupational exposure limits (OELs) serve as health-based benchmarks against which measured or estimated workplace exposures can be compared. In the years since the introduction of OELs to public health practice, both developed and developing countries have established processes for deriving, setting, and using OELs to protect workers exposed to hazardous chemicals. These processes vary widely, however, and have thus resulted in a confusing international landscape for identifying and applying such limits in workplaces. The occupational hygienist will encounter significant overlap in coverage among organizations for many chemicals, while other important chemicals have OELs developed by few, if any, organizations. Where multiple organizations have published an OEL, the derived value often varies considerably-reflecting differences in both risk policy and risk assessment methodology as well as access to available pertinent data. This paper explores the underlying reasons for variability in OELs, and recommends the harmonization of risk-based methods used by OEL-deriving organizations. A framework is also proposed for the identification and systematic evaluation of OEL resources, which occupational hygienists can use to support risk characterization and risk management decisions in situations where multiple potentially relevant OELs exist. |
Coccidioides exposure and coccidioidomycosis among prison employees, California, United States
de Perio MA , Niemeier RT , Burr GA . Emerg Infect Dis 2015 21 (6) 1031-3 Responding to a request by corrections agency management, we investigated coccidioidomycosis in prison employees in central California, a coccidioidomycosis-endemic area. We identified 103 cases of coccidioidomycosis that occurred over 4.5 years. As a result, we recommended training and other steps to reduce dust exposure among employees and thus potential exposure to Coccidioides. |
Challenges in assessing transmission of Mycobacterium tuberculosis in long-term-care facilities
Jackson DA , Mailer K , Porter KA , Niemeier RT , Fearey DA , Pope L , Lambert LA , Mitruka K , de Perio MA . Am J Infect Control 2015 43 (9) 992-6 In 2012, the Centers for Disease Control and Prevention (CDC) reported 3.2 cases of tuberculosis (TB) per 100,000 persons in the United States.1 Although TB incidence has declined during the past several decades, the 2010 goal of < 1 case per 1,000,000 persons—as established in the national strategic plan for TB elimination—has yet to be achieved.2 Although persons aged ≥ 65 years accounted for only 14% of the population in 2012, this group represented 22% of reported cases of TB.3,4 An analysis of 1993–2008 cases reported in the United States showed that the rate of TB among elderly adults was as much as 30% higher than among younger adults.5 Even more striking are the disproportionate rates documented among those living in long-term-care facilities (LTCFs). Previous reports have estimated that adults aged ≥ 65 years residing in LTCFs may have between 4 and 50 times the risk of developing TB disease than elderly persons living in the community.5–7 | As of April 2014, approximately 3.2 million workers were employed in LTCFs.8 The size of this occupational group will grow significantly in the coming years if LTCF resident populations increase as expected. Past estimates suggest the TB case rates are 3 times higher among LTCF workers compared with those working in any other job.9 Therefore, prevention and control of TB in LTCFs are essential to protect both the residents and employees in these settings. The goal of this article is to summarize findings of an LTCF TB outbreak investigation to highlight the unique challenges posed by Mycobacterium tuberculosis transmission in these settings. |
Evaluation of exposure to tuberculosis among employees at a medical center
de Perio MA , Todd Niemeier R . J Occup Environ Hyg 2014 11 (6) D63-8 Tuberculosis (TB), a disease caused by the bacteria Mycobacterium tuberculosis (M. tuberculosis), is spread from person to person through the air. TB usually infects the lungs, but it can also infect other body parts such as the brain, kidneys, or spine. People who are infected by the bacteria but who do not exhibit symptoms have latent TB infection. It is estimated that one-third of the world’s population has latent TB infection, and approximately 5%–10% of those infected will develop TB disease within their lifetimes.(1–5) | In July 2011, the National Institute for Occupational Safety and Health (NIOSH) received a health hazard evaluation request from management representatives at a medical center in Arizona concerning exposure of employees to M. tuberculosis. They asked for our assistance in evaluating the infection control and occupational health practices related to TB. | At the time of our visit, the medical center included an inpatient hospital with 73 beds and adjacent outpatient facility, and the center had approximately 1000 employees. One nurse, the infection control practitioner, was responsible for all infection control and occupational health activities at the medical center. The medical center’s TB policy required annual tuberculin skin testing (TST) of all employees with face-to-face patient contact, which included the majority of employees. |
Resident aggression toward staff at a center for the developmentally disabled
West CA , Galloway E , Niemeier MT . Workplace Health Saf 2014 62 (1) 19-26 Few studies have examined factors contributing to nonfatal assaults to staff working in residential care facilities. The authors evaluated resident assaults toward direct care/nursing staff at an Intermediate Care Facility for Individuals with Mental Retardation (ICF/MR), which included observations of work areas, employee interviews, calculation of injury and assault rates for 2004 to 2007 from Occupational Safety and Health Administration Logs, and review of state ICF/MR guidelines. Most staff interviewed reported having been injured during physical restraint of a resident and the average rate of injury from assault at the center evaluated was higher than the average national rates for the health care and social assistance sector for the same time period. The center lacked policies for a safe workplace. The authors recommended review and maintenance of workplace violence prevention policies and developing a post-incident response and evaluation program to assist staff in coping with the consequences of assault and/or occupational injury. |
Campylobacter infection in poultry-processing workers, Virginia, USA, 2008-2011
de Perio MA , Niemeier RT , Levine SJ , Gruszynski K , Gibbins JD . Emerg Infect Dis 2013 19 (2) 286-8 During a health hazard evaluation, we investigated 29 cases of laboratory-diagnosed Campylobacter infection among workers at a poultry-processing plant. Most infected employees worked at the plant <1 month, worked as live hangers, and lived at a state-operated center. To lessen the infection risk, we recommended improvements to engineering and administrative controls at the plant. |
Evaluating vehicle fire training inhalation hazards
Fent KW , Evans DE , Niemeier MT . Fire Eng 2012 165 (2) 63-68 The National Institute for Occupational Safety and Health (NIOSH) received a health hazard evaluation (HHE) request from an Ohio township fire and rescue department concerning potential inhalation exposures during vehicle fire suppression training. Although vehicle fires can be suppressed quickly, they can release hundreds of toxic chemicals into the air, which could cause short- and even long-term health effects over a firefighter's career. Even after a fire is extinguished, the off-gassing of potentially harmful chemicals and particles may continue because of thermal decomposition. Some of the chemicals released from vehicle fires are likely to be different from those released during structural fires because vehicles contain materials such as rubber (belts, tires), petrochemicals (oil, gasoline), and acids (batteries). |
Checklist model to improve work practices in small-scale demolition operations with silica dust exposures
Muianga C , Rice C , Lentz T , Lockey J , Niemeier R , Succop P . Int J Environ Res Public Health 2012 9 (2) 343-361 A systematic approach was developed to review, revise and adapt existing exposure control guidance used in developed countries for use in developing countries. One-page employee and multiple-page supervisor guidance sheets were adapted from existing documents using a logic framework and workers were trained to use the information to improve work practices. Interactive, hands-on training was delivered to 26 workers at five small-scale demolition projects in Maputo City, Mozambique, and evaluated. A pre-and-post walkthrough survey used by trained observers documented work practice changes. Worker feedback indicated that the training was effective and useful. Workers acquired knowledge (84% increase, p < 0.01) and applied the work practice guidance. The difference of proportions between use of work practice components before and after the intervention was statistically significant (p < 0.05). Changes in work practices following training included preplanning, use of wet methods and natural ventilation and end-of-task review. Respirable dust measurements indicated a reduction in exposure following training. Consistency in observer ratings and observations support the reliability and validity of the instruments. This approach demonstrated the short-term benefit of training in changing work practices; follow-up is required to determine the long-term impact on changes in work practices, and to evaluate the need for refresher training. |
The effectiveness of using interferon-gamma release assays in screening immigration employees for latent tuberculosis infection
de Perio MA , Niemeier RT , Groenewold MR . Int J Occup Environ Health 2011 17 (4) 322-327 We assessed the prevalence of latent tuberculosis infection in immigration employees and compared two of the screening methods. Using a cross-sectional study design, we administered questionnaires regarding demographics, work, medical history, and tuberculosis risk factors to employees at two immigration facilities. Participants underwent tuberculin skin test (TST) placement and blood collection for the QuantiFERONTB Gold in-Tube (QFT-GIT) assay. Fifty-four employees underwent QFT-GIT and TST placement. All QFT-GIT results were negative, and three employees tested TST positive. Twenty-three (49%) of 47 employees requiring two-step TST testing underwent second TST placement. Return rates for first and second TST reading were 76% and 74%, respectively. The QFT-GIT completion rate was higher than that for TST (100% vs. 39%, P < 0.001). Agreement between TST and QFTGIT was 94%. Immigration employees had low return rates for their TST reading and second TST placement. Performing the one-visit QFT-GIT has administrative and logistical advantages in this occupational group. |
Controlling diesel exhaust exposure inside firehouses
Baldwin TN , Hales TR , Niemeier MT . Fire Eng 2011 164 (2) 63-74 Diesel exhaust in firehouses has been and continues to be a problem for many firefighters. A diesel-powered apparatus generates exhaust whenever it leaves or returns to a station. If not properly captured, this exhaust will enter not only the apparatus bay but also the firefighters’ living quarters. As a result, firefighters can be exposed to diesel exhaust for a significant portion of their shifts. Scientific evidence suggests an association between lung cancer and occupational exposure to diesel exhaust emissions. Safety and health professionals at the National Institute for Occupational Safety and Health (NIOSH) have evaluated several fire stations for diesel exhaust through its Health Hazard Evaluation (HHE) program. We address the health effects of diesel exhaust, the amount of diesel exhaust typically found in fire stations, and the controls and work practices that can reduce firefighters’ exposure. |
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