Lithium-ion battery pack fires pose great hazards to the safety and health of miners. A detailed experimental study has been conducted at the National Institute for Occupational Safety and Health (NIOSH) Pittsburgh Mining Research Division (PMRD) to investigate the effectiveness of different fire suppression systems on Li-ion battery pack fire extinguishment. Tests were conducted in a well-ventilated container. Two sizes of battery packs (12 V, 24 V) were heated by heater strips to trigger thermal runaway and fire. Water mist with different flow rates, ABC powder, type D dry chemical, and water mist with F500 additives were used as the fire suppression agents. Multiple thermocouples were installed on the battery packs to measure the temperature evolution during the tests. The results indicated that the water mist with F500 additives is the most effective suppressant among the agents tested. Dry chemicals, however, do quench the fire for a moment, but cannot prevent re-ignition of the battery since they do not provide enough cooling. The findings of this paper can be used to develop safer battery fire suppression techniques in mining environments. © 2023, This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.

Mine equipment fires remain as one of the most concerning safety issues in the mining industry, and most equipment fires were caused by hot surface ignitions. Detailed experimental investigations were conducted at the NIOSH Pittsburgh Mining Research Division on hot surface ignition of liquid fuels under ventilation in a mining environment. Three types of metal surface materials (stainless steel, cast iron, carbon steel), three types of liquids (diesel fuel, hydraulic fluid, engine oil), four air ventilation speeds (0, 0.5, 1.5, 3 m/s) were used to study the hot surface ignition probability under these conditions. Visual observation and thermocouples attached on the metal surface were used to indicate the hot surface ignition from the measured temperatures. Results show that the type of metal has a noticeable effect on the hot surface ignition, while ventilation speed has a mixed influence on ignition. Different types of liquid fuels also show different ranges of ignition temperatures. Results from this work can be used to help understand equipment mine fires and develop mitigation strategies.

A detailed experimental investigation on the critical external heat leading to the failure of lithium-ion (Li-ion) batteries was conducted using an Accelerating Rate Calorimeter (ARC) at the National Institute for Occupational Safety and Health (NIOSH). Several types of commercial Li-ion batteries were selected for the study, including an iron phosphate Li-ion battery (LFP), a lithium-titanate battery (LTO), and a lithium-nickel-manganese-cobalt-oxide battery (NMC). Each battery was placed in a specially designed sealed steel canister and heated in the ARC. Battery voltage throughout the test was monitored and used to indicate the time to a battery failure. Three thermocouples, one attached to the battery surface, one measuring air temperature inside the canister, and one attached to the canister's internal surface, were used to record temperature changes during the heating tests. Different thermal behaviors were observed for the various battery types. An analytical model was developed to estimate the total external heat received by the battery using the measured temperatures. Experimental data ranked the batteries tested in terms of the heat to failure as: LFP 26,650 (11 kJ) > LFP 18650 (4.3 kJ) > NMC 18650 MH1 (3.6 kJ) ≈ LTO 18650 (3.6 kJ) > NMC 18650 HG2 (3 kJ). Total heat normalized to the battery nominal energy capacity was also calculated and ranked as: LTO 18650 ≈ LFP 26650 ≈ LFP 18650 > NMC 18650 MH1 ≈ NMC 18650 HG2. The test and analysis method developed can be extended to other types of batteries with a cylindrical shape. Results from this work provide insights to the thermal safety of Li-ion batteries and can help enhance battery thermal design and management.

OBJECTIVE: To describe varicella cases in Tshuapa Province of the Democratic Republic of the Congo identified during monkeypox surveillance. METHODS: Demographic, clinical, and epidemiological data were collected from each suspected monkeypox case 2009-2014. Samples were tested by PCR for both Orthopoxviruses and varicella-zoster virus (VZV); a subset of VZV positive samples were genotyped. We defined a varicella case as a rash illness with laboratory-confirmed VZV. RESULTS: 366 varicella cases were identified; 66% were </=19 years old. Most patients had non-typical varicella rash with lesions reported as the same size and stage of evolution (86%), deep and profound (91%), on palms of hands and/or soles of feet (86%), and not itchy (49%). Many had non-typical signs and symptoms, such as lymphadenopathy (70%) and sensitivity to light (23%). A higher proportion of persons aged >/=20 years than persons aged </=19 years had >/=50 lesions (79% versus 65%, p = 0.007) and were bedridden (15% versus 9%, p = 0.056). All VZV isolates genotyped from 79 varicella cases were clade 5. During the surveillance period, one possible VZV-related death occurred in a 7 year-old child. CONCLUSIONS: A large proportion of patients presented with nontypical varicella rash and clinical signs and symptoms, highlighting challenges identifying varicella in an area with endemic monkeypox. Continued surveillance and laboratory diagnosis will help in rapid identification and control of both monkeypox and varicella and improve our understanding of varicella epidemiology in Africa. This article is protected by copyright. All rights reserved.

On September 22, 2017, a suspected human case of monkeypox was reported to the Nigeria Centre for Disease Control (NCDC) from Bayelsa State in southern Nigeria. Because monkeypox had not been reported in Nigeria since 1978 (1), the case raised national and international concern. A multisectoral, international outbreak investigation was undertaken to identify sources and risk factors, establish surveillance, and enhance preparedness. A suspected case was defined as the sudden onset of fever, followed by a vesiculopustular rash primarily on the face, palms, and soles. A confirmed case was any suspected case with laboratory confirmation (by serology, molecular detection of viral DNA, or virus isolation). A probable case was a suspected case epidemiologically linked to a confirmed case. As of February 25, 2018, a total of 228 suspected cases (including 89 confirmed and three probable cases) had been investigated in 24 of Nigeria’s 36 states and the Federal Capital Territory. Six deaths (6.7%) were recorded among the 89 confirmed cases. The outbreak has not been declared over, and NCDC continues to collect data to develop a baseline level for this disease, which had not been reported in 40 years and now might be endemic to Nigeria. Given the zoonotic nature of the disease, this outbreak has required a robust One Health outbreak collaboration among human, animal, and environmental health institutions.

BACKGROUND: Hand, foot, and mouth disease (HFMD) is generally considered a rare illness in adults. Classically, HFMD has been strongly associated with coxsackievirus strain A16 and enterovirus 71. The coxsackievirus A6 (CVA6) strain has been linked to severe worldwide outbreaks since 2008. CVA6 is associated with a more severe and profound course of disease, affecting both children and adults. OBJECTIVES: To present a series of five adult patients diagnosed with HFMD due to CVA6. We investigate method of diagnosis and compare clinical presentation of adult cases to those in children. STUDY DESIGN: Each patient underwent a full-body skin exam as well as inspection of the oral cavity. Rapid plasma reagin (RPR) and serologic assays by complement fixation against coxsackievirus B (1-6) and A (2,4,7,9,10,16) were performed as indicated. As standard serological testing does not detect CVA6, real-time reverse transcription-polymerase chain reaction (qRT-PCR) of serum, buccal swabs, and skin scrapings were performed by the Centers for Disease Control and Prevention (CDC). RESULTS: Each patient had clinical findings consistent with various stages of HFMD. One patient presented with delayed onychomadesis and desquamation of the palms and soles. RPR and serologic assays by complement fixation against CVB (1-6) and CVA (2,4,7,9,10,16) were mostly negative, although elevated in two patients due to cross-reactivity. qRT-PCR identified CVA6 genetic material in samples from all patients. CONCLUSION: This series demonstrates that there is a wide array of disease presentation of CVA6 associated HFMD in adults.

OBJECTIVE: To characterize the atypical cutaneous presentations in the coxsackievirus A6 (CVA6)-associated North American enterovirus outbreak of 2011-2012. METHODS: We performed a retrospective case series of pediatric patients who presented with atypical cases of hand, foot, and mouth disease (HFMD) from July 2011 to June 2012 at 7 academic pediatric dermatology centers. Patients were included if they tested positive for CVA6 or if they met clinical criteria for atypical HFMD (an enanthem or exanthem characteristic of HFMD with unusual morphology or extent of cutaneous findings). We collected demographic, epidemiologic, and clinical data including history of skin conditions, morphology and extent of exanthem, systemic symptoms, and diagnostic test results. RESULTS: Eighty patients were included in this study (median age 1.5 years, range 4 months-16 years). Seventeen patients were CVA6-positive, and 63 met clinical inclusion criteria. Ninety-nine percent of patients exhibited a vesiculobullous and erosive eruption; 61% of patients had rash involving >10% body surface area. The exanthem had a perioral, extremity, and truncal distribution in addition to involving classic HFMD areas such as palms, soles, and buttocks. In 55% of patients, the eruption was accentuated in areas of eczematous dermatitis, termed "eczema coxsackium." Other morphologies included Gianotti-Crosti-like (37%), petechial/purpuric (17%) eruptions, and delayed onychomadesis and palm and sole desquamation. There were no patients with serious systemic complications. CONCLUSIONS: The CVA6-associated enterovirus outbreak was responsible for an exanthem potentially more widespread, severe, and varied than classic HFMD that could be confused with bullous impetigo, eczema herpeticum, vasculitis, and primary immunobullous disease.

TO THE EDITOR: Coxsackievirus A6 (CVA6) is a human enterovirus associated with herpangina in infants. In the winter of 2012, we evaluated a cluster of 8 patients, 4 months-3 years of age, who were brought for treatment at Boston Children's Hospital (Boston, MA, USA) with a variant of hand, foot, and mouth disease (HFMD) that has now been linked to CVA6 (Table). During this same period, the Boston Public Health Commission's syndromic surveillance system detected a 3.3-fold increase in emergency department discharge diagnoses of HFMD. In the United States, HFMD typically occurs in the summer and early autumn and is characterized by a febrile enanthem of oral ulcers and macular or vesicular lesions on the palms and soles; the etiologic agents are most often CVA16 and enterovirus 71.

A previously healthy 6-year-old female child presented to the outpatient clinic with a generalized erythematous, annular, slightly raised and mildly pruritic rash that was present primarily on the right upper arm for 1 week. She complained of low-grade fever (up to 37.9°C), myalgia and fatigue. One week previously, her primary physician had treated her with oral azithromycin and cephalexin for the rash. Despite this, the rash worsened, and lesions were present on the trunk, face and neck, sparing palms and soles. The patient denied respiratory symptoms, diarrhea, vomiting, headache, recent travel and tick bite exposure. Her medical history included only allergic rhinitis treated with diphenhydramine and montelukast. The patient’s mother and 15-year-old sister, both of whom had familial Mediterranean fever, developed a similar rash on their face, arms and trunk. In addition, the boyfriend of the 15-year-old sister and the playmate of the patient who frequently visited the home had begun to develop similar lesions. | The family reported owning 1 rat, 3 cats and 3 dogs. They volunteered regularly in an animal shelter and had recently adopted a kitten found in a trash dumpster. The patient and the other family members had been in close contact with the kitten. When initially adopted, the kitten had an annular erythematous rash, cough, runny nose and hair loss, which was improving with antibiotics treatment.

OBJECTIVE: The authors investigated the effect of boot weight and sole flexibility on spatiotemporal gait characteristics and physiological responses of firefighters in negotiating obstacles. BACKGROUND: Falls and overexertion are the leading causes of fire ground injuries and fatalities among firefighters. There have been few in-depth studies conducted to evaluate the risk factors of falls and overexertion associated with firefighter boots. METHOD: For the study, 13 female and 14 male firefighters, while wearing full turnout clothing and randomly assigned boots, walked for 5 min while stepping over obstacles. The independent variables included boot weight, sole flexibility, gender, and task duration. Spatiotemporal measures of foot trajectories and toe clearance were determined. Minute ventilation, oxygen consumption, carbon dioxide production, and heart rate were measured. RESULTS: Increased boot weight was found to significantly reduce trailing toe clearance when crossing the 30-cm obstacle. Significant increases in lateral displacement of the foot were found near the end of the 5-min walk compared with the beginning of the task Increased boot weight significantly increased oxygen consumption. There were significant decreases in oxygen consumption for more flexible soles. CONCLUSION: Firefighters were more likely to trip over obstacles when wearing heavier boots and after walking for a period of time. Boot weight affected metabolic variables (5% to 11% increases per 1-kg increase in boot weight), which were mitigated by sole flexibility (5% to 7% decrease for more flexible soles). APPLICATION: This study provides useful information for firefighters and boot manufacturers in boot selection and design for reducing falls and overexertion.