To Study Acute Changes in Brain Oxygenation on MRI in Healthcare Workers Using N95 Mask and PPE Kits for Six Hours a Day

Background Due to long working hours wearing an N95 mask and PPE kit during the COVID-19 pandemic, the healthcare workers (HCWs) complained of headaches, confusion, and exhaustion. This study was therefore performed to study the changes in brain oxygenation. Aim To compare brain oxygenation in health care workers wearing an N95 mask with a PPE kit versus a three-ply mask during an intensive care setting for 6 hours. Materials and Methods Thirty clinicians and 30 paramedical staff participated in the study. The control (three-ply mask) and subject (N95 mask with PPE) groups included 15 clinicians and 15 paramedical staff. A comparative analysis of brain oxygenation using a 3T magnetic resonance imaging (MRI) machine was performed in these two groups at the beginning and the end of their work shift. Results The mean age of the individuals in the control and subject groups was 30.8 and 30.13 years, respectively. The median value of brain oxygenation in the control and subject groups in the pre-shift was between 33 and 31 and post-shift was 30 and 24. The drop in brain oxygenation in subjects was more than the controls (p = 0.004) in the post-shift assessments. The cerebral blood flow (CBF) in the bilateral middle cerebral artery (MCA) using arterial spin labeling (ASL) showed a rise in CBF in both groups post-shift as compared with the pre-shift values. The median values of the right and left MCA in the control and subject groups pre-shift were 82.75/83.45 and 89.75/106.65. The post-shift median values of both MCAs of the control and subject groups were 115.65/115.55 and 109.60/119.49. Conclusion MRI-BOLD imaging revealed a significant drop in brain oxygenation in the subject group as compared with the control group. Multiphasic-ASL showed a compensatory rise in CBF in both groups.

Heat Exposure and Physiological Changes among Cooks

Cooks who are exposed to heat produced from stoves when working in the kitchen are at risk of thermal stress and heat-related illness. Physiological changes such as increased heart rate, sweat production and blood pressure may also affect them. This study aimed to determine the area heat exposure levels and physiological changes including core body temperature, blood pressure and heart rate during pre-, mid- and post-shift among cooks and its association, and to compare the mean difference of physiological changes between the shifts. This cross-sectional study utilised the purposive sampling method and recruited 30 cooks from food stalls and cafeterias in Kelantan. Area heat measurements were collected from 14 sites (7 inside and 7 outside the USM Health Campus). Wet-bulb Globe Temperature (WBGT) monitor was mounted on a tripod at 1.1 m height near the source of heat for 8 hours. The core body temperature, blood pressure, and heart rate were taken three times per day during pre-, mid- and post-shift for physiological changes measurement. Respondents’ personal information, health history, work description, and symptoms of heat-related illness were collected using a questionnaire. The overall WBGT area levels at each sampling site were homogeneously distributed. There was significant increase in core body temperature and heart rate from pre-shift to post-shift. However, there was no significant correlation (p>0.05) between heat exposure (WBGT index) established with the physiological changes. This may suggest that the increase in core body temperature and heart rate might be attributed to other factors and needed further investigation.

The use of digital technologies in pre-trip and post-trip medical examinations — the legal aspect

One of the duties of an employee as a subject of labor legal relations is the obligation to undergo established pre-trip, pre-shift, and post-trip, post-shift medical examinations. The digitalization of all spheres of public life, the erasure of spatial boundaries, the development of artificial intelligence naturally change the procedure for conducting these types of medical examinations. The purpose of this article is to identify the main proposals for changing the procedure for carrying out these types of medical examinations, as well as to analyze their legality from the point of view of the current legislation. In the course of the study, the current legislation was analyzed, collisions, gaps and difficulties in its application by business entities were identified when organizing and conducting pre-shift, pre-trip and post-shift, post-trip medical examinations. The results of pilot studies and analysis of judicial practice on these issues are presented. The objects of research were the official websites of manufacturers of software and hardware systems used for conducting pre-shift, pre-trip and post-shift, post-trip medical examinations remotely. It is concluded that the remote method of conducting pre-trip, pre-shift, and post-trip, post-shift medical examinations does not comply with the law, as well as the need for administrative control over the quality of pre-trip, pre-shift, and post-trip, post-shift medical examinations.

A Preliminary Investigation: Evaluating the Effectiveness of an Occupational Specific Training Program to Improve Lower Body Strength and Speed for Law Enforcement Officers

Based on current law enforcement officer (LEO) duties, musculoskeletal injury risk is elevated due to the unpredictable nature of physically demanding tasks. The purpose of this 4-week study was to determine the effectiveness of a 15-min post-shift standardized occupational specific training program. The standardized program was designed to improve lower-body strength and speed to aid physically demanding task performance. Seven male LEOs completed the program after their 12-h shift. Subjects were required to use the department fitness center to perform the 15-min standardized program consisting of a dynamic warm-up, 4 sets of 3 repetitions on hex-bar deadlift and four 20-m sprints. Two minutes of rest was required between each set of 3 repetitions on hex-bar deadlift and 1 min of rest between each 20-m sprint. A dependent T-test was used between pre-test and post-test scores for hex-bar deadlift (HBD) and sprint. Data revealed significant improvements in relative lower-body strength with HBD (p ≤ 0.001). However, insignificant results were demonstrated with the 20-m sprint (p ≤ 0.262). In conclusion, a 15-min post-shift workout can improve lower-body strength as measured by the hex-bar deadlift. However, data indicated running speed may require a different training approach to improve the 20-m sprint.

Mycotoxins Exposure of French Grain Elevator Workers: Biomonitoring and Airborne Measurements

It is now recognized that additional exposure to mycotoxins may occur through inhalation of contaminated dust at a workplace. The aim of this study was to characterize the multi-mycotoxin exposure of French grain elevator workers using biomonitoring and airborne measurements. Eighteen workers participated in the study. Personal airborne dust samples were analyzed for their mycotoxin concentrations. Workers provided multiple urine samples including pre-shift, post-shift and first morning urine samples or 24 h urine samples. Mycotoxin urinary biomarkers (aflatoxin B1, aflatoxin M1, ochratoxin A, ochratoxin α, deoxynivalenol, zearalenone, α-zearalenol, β-zearalenol, fumonisin B1, HT-2 toxin and T-2 toxin) were measured using a liquid chromatography–high-resolution mass spectrometry method. Grain elevator workers were highly exposed to organic airborne dust (median 4.92 mg.m−3). DON, ZEN and FB1 were frequent contaminants in 54, 76 and 72% of air samples, respectively. The mycotoxin biomarkers quantified were DON (98%), ZEN (99%), α-ZEL (52%), β-ZEL (33%), OTA (76%), T-2 (4%) and HT-2 (4%). DON elimination profiles showed highest concentrations in samples collected after the end of the work shift and the urinary DON concentrations were significantly higher in post-shift than in pre-shift-samples (9.9 and 22.1 µg/L, respectively). ZEN and its metabolites concentrations did not vary according to the sampling time. However, the levels of α-/β-ZEL were consistent with an additional occupational exposure. These data provide valuable information on grain worker exposure to mycotoxins. They also highlight the usefulness of multi-mycotoxin methods in assessing external and internal exposures, which shed light on the extent and pathways of exposure occurring in occupational settings.

Naphthalene: irritative and inflammatory effects on the airways

Objective This cross-sectional study determined whether acute sensory irritative or (sub)chronic inflammatory effects of the eyes, nose or respiratory tract are observed in employees who are exposed to naphthalene at the workplace. Methods Thirtynine healthy and non-smoking male employees with either moderate (n = 22) or high (n = 17) exposure to naphthalene were compared to 22 male employees from the same plants with no or only rare exposure to naphthalene. (Sub)clinical endpoint measures included nasal endoscopy, smell sensitivity, self-reported work-related complaints and the intensity of naphthalene odor and irritation. In addition, cellular and soluble mediators in blood, nasal lavage fluid (NALF) and induced sputum (IS) were analysed. All measurements were carried out pre-shift on Monday and post-shift on Thursday. Personal air monitoring revealed naphthalene shift concentrations up to 11.6 mg/m3 with short-term peak concentrations up to 145.8 mg/m3 and 1- and 2-naphthol levels (sum) in post-shift urine up to 10.1 mg/L. Results Acute sensory irritating effects at the eyes and upper airways were reported to occur when directly handling naphthalene (e.g., sieving pure naphthalene). Generally, naphthalene odor was described as intense and unpleasant. Habituation effects or olfactory fatigue were not observed. Endoscopic examination revealed mild inflammatory effects at the nasal mucosa of exposed employees in terms of reddening and swelling and abnormal mucus production. No consistent pattern of cellular and soluble mediators in blood, NALF or IS was observed which would indicate a chronic or acute inflammatory effect of naphthalene in exposed workers. Conclusions The results suggest that exposure to naphthalene induces acute sensory irritative effects in exposed workers. No (sub)chronic inflammatory effects on the nasal epithelium or the respiratory tract could be observed under the study conditions described here.

Fluoride Exposure and the Effect of Tobacco Smoking on Urinary Fluoride Levels in Primary Aluminum Workers

Workers in primary aluminum smelter are exposed to fluoride from cryolite (Na3AlF6) used in the electrolysis process. Post-shift urinary fluoride is considered as an appropriate index for examination of fluoride exposure. The objective of the study was to investigate the exposure to fluoride in primary aluminum smelter in Žiar nad Hronom (Slovakia) during three consecutive two-year periods between 2012 and 2018. The relationship between fluoride exposure in the occupational environment, tobacco smoking, and pre- and post-shift urinary fluoride concentration was investigated in 76 male workers in the ages from 21 to 60 years. Workers were monitored by personal fluoride sampling equipment. Their urinary samples were collected prior to the start and at the end of an eight-hour shift. Fluoride content in urine samples was analyzed by potentiometric ion-selective electrode and expressed as weight ratio of fluoride content to creatinine. The Mean ± SD particulate fluoride concentration in occupational air was 0.966 ± 1.658 mg/m3 and gas-phase fluoride concentration was 0.327 ± 0.809 mg/m3. Mean urinary fluoride concentration of all workers was significantly higher (p < 0.001) after the eight-hour shift. Smokers tended to have a higher post-shift mean urinary fluoride concentration than non-smokers, but this difference was not statistically significant (p = 0.11). The difference between these two groups of workers was also not statistically significant (p = 0.62) before the shift. Therefore, according to results, smoking caused no statistically significant difference in urinary fluoride levels between the group of smokers and group of non-smokers in primary aluminum workers.

Three-Year Study of Markers of Oxidative Stress in Exhaled Breath Condensate in Workers Producing Nanocomposites, Extended by Plasma and Urine Analysis in Last Two Years

Human data concerning exposure to nanoparticles are very limited, and biomarkers for monitoring exposure are urgently needed. In a follow-up of a 2016 study in a nanocomposites plant, in which only exhaled breath condensate (EBC) was examined, eight markers of oxidative stress were analyzed in three bodily fluids, i.e., EBC, plasma and urine, in both pre-shift and post-shift samples in 2017 and 2018. Aerosol exposures were monitored. Mass concentration in 2017 was 0.351 mg/m3 during machining, and 0.179 and 0.217 mg/m3 during machining and welding, respectively, in 2018. In number concentrations, nanoparticles formed 96%, 90% and 59%, respectively. In both years, pre-shift elevations of 50.0% in EBC, 37.5% in plasma and 6.25% in urine biomarkers were observed. Post-shift elevation reached 62.5% in EBC, 68.8% in plasma and 18.8% in urine samples. The same trend was observed in all biological fluids. Individual factors were responsible for the elevation of control subjects’ afternoon vs. morning markers in 2018; all were significantly lower compared to those of workers. Malondialdehyde levels were always acutely shifted, and 8-hydroxy-2-deoxyguanosine levels best showed chronic exposure effect. EBC and plasma analysis appear to be the ideal fluids for bio-monitoring of oxidative stress arising from engineered nanomaterials. Potential late effects need to be targeted and prevented, as there is a similarity of EBC findings in patients with silicosis and asbestosis.