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Pneumatic nail guns have been shown in published studies to cause injury and death to both workers and consumers, but those equipped with sequential trigger mechanisms provide much greater safety protection against unintentional discharge than those equipped with contact triggers. In 2015 the American National Standards Institute (ANSI) approved a revision to its 2002 nail gun standard, but failed to require sequential triggers. Substantive and procedural deficiencies in the ANSI standard's development process resulted in a scientifically unsound nail gun safety standard, detracting from its use as the basis for a mandatory national safety standard and ultimately from its ability to protect worker and consumer users. Am. J. Ind. Med. 60:147-151, 2017. © 2016 Wiley Periodicals, Inc., (© 2016 Wiley Periodicals, Inc.)

Investigations of carbon monoxide (CO-related poisonings and deaths on houseboats were conducted by the Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. These investigations measured hazardous CO concentrations on and around houseboats that utilize gasoline-powered generators. Engineering control devices were developed and tested to mitigate this deadly hazard. CO emissions were measured using various sampling techniques which included exhaust emission analyzers, detector tubes, evacuated containers (grab air samples analyzed by a gas chromatograph), and direct-reading CO monitors. CO results on houseboats equipped with gasoline-powered generators without emission controls indicated hazardous CO concentrations exceeding immediately dangerous to life and health (IDLH) levels in potentially occupied areas of the houseboat. Air sample results on houseboats that were equipped with engineering controls to remove the hazard were highly effective and reduced CO levels by over 98% in potentially occupied areas. The engineering control devices used to reduce the hazardous CO emissions from gasoline-powered generators on houseboats were extremely effective at reducing CO concentrations to safe levels in potentially occupied areas on the houseboats and are now beginning to be widely used.

Airborne infection isolation rooms (AIIRs) house patients with tuberculosis, severe acute respiratory syndrome (SARS), and many other airborne infectious diseases. Currently, facility engineers and designers of heating, ventilation, and air-conditioning (HVAC) systems have few analytical tools to estimate a room's leakage area and establish an appropriate flow differential (DeltaQ) in hospitals, shelters, and other facilities where communicable diseases are present. An accurate estimate of leakage area and selection of DeltaQ is essential for ensuring that there is negative pressure (i.e., pressure differential [DeltaP]) between an AIIR and adjoining areas. National Institute for Occupational Safety and Health (NIOSH) researchers evaluated the relationship between DeltaQ and DeltaP in 67 AIIRs across the United States and in simulated AIIR. Data gathered in the simulated AIIR was used to develop an empirical model describing the relationship between DeltaQ, DeltaP, and leakage area. Data collected in health care facilities showed that the model accurately predicted the leakage area 44 of 48 times. Statistical analysis of the model and experimental validation showed that the model effectively estimated the actual leakage area from -39% to +22% with 90% confidence. The NIOSH model is an effective, cost-cutting tool that can be used by HVAC engineers and designers to estimate leakage area and select an appropriate DeltaQ in AIIRs to reduce the airborne transmission of disease.

National Institute for Occupational Safety and Health (NIOSH) researchers evaluated two exhaust stack designs for reducing carbon monoxide (CO) exposures from gasoline-powered generator exhaust on houseboats. Tests were conducted (a) after dark, (b) in high-temperature and high-humidity environments, (c) during temperature inversions, (d) under various generator loads, and (e) at different houseboat trim angles. Two different designs of houseboat exhaust stacks were evaluated and compared with the side-exhaust configuration, which is standard on many houseboats. The two designs were flagpole and vertical stack. Both exhaust stacks performed dramatically better than the standard water level, side-exhaust configuration. The highest mean CO concentrations on the upper and lower decks of the houseboat with the vertical exhaust stack were 27 ppm and 17 ppm. The highest mean CO concentrations on the upper and lower decks of the houseboat with the modified flagpole stack were 5 ppm and 2 ppm. These findings are much lower than the 67 ppm and 341 ppm for the highest mean CO concentrations found on the upper and lower decks of houseboats having the usual side-exhausted configuration. The NIOSH evaluation also indicated that high-temperature and high-humidity levels, temperature inversions, generator loading, and houseboat trim angles had little effect on the exhaust stack performance. It also demonstrated the importance of proper design and installation of exhaust stacks to ensure that all exhaust gases are released through the stack. Based on the results of this work, NIOSH investigators continue to recommend that houseboat manufacturers, rental companies, and owners retrofit their gasoline-powered generators with exhaust stacks to reduce the hazard of CO poisoning and death to individuals on or near the houseboat.

The extent of health effects and exposure to environmental contaminants among workers and residents indirectly affected by the September 11, 2001, attack on the World Trade Center (WTC) is unknown. The objective of this study was to evaluate concerns related to health effects and occupational exposures three months after the WTC disaster among a population of employees working in a building close to the disaster site. A cross-sectional questionnaire survey was performed of Federal employees working near the WTC site in New York City (NYC) and a comparison group of Federal employees in Dallas, Texas. An industrial hygiene evaluation of the NYC workplace was conducted. Constitutional and mental health symptoms were reported more frequently among workers in NYC compared to those in Dallas; level of social support was inversely related to prevalence of mental health symptoms. Post-September 11th counseling services were utilized to a greater degree among workers in NYC, while utilization of other types of medical services did not differ significantly between the groups. No occupational exposures to substances at concentrations that would explain the reported constitutional symptoms were found; however, we were unable to assess potential occupational exposures in the time immediately after the WTC disaster. There is no evidence of ongoing hazardous exposure to airborne contaminants among the workers surveyed. Specific causes of reported constitutional health symptoms have not been determined. Health care providers and management and employee groups should be aware of the need to address mental health issues as well as constitutional symptoms among the large number of workers in the NYC area who have been indirectly affected by the WTC disaster.

NIOSH researchers evaluated the ability of fifth-generation dry-cleaning machines to control occupational exposure to perchloroethylene (PERC). Use of these machines is mandated in some countries; however, less than 1 percent of all U.S. shops have them. A study was conducted at a U.S. dry-cleaning shop where two fifth-generation machines were used. Both machines had a refrigerated condenser as a primary control and a carbon adsorber as a secondary control to recover PERC vapors during the dry cycle. These machines were designed to lower the PERC concentration in the cylinder at the end of the dry cycle to below 290 ppm. A single-beam infrared photometer continuously monitors the PERC concentration in the machine cylinder, and a door interlock prevents opening until the concentration is below 290 ppm. Personal breathing zone air samples were measured for the machine operator and presser. The operator had time-weighted average (TWA) PERC exposures that were less than 2 ppm. Highest exposures occurred during loading and unloading the machine and when performing routine machine maintenance. All presser samples were below the limit of detection. Real-time video exposure monitoring showed that the operator had peak exposures near 160 ppm during loading and unloading the machine (below the OSHA maximum of 300 ppm). This exposure (160 ppm) is an order of magnitude lower than exposures with more traditional machines that are widely used in the United States. The evaluated machines were very effective at reducing TWA PERC exposures as well as peak exposures that occur during machine loading and unloading. State-of-the-art dry-cleaning machines equipped with refrigerated condensers, carbon adsorbers, drum monitors, and door interlocks can provide substantially better protection than more traditional machines that are widely used in the United States.

From 1990 to 2000, a total of 111 carbon monoxide (CO) poisonings occurred on Lake Powell near the Arizona and Utah border. Seventy-four of the poisonings occurred on houseboats, and 64 were attributable to generator exhaust alone. Seven of the 74 houseboat-related CO poisonings resulted in death. Although many of the reported CO poisonings occurred to members of the general public, some poisonings involved workers performing houseboat maintenance. The National Institute for Occupational Safety and Health evaluated an engineering control retrofitted to a houseboat gasoline-powered generator to reduce the hazard of CO poisoning from the exhaust. The control consisted of a water separator and a 17-foot exhaust stack that extended 9 feet above the upper deck of the houseboat. When compared to a houseboat having no engineering controls, study results showed that the exhaust stack provides a dramatically safer environment to individuals on or near the houseboat. CO concentrations were reduced by 10 times or more at numerous locations on the houseboat. Average CO concentrations near the rear swim deck of the houseboat, an area where occupants frequently congregate, were reduced from an average of 606.6 ppm to 2.85 ppm, a reduction greater than 99%. CO concentrations were also reduced on the upper deck of the houseboat. Hazardous CO concentration in the confined area beneath the near swim deck were eliminated. Based on the results of this study, it is clear that houseboats having gasoline-powered generators that have been outfitted from the factory or retrofitted with an exhaust stack that extends well above the upper deck of the boat will greatly reduce the hazard of CO poisoning.

Real-time monitoring was used to evaluate the ability of engineering control devices retrofitted on two existing dry-cleaning machines to reduce worker exposures to perchloroethylene. In one dry-cleaning shop, a refrigerated condenser was installed on a machine that had a water-cooled condenser to reduce the air temperature, improve vapor recovery, and lower exposures. In a second shop, a carbon adsorber was retrofitted on a machine to adsorb residual perchloroethylene not collected by the existing refrigerated condenser to improve vapor recovery and reduce exposures. Both controls were successful at reducing the perchloroethylene exposures of the dry-cleaning machine operator. Real-time monitoring was performed to evaluate how the engineering controls affected exposures during loading and unloading the dry-cleaning machine, a task generally considered to account for the highest exposures. The real-time monitoring showed that dramatic reductions occurred in exposures during loading and unloading of the dry-cleaning machine due to the engineering controls. Peak operator exposures during loading and unloading were reduced by 60 percent in the shop that had a refrigerated condenser installed on the dry-cleaning machine and 92 percent in the shop that had a carbon adsorber installed. Although loading and unloading exposures were dramatically reduced, drops in full-shift time-weighted average (TWA) exposures were less dramatic. TWA exposures to perchloroethylene, as measured by conventional air sampling, showed smaller reductions in operator exposures of 28 percent or less. Differences between exposure results from real-time and conventional air sampling very likely resulted from other uncontrolled sources of exposure, differences in shop general ventilation before and after the control was installed, relatively small sample sizes, and experimental variability inherent in field research. Although there were some difficulties and complications with installation and maintenance of the engineering controls, this study showed that retrofitting engineering controls may be a feasible option for some dry-cleaning shop owners to reduce worker exposures to perchloroethylene. By installing retrofit controls, a dry-cleaning facility can reduce exposures, in some cases dramatically, and bring operators into compliance with the Occupational Safety and Health Administration (OSHA) peak exposure limit of 300 ppm. Retrofit engineering controls are also likely to enable many dry-cleaning workers to lower their overall personal TWA exposures to perchloroethylene.

The effectiveness of commercially available interventions for reducing workers' perchloroethylene exposures in three small dry-cleaning shops was evaluated. Depending upon machine configuration, the intervention consisted of the addition of either a refrigerated condenser or a closed-loop carbon adsorber to the existing dry-cleaning machine. These relatively inexpensive (less than $5000) engineering controls were designed to reduce perchloroethylene emissions when dry-cleaning machine doors were opened for loading or unloading. Effectiveness of the interventions was judged by comparing pre- and postintervention perchloroethylene exposures using three types of measurements in each shop: (1) full-shift, personal breathing zone, air monitoring, (2) next-morning, end-exhaled worker breath concentrations of perchloroethylene, and (3) differences in the end-exhaled breath perchloroethylene concentrations before and after opening the dry-cleaning machine door. In general, measurements supported the hypothesis that machine operators' exposures to perchloroethylene can be reduced. However, work practices, especially maintenance practices, influenced exposures more than was originally anticipated. Only owners of dry-cleaning machines in good repair, with few leaks, should consider retrofitting them, and only after consultation with their machine's manufacturer. If machines are in poor condition, a new machine or alternative technology should be considered. Shop owners and employees should never circumvent safety features on dry-cleaning machines.

This study modeled the time required for a gasoline-powered, 5 horsepower (hp), 4-cycle engine to generate carbon monoxide (CO) concentrations exceeding the National Institute for Occupational Safety and Health 200-ppm ceiling and 1200-ppm immediately dangerous to life and health concentration for various room sizes and ventilation rates. The model permitted the ambiguous term "well-ventilated area" to be defined. The model was compared with field data collected at a site where two workers were poisoned while operating a 5-hp concrete saw in a bathroom having open doors and an operating ventilation system. There is agreement between both the modeled and field-generated data, indicating that hazardous CO concentrations can develop within minutes. Comparison of field and modeling data showed the measured CO generation rate at approximately one-half of the value used in the model, which may be partially because the engine used in the field was not under load during data collection. The generation rate and room size from the actual poisoning was then used in the model. The model determined that ventilation rates of nearly 5000 ft3/min (120 air changes per hour) would be required to prevent the CO concentration from exceeding the 200-ppm ceiling for short periods. Results suggest that small gasoline-powered engines should not be operated inside of buildings or in semienclosed spaces and that manufacturers of such tools should improve their warnings and develop engineering control options for better user protection.