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Artificial stone (AS) is a composite material that has seen widespread use in construction, particularly for kitchen benchtops. However, fabrication processes with AS have been associated with serious lung disease. Safety data sheets (SDSs) aim to provide important information pertaining to composition and health risks. In the case of a complex mixture, SDSs may be problematic in terms of specific information on overall health risks. To assess this issue, we compared empirically determined mineral, metallic, and organic resin content of 25 individual AS products across six suppliers, with the corresponding SDS information. X-ray diffraction was used to quantitate the mineralogical components of AS samples, and X-ray fluorescence was used to estimate the metallic components. Organic material (resin content) was estimated using weight loss during calcination. Although the resin content for all AS samples was within the SDS-reported ranges, there was considerable variability in the crystalline silica content when comparing with supplier's SDS. Potentially toxicologically relevant metallic and mineral constituents were not reported. Some supplier SDSs were found to provide more information than others. Only one of the six suppliers provided crystalline mineral content other than silica, and only two suppliers provided any information about metals. There remains a limited understanding of lung pathogenesis from AS, and this study highlights the need for more comprehensive and standardized SDS information for risk assessment and management. [ABSTRACT FROM AUTHOR]

The objective of this systematic review was to determine the safety and effectiveness of any public health intervention designed to prevent and/or manage musculoskeletal symptoms (MSSs) in any type of musician. A total of 14 studies were included. Studies investigated exercise and/or education programs, and changes to equipment, with a range of musicians. There was some evidence to suggest that smaller piano keyboards, and exercise programs may be effective. Studies suggesting a benefit of exercise programs typically had lower level designs and higher risk of methodological bias, compared with those that reported no benefit. Future research should use more robust methods to reduce bias and come to definitive conclusions regarding the safety and effectiveness of interventions prior to implementation, to reduce the burden of MSSs for musicians. [ABSTRACT FROM AUTHOR]

The authors reflect on the history of the conferences and exhibitions of the Australian Institute of Occupational Hygienists Inc. (AIOH) and the highlights of the organization's 40th anniversary virtual symposium in 2020. Topics include the AIOH's membership to the Asian Network of Occupational Hygiene (ANOH) and the Occupational Hygiene Training Association (OHTA), and how the virtual symposium was planned and implemented.

We believe both conditions should have been specifically considered and analyzed by the authors, but no data are reported in the article in this regard, i.e. specular luminance measurement from the screen in addition to specular luminance from walls, snow, water, etc. Blue light exposure comes from the ambient outdoor reflected blue light (extended occupational visual field) [[2]], as well as specular light from the screen, of which no reflection properties are described in the paper. [Extracted from the article]

Highlights: [•] We describe a protocol for testing skin absorption of toxic gases in HAZMAT scenarios. [•] We apply this to chlorine and hydrogen cyanide for skin decontamination decision-making. [•] Human skin penetration is generally low for exposures up to LCL0 for 30min. [•] Street clothing and environmental factors influence offgassing profiles and absorption. [•] Findings can be translated into practical guidelines for emergency responders. [Copyright &y& Elsevier]

Abstract: High school-based introductory occupational safety education has become common and serves an important role in preparing students for entry into the workforce. However, the practices and perspectives of teachers have received limited attention. We sought to gather empirical data from high schools in South Australia and examine potential predictors of effective safety education. Focus groups and interviews with teachers and school to work advisors were undertaken and a questionnaire survey of teachers conducted. Potential predictors of perceived effective learning were grouped in terms of teacher-, school- and teaching-related characteristics. Of the 156 respondents from 103 schools, 16% had received no formal safety training, 86% felt that the school management was supportive, and 36% felt that their ability to teach the topic effectively was compromised due to other demands of their role. Although general learning guidelines were available, there was variability in the time spent, teaching methods and resources used. In a multivariate model, perceived student engagement was significantly associated with the use of case studies (adjusted odds ratio=2.2). The teaching of occupational safety in high schools would benefit by a standardized yet engaging approach, incorporating case studies. In-service teacher training with more explicit guidance on effective content and delivery is recommended. [Copyright &y& Elsevier]

Abstract: In an atmospheric HAZMAT release unprotected public dermal exposure is often of short duration, but with potential secondary exposure if not decontaminated promptly. Mass decontamination is resource intensive and needs to be justified. For many HAZMAT agents there is no evidence-base on which to provide guidance on decontamination, particularly for non-symptomatic worried well. It is important to understand the influence of street clothing and environmental and other factors. Ammonia is a common HAZMAT agent and was selected for in vitro human skin studies of absorption, penetration and off-gassing at test concentrations up to 2000ppm, incorporating primary and secondary exposure combinations up to 60min. Intact skin provided a good barrier to ammonia penetration. Heavy street clothing such as denim was found to act as an initial barrier to skin absorption but subsequently as a reservoir for secondary exposure, under variable temperature and humidity conditions. Rapid off-gassing was observed for lighter fabrics including polyester and cotton. The findings here have been summarized as a set of practical guidelines for emergency responders who are required to make decisions about ammonia decontamination including for non-symptomatic individuals. This evidence-based diagrammatic approach allows for specific actions based on different atmospheric ammonia concentrations and other parameters. [Copyright &y& Elsevier]

Soil contamination by volatile hydrocarbons is of public health importance due to vapor intrusion and indoor inhalation exposures. These are assessed using measurement or predictive modeling and need to consider the key areas of subsurface partitioning and transport, dwelling ventilation, and receptor inhalation dosimetry. While subsurface partitioning and transport have been subject to intensive international investigation, limited consideration has been given to the latter. Building ventilation research has developed multi-zone airflow and contaminant dispersal models including AccuRate, an Australian model that examines natural ventilation modeling, roof and sub-floor ventilation, and identifies the importance of geometry and thermal factors on ventilation (the most sensitive variable) and indoor pollutant concentrations. Inhalation dosimetry has received recent attention due to concerns over child inhalation susceptibility and dose metrics. Research using coupled computational fluid dynamics (CFD) and physiologically based pharmaco-kinetic (PBPK) models has reported variance from previous animal models’ extrapolation while CFD modeling of transient lung vapor absorption suggests the significance of transient versus steady-state evaluation of volatiles absorption into tissue and blood. The transient nature of sub-surface fate and transport, ventilation, and inhalation uptake thus warrants integrated exploration and application in order to realize improvements in vapor intrusion assessments. These perspectives and Australian modeling initiatives are presented in this article. [ABSTRACT FROM AUTHOR]

We aimed to evaluate and compare the prevalence and profile of musculoskeletal symptom (MSS) outcomes across cohorts of university music students with different 'majors': (i) performance and nonperformance students, and (ii) classical and non-classical performance students. Data were collected using a cross-sectional questionnaire survey, and regression analyses were used to compare the groups. Of the 166 participating students, 92.5% reported experiencing MSSs in the last 12 months, and 72.6% in the last 7 days. Few significant differences were identified between groups. Musculoskeletal symptoms are a problem for all types of university music students, and all should have access to support to prevent and manage their MSSs, regardless of their majors. [ABSTRACT FROM AUTHOR]

Abstract: Problem: Young workers are over-represented in injury statistics. In order to develop injury prevention strategies, this study investigated time trends and predictive factors relating to safety skills, confidence, and attitudes. Method: Annual surveys were conducted from 2006-2009 among incoming students at the University of Adelaide. The questions addressed safety training, injury experience, and health and safety perceptions. Results: Time trends in training, perceived safety skills, confidence, and attitudes were not significant. In terms of skills and confidence, the most important correlate was safety training outside of high school (odds ratio=1.6), especially when repeated, assessed, or in face to face mode. Feeling strongly about safety issues was best predicted by injury experience (OR=1.7) and gender. Discussion: These results emphasize the value of assessed training, but they are also consistent with published U.S. data, indicating no improvement over time. It is suggested that there be a more integrated approach in safety education, involving schools and workplaces. Impact on industry: By developing an understanding of student safety perceptions and experiences, this research aims to target strategies to reduce the excess injury rate for young workers. Workplaces should be more aware of the limitations of school-based safety education and a more integrated and evidence-based approach should be developed, involving schools and workplaces. [Copyright &y& Elsevier]

Exposure to Environmental Tobacco Smoke (ETS) in hotels and clubs is of community concern and may lead to a variety of adverse health outcomes for workers and patrons. This study sought to measure ETS in both smoking and non-smoking areas of hospitality venues in South Australia and to assess the effectiveness of ETS control measures. Seven hotels, clubs and cafes were investigated and the concentrations of airborne nicotine and particulate matter (PM 10 ) were measured as markers of ETS exposure during normal to busy periods. Overall average concentrations were higher in smoking areas (nicotine = 15 μg/m 3 and PM 10  = 255μg/m 3 ) compared with non-smoking dining areas (nicotine = 7 μg/m 3 and PM 10  = 192 μg/m 3 ). The data demonstrate an approximate two-fold reduction of ETS within non-smoking areas and suggest that mechanical ventilation is only partially effective in preventing propagation of ETS throughout premises. Risk models suggest that ETS exposures in non-smoking areas may still represent an appreciable health risk. It is recommended that smoking be totally banned in enclosed publicly accessible areas. [ABSTRACT FROM AUTHOR]

Since breast feeding is acknowledged as the best nutrition for young babies, it needs to be protected, supported and promoted. This includes enabling mothers to continue breastfeeding even when they return to work. This paper describes a project that promotes balancing breastfeeding and paid work through the development, distribution, promotion and evaluation of suitable materials to workplaces employers and women in Australia. Information provided in a workplace kit was based on previous successful strategies from published works in refereed journals and in consultation with employers, employees and other key people. Information for employees was further summarized and translated into Arabic, Chinese, Turkish, Spanish and Vietnamese. Over 50 000 information kits were distributed Australia-wide using a database that comprised contact details of medium to large workplaces plus employee and employer organizations, with preference given to workplaces that employed women of childbearing age and women from diverse cultural backgrounds. The translated material was also distributed to migrant resource centres and working women's centres around Australia. Promotion of the project was extensive, resulting in 20 newspaper articles, 17 radio interviews or news items, and articles in 18 newsletters and professional journals and three magazines. The project was also promoted at three conferences and one seminar. Evaluation (directed at employers) focused primarily on the distribution and content of the information kit, since the evaluation was conducted soon after distribution. The evaluation survey was sent to 1571 valid contact (808 e-mail addresses, 1360 fax numbers). The response rate was 12.8% (n=202). Seventy per cent of responding businesses rated the information kit as excellent. Over half anticipated the kit would be useful in their organizations, while over two-thirds agreed that the kit provided sufficient information and suitable solutions to support balancing breastfeeding and work in their organization. While this project has achieved its objectives, further work is required to assist organizations to develop and implement policies and procedures for balancing breastfeeding and work, so that breastfeeding mother who are returning to work can continue to breastfeed as long as they and their baby require it. [ABSTRACT FROM AUTHOR]

Concerns have been raised for the health and wellbeing of self-employed workers. Musicians are the 'original' gig workers, and musicians have a high prevalence of musculoskeletal symptoms (MSSs). Studies of musicians' MSSs have typically focused on classical, employer-employed musicians; leaving self-employed musicians under-investigated. We investigated the prevalence of MSS outcomes in all types of professional musicians, and compared the MSS outcomes between self-employed and employer-employed musicians. We conducted a cross-sectional study of professional musicians. Given the large proportion of musicians who were both self-employed and employer-employed, three groups were compared: self-employed only (self-employed group), employer-employed only (employer-employed group), and both self-employed and employer-employed (both group) musicians. Multivariable regression analyses were conducted. A total of 225 professional musicians were included in the study, 87.9% of whom reported MSSs in the last 12 months. For MSSs that impaired musical activity, the 12-month prevalence was 43.2%. Musicians in the self-employed group reported a significantly higher 7-day prevalence of MSSs compared with those in the employer-employed group. Compared with musicians in the employer-employed group, musicians in the both group reported a higher 12-month prevalence of MSSs that impaired musical activity. A higher proportion of symptomatic musicians in the both group reported seeing a health professional for their MSSs, compared with the employer-employed group. Similarly, symptomatic musicians in the both group reported higher ratings of emotional impact from MSSs, compared with symptomatic musicians in the employer-employed group. The majority of musicians have experienced MSSs. Several significant differences were reported between the three groups of musicians, with musicians in the both group generally reporting poorer MSS outcomes, compared with musicians in the employer-employed group. There are several potential reasons for why musicians who are both self-employed and employer-employed appear to have poorer MSS outcomes, including the stress of balancing multiple demands. Further research is required into the risk factors for MSS outcomes in self-employed musicians, including those who are both self-employed and employer-employed, and interventions should be directed towards self-employed musicians to minimise the MSS burden. [ABSTRACT FROM AUTHOR]

This technical note provides details of an experimental technique for in-vitro skin studies with atmospheric chemical challenge. There appear to be major evidence gaps in relation to dermal exposure of gases. We describe a modification of standard OECD protocols for an atmospheric delivery system which can be used to understand interaction of toxic gases and the skin. The system can be used to examine the mechanisms by which skin uptake occurs. Auxiliary components which allow for parameter variation such as temperature and relative humidity are also described. Methodology presented in this technical note uses examples of gas challenges (ammonia, chlorine) to illustrate its application to gases of differing physicochemical properties. This adapted protocol can be applied in the context of HAZMAT scenarios involving atmospheric toxic chemical release and dermal absorption potential under variable exposure conditions. [ABSTRACT FROM AUTHOR]

Background and Objective: The resurgence of severe and progressive silicosis among engineered stone benchtop industry workers is a global health crisis. We investigated the link between the physico‐chemical characteristics of engineered stone dust and lung cell responses to understand components that pose the greatest risk. Methods: Respirable dust from 50 resin‐based engineered stones, 3 natural stones and 2 non‐resin‐based materials was generated and analysed for mineralogy, morphology, metals, resin, particle size and charge. Human alveolar epithelial cells and macrophages were exposed in vitro to dust and assessed for cytotoxicity and inflammation. Principal component analysis and stepwise linear regression were used to explore the relationship between engineered stone components and the cellular response. Results: Cutting engineered stone generated fine particles of <600 nm. Crystalline silica was the main component with metal elements such as Ti, Cu, Co and Fe also present. There was some evidence to suggest differences in cytotoxicity (p = 0.061) and IL‐6 (p = 0.084) between dust samples. However, IL‐8 (CXCL8) and TNF‐α levels in macrophages were clearly variable (p < 0.05). Quartz explained 11% of the variance (p = 0.019) in macrophage inflammation while Co and Al accounted for 32% of the variance (p < 0.001) in macrophage toxicity, suggesting that crystalline silica only partly explains the cell response. Two of the reduced‐silica, non‐engineered stone products induced considerable inflammation in macrophages. Conclusion: These data suggest that silica is not the only component of concern in these products, highlighting the caution required as alternative materials are produced in an effort to reduce disease risk. To understand the drivers of severe silicosis among engineered stone workers, we performed the most comprehensive multidisciplinary study linking engineered stone particle chemistry to the lung cell response published to date. We found that silica, aluminium and cobalt were associated with the cell response, highlighting the importance of non‐silica elements. [ABSTRACT FROM AUTHOR]

Musculoskeletal (MSK) symptoms are common amongst professional musicians. No study has reported on workers' compensation claims (WCCs) of musicians to determine the proportion of claims and costs attributed to MSK conditions. We analyzed Australian WCCs for professional musicians 2004/2005–2015/2016. MSK conditions accounted for 69.78% of claims; 50.46% of which were for upper limb conditions. MSK conditions also accounted for 77.76% of costs for musicians' WCC. The most common reported mechanism for MSK claims was body stressing (72.48%), and the most common agency was "other non-powered equipment" (including musical instruments; 39.71%), which also accounted for 51.27% of upper limb claims specifically. For the first time, we showed that MSK conditions account for the majority of musicians' WCC, and the majority of the cost of claims, making them the biggest health issue for professional musicians. [ABSTRACT FROM AUTHOR]

Greenhouses are enclosed structures which have various characteristics that enhance crop productivity, but the implications for workers' pesticide exposure and uptake are not well understood. A narrative literature review was conducted to explore the mechanism/s of interactions between greenhouse characteristics and occupational pesticide exposure. Using a "work", "worker" and "workplace" conceptual framework, the greenhouse environment (hot and humid microclimate, limited space and dense crop arrangements) combines with work characteristics (high work and pesticide use intensity, multi-tasking, predominantly manual spraying techniques and quick reentry to treated farms) to potentially increase occupational pesticide exposure, compared with open field farming. Greenhouse environments, are variable but have been shown to influence pesticide availability, route, pathways and frequency of exposure, deposition and distribution on a worker's body as well as use and performance of exposure control methods. Training programs can emphasize the differences in exposure potential between greenhouse and open field farming. Development of tailored guidelines for exposure control strategies to better suit the level of uniqueness of greenhouse agriculture seems warranted. [ABSTRACT FROM AUTHOR]

Abstract Permeation of oxides of nitrogen and sulfur gases through skin and the consequences of dermal exposure are still poorly understood. We measured the penetration profile of three common industrial gases through skin, for short-term exposures relevant to HAZMAT scenarios. Time variations of gas concentration, clothing effects, temperature and humidity on epidermal absorption and penetration were assessed. Fabric off-gassing profiles were also investigated. The results show oxides of nitrogen (NO and NO 2) at airborne concentrations up to lethal inhalation levels (e.g. 3000 ppm) have little skin penetration ability. Skin absorption and reservoir effects were noted. Skin exposed to SO 2 (3000 ppm/30 min) shows negligible skin absorption or penetration. Fabric on skin marginally increased SO 2 absorption and subsequent ventilation did not reduce the absorbed fraction. Increased temperature and humidity had limited additional effect on skin penetration. Importantly, clothing demonstrated sink properties, especially for SO 2. Short-term skin exposure relevant to accidents will not significantly contribute to body burden. The greatest concern will likely be off-gassing of chemical-laden fabric for asthma suffers. The risk-based management approach is to avoid potential secondary inhalation from fabric off-gassing by removal of outer layer of bulky clothing. Decontamination and moving into an area of enhanced ventilation may also be advised. Graphical abstract Unlabelled Image Highlights • We describe skin absorption of oxidant gases under accident exposure scenarios. • Human skin penetration is low for exposures at lethal concentrations up to 30 min. • Clothing influences off-gassing profiles and skin absorption. • Findings can be translated into practical guidance for first responders. [ABSTRACT FROM AUTHOR]

The authors aimed to characterize the current evidence base regarding musicians' musculoskeletal symptoms (MSS), in order to identify gaps for future research. A systematic search was conducted to identify peer-review studies published in English in 2007-2016 that investigated musicians' MSS. Narrative reviews, case reports, protocols, and questionnaire or program development papers were excluded. Data were synthesized descriptively in order to identify gaps in the current evidence base. Five systematic reviews and 153 primary studies (133 unique) were included in this review. The majority (71%) of studies investigated professional musicians and/or university music students, with orchestral musicians being the most commonly investigated group. The majority of studies investigated the extent of the problem (68%) and/or associated factors (54%). Eight studies compared the prevalence of MSS outcomes with other populations. A range of risk factors were investigated; however, few studies used longitudinal designs. A total of 16 intervention studies were identified (3 clinical, 13 public health), with 12 investigating education or exercise programs. There is a need for research into musicians beyond classical university music students and professional orchestral musicians, and these musical sub-groups should be compared to determine the most at risk groups of musicians. Studies looking at potential risk factors should move towards longitudinal designs so that the temporal relationship of these factors and MSS could be established, where cross-sectional designs have indicated that an association exists. Intervention studies should be based upon the risk factors identified, and extend beyond education and exercise programs. Int J Occup Med Environ Health. 2019;32(3):291-331. [ABSTRACT FROM AUTHOR]

Engineered stones are often characterized for their crystalline silica content. Their organic composition, particularly that of the emissions generated during fabrication work using hand-held power tools, is relatively unexplored. We forensically screened the emissions from dry-cutting 12 engineered stone products in a test chamber for their organic composition by pyrolysis-gas chromatography-mass spectrometry (GC-MS) plus selected traditional capture and analysis techniques. Phthalic anhydride, which has a Respiratory Sensitization (RSEN) Notation by the American Conference of Governmental Industrial Hygienists (ACGIH), was the most common and abundant compound, at 26–85% of the total organic composition of engineered stone emissions. Benzaldehyde and styrene were also present in all twelve samples. During active cutting, the predominant volatile organic compound (VOC) emitted was styrene, with phthalic anhydride, benzene, ethylbenzene, and toluene also detected. These results have important health implications as styrene and phthalic anhydride are irritants to the respiratory tract. This study suggests a risk of concurrent exposure to high levels of respirable crystalline silica and organic lung irritants during engineered stone fabrication work. [ABSTRACT FROM AUTHOR]

An Australian National Dust Disease Taskforce was established to address the re-emergence of occupational lung disease, in particular silicosis. Exposure to respirable crystalline silica (RCS) occurs in various industries in Australia. We asked occupational hygienists about their practical experiences and perspectives on RCS exposure and regulatory action. A total of 105 members of the Australian Institute of Occupational Hygienists completed an anonymous questionnaire, which addressed individual characteristics, experience, perceived level of employer awareness, effectiveness of current regulation, and recommendations for improvement, across three main industrial sectors. Based on professional experience, 71% were concerned about the potential for RCS over-exposure. Barriers to adequate exposure control included lack of management commitment and financial resources. The employment of specialist occupational hygiene inspectors was considered to be the most effective regulatory strategy. Given the large number of exposed workers in the construction industry, with only a moderate awareness, there is the potential for significant cost shifting of the burden of occupational lung disease from employers on to individuals and the public health system. A nationally consistent approach to RCS exposure control across all industrial sectors is now recommended, with an increased focus on measuring and controlling exposure. [ABSTRACT FROM AUTHOR]

Accidental or intentional releases of toxic gases or vapors are the most common occurrence in hazardous material (HAZMAT) incidents that result in human injuries. The most serious hazard from exposure to gases or vapors is via the respiratory system. Dermal uptake, as a secondary route, is still a concern, most acutely for the unprotected public. There is a limited evidence base describing skin absorption of toxic gases and vapors in HAZMAT exposure scenarios, which are relatively brief compared with traditional test periods for skin absorption studies. We describe research designed to provide experimental data to support decision-making by first responders regarding skin decontamination in HAZMAT-focused exposure scenarios involving toxic gases. We present findings for three common fumigants, methyl bromide, sulfuryl fluoride, and chloropicrin assessed using an Organization for Economic Co-operation and Development in vitro toxicology protocol utilizing human skin and gas/vapor exposures. Results indicate that for atmospheric concentrations that would be lethal via inhalation (LCLo), intact skin provides an excellent barrier to exposures up to 30 min, with little influence of common clothing fabric and high temperature and humidity conditions. The findings may challenge the current HAZMAT dogma requiring mass personal decontamination by strip and shower for short-term exposures to sulfuryl fluoride and chloropicrin gas/vapor. [ABSTRACT FROM AUTHOR]

Ethylene oxide (EO) is a reactive gas used by numerous industries and medical facilities as a sterilant, a fumigant, and as a chemical intermediate in chemical manufacturing. Due to its common use, EO has been involved in a number of leaks and explosive incidents/accidents requiring HAZMAT response. However, the extent of skin absorption under short-term HAZMAT conditions has not been directly assessed. Such data would assist decision making by first responders regarding skin decontamination in EO HAZMAT incidents. An in vitro test protocol with human skin was used for EO exposures at 800 ppm and 3000 ppm. No evidence of dermal penetration was seen for 800 ppm EO during a 30-min challenge. For 3000 ppm, EO penetration was observed after 20 min and was greater under higher temperature/humidity conditions. Fabric (heavy cotton) on skin enhanced penetration 5-fold compared with naked skin. Off gassing from exposed fabric was rapid. The results show dermal uptake of EO vapour from exposure at 3000 ppm is small but clothing may contribute to further dermal absorption/penetration over time. For exposed, but asymptomatic, persons in EO HAZMAT incidents first responders should remove bulky clothing to prevent potential skin damage and further uptake. [ABSTRACT FROM AUTHOR]

Accidental or intentional releases of toxic gases can have significant public health consequences and emergency resource demands. Management of exposed individuals during hazardous material incidents should be risk and evidence based, but there are knowledge gaps in relation to dermal absorption of gases and management advice for potentially exposed individuals. Using a modified Organization for Economic Co-operation and Development (OECD) in vitro toxicology protocol with human donor skin, this article reports on two common and odorous chemicals, hydrogen sulphide and phosphine. Results show that undamaged human skin provides a good barrier to hydrogen sulphide (up to 800 ppm) and phosphine (up to 1000 ppm) penetration for up to 30 min exposures, with little variability in the presence of clothing or in elevated temperature and humidity conditions. A practical guideline template for skin decontamination has been developed, and implications of the research for first responders are outlined. [ABSTRACT FROM AUTHOR]

Fluorescent or LED nail lamps are used in manicure and pedicure salons to cure nail coatings. These are UV sources, but with significant blue light emissions. Most of the literature emphasizes skin damage and cancer risk from UV exposure rather than blue light-induced damage to visual photoreceptors. Nail technicians using the lamps routinely may have potentially greater exposure than customers. However, there are no data on blue light radiance levels combined with time activity patterns for exposure assessment. This research aimed to determine exposures through simulation experiments, informed by observational studies in seven nail salons. Typical and worst-case time activity patterns were established, and spectral radiance doses determined in the occupational visual field for two LED nail curing lamps. The results showed the effective spectral radiance dose were below the current guideline promulgated by the International Commission on Non-Ionising Radiation Protection. Interestingly, radiances at the corners of one LED nail curing lamp was higher than at the center, which shows the amount of exposure can differ depending on the viewing angle. This research is the first to determine spectral radiance doses. A covered design is highly recommended for blocking the emission of blue light from a nail lamp. [ABSTRACT FROM AUTHOR]

Background: Occupational exposure to extreme heat without sufficient protection may not only increase the risk of heat-related illnesses and injuries but also compromise economic productivity. With predictions of more frequent and intense bouts of hot weather, workplace heat exposure is presenting a growing challenge to workers' health and safety. This study aims to investigate workers' perceptions and behavioural responses towards extreme heat exposure in a warming climate.Methods: A cross-sectional questionnaire survey was conducted in 2012 in South Australia among selected outdoor industries. Workers' heat risk perceptions were measured in the following five aspects: concerns about heat exposure, attitudes towards more training, policy and guideline support, the adjustment of work habits, and degree of satisfaction of current preventive measures. Bivariate and multivariate logistic regression analyses were used to identify factors significantly associated with workers' heat perceptions.Results: A total of 749 respondents participated in this survey, with a response rate of 50.9 %. A little more than half (51.2 %) of respondents were moderately or very much concerned about workplace heat exposure. Factors associated with workers' heat concerns included age, undertaking very physically demanding work, and the use of personal protective equipment, heat illness history, and injury experience during hot weather. Less than half (43.4 %) of the respondents had received heat-related training. Workers aged 25-54 years and those with previous heat-related illness/injury history showed more supportive attitudes towards heat-related training. The provision of cool drinking water was the most common heat prevention measure. A little more than half (51.4 %) of respondents were satisfied with the current heat prevention measures. About two-thirds (63.8 %) of respondents agreed that there should be more heat-related regulations and guidelines for working during very hot weather. More than two-thirds (68.8 %) of the respondents were willing to adjust their current work habits to adapt to the likely increasing extreme heat, especially those with previous heat illness experience.Conclusions: The findings suggest a need to strengthen workers' heat risk awareness and refine current heat prevention strategies in a warming climate. Further heat educational programmes and training should focus on those undertaking physically demanding work outdoors, in particular young workers and those over 55 years with low education levels. [ABSTRACT FROM AUTHOR]

With warmer weather projections, workplace heat exposure is presenting a growing challenge to workers’ health and safety. Occupational hygienists are the specialist group conducting measurements and providing advice on heat stress management to industry. In order to provide insights into hygienists perceptions on workplace heat exposure, current and future preparedness for extreme heat, and barriers to possible heat adaptation strategies, a self-administered questionnaire survey was conducted during a national conference of the Australian Institute of Occupational Hygienists. Nearly 90% of the 180 respondents were at least moderately concerned about extreme heat and 19% were dissatisfied with current heat stress prevention measures. Barriers recognized by the participants were lack of awareness (68%), insufficient training (56%), unsatisfactory management commitment (52%), and low compliance with prevention policies (40%). The findings suggest a need to refine occupational heat management and prevention strategies. [ABSTRACT FROM AUTHOR]

This study aims to investigate the impact of heatwaves on worker׳s health and safety; to identify workers at higher risk of prevalent illnesses and injuries due to heatwaves; and to provide evidence for policy-makers and service providers. South Australian workers׳ compensation claims data for 2001–2010 were transformed into time series format, merged with meteorological data and analysed using generalized estimating equation (GEE) models. For total injury claims there was no significant difference detected between heatwave and non-heatwave periods. However, for outdoor industries, daily claims increased significantly by 6.2% during heatwaves. Over-represented in hot weather were male labourers and tradespersons aged ≥55 years, and those employed in ‘agriculture, forestry and fishing’ and ‘electricity, gas and water’. Occupational burns, wounds, lacerations, and amputations as well as heat illnesses were significantly associated with heatwaves. Similarly, moving objects, contact with chemicals, and injuries related to environmental factors increased significantly during heatwaves, especially among middle-aged and older male workers. With the predicted increase of extremely hot weather, there is a need for relevant adaptation and prevention measures at both practice and policy levels for vulnerable work groups. [ABSTRACT FROM AUTHOR]

Older people are often over-represented in morbidity and mortality statistics associated with hot and cold weather, despite remaining mostly indoors. The study "Improving thermal environment of housing for older Australians" focused on assessing the relationships between the indoor environment, building characteristics, thermal comfort and perceived health/wellbeing of older South Australians over a study period that included the warmest summer on record. Our findings showed that indoor temperatures in some of the houses reached above 35 °C. With concerns about energy costs, occupants often use adaptive behaviours to achieve thermal comfort instead of using cooling (or heating), although feeling less satisfied with the thermal environment and perceiving health/wellbeing to worsen at above 28 °C (and below 15 °C). Symptoms experienced during hot weather included tiredness, shortness of breath, sleeplessness and dizziness, with coughs and colds, painful joints, shortness of breath and influenza experienced during cold weather. To express the influence of temperature and humidity on perceived health/wellbeing, a Temperature Humidity Health Index (THHI) was developed for this cohort. A health/wellbeing perception of "very good" is achieved between an 18.4 °C and 24.3 °C indoor operative temperature and a 55% relative humidity. The evidence from this research is used to inform guidelines about maintaining home environments to be conducive to the health/wellbeing of older people. [ABSTRACT FROM AUTHOR]

The costs of global warming are substantial. These include expenses from occupational illnesses and injuries (OIIs), which have been associated with increases during heatwaves. This study estimated retrospective and projected future heatwave-attributable OIIs and their costs in Australia. Climate and workers' compensation claims data were extracted from seven Australian capital cities representing OIIs from July 2005 to June 2018. Heatwaves were defined using the Excess Heat Factor. OIIs and associated costs were estimated separately per city and pooled to derive national estimates. Results were projected to 2030 (2016–2045) and 2050 (2036–2065). The risk of OIIs and associated costs increased during heatwaves, with the risk increasing during severe and particularly extreme heatwaves. Of all OIIs, 0.13% (95% empirical confidence interval [eCI]: 0.11–0.16%) were heatwave-attributable, equivalent to 120 (95%eCI:70–181) OIIs annually. 0.25% of costs were heatwave-attributable (95%eCI: 0.18–0.34%), equal to $AU4.3 (95%eCI: 1.4–7.4) million annually. Estimates of heatwave-attributable OIIs by 2050, under Representative Concentration Pathway [RCP]4.5 and RCP8.5, were 0.17% (95%eCI: 0.10–0.27%) and 0.23% (95%eCI: 0.13–0.37%), respectively. National costs estimates for 2030 under RCP4.5 and RCP8.5 were 0.13% (95%eCI: 0.27-0.46%) and 0.04% (95%eCI: 0.66-0.60), respectively. These estimates for extreme heatwaves were 0.04% (95%eCI: 0.02–0.06%) and 0.04% (95%eCI: 0.01–0.07), respectively. Cost-AFs in 2050 were, under RCP4.5, 0.127% (95%eCI: 0.27-0.46) for all heatwaves and 0.04% (95%eCI: 0.01-0.09%) for extreme heatwaves. Attributable fractions were approximately similar to baseline when assuming theoretical climate adaptation. Heatwaves represent notable and preventable portions of preventable OIIs and economic burden. OIIs are likely to increase in the future, and costs during extreme heatwaves in 2030. Workplace and public health policies aimed at heat adaptation can reduce heat-attributable morbidity and costs. [Display omitted] • Limited research on expenses from work injuries and illnesses during heatwaves. • Assessment of heatwave-attributable occupational injuries, illnesses and costs. • Increased injuries and illnesses during heatwaves both retrospectively and future. • Costs increased during heatwaves, with some evidence for projected increases. • Climate adaptation can potentially reduce occupational burden. [ABSTRACT FROM AUTHOR]

Hands and forearms are the principal sites of dermal exposure to organophosphate insecticides, which makes glove use one of the most important components of an exposure control strategy. However, the selection of suitable gloves depends on issues such as task, type, and concentration of organophosphate as well as cost. In addition, chemical protection performance of gloves may be temperature dependent, which is of increasing concern in a warming climate. Two recommended reusable glove materials (polyvinylchloride and nitrile butadiene rubber) and one single-use glove (nitrile/neoprene) were tested for permeation resistance to actual formulations of organophosphate insecticides with active ingredients dimethoate and malathion. Chemical resistance parameters were measured using American society for testing and materials permeation test cells and compared across glove, organophosphate type, and temperature. The three gloves demonstrated comparable and adequate chemical resistance (less than one µg cm−2 min−1 for up to 8 hr exposure; 25–60 °C) for dilute forms of dimethoate and malathion, used during spraying activities. However, the single-use nitrile/neoprene glove is not designed to fully cover the elbow which limits its suitability. In permeation tests that reflect "worst case" exposure scenario to concentrated (neat) organophosphate formulations, as in mixing/loading tasks, a significant variation in chemical resistance between gloves was observed. While polyvinylchloride offered the maximum resistance, physical degradation of nitrile butadiene rubber after 3 hr of continuous exposure makes it unsuitable for handling neat dimethoate. The single-use nitrile/neoprene glove material had considerably poorer permeation resistance (up to 155-fold greater permeation and 6-fold shorter breakthrough) against neat formulations. Overall, elevated temperature (>40 °C) was shown to result in significantly greater (P < 0.05) cumulative permeation of neat formulation insecticides. This work demonstrates the variation in glove performance and potential for greater exposure risk particularly when mixing concentrated pesticides at elevated temperature conditions such as an occluded human skin or hot greenhouses. Training and guidance on testing, selection, use, and storage of gloves should consider in-use exposure scenarios and temperature-induced reduction in chemical protective performance. [ABSTRACT FROM AUTHOR]

The thermal working environment can have direct and in-direct effects on health and safety. Ambient temperatures have been associated with an increased risk of occupational injuries but it is unknown how the relationship can vary by weather, location and climate. To examine the relationship between ambient temperatures and work-related injury and illness compensation claims in three Australian cities: Melbourne and Perth (temperate climate) and Brisbane (subtropical climate) in order to determine how hot and cold weather influences the risk of occupational injury in Australia. Workers' compensation claims from each city for the period 2005 to 2016 were merged with local daily weather data. A time-stratified case-crossover design combined with a distributed lag non-linear model was used to quantify the impacts of daily maximum temperature (T max) on the risk of work-related injuries and illnesses. Compared to the median maximum temperature (T max), extremely hot temperatures (99th percentile) were associated with a 14% (95%CI: 3–25%) increase in total workers' compensation claims in Melbourne, but there were no observed effects in Brisbane or Perth, with the exception of traumatic injuries that increased by 17% (95%CI: 3–35%) during extreme heat in Perth. For extremely low temperatures (1st percentile), there was a protective effect in Brisbane (RR 0.89; 95%CI: 0.81–0.98), while no effects were observed in Melbourne or Perth. The relationship between injury and ambient temperature appears to be variable depending on location and climate. In general, work-related injuries and illnesses appear to be more common at higher temperatures than lower temperatures. Adopting adaptation and prevention measures could reduce the social and economic burden of injury, and formulating effective measures for dealing with high temperatures should be prioritised given the predicted increase in the frequency and intensity of hot weather. Unlabelled Image • The association of ambient temperatures with workers compensation claims was quantified in three Australian cities • Relationships between temperature and work-related injuries and illnesses varied by location and climate • Cooler day time maximum temperatures were associated with reduced risks to workers in all three cities • The avoidable burden of temperature was higher in sub-tropical Brisbane than in temperate Melbourne and Perth [ABSTRACT FROM AUTHOR]

Abstract Exposure to extreme heat can lead to a range of heat-related illnesses, exacerbate pre-existing health conditions and cause increased demand on the healthcare system. A projected increase in temperature may lead to greater healthcare expenditure, however, at present the costs of heat-related healthcare utilization is under-researched. This study aims to review the literature on heat-related costs for the healthcare system with a focus on ED visits, hospitalization, and ambulance call-outs. PubMed, Scopus, and Embase were used to search relevant literature from database inception to December 2017 and limited to human studies and English language. After screening, a total of ten papers were identified for final inclusion. In general, the healthcare costs of heat extremes have been poorly investigated in developed countries and not reported in developing countries where the largest heat-vulnerable populations reside. Studies showed that exposure to extreme heat was causing a substantial economic burden on healthcare systems. Females, the elderly, low-income families, and ethnic minorities had the highest healthcare costs on a range of health services utilization. Although a few studies have estimated heat healthcare costs, none of them quantified the temperature-healthcare cost relationship. There is a need to systematically examine heat-attributable costs for the healthcare system in the context of climate change to better inform heat-related policy making, target interventions and resource allocation. Graphical abstract Unlabelled Image Highlights • Heat exposure was causing a substantial economic burden on healthcare systems. • Heat attributable healthcare costs are likely to increase in a changing climate. • Females, the elderly, and low income groups had the highest heat healthcare costs. • More evidence is needed for the evaluation of heat attributable healthcare costs. [ABSTRACT FROM AUTHOR]

Abstract Background The thermal environment can directly affect workers' occupational health and safety, and act as a contributing factor to injury or illness. However, the literature addressing risks posed by varying temperatures on work-related injuries and illnesses is limited. Objectives To examine the occupational injury and illness risk profiles for hot and cold conditions. Methods Daily numbers of workers' compensation claims in Adelaide, South Australia from 2003 to 2013 (n = 224,631) were sourced together with daily weather data. The impacts of maximum daily temperature on the risk of work-related injuries and illnesses was assessed using a time-stratified case-crossover study design combined with a distributed lag non-linear model. Results The minimum number of workers' compensation claims occurred when the maximum daily temperature was 25 °C. Compared with this optimal temperature, extremely hot temperatures (99th percentile) were associated with an increase in overall claims (RR: 1.30, 95%CI: 1.18–1.44) whereas a non-significant increase was observed with extremely cold temperatures (1st percentile, RR: 1.10 (95%CI: 0.99–1.21). Heat exposure had an acute effect on workers' injuries whereas cold conditions resulted in delayed effects. Moderate temperatures were associated with a greater injury burden than extreme temperatures. Conclusion Days of very high temperatures were associated with the greatest risks of occupational injuries; whereas moderate temperatures, which occur more commonly, have the greatest burden. These findings suggest that the broader range of thermal conditions should be considered in workplace injury and illness prevention strategies. Highlights • We examined the impact of ambient temperatures on work-related injuries and illnesses and quantified the associated burden. • Temperatures above and below the optimum of 25oC increased the risk of work-related injuries and illnesses. • Vulnerable groups varied according to occupation and work environments. • Moderate temperature ranges had the greatest burden yet the greatest risk was observed at extreme temperatures. [ABSTRACT FROM AUTHOR]

Purpose: Heatwaves, or extended periods of extreme heat, are predicted to increase in frequency, intensity and duration with climate change, but their impact on occupational injury has not been extensively studied. We examined the relationship between heatwaves of varying severity and work-related injuries and illnesses. We used a newly proposed metric of heatwave severity, the Excess Heat Factor (EHF), which accounts for local climate characteristics and acclimatization and compared it with heatwaves defined by daily maximum temperature.Methods: Work-related injuries and illnesses were identified from two administrative data sources: workers' compensation claims and work-related ambulance call-outs for the years 2003-2013 in Adelaide, Australia. The EHF metrics were obtained from the Australian Bureau of Meteorology. A time-stratified case-crossover regression model was used to examine associations between heatwaves of three levels of severity, workers' compensation claims, and work-related ambulance call-outs.Results: There was an increase in work-related ambulance call-outs and compensation claims during low and moderately severe heatwaves as defined using the EHF, and a non-significant decline during high-severity heatwaves. Positive associations were observed during moderate heatwaves in compensation claims made by new workers (RR 1.31, 95% CI 1.10-1.55), workers in medium-sized enterprises (RR 1.15, 95% CI 1.01-1.30), indoor industries (RR 1.09, 95% CI 1.01-1.17), males (RR 1.13, 95% CI 1.03-1.23) and laborers (RR 1.21, 95% CI 1.04-1.39).Conclusions: Workers should adopt appropriate precautions during moderately severe heatwaves, when the risks of work-related injuries and illnesses are increased. Workplace policies and guidelines need to consider the health and safety of workers during heatwaves with relevant prevention and adaptation measures. [ABSTRACT FROM AUTHOR]

Highlights • Relationship between heat and work injuries is strong but varies by work location and type of work. • Research is needed to characterize specific injuries, workers at risk and injury mechanisms. • There is a need for employers and workers to be aware of the health risks during hot weather. • Targeted interventions and workplace policies focussed on preventative strategies are needed. Abstract Rationale There is increasing concern about occupational illness, injury and productivity losses due to hot weather in a changing climate. Most of the current understanding appears to relate to heat-induced illness, and relatively little regarding injuries. Objectives This paper sought to summarise the evidence on the relationship between heat exposure and injuries, to describe aetiological mechanisms and to provide policy suggestions and further research directions. Methods A literature review was conducted using a systematic search for published and grey-literature using Embase, PubMed, Scopus, CINAHL, Science Direct and Web of Science databases as well as relevant websites. Results and conclusions There was a diversity of studies in terms of occupations, industries and methods utilised. The evidence suggests an imprecise but positive relationship between hot weather and occupational injuries, and the most likely mechanism involves fatigue, reduced psychomotor performance, loss of concentration and reduced alertness. The findings reflect an increased awareness of injury risk during hot weather and the economic benefits associated with averting injury, poor health outcomes and lost productivity. Implications More work is required to characterise specific injuries and the workers at risk. Policymakers and employers should be aware that heat exposure can lead to occupational injuries with information and training resources developed to aid prevention. [ABSTRACT FROM AUTHOR]

This article presents the first empirical experimental data on the skin absorption of methyl chloride gas using an in vitro technique and human skin. Methyl chloride is a commonly used industrial agent that is known to be an inhalational hazard but is also reported to be absorbed through human skin in amounts that contribute substantially to systemic intoxication. As a result, is has been assigned a skin notation by the ACGIH. Other than predictive models, there is a general paucity of experimental data on the skin absorption of methyl chloride and therefore a distinct lack of empirical evidence in the open literature to support the assignment of a skin notation for this chemical. This study found that methyl chloride permeates through human epidermis when exposed at high atmospheric concentrations within relatively short timeframes. Therefore, providing important initial empirical evidence in support of the assignment of a skin notation. [ABSTRACT FROM AUTHOR]

Owing to their volatility, the most important occupational exposure route for low-molecular-weight amines is considered to be inhalation. However, dermal exposure is also possible in many workplace situations. There are limited data available on the dermal uptake of these amines through human skin, and existing exposure standard skin notations are typically based on acute toxicity animal studies or by chemical analogy. This gap in knowledge is in part due to a lack of standardized approach for assessing dermal uptake. We describe a relatively simple protocol for the determination of permeation of low-molecular-weight amines through human skin in vitro. Using isopropylamine as a test amine, it was found that isopropylamine vapour has limited capacity to absorb into, or penetrate through, the epidermal layer of human skin, even at lethal atmospheric concentrations. This protocol can be adapted for a range of exposure scenarios, including clothing effects, and may be used to determine whether skin notations are warranted. [ABSTRACT FROM AUTHOR]

Owing to their volatility, the most important occupational exposure route for low-molecular-weight amines is considered to be inhalation. However, dermal exposure is also possible in many workplace situations. There are limited data available on the dermal uptake of these amines through human skin, and existing exposure standard skin notations are typically based on acute toxicity animal studies or by chemical analogy. This gap in knowledge is in part due to a lack of standardized approach for assessing dermal uptake. We describe a relatively simple protocol for the determination of permeation of low-molecular-weight amines through human skin in vitro. Using isopropylamine as a test amine, it was found that isopropylamine vapour has limited capacity to absorb into, or penetrate through, the epidermal layer of human skin, even at lethal atmospheric concentrations. This protocol can be adapted for a range of exposure scenarios, including clothing effects, and may be used to determine whether skin notations are warranted. [ABSTRACT FROM AUTHOR]

The extreme heat wave in Australia in 2009 resulted in significantly increased number of daily deaths. The circumstances that lead to deaths during extreme heat have not been explored before in Australia. This study aims to identify the individual and community risk factors for deaths during this extreme heat wave in Adelaide. A matched case-control study was conducted. Cases were those who died in the Adelaide metropolitan area during the heat wave period. For each case, two community controls were randomly selected, matched by age and gender. Face-to-face or telephone interviews were conducted to collect data of demographic information, living environment, social support, health status and behavioural changes during the heat wave. Descriptive analysis, as well as simple and multiple conditional logistic regressions were performed. In total, 82 deaths and 164 matched community controls were included in the analysis, with a median age of 77.5 (range 26.6-100.7). The multiple logistic regression model indicated that, compared with controls, the risk of death during the heat wave was significantly increased for people living alone (AOR = 42.31, 95 % CI 2.3, 792.8) or having existing chronic heart disease (AOR = 22.4, 95 % CI 1.7, 303.0). In addition, having air conditioning in bedrooms (AOR = 0.004, 95 % CI 0.00006, 0.28) and participating in social activities more than once a week (AOR = 0.011, 95 % CI 0.0004, 0.29) indicated significant protective effects. We have identified factors that could significantly impact on the likelihood of deaths during heat waves. Our findings could assist in the development of future intervention programs and policies to reduce mortality associated with a warmer climate. [ABSTRACT FROM AUTHOR]

Background: Motor vehicle-related air pollution can potentially impair lung function. The effect of pollution in people with compromised pulmonary function such as in COPD has not been previously investigated. To examine the association of lung function with motor vehicle density in people with spirometrically determined COPD in a cross-sectional study. Methods: In 2004-06, The North West Adelaide Health Study (NWAHS), a biomedical cohort of adults assessed pre and post-bronchodilator spirometry (n = 3,103). Traffic density, obtained from the motor vehicle inventory maintained by the South Australian Environment Protection Authority, was expressed as the daily numbers of vehicles travelling within a 200 m diameter zone around participants' geocoded residences. Results: In subjects with COPD (FEV1/FVC <0.7, n = 221, 7.1 %), increasing daily vehicle density was associated with statistically significant decreases in lung function parameters after adjustment for smoking and socio-economic variables. Mean (95 % CI) post-bronchodilator % predicted FEV1 was 81 % (76-87) in the low (⩽7179/day) compared with 71 % (67-75) in the high (⩾15,270/day) vehicle exposure group (p < 0.05). Linear regression analysis in all subjects with COPD showed significant decrements in post-bronchodilator FEV1/FVC ratio and % predicted FEV1 of 0.03 and 0.05 % respectively per daily increase in 1000 vehicles. In men with COPD (n = 150), the corresponding reductions were 0.03 and 0.06 %. Smaller, non-significant decrements were seen in females. No difference was seen in those without COPD. Conclusions: Vehicle traffic density was associated with significant reductions in lung function in people with COPD. Urban planning should consider the health impacts for those with pre-existing respiratory conditions. [ABSTRACT FROM AUTHOR]

[Display omitted] • PFAS were measured in foods, water, dust, soil, and appliances on fire stations. • Multiple pathways for firefighters' exposure to PFAS were characterised. • PFAS Intake levels were estimated under different exposure scenarios. • Consumption of food grown on fire stations seems the dominant exposure pathway. Human exposure to per- and polyfluoroalkyl substances also known as PFAS is an ongoing occupational and environmental health problem. This study seeks to characterise multiple pathways for firefighters' exposure to PFAS. PFAS were analysed in 688 environmental samples such as eggs, fruits, vegetables, dust, soil, surface swabs, appliance washes and water obtained from fire stations. Relevant exposure pathways were identified and daily intake levels were estimated using PFAS concentrations and exposure factors relevant to firefighters. Five PFAS including perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), 6:2 fluorotelomer sulfonate (6:2 FTS), and 8:2 fluorotelomer sulfonic acid (8:2 FTS) were frequently detected in the samples. Based on the median concentrations in each sample type, PFOS was the most abundant contaminant in eggs (80%), fruits (52%), dust (81%), surface swab (66%), soil (83%) and appliance wash (31%) samples. On the other hand, PFHxS was most abundant in vegetables (77%) and 8:2 FTS in water (58%). The intake estimation results show that dietary exposure from ingestion of foods produced on fire stations was the predominant exposure pathway, representing 82% and 62% of firefighters' total PFAS intake under typical and worst-case exposure scenarios, respectively. Incidental ingestion and dermal absorption of PFAS in dust contributed 15% for typical and 34% for worst-case exposure scenarios. The relative contributions from incidental ingestion and dermal absorption of PFAS in soil and appliance washes were insignificant. Overall, the study identifies multiple exposure pathways relevant to career firefighters including consumption of food grown on fire stations, which has not previously been recognised within the occupational exposure context. The results suggest exposure control strategies that target foods produced on fire stations could substantially reduce firefighters' exposure to PFAS. [ABSTRACT FROM AUTHOR]

Excessive workplace heat exposures are presenting an increasing challenge in terms of occupational injuries and heat-related illnesses. Although heat safety guidelines exist in many industries, the extent to which heat exposure is perceived to impact on workers is yet to be fully explored. In this case study, a qualitative approach was used to investigate outdoor council workers’ experiences and perceptions of heat impacts in the workplace. Thirty-two male workers participated in 5 focus groups. Proceedings were audio-recorded, transcribed and data coded using thematic analysis. Findings indicated that although existing heat policies are in place, hot weather continues to impact workers’ health and well-being, work practices and productivity. The results showed the importance of workplace management and training, and an understanding of the need for workers to be able to self-pace during hot weather. The impacts of these factors on the behavioral adaptation of workers are discussed along with implications of the research for the management of heat-related risks in workplaces. [ABSTRACT FROM AUTHOR]

Environmental noise is a significant risk factor for a range of short- and long-term adverse health outcomes such as annoyance, cognitive development impairment, sleep disturbance, cardiovascular effects, and psychiatric problems. The aim of this study was to gather standardized quality of life (QOL) data hitherto rarely correlated with noise annoyance by source category. To provide an evidence-base for environmental noise policy development, a representative state- based survey was undertaken in South Australia (SA). A total of 3015 face-to-face interviews were conducted, using a questionnaire addressing noise sources, distances to busy roads and standardized measures of perceived annoyance and QOL. Population weighted descriptive survey and regression analysis. The most common sources of noise annoyances were road transport (27.7%, using a Likert scale, aggregating "little" to "extreme" annoyance), neighbors (22.0%), construction noise (10.0%), air conditioner noise (5.8%), rail transport noise (4.7%), and industry (3.9%). Using the QOL instrument, all eight health dimensions were significantly decreased for those reporting high noise annoyance ("very much" to "extreme") in relation to road transport and neighbors compared to those reporting low annoyance ("none" to "moderate") from these sources. Noise annoyance is common in the SA general population, and the evidence for a strong association with QOL reinforces the need for environmental noise management at a population basis. [ABSTRACT FROM AUTHOR]

Abstract: Climate change projections have drawn attention to the risks of extreme heat and the importance of public health interventions to minimise the impact. The city of Perth, Western Australia, frequently experiences hot summer conditions, with recent summers showing above average temperatures. Daily maximum and minimum temperatures, mortality, emergency department (ED) presentations and hospital admissions data were acquired for Perth for the period 1994 to 2008. Using an observed/expected analysis, the temperature thresholds for mortality were estimated at 34–36°C (maximum) and 20°C (minimum). Generalised estimating equations (GEEs) were used to estimate the percentage increase in mortality and morbidity outcomes with a 10°C increment in temperature, with adjustment for air pollutants. Effect estimates are reported as incidence rate ratios (IRRs). The health impact of heatwave days (three or more days of ≥35°C) was also investigated. A 9.8% increase in daily mortality (IRR 1.098; 95%CI: 1.007–1.196) was associated with a 10°C increase in maximum temperature above threshold. Total ED presentations increased by 4.4% (IRR 1.044; 95%CI: 1.033–1.054) and renal-related ED presentations by 10.2% (IRR 1.102; 95%CI: 1.071–1.135) per 10°C increase in maximum temperature. Heatwave days were associated with increases in daily mortality and ED presentations, while total hospital admissions were decreased on heatwave days. Public health interventions will be increasingly important to minimise the adverse health impacts of hot weather in Perth, particularly if the recent trend of rising average temperatures and more hot days continues as projected. [Copyright &y& Elsevier]

Purpose: We aimed to measure mortality and cancer incidence in a cohort of lead-exposed workers by using blood lead levels to assess exposure. Methods: The cohort comprised male lead workers. Subjects were matched to cancer and death registries. Observed death and cancer incidence rates were compared with population rates to obtain standardized mortality ratios (SMR) and standardized incidence ratios (SIR). Results: There were 4114 male subjects with average follow-up time of 16.2 years, and 406 deaths were observed. There were significant results for overall death (SMR, 111; 95% confidence interval [95% CI], 101–123), digestive system deaths (SMR, 167; 95% CI, 110–250), and deaths from external causes (SMR, 135; 95% CI, 105–174). A total of 228 subjects had cancer, with an overall SIR of 83 (95% CI, 73–95); liver cancer SIR of 217 (95% CI, 103–454) and esophageal cancer SIR of 240 (95% CI, 129–447). The latter was seven-fold greater (SIR 755; 95% CI, 314–1813) among those with a blood lead level result above 30 μg/dL compared with population rates. No other increases in cancers were observed. Conclusions: Overall mortality was elevated. Although incidence rates of overall cancer were low, further studies and analysis are required to investigate any biologically plausible associations between inorganic lead and liver or esophageal cancer. [Copyright &y& Elsevier]

Abstract: Background: Although ambient air pollution exposure has been linked with poor health in many parts of the world, no previous study has investigated the effect on morbidity in the city of Adelaide, South Australia. Objective: To explore the association between particulate matter (PM) and hospitalisations, including respiratory and cardiovascular admissions in Adelaide, South Australia. Methods: For the study period September 2001 to October 2007, daily counts of all-cause, cardiovascular and respiratory hospital admissions were collected, as well as daily air quality data including concentrations of particulates, ozone and nitrogen dioxide. Visibility codes for present weather conditions identified days when airborne dust or smoke was observed. The associations between PM and hospitalisations were estimated using time-stratified case-crossover analyses controlling for covariates including temperature, relative humidity, other pollutants, day of the week and public holidays. Results: Mean PM10 concentrations were higher in the warm season, whereas PM2.5 concentrations were higher in the cool season. Hospital admissions were associated with PM10 in the cool season and with PM2.5 in both seasons. No significant effect of PM on all-age respiratory admissions was detected, however cardiovascular admissions were associated with both PM2.5 and PM10 in the cool season with the highest effects for PM2.5 (4.48%, 95% CI: 0.74%, 8.36% increase per 10μg/m3 increase in PM2.5). Conclusion: These findings suggest that despite the city''s relatively low levels of air pollution, PM concentrations are associated with increases in morbidity in Adelaide. Further studies are needed to investigate the sources of PM which may be contributing to the higher cool season effects. [Copyright &y& Elsevier]

Abstract: Background: Climate change projections have highlighted the need for public health planning for extreme heat. In Adelaide, South Australia, hot weather is characteristic of summer and heatwaves can have a significant health burden. This study examines the heat thresholds and temperature relationships for mortality and morbidity outcomes in Adelaide. Methods: Daily maximum and minimum temperatures, daily mortality, ambulance call-outs, emergency department (ED) presentations and hospital admissions were obtained for Adelaide, between 1993 and 2009. Heat thresholds for health outcomes were estimated using an observed/expected analysis. Generalized estimating equations were used to estimate the percentage increase in mortality and morbidity outcomes above the threshold temperatures, with adjustment for the effects of ozone (O3) and particulate matter<10μm in mass median aerodynamic diameter (PM10). Effect estimates are reported as incidence rate ratios (IRRs). Results: Heat-related mortality and morbidity become apparent above maximum and minimum temperature thresholds of 30°C and 16°C for mortality; 26°C and 18°C for ambulance call-outs; and 34°C and 22°C for heat-related ED presentations. Most health outcomes showed a positive relationship with daily temperatures over thresholds. When adjusted for air pollutants, a 10°C increase in maximum temperature was associated with a 4.9% increase in daily ambulance call-outs (IRR 1.049; 95% CI 1.027–1.072), and a 3.4% increase in mental health related hospital admissions (IRR 1.034; 95% CI 1.009–1.059) for the all-age population. Heat-related ED presentations increased over 6-fold per 10°C increase in maximum temperature. Daily temperatures were also associated with all-cause and mental health related ED presentations. Associations between temperature over thresholds and daily mortality and renal hospital admissions were not significant when adjusted for ozone and PM10; however at extreme temperatures mortality increased significantly with increasing heat duration. Conclusions: Heat-attributable mortality and morbidity are associated with elevated summer temperatures in Adelaide, particularly ambulance call-outs, mental health and heat-related illness. [Copyright &y& Elsevier]

Issue addressed: Many studies world wide have provided evidence that older persons are a sub-population at increased risk of heat-related morbidity and mortality. This article gives an overview of the current state of knowledge of risk factors and provides commentary on the role of health promotion in the prevention of a climate change-related increase in elderly heat casualties. Methods: A search of peer-reviewed medical and epidemiological literature and community health websites was conducted in order to gain an in-depth understanding of heat-susceptibility in the elderly and preventive strategies. Key search words included: elderly, aged, older, heat, thermoregulation, heat wave, mortality, heat effects, dehydration, heat-related illness, adaptation, adaptive capacity. Results: The reasons underlying reduced heat tolerance in this group are multi-faceted, comprising physiological, social and behavioural limitations, with comorbidities and polypharmacy being contributing factors. Additionally, some older persons may be unable or reluctant to undertake adaptations necessary to maintain thermal homeostasis due to diminished awareness of the heat, lowered thirst sensation, mobility or cognitive impairments, a lowered perception of risk, or economic concerns. Conclusion: With older persons in poor health being particularly vulnerable to heat, preventive messages need to promote protective behaviours and help build resilience as temperatures rise. [ABSTRACT FROM AUTHOR]