Dissertations / Theses on the topic 'Occupational Public Health'

Heat stress is a recognized occupational hazard present in many work environments. Its effects increase with increasing environmental heat loads. There is good evidence that exertional heat illness is associated with ambient thermal conditions in outdoor environments. Further, there is reason to believe that risk of acute injury may also increase with the ambient environment. For these reasons, the assessment of heat stress, which can be done through the characterization of the wet bulb globe temperature (WBGT), is designed to limit exposures to those that could be sustained for an 8-h day. The ACGIH Threshold Limit Value (TLV) for heat stress was based on limited data from Lind in the 1960s. Because there are practical limitations of using thermal indices, measurement of physiological parameters, such as body temperature and heart rate are used with environmental indices or as their alternative.

The illness and injury records from the Deepwater Horizon cleanup effort provided an opportunity to examine the effects of ambient thermal conditions on exertional heat illness and acute injury, and also the cumulative effect of the previous day’s environmental conditions. The ability of the current WBGT-based occupational exposure limits to discriminate unsustainable heat exposures, and the proposal of alternative occupational limits was performed on data from two progressive heat stress protocol trials performed at USF. The USF studies also provided the opportunity to explore physiological strain indicators (rectal temperature, heart rate, skin temperature and the Physiological Strain Index) to determine the threshold between unsustainable and sustainable heat exposures. Analysis were performed using Poisson models, conditional logistic regressions, logistic regressions, and receiver operator curves (ROC curves).

It was found that the odds to present an acute event, either exertional heat illness or acute injuries increased significantly with rising environmental conditions above 20 °C (RR 1.40 and RR 1.06, respectively). There was evidence of the cumulative effect from the prior day’s temperature and increased risk of exertional heat illness (RRs from 1.0–10.4). Regarding the accuracy of the current TLV, the results of the present investigation showed that this occupational exposure limit is extremely sensitive to predict cases associated with unsustainable heat exposures, its area under the curve (AUC) was 0.85; however its specificity was very low (specificity=0.05), with a huge percentage of false positives (95%). The suggested alternative models improved the specificity of the occupational exposure limits (specificities from 0.36 to 0.50), maintaining large AUCs (between 0.84 and 0.89). Nevertheless, any decision in trading sensitivity for specificity must be taken with extreme caution because of the steeped increment risk of heat related illness associated with small increments in environmental heat found also in the present study. Physiologic heat strain indices were found as accurate predictors for unsustainable heat stress exposures (AUCs from 0.74 to 0.89), especially when measurements of heart rate and skin temperature are combined (AUC=0.89 with a specificity of 0.56 at a sensitivity=0.95). Their implementation in industrial settings seems to be practical to prevent unsustainable heat stress conditions.

A variety of paint products are used for their aesthetic and anti-corrosive properties. Isocyanates are consistently found in automobile paint products, particularly in clear coat polyurethane products. Clear coat is typically sprayed via pressurized air by means of an auto-spray robot. In clear coat repair situations, manual, air-powered spray guns are used, and manual spray Operators administer the clear coat material. The isocyanates are a primary anti-corrosive agent in polyurethane products. The Occupational Safety and Health Administration (OSHA) has not established a Permissible Exposure Limit (PEL). The National Institute for Occupational Safety and Health (NIOSH) and American Conference of Governmental Industrial Hygienists (ACGIH) have set Recommended Exposure Limit (REL) and Threshold Limit Value (TLV), respectively. NIOSH recommends a 0.005 parts per million (ppm), 10-hour Time Weighted Average (TWA), and a ceiling exposure of 0.020 ppm in a 10 minute period. Similarly, ACGIH recommends a 0.005 ppm, 8 hour TWA.

Automobile manufacturers use clear coats in a variety of ways. Some may use clear coats with blocked isocyanates, or isocyanates that are completely reacted, and others may use clear coat products that allow isocyanates to be liberated during an application, baking, and curing process. The research objective of this study was to characterize exposure, focusing on a single manufacturer’s use of isocyanate-containing clear coats in their Paint Department. A newly evaluated medium (ISO 17734) using di-n-butylamine as a derivative agent, in a denuder tube, was selected instead of NIOSH methods 5521, 5522, and 5525. The ISO evaluated medium was selected to reduce secondary hazard exposure to toluene in impingers. Second, a medium developed by SKC, Inc., called ISO-CHEK®, was not selected because of the short collection time, sensitivity of the medium after collection, and storage and shipping requirements for analysis.

Sampling took place over two days, one day for manual spray operations with 2 personal samples from Operators, and 4 area samples collected, and the second day for auto-sprayer Inspectors with 4 personal samples collected. The samples were then analyzed for hexamethylene diisocyanates (HDI) monomer and homopolymer species. The 0.005 ppm, 10 hour TWA; the 0.020 ppm ceiling limit (10 minutes); and the 0.005 ppm 8-hour TWA TLV were not exceeded on either day of sampling. Neither the area nor the personal samples exceeded the 10 hour TWA, ceiling limit, or TLV. In fact, the results had to be recalculated in to parts per billion (ppb). The average exposure for manual spray Operators was 0.052 ppb for the homopolymer, and 0.024 ppb for the monomer species. For auto-spray Inspectors, the average was 0.053 ppb for the homopolymer component and 0.021 ppb for the monomer species. Though the average isocyanate concentration was similar for both Operators and Inspectors, the averages are still below REL and TLV recommendations. These data provided preliminary information regarding the exposure to isocyanates from clear coat use, and also provide context for future evaluation of isocyanate use at this automobile manufacturer. The low concentration of isocyanates could indicate working ventilation systems, liberation of isocyanate species to non-hazardous forms, or low volatilization of isocyanates from the clear coat.

The purpose of this case study was to explore the perceptions and experiences of hospital emergency preparedness coordinators of preparing for and responding to incidents. Stakeholder and protection motivation theories provided the theoretical framework for the study. The nonprobability sampling technique of purposive sample was used to identify 10 hospital preparedness coordinators employed at acute care hospitals with emergency departments located in Connecticut and Massachusetts. A field-tested researcher developed 20-question interview questionnaire guided data collection. This qualitative case study answers the questions: What are hospital emergency preparedness coordinators perspectives of hospital preparedness? How do hospital emergency preparedness coordinators prepare for a hospital incident? How do hospital emergency preparedness coordinators respond to a hospital incident? What factors do hospital emergency preparedness coordinators believe best prepares a hospital for incidents? Ranked in order of replication, the researcher identified three themes using first and second cycle coding techniques with pattern coding: (a) planning, (b) training, and (c) communication. Control and motivation emerged as subthemes. Results of the study provide detail rich data for hospital emergency preparedness coordinators, and provide insight and information for stakeholders from all types of private and public organizations to improve hospital emergency preparedness programs.

ISBN 978-91-85721-21-4

Pneumoconiosis is a chronic and slowly progressive parenchymal lung disease. Estimates suggest that about 68,000 ex-miners in Botswana will develop or have already developed pneumoconiosis. However, most of these cases do not know they have the disease because of the poor quality of care in primary healthcare settings and weak implementation of the Occupational Diseases in the Mines and Works (ODMW) Act.

This dissertation was a health service research framed from the systems approach using the chronic care model as a theoretical tool. The study employed a concurrent, convergent parallel mixed method research which combined quantitative and qualitative methods of inquiry. The quantitative arm of the study evaluated whether the Botswana primary care settings meet ‘reasonably good standards’ of the pneumoconiosis quality of care measured on the chronic care model. The chronic care model measures quality of care on a 0 to 11 scale, where “0” denotes lack of quality care and “11” stands for optimal quality of care. Reasonably good quality of care comprises scores between 6 and 8 on the scale. The qualitative arm of the study assessed the implementation of the ODMW Act in the Botswana primary healthcare settings. The study mixed quantitative and qualitative results at the interpretation stage to determine the extent to which quality of care for pneumoconiosis and the ODMW Act implementation promote equitable access to pneumoconiosis services among ex-miners in Botswana. (Abstract shortened by ProQuest.)

The aim of this study was to investigate how a workplace should be formed to promote health according to the employees. The study was made in IKEA handla hemma in Älmhult, Sweden. The aim of the study was to find out why people experience health at their workplace environment, from a salutogenetic point of view. The study is based on 12 strategically selected interviews and where analysed according to Grounded Theory. This resulted in a model where the core category was “The prevailing spirit of the organisation” and the five main categories was “That the organisation creates favourable conditions to promote health”, “That there is a god atmosphere amongst the colleagues and the bosses”, “The personal point of view about health”, “The relationship to goals and responsibility” and “The personal point of view about their surroundings”. The result shows that it’s important to look upon health in its entirety. Health isn’t stronger than its weakest point. The findings should work as a guide in the on going work with the employees at IKEA handla hemma. For the future it would be interesting to do a study in a workplace with worse health and then compare them with each other.

Firefighters and asphalt pavers are exposed to polycyclic aromatic hydrocarbons (PAHs) during various work activities. The purpose of this study was to evaluate urinary PAH levels and compare these bio-monitoring levels among firefighters, asphalt pavers, and non-occupationally exposed individuals. The National Institute of Standards and Technology (NIST) urinary PAH levels were used for non-occupationally exposed controls. When compared to the NIST standard for smokers and non-smokers, firefighters demonstrated statistically significant differences in urinary concentration differences for the following metabolites: 2-OH-fluorene, 3-OH-fluorene and 1-OH-pyrene, which were lower in firefighters than the NIST mean for smokers. 1-OHphenanthrene, 2-OH-phenanthrene and 3-OH-phenanthrene were higher among world trade center exposed firefighters than the NIST mean for smokers. When firefighters were compared to the NIST non-smoker standard, firefighters demonstrated elevated levels in all tested PAH biomarkers due to a mixture of smokers and non-smokers in the firefighter cohort.

Asphalt workers had statistically significant higher urinary concentration elevations in 2OH-fluorene, 1-OH-phenanthrene and 3-OH-phenanthrene as compared to the NIST smoker mean. When asphalt pavers were compared to the NIST non-smoker mean, asphalt pavers had statistically significant increases in all tested PAH biomarkers, with the exception of 2-OHphenanthrene. While firefighters did not demonstrate a substantial change in urinary PAH metabolite levels compared to control populations of smokers and non-smokers, asphalt pavers experienced concentrations that were in some cases increased by orders of magnitude compare to NIST controls. Future research may be needed to evaluate any potential health risk posted to occupational exposed asphalt pavers.