Max Kiefer

Evaluation of Some Potential Chemical Exposure Risks During Flowback Operations in Unconventional Oil and Gas Extraction: Preliminary Results

Approximately 562,000 workers were employed in the U.S. oil and gas extraction industry in 2012; nearly half of those workers were employed by well servicing companies, which include companies that conduct hydraulic fracturing and flowback operations.(1) To understand possible risks for chemical exposures in modern oil and gas extraction operations, the National Institute for Occupational Safety and Health (NIOSH) initiated the Field Effort to Assess Chemical Exposures in Oil and Gas Workers.(2) Initial research identified exposure risks for respirable crystalline silica during hydraulic fracturing as an occupational health hazard.(3–5) This report describes industrial hygiene sampling during flowback operations at six unconventional oil and gas extraction sites in Colorado and Wyoming during spring and summer 2013. The results are considered preliminary; additional exposure assessments are needed to better understand the range of possible exposures, risk factors, and controls during flowback operations.

1-hydroxypyrene levels in coal-handling workers at a coke oven

An environmental and medical survey was conducted at the coal-handling area of a coke oven, where workers came in contact with coal-tar sludge. The purpose of the study was to determine if skin contact with coal-tar sludge was an important route of exposure to pyrene because workers were observed to have substantial contact with the sludge. Environmental monitoring revealed minimal airborne exposure to pyrene, a byproduct of the coke distillation process; only one personal breathing zone sample detected pyrene, and at least of 0.001 mg/m3. However, the mean preshift urinary 1-hydroxypyrene concentration was 1.00 mumol/mol creatinine (range, 0.16 to 2.96 mumol/mol creatinine) and the mean postshift level was 1.7 mumol/mol creatinine (range, 0.24 to 4.85 mumol/mol creatinine) (P < 0.01). These levels probably reflect absorption as a result of skin exposure.

Public Health Investigation After the Discovery of Ricin in a South Carolina Postal Facility

OBJECTIVES In October 2003, a package containing ricin and a note threatening to poison water supplies was discovered in a South Carolina postal facility, becoming the first potential chemical terrorism event involving ricin in the United States. We examined the comprehensive public health investigation that followed and discuss the lessons learned from it. METHODS An investigation consisting primarily of environmental sampling for ricin contamination, performance of health assessments on affected personnel, and local, regional, and national surveillance for ricin-associated illness. RESULTS Laboratory analysis of 75 environmental sampling specimens revealed no ricin contamination. Health assessments of 36 affected employees were completed. Local surveillance initially identified 3 suspected cases, and national surveillance identified 399 outliers during the 2-week period after the incident. No confirmed cases of ricin-associated illness were identified. CONCLUSIONS A multifaceted and multidisciplinary approach is required for an effective public health response to a chemical threat such as ricin. The results of all of the described activities were used to determine that the facility was safe to reopen and that no public health threat existed.

Monitoring of exposure to benomyl in nursery workers.

We compared urinary levels of the metabolite methyl-5-hydroxy-2-benzimidazole carbamate (5-HBC) among nursery workers exposed to the fungicide benomyl (specifically Benlate 50 DF [DuPont, Wilmington, DE]) and workers not exposed to benomyl. Environmental exposures were quantitated from gloves, body patches, and air samples collected with area and personal monitors. The median concentration of 5-HBC in the urine of benomyl-exposed workers was 23.8 mumol of 5-HBC per mole of creatinine. No 5-HBC was detected in the reference group. Industrial hygiene results and biological monitoring findings indicate that use of Benlate 50 DF in the ornamental industry can lead to absorption of the active ingredient, benomyl. Weighing, mixing, and application activities involved the highest exposures. Dermal contact appeared to be the primary route of exposure.

Environmental and Occupational Health Response to SARS, Taiwan, 2003

Environmental and Occupational Health Industrial hygiene emergency response to SARS in Taiwan.

Advancing the framework for considering the effects of climate change on worker safety and health.

ABSTRACT In 2009, a preliminary framework for how climate change could affect worker safety and health was described. That framework was based on a literature search from 1988–2008 that supported seven categories of climate-related occupational hazards: (1) increased ambient temperature; (2) air pollution; (3) ultraviolet radiation exposure; (4) extreme weather; (5) vector-borne diseases and expanded habitats; (6) industrial transitions and emerging industries; and (7) changes in the built environment. This article reviews the published literature from 2008–2014 in each of the seven categories. Additionally, three new topics related to occupational safety and health are considered: mental health effects, economic burden, and potential worker safety and health impacts associated with the nascent field of climate intervention (geoengineering). Beyond updating the literature, this article also identifies key priorities for action to better characterize and understand how occupational safety and health may be associated with climate change events and ensure that worker health and safety issues are anticipated, recognized, evaluated, and mitigated. These key priorities include research, surveillance, risk assessment, risk management, and policy development. Strong evidence indicates that climate change will continue to present occupational safety and health hazards, and this framework may be a useful tool for preventing adverse effects to workers.

Risk Factors, Health Behaviors, and Injury Among Adults Employed in the Transportation, Warehousing, and Utilities Super Sector

BACKGROUND The TWU super sector is engaged in the movement of passengers and cargo, warehousing of goods, and the delivery of services. The purpose of this study is to describe employee self-reported personal risk factors, health behaviors and habits, disease and chronic conditions, and employer-reported nonfatal injury experiences of workers in the TWU super sector. METHODS National Health Interview Survey (NHIS) data for 1997-2007, grouped into six morbidity and disability categories and three age groups, were reviewed. Demographic characteristics and prevalence estimates are reported for workers in the TWU super sector and the entire U.S. workforce, and compared with national adult population data from the NHIS. Bureau of Labor Statistics employer-reported TWU injury data from 2003 to 2007 was also reviewed. RESULTS An average of 8.3 million workers were employed annually in the TWU super sector. TWU workers 65 or older reported the highest prevalence of hypertension (49%) across all industry sectors, but the 20% prevalence is notable among middle age workers (25-64). TWU workers had the highest prevalence of obesity (28%), compared to workers in all other industry sectors. Female TWU workers experienced the highest number of lost workdays (6.5) in the past year across all TWU demographic groups. CONCLUSIONS Self-reported high proportions of chronic conditions including hypertension and heart disease combined with elevated levels of being overweight and obese, and lack of physical activity-particularly among TWUs oldest workers-can meaningfully inform wellness strategies and interventions focused on this demographic group. Am. J. Ind. Med. 56:556-568, 2013.

Protecting Poultry Workers from Exposure to Avian Influenza Viruses

Emerging zoonotic diseases are of increasing regional and global importance. Preventing occupational exposure to zoonotic diseases protects workers as well as their families, communities, and the public health. Workers can be protected from zoonotic diseases most effectively by preventing and controlling diseases in animals, reducing workplace exposures, and educating workers. Certain avian influenza viruses are potential zoonotic disease agents that may be transmitted from infected birds to humans. Poultry workers are at risk of becoming infected with these viruses if they are exposed to infected birds or virus-contaminated materials or environments. Critical components of worker protection include educating employers and training poultry workers about occupational exposure to avian influenza viruses. Other recommendations for protecting poultry workers include the use of good hygiene and work practices, personal protective clothing and equipment, vaccination for seasonal influenza viruses, antiviral medication, and medical surveillance. Current recommendations for protecting poultry workers from exposure to avian influenza viruses are summarized in this article.

Recommendations for Biomonitoring of Emergency Responders: Focus on Occupational Health Investigations and Occupational Health Research

The disaster environment frequently presents rapidly evolving and unpredictable hazardous exposures to emergency responders. Improved estimates of exposure and effect from biomonitoring can be used to assess exposure-response relationships, potential health consequences, and effectiveness of control measures. Disaster settings, however, pose significant challenges for biomonitoring. A decision process for determining when to conduct biomonitoring during and following disasters was developed. Separate but overlapping decision processes were developed for biomonitoring performed as part of occupational health investigations that directly benefit emergency responders in the short term and for biomonitoring intended to support research studies. Two categories of factors critical to the decision process for biomonitoring were identified: Is biomonitoring appropriate for the intended purpose and is biomonitoring feasible under the circumstances of the emergency response? Factors within these categories include information needs, relevance, interpretability, ethics, methodology, and logistics. Biomonitoring of emergency responders can be a valuable tool for exposure and risk assessment. Information needs, relevance, and interpretability will largely determine if biomonitoring is appropriate; logistical factors will largely determine if biomonitoring is feasible. The decision process should be formalized and may benefit from advance planning.

Sudden Deaths Among Oil and Gas Extraction Workers Resulting from Oxygen Deficiency and Inhalation of Hydrocarbon Gases and Vapors - United States, January 2010-March 2015.

In 2013, an occupational medicine physician from the University of California, San Francisco, contacted CDCs National Institute for Occupational Safety and Health (NIOSH), and the Occupational Safety and Health Administration (OSHA) about two oil and gas extraction worker deaths in the western United States. The suspected cause of these deaths was exposure to hydrocarbon gases and vapors (HGVs) and oxygen (O2)-deficient atmospheres after opening the hatches of hydrocarbon storage tanks. The physician and experts from NIOSH and OSHA reviewed available fatality reports from January 2010 to March 2015, and identified seven additional deaths with similar characteristics (nine total deaths). Recommendations were made to industry and regulators regarding the hazards associated with opening hatches of tanks, and controls to reduce or eliminate the potential for HGV exposure were proposed. Health care professionals who treat or evaluate oil and gas workers need to be aware that workers might report symptoms of exposure to high concentrations of HGVs and possible O2 deficiency; employers and workers need to be aware of this hazard and know how to limit exposure. Medical examiners investigating the death of oil and gas workers who open tank hatches should consider the contribution of O2 deficiency and HGV exposure.