Ziqing Zhuang

Head-and-Face Anthropometric Survey of U.S. Respirator Users

Sizing data generated by the military for use in fitting respirators have been the normative basis for commercial respirator sizing. Anthropometric data developed for males and females of military age in the 1950s and 1960s are still in use today and form the only comprehensive body of information available on this subject. The twofold objective of this study was to: (1) develop an anthropometric database detailing the face size distributions of respirator users using both traditional measurement methods and three-dimensional scanning systems; and (2) use the database to establish fit test panels to be incorporated into the National Institute for Occupational Safety and Healths respirator certification and international standards. A stratified sampling plan was used with three age strata, two gender strata, and four race/ethnic group strata. The plan called for an equal sample size of 166 in each cell. Subjects were obtained at 41 sites from 8 states. In addition to height and weight, 18 facial dimensions and neck circumferences were measured using traditional methods. A total of 3997 subjects were measured using traditional methods, and 1013 of them were also scanned using a 3-D head scanner. As this was a volunteer sample, subjects did not appear in the specific proportions needed for the sampling plan. The resulting data were weighted to correspond to the U.S. population. This article presents the summary statistics for the traditional measurement data only. Multivariate analyses of the data from this study and military data revealed that using historical, military data would be inadequate for describing the anthropometric variability of the current U.S. work force.

Exposure to silica and silicosis among tin miners in China: exposure-response analyses and risk assessment.

OBJECTIVES To investigate the risk of silicosis among tin miners and to investigate the relation between silicosis and cumulative exposure to dust (Chinese total dust and respirable crystalline silica dust). METHODS A cohort study of 3010 miners exposed to silica dust and employed for at least 1 year during 1960–5 in any of four Chinese tin mines was conducted. Historical total dust data from China were used to create a job exposure matrix for facility, job title, and calendar year. The total dust exposure data from China were converted to estimates of exposure to respirable crystalline silica for comparison with findings from other epidemiological studies of silicosis. Each workers work history was abstracted from the complete employment records in mine files. Diagnoses of silicosis were based on 1986 Chinese pneumoconiosis Roentgen diagnostic criteria, which classified silicosis as stages I-III—similar to an International Labour Organisation (ILO) classification of 1/1 or greater. RESULTS There were 1015 (33.7%) miners identified with silicosis, who had a mean age of 48.3 years, with a mean of 21.3 years after first exposure (equivalent to 11.0 net years in a dusty job). Among those who had silicosis, 684 miners (67.4%) developed silicosis after exposure ended (a mean of 3.7 years after). The risk of silicosis was strongly related to cumulative exposure to silica dust and was well fitted by the Weibull distribution, with the risk of silicosis less than 0.1% when the Chinese measure of cumulative exposure to total dust (CTD) was under 10 mg/m3-years (or 0.36 mg/m3-years of respirable crystalline silica), increasing to 68.7% when CTD exposure was 150 mg/m3-years (or 5.4 mg/m3-years of respirable crystalline silica). Latency period was not correlated to the risk of silicosis or cumulative dose of exposure. This study predicts about a 36% cumulative risk of silicosis for a 45 year lifetime exposure to these tin mine dusts at the CTD exposure standard of 2 mg/m3, and a 55% risk at 45 years exposure to the current United States Occupational Safety and Health Administration and Mine Safety and Health Administration standards of 0.1 mg/m3100% respirable crystalline silica dust. CONCLUSIONS A clear exposure-response relation was detected for silicosis in Chinese tin miners. The study results were similar to most, but not all, findings from other large scale exposure-response studies.

New Respirator Fit Test Panels Representing the Current U.S. Civilian Work Force

The fit test panels currently used for respirator research, design, and certification are 25-subject panels developed by Los Alamos National Laboratory (LANL) and are based on data from the 1967 and 1968 anthropometric surveys of U.S. Air Force personnel. Military data do not represent the great diversity in face size and shape seen in civilian populations. In addition, the demographics of the U.S. population have changed over the last 30 years. Thus, it is necessary to assess and refine the LANL fit test panels. This paper presents the development of new respirator fit test panels representative of current U.S. civilian workers based on an anthropometric survey of 3997 respirator users conducted in 2003. One panel was developed using face length and face width (bivariate approach) and weighting subjects to match the age and race distribution of the U.S. population as determined from the 2000 census. Another panel was developed using the first two principal components obtained from a set of 10 facial dimensions (age and race adjusted). These 10 dimensions are associated with respirator fit and leakage and can predict the remaining face dimensions well. Respirators designed to fit these panels are expected to accommodate more than 95% of the current U.S. civilian workers. Both panels are more representative of the U.S. population than the existing LANL panel and may be appropriate for testing both half-masks and full-facepiece respirators. Respirator manufacturers, standards development organizations, and government respirator certification bodies need to select the appropriate fit test panel for their particular needs. The bivariate panel is simpler to use than the principal component analysis (PCA) panel and is most similar to the LANL panel currently used. The inclusion of the eight additional facial measurements allows the PCA panel to provide better criteria for excluding extreme face sizes from being used. Because the boundaries of the two new panels are significantly different from the LANL panel, it may be necessary to develop new respirator sizing systems. A new five-category sizing system is proposed.

Fitting Characteristics of Eighteen N95 Filtering-Facepiece Respirators

Four performance measures were used to evaluate the fitting characteristics of 18 models of N95 filtering-facepiece respirators: (1) the 5th percentile simulated workplace protection factor (SWPF) value, (2) the shift average SWPF value, (3) the h-value, and (4) the assignment error. The effect of fit-testing on the level of protection provided by the respirators was also evaluated. The respirators were tested on a panel of 25 subjects with various face sizes. Simulated workplace protection factor values, determined from six total penetration (face-seal leakage plus filter penetration) tests with re-donning between each test, were used to indicate respirator performance. Five fit-tests were used: Bitrex™, saccharin, generated aerosol corrected for filter penetration, PortaCount® Plus corrected for filter penetration, and the PortaCount Plus with the N95-Companion™ accessory. Without fit-testing, the 5th percentile SWPF for all models combined was 2.9 with individual model values ranging from 1.3 to 48.0. Passing a fit-test generally resulted in an increase in protection. In addition, the h-value of each respirator was computed. The h-value has been determined to be the population fraction of individuals who will obtain an adequate level of protection (i.e., SWPF ≥ 10, which is the expected level of protection for half-facepiece respirators) when a respirator is selected and donned (including a user seal check) in accordance with the manufacturers instructions without fit-testing. The h-value for all models combined was 0.74 (i.e., 74% of all donnings resulted in an adequate level of protection), with individual model h-values ranging from 0.31 to 0.99. Only three models had h-values above 0.95. Higher SWPF values were achieved by excluding SWPF values determined for test subject/respirator combinations that failed a fit-test. The improvement was greatest for respirator models with lower h-values. Using the concepts of shift average and assignment error to measure respirator performance yielded similar results. The highest level of protection was provided by passing a fit-test with a respirator having good fitting characteristics.

Facial Anthropometric Differences among Gender, Ethnicity, and Age Groups

OBJECTIVES The impact of race/ethnicity upon facial anthropometric data in the US workforce, on the development of personal protective equipment, has not been investigated to any significant degree. The proliferation of minority populations in the US workforce has increased the need to investigate differences in facial dimensions among these workers. The objective of this study was to determine the face shape and size differences among race and age groups from the National Institute for Occupational Safety and Health survey of 3997 US civilian workers. METHODS Survey participants were divided into two gender groups, four racial/ethnic groups, and three age groups. Measurements of height, weight, neck circumference, and 18 facial dimensions were collected using traditional anthropometric techniques. A multivariate analysis of the data was performed using Principal Component Analysis. An exploratory analysis to determine the effect of different demographic factors had on anthropometric features was assessed via a linear model. The 21 anthropometric measurements, body mass index, and the first and second principal component scores were dependent variables, while gender, ethnicity, age, occupation, weight, and height served as independent variables. RESULTS Gender significantly contributes to size for 19 of 24 dependent variables. African-Americans have statistically shorter, wider, and shallower noses than Caucasians. Hispanic workers have 14 facial features that are significantly larger than Caucasians, while their nose protrusion, height, and head length are significantly shorter. The other ethnic group was composed primarily of Asian subjects and has statistically different dimensions from Caucasians for 16 anthropometric values. Nineteen anthropometric values for subjects at least 45 years of age are statistically different from those measured for subjects between 18 and 29 years of age. Workers employed in manufacturing, fire fighting, healthcare, law enforcement, and other occupational groups have facial features that differ significantly than those in construction. CONCLUSIONS Statistically significant differences in facial anthropometric dimensions (P < 0.05) were noted between males and females, all racial/ethnic groups, and the subjects who were at least 45 years old when compared to workers between 18 and 29 years of age. These findings could be important to the design and manufacture of respirators, as well as employers responsible for supplying respiratory protective equipment to their employees.

Digital 3-D headforms with facial features representative of the current US workforce.

Existing headforms are based on anthropometric data collected over 30 years ago. In 2003, the National Institute for Occupational Safety and Health conducted an anthropometric survey of 3997 respirator users, of which 1013 subjects were scanned with a Cyberware 3-D Rapid Digitizer. The objective of this study was to create headforms representative of the current US workforce. Ten facial dimensions relevant to respirator fit were chosen for defining a principal component analysis model, which divides the user population into five face-size categories. Mean facial dimensions were then computed to target the ideal facial dimensions for each size category. Five scans in each category were chosen and averaged to construct a representative headform for each size category. Five digital 3-D headforms were developed: small, medium, large, long/narrow and short/wide. All dimensions are within 3 mm of the computed means for the sample population in each size category. Statement of Relevance: This manuscript describes a new approach to constructing headforms that takes into account the facial form (size and shape) of the US workforce. These headforms could be incorporated into respirator research, certification standards and design in efforts to reduce the risk of injury or illness caused by inhalation hazards.

The Effect of Subject Characteristics and Respirator Features on Respirator Fit

A recent study was conducted to compare five fit test methods for screening out poor-fitting N95 filtering-facepiece respirators. Eighteen models of NIOSH-certified, N95 filtering-facepiece respirators were used to assess the fit test methods by using a simulated workplace protection factor (SWPF) test. The purpose of this companion study was to investigate the effect of subject characteristics (gender and face dimensions) and respirator features on respirator fit. The respirator features studied were design style (folding and cup style) and number of sizes available (one size fits all, two sizes, and three sizes). Thirty-three subjects participated in this study. Each was measured for 12 face dimensions using traditional calipers and tape. From this group, 25 subjects with face size categories 1 to 10 tested each respirator. The SWPF test protocol entailed using the PortaCount Plus to determine a SWPF based on total penetration (face-seal leakage plus filter penetration) while the subject performed six simulated workplace movements. Six tests were conducted for each subject/respirator model combination with redonning between tests. The respirator design style (folding style and cup style) did not have a significant effect on respirator fit in this study. The number of respirator sizes available for a model had significant impact on respirator fit on the panel for cup-style respirators with one and two sizes available. There was no significant difference in the geometric mean fit factor between male and female subjects for 16 of the 18 respirator models. Subsets of one to six face dimensions were found to be significantly correlated with SWPFs (p < 0.05) in 16 of the 33 respirator model/respirator size combinations. Bigonial breadth, face width, face length, and nose protrusion appeared the most in subsets (five or six) of face dimensions and their multiple linear regression coefficients were significantly different from zero (p < 0.05). Lip length was found in only one subset. The use of face length and lip length as the criteria to define the current half-facepiece respirator fit test panel may need to be reconsidered when revising the panel. Based on the findings from this and previous studies, face length and face width are recommended measurements that should be used for defining the panel for half-facepiece respirators.

Head-and-Face Anthropometric Survey of Chinese Workers

Millions of workers in China rely on respirators and other personal protective equipment to reduce the risk of injury and occupational diseases. However, it has been >25 years since the first survey of facial dimensions for Chinese adults was published, and it has never been completely updated. Thus, an anthropometric survey of Chinese civilian workers was conducted in 2006. A total of 3000 subjects (2026 males and 974 females) between the ages of 18 and 66 years old was measured using traditional techniques. Nineteen facial dimensions, height, weight, neck circumference, waist circumference and hip circumference were measured. A stratified sampling plan of three age strata and two gender strata was implemented. Linear regression analysis was used to evaluate the possible effects of gender, age, occupation and body size on facial dimensions. The regression coefficients for gender indicated that for all anthropometric dimensions, males had significantly larger measurements than females. As body mass index increased, dimensions measured increased significantly. Construction workers and miners had significantly smaller measurements than individuals employed in healthcare or manufacturing for a majority of dimensions. Five representative indexes of facial dimension (face length, face width, nose protrusion, bigonial breadth and nasal root breadth) were selected based on correlation and cluster analysis of all dimensions. Through comparison with the facial dimensions of American subjects, this study indicated that Chinese civilian workers have shorter face length, smaller nose protrusion, larger face width and longer lip length.

Estimating historical respirable crystalline silica exposures for Chinese pottery workers and iron/copper, tin, and tungsten miners

Collaborative studies of Chinese workers, using over four decades of dust monitoring data, are being conducted by the National Institute for Occupational Safety and Health (NIOSH) and Tongji Medical University in China. The goal of these projects is to establish exposure-response relationships for the development of diseases such as silicosis or lung cancer in cohorts of pottery and mine workers. It is necessary to convert Chinese dust measurements to respirable silica measurements in order to make results from the Chinese data comparable to other results in the literature. This article describes the development of conversion factors and estimates of historical respirable crystalline silica exposure for Chinese workers. Ambient total dust concentrations (n>17000) and crystalline silica concentrations (n=347) in bulk dust were first gathered from historical industrial hygiene records. Analysis of the silica content in historical bulk samples revealed no trend from 1950 up to the present. During 1988-1989, side-by-side airborne dust samples (n=143 pairs) were collected using nylon cyclones and traditional Chinese samplers in 20 metal mines and nine pottery factories in China. These data were used to establish conversion factors between respirable crystalline silica concentrations and Chinese total dust concentrations. Based on the analysis of the available evidence, conversion factors derived from the 1988-1989 sampling campaign are assumed to apply to other time periods in this paper. The conversion factors were estimated to be 0.0143 for iron/copper, 0.0355 for pottery factories, 0.0429 for tin mines, and 0.0861 for tungsten mines. Conversion factors for individual facilities within each industry were also calculated. Analysis of variance revealed that mean conversion factors are significantly different among facilities within the iron/copper industry and within the pottery industry. The relative merits of using facility-specific conversion factors, industry-wide conversion factors, or a weighted average of the two are discussed. The exposure matrix of the historical Chinese total dust concentrations was multiplied by these conversion factors to obtain an exposure matrix of historical respirable crystalline silica concentrations.

Headform and N95 Filtering Facepiece Respirator Interaction: Contact Pressure Simulation and Validation

This article presents a computational and experimental study of contact pressure between six N95 filtering facepiece respirators (FFRs) and five newly developed digital headforms (small, medium, large, long/narrow, and short/wide). Contact interaction is simulated using the finite element method and validated by experiments using a pressure mapping system. The headform model has multiple layers: a skin layer, muscle layer, fatty tissue layer, and bone layer. Each headform is divided into five parts (two parts for the cheeks, one part for the upper forehead, one part for the chin, and one part for the back side of the head). Each respirator model comprises multiple layers and two straps. The simulation process has two stages for each respirator/headform combination. The first stage is to wrap the straps around the back of the headform and pull the respirator away from the face. The second stage is to release the respirator so that the respirator moves toward the face. Strap forces and contact interactions are generated between the respirators and the headforms. Meanwhile, a real-time surface pressure mapping system is used to record the pressures at six key locations to validate the computational results. There is a strong correlation between computational and experimental results (R2 = 0.88). By comparing the pressure values from simulations and experiments, we have validated the simulation models.