Background Chronic hepatitis C virus (HCV), which is a concern in many countries, is the leading cause of liver cancer around the world. Since Taiwan launched its national health insurance system in 1995, it has managed to extend health coverage to 99% of the Taiwanese population, providing free but limited antiviral treatment each year since 2017. However, many people in rural areas are unaware that they have chronic HCV; nor do they realize that new drugs with high cure rates could drastically reduce their health burden. The aim of this study is to explore the implementation facilitators of and barriers to inviting potentially infected patients in rural areas to be transferred for HCV ribonucleic acid (RNA) confirmation and new drug treatment. Methods A descriptive and prospective study design with an interdisciplinary collaboration approach was implemented. After five elements of referral were developed, telephone counseling was conducted between August 2018 and May 2019 in Yunlin, Taiwan. The elements of referral developed by the research team were: (1) forming and coordinating physicians’ schedules, (2) recruiting and training volunteers, (3) training the nursing staff, (4) raising funds or resources, and (5) connecting with village leaders. Thereafter, we collaborated with two district health centers, a private local hospital, and health clinics. Based on the medical records provided by these agencies, community adults that were HCV antibody (anti-HCV) positive were invited to join the program. Results Of the 1795 adults who were serum anti-HCV positive, 1149 (64%) accepted transfer to a qualified hospital; of these, 623 (54.2%) had an HCV infection. 552 (88.6%) of those infected started receiving direct-acting antivirals (DAAs) treatment. The top four barriers to accepting transfer were: (1) they perceived themselves to be healthy (n = 98, 32.3%); (2) mistrust of treatment/healthcare (n = 60, 20.2%); (3) limited transportation to the hospital (n = 52, 17.5%); and (4) work conflict (n = 30, 10.1%). Conclusion An interdisciplinary collaboration approach significantly contributed to the invitation of CHC patients, as well as their acceptance of HCV RNA confirmation and free DAAs treatment. Using anti-HCV data from previous medical records for case-finding and collaborating with a hospital and health clinics proved to be an efficient strategy.

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This study used a full scale mockup of a concrete drilling simulator to simulate drilling processes in an exposure chamber. Six drilling conditions were selected with rotating speeds and drill bit sizes varied from 265 to 587 rpm and 16 to 32 mm, respectively. For each drilling condition, the emitted noise power spectrums were measured and dust exposure concentrations of the fractions of the total (C(tot)), inhalable (C(inh)), thoracic (C(tho)), and respirable (C(res)) were estimated. We find that neither the resultant dust exposure levels nor the noise levels can be explained simply by the involved drilling mechanical energy. By dividing the emitted noise power spectrums into the high and low frequency noise (i.e., W(H) and W(L)), we find that 86.3%, 85.6%, 81.5%, and 77.6% variations of C(tot), C(inh), C(tho), and C(res) could be explained by the combination of W(H) and W(L), respectively. We also find that the emissions of coarse particles and W(L) were possibly contributed by two mechanisms of the impact wear and brittle fracture wear, whereas fine particles and W(H) could be contributed by the mechanism of abrasive wear. Although the predictive models obtained from this study could not be directly used in other dust emission sources, the developed methodology would be beneficial to industries in the future for aerosol exposure assessment, particularly when conducting conventional personal aerosol samplings is not possible in the field.

The aim of this study is to develop methodologies suitable for conducting multiple organic solvent exposure assessments for workers in the plastic material printing industries. By reviewing the existing sampling and analytical methods for the seven organic solvents used in the industry (including isopropyl alcohol, 2-butanone, ethyl acetate, methyl isobutyl ketone, toluene, n-butyl acetate, and cyclohexanone), coconut shell charcoal is suggested as an appropriate sorbent media for collecting samples, and GC/FID is chosen as the instrument for chemical analyses. Both CS 2 + 5% (v/v) 1-butanol and CS 2 + 5% (v/v) isobutanol are proposed as candidate desorption reagents. Since the recovery rates obtained from the latter (83.47%-99.84%) are higher than those of the former (80.12%-98.00%), the latter is chosen in the present study. The linearities of all the resulting calibration curves are r 2 ≥ 0.995, with recovery rates (R) of ≥ 75%, and the corresponding coefficients of variations (CV) ≤ 7% for all target organic solvents. The results also suggest that the collected samples should be stored in a -10°C environment and be analyzed within 30 days. Finally, suggestions are made for amending the storage temperatures and storage days currently promulgated in related NIOSH methods based on data obtained from present study. The proposed methodology would be beneficial to the plastic material printing industry, enabling the simultaneous assessment of workers' exposure to multiple organic solvents.

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