Implications of Common and Special Variation for Occupational Health

Deubner, David C.

doi:10.1097/jom.0b013e31828dc94e

Cited by 2 publications

(1 citation statement)

References 13 publications

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“…Peaks can arise from normal process variation (regular peaks) or from process upset conditions and non-routine operations (irregular peaks) (24,25). Regular peaks are more likely identified using exposure data from routine monitoring, whereas irregular peaks can be missed without continuous monitoring to account for unplanned events, non-routine operations, or lessfrequently performed tasks.…”

Section: Issues In Measuring Peak Exposurementioning

confidence: 99%

Peak Inhalation Exposure Metrics Used in Occupational Epidemiologic and Exposure Studies

Virji

Kurth

2021

Front. Public Health

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Peak exposures are of concern because they can potentially overwhelm normal defense mechanisms and induce adverse health effects. Metrics of peak exposure have been used in epidemiologic and exposure studies, but consensus is lacking on its definition. The relevant characteristics of peak exposure are dependent upon exposure patterns, biokinetics of exposure, and disease mechanisms. The objective of this review was to summarize the use of peak metrics in epidemiologic and exposure studies. A comprehensive search of Medline, Embase, Web of Science, and NIOSHTIC-2 databases was conducted using keywords related to peak exposures. The retrieved references were reviewed and selected for indexing if they included a peak metric and met additional criteria. Information on health outcomes and peak exposure metrics was extracted from each reference. A total of 1,215 epidemiologic or exposure references were identified, of which 182 were indexed and summarized. For the 72 epidemiologic studies, the health outcomes most frequently evaluated were: chronic respiratory effects, cancer and acute respiratory symptoms. Exposures were frequently assessed using task-based and full-shift time-integrated methods, qualitative methods, and real-time instruments. Peak exposure summary metrics included the presence or absence of a peak event, highest exposure intensity and frequency greater than a target. Peak metrics in the 110 exposure studies most frequently included highest exposure intensity, average short-duration intensity, and graphical presentation of the real-time data (plots). This review provides a framework for considering biologically relevant peak exposure metrics for epidemiologic and exposure studies to help inform risk assessment and exposure mitigation.

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Section: Issues In Measuring Peak Exposurementioning

confidence: 99%

Peak Inhalation Exposure Metrics Used in Occupational Epidemiologic and Exposure Studies

Virji

Kurth

2021

Front. Public Health

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Associations of Metrics of Peak Inhalation Exposure and Skin Exposure Indices With Beryllium Sensitization at a Beryllium Manufacturing Facility

Virji

Schuler

Cox‐Ganser

et al. 2019

Annals of Work Exposures and Health

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Objectives Peak beryllium inhalation exposures and exposure to the skin may be relevant for developing beryllium sensitization (BeS). The objective of this study was to identify risk factors associated with BeS to inform the prevention of sensitization, and the development of chronic beryllium disease (CBD). Methods In a survey of short-term workers employed at a primary beryllium manufacturing facility between the years 1994–1999, 264 participants completed a questionnaire and were tested for BeS. A range of qualitative and quantitative peak inhalation metrics and skin exposure indices were created using: personal full-shift beryllium exposure measurements, 15 min to 24 h process-specific task and area exposure measurements, glove measurements as indicator of skin exposure, process-upset information gleaned from historical reports, and self-reported information on exposure events. Hierarchical clustering was conducted to systematically group participants based on similarity of patterns of 16 exposure variables. The associations of the exposure metrics with BeS and self-reported skin symptoms (in work areas processing beryllium salts as well as in other work areas) were evaluated using correlation analysis, log-binomial and logistic regression models with splines. Results Metrics of peak inhalation exposure, indices of skin exposure, and using material containing beryllium salts were significantly associated with skin symptoms and BeS; skin symptoms were a strong predictor of BeS. However, in this cohort, we could not tease apart the independent effects of skin exposure from inhalation exposure, as these exposures occurred simultaneously and were highly correlated. Hierarchical clustering identified groups of participants with unique patterns of exposure characteristics resulting in different prevalence of BeS and skin symptoms. A cluster with high skin exposure index and use of material containing beryllium salts had the highest prevalence of BeS and self-reported skin symptoms, followed by a cluster with high inhalation and skin exposure index and a very small fraction of jobs in which beryllium salts were used. A cluster with low inhalation and skin exposure and no workers using beryllium salts had no cases of BeS. Conclusion Multiple pathways and types of exposure were associated with BeS and may be important for informing BeS prevention. Prevention efforts should focus on controlling airborne beryllium exposures with attention to peaks, use of process characteristics (e.g. the likelihood of upset conditions to design interventions) minimize skin exposure to beryllium particles, and in particular, eliminate skin contact with beryllium salts to interrupt potential exposure pathways for BeS risk.

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Implications of Common and Special Variation for Occupational Health

Abstract: Jobs and tasks should be characterized for special variation in addition to traditional air sampling. Both special variation and common variation should be considered in occupational medicine preventive practice.

Cited by 2 publications

References 13 publications

Peak Inhalation Exposure Metrics Used in Occupational Epidemiologic and Exposure Studies

Peak Inhalation Exposure Metrics Used in Occupational Epidemiologic and Exposure Studies

Associations of Metrics of Peak Inhalation Exposure and Skin Exposure Indices With Beryllium Sensitization at a Beryllium Manufacturing Facility

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