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Exposure of ground-rig applicators to the herbicide bromoxynil applied as a 1:1 mixture of butyrate and octanoate.

Bromoxynil is a herbicide used extensively on the Canadian prairies for weed control in cereal production. This is a report on exposure to and absorption of bromoxynil by farmers during handling, transferring, mixing, and then applying the herbicide to cereal crops using tractor-drawn ground-rigs. The 14 individual spray operations, in which farmers applied 9 kg of bromoxynil (phenol equivalent, p.e.) to 32 ha, lasted from 113 to 549 min and involved one to five tank fills. In five of the spray operations, the farmers wore neoprene gauntlet-style protective gloves. Tractors, equipped with cabs, were used in nine spray operations.Air sampling, hand washes, and dermal patch dosimeters served as the basis to calculate the amount of bromoxynil (p.e.) available for inhalation, deposition on the hands, and deposition under a standardized set of protective clothing. Tractors, equipped with cabs, decreased inhalation exposure by a factor of approximately 10. Use of gauntlet-style neoprene protective gloves decreased dermal exposure to the hands region of the body by 25 times, whereas two layers of laundered cotton provided a protective effect of > 15 in the chest region. The median value for the amount of bromoxynil (p.e.) inhaled was 0.018 microg x kg BW(-1)x kg (p.e.)(-1) for the 14 spray operations. The hands region of the body was the area most exposed to bromoxynil (p.e.), the median value of dermal deposition to the hands being 808 microg (p.e.) compared to 1,600 microg (p.e.) for the whole body, when protective gloves were not worn. The urinary excretion pattern of bromoxynil (p.e.) did not demonstrate an obvious maximum followed by a continuous decline to background concentrations. Instead, the amounts excreted increased over the first few days after application and then tended to remain relatively constant during the remainder of the 10-day sampling period. The median value for urinary excretion was 2.22 ng x g creat(-1) x kg BW(-1) x kg (p.e.)(-1).

Absorption↗

Cotton liners to mediate glove comfort for greenhouse applicators.

Greenhouse applicators' acceptance of cotton knit gloves worn as liners under nitrile chemical-resistant gloves (CRG) for pesticide application was investigated through a wear study in Iowa and New York. Comfort was assessed by questionnaires and interviews with 10 applicators. Contamination levels of four pesticides on CRG and liners at thumb, forefinger, palm, and cuff locations were determined by chemical analysis using high-performance liquid chromatography or gas chromatography. Applicators reported feeling more comfortable with cotton liners under their CRG than without and that cotton liners were easy to manage. Contamination was significantly greater on nitrile CRG than on cotton liners underneath, but a few liner specimens had measurable contamination. No significant contamination differences were found between right- and left-hand gloves. Contamination varied significantly by hand location, with cuffs least, and by pesticide, with chlorpyrifos most. These results support the Environmental Protection Agency's recommendation that liners should be disposable, but further work on liners and their laundering feasibility seems indicated.

Agriculture↗

Occupational risk factors for kidney cancer: a cohort study in Sweden.

Although many studies have examined the associations between occupational exposures and kidney cancer, the evidence is not consistent. To examine the risk of occupational exposures on kidney cancer, we carried out a follow-up study on the economically active Swedish population, based on the latest update of the Swedish Family-Cancer Database. We calculated standardized incidence ratios (SIR) and 95% confidence intervals (CIs) for different occupational groups, adjusted for age, period, and socioeconomic status. The reference group was all the economically active population. An increased risk of renal parenchymal cancer was observed for miners and quarry workers, drivers, sales agents, transport workers, and public safety and protection workers among men, and launderers and dry cleaners among women. Significantly increased SIRs of renal pelvical cancer were also observed for the food manufacture workers among men, and journalists and shoe and leather industry workers among women. Male forestry workers, smelters, and metal foundry workers had increased risk for unspecified kidney cancer. Although smoking may explain some of these results, exposure to gasoline, diesel, their exposure products, some metal and chemicals in shoe and leather works, and dry-cleaning products may be associated with kidney cancer.

Confidence Intervals↗

An appraisal of Impregon as a deterrent of domestic fungus growth.

Impregon brand of tetrachlorsalicylanilide (TCSA) has been profferred widely as a household fungistatic agent, although its value remains unproved. To assess its effects, this agent was used as a laundry and paint additive and as a treatment for burlap rug backing; after recommended applications of Impregon, coded replicate materials were inoculated with mixed suspensions of fungus particles. No difference was evident in fungus growth points on fabric swatches washed in tap water with and without Impregon. However, growth on both of these was significantly greater than on samples laundered in tap water using only a commercial soap or liquid detergent. Fungus soiling of burlap was not clearly diminished by prescribed applications of Impregon solution 3 mo previously. Similarly, the addition of this agent to paint did not suppress fungus growth on Masonite plaques to which it had been applied. However, comparable levels of Impregon incorporated into agar media substantially inhibited spore germination. These findings suggest that the bioavailability of TCSA is insufficient to provide desired household antifungal effects when Impregon is used in accord with current recommendations.

Air Microbiology↗

Prevention of hip fractures in the elderly: receptivity to protective garments.

A case study was undertaken to determine perceptions about protective garments for the prevention of recurrent hip fractures. We studied 169 patients with hip fractures, over 50 years of age, who were admitted to four university-affiliated hospitals. Proxy respondents were interviewed for 36% (n = 61) of the patients. Significant differences were found in the two groups; therefore, only the analyses from 108 patients who were interviewed are reported. Seventy percent of the patients were willing to wear a padded garment prescribed by a doctor. Factors associated with a positive response were no previous hip fracture, and an intrinsic cause of the fracture (P <or= 0.05). Over half (55%) of the patients were willing to wear an inflatable garment. Being female and fracturing the hip away from home were two factors that were associated with a positive response. Characteristics of the protective garment that patients thought were a concern or very important were effectiveness (83%), fit (82%), comfort (78%), laundering (66%), cost (57%), not showing (55%) and looked well (54%). These findings may assist investigators in the design of protective garments and thereby increase the receptivity and compliance among elderly patients.

Journal Article↗

Low-temperature washing of patients' clothing; effects of detergent with disinfectant and a tunnel drier on bacterial survival.

Patients' dresses were washed at 40 degrees C using an ordinary detergent for 1 week and a novel detergent with added 'Triclosan' for the following 2 weeks. The bacterial load on the finished laundry was acceptably low using either detergent. The killing of residual bacteria on washed clothing by drying in a tunnel finisher was demonstrated. This preliminary study did not show any benefits to be gained from the addition of 'Triclosan' to detergent for the low-temperature laundering of patients' clothing.

Bacteria↗

The quality of epidemiological data in coronary heart disease and atherosclerosis.

There are inherent difficulties in the use of indirect observations in the epidemiology of a chronic ubiquitous disease such as atherosclerosis. Such difficulties do not condone basic errors in epidemiological methodology, the use of low quality data, a lack of precision in measurements, invalid extrapolations and inappropriate use of terminology and coronary heart disease as a surrogate or synonym of coronary atherosclerosis and bias in the interpretation of data. These errors reveal a lack of rigorous and scientific standards in the epidemiology of coronary heart disease. Analysis cannot launder such data. Independent scientists must evaluate the data in respect of precision, logic and truth.

Arteriosclerosis↗

Socioeconomic/occupational risk factors for lymphoproliferative diseases in Sweden.

PURPOSE: The aim of the study is to investigate associations between socioeconomic and occupational factors and lymphoproliferative (LP) diseases. METHODS: We performed a follow-up study on the economically active Swedish population, based on the Swedish Family-Cancer Database. Standardized incidence ratios and 95% confidence intervals were calculated in different social classes and occupations. RESULTS: An increased risk for LP diseases was observed for physicians, plumbers, chemical process workers, and food manufacture workers among men and shoe and leather workers, mechanics, iron and metalware workers, and launderers and dry cleaners among women. CONCLUSIONS: Results suggest that socioeconomic and occupational factors have a minor effect on risk for LP diseases. Exposure to organic solvents may increase the risk for some LP diseases, although inconsistencies of findings between subcohorts do not rule out spurious associations.

Female↗

Fomite transmission in head lice.

Control of various infestations requires an accurate understanding of transmission. After thousands of years of lice infestation, scientific documentation of indirect contact transmission has been substantiated. Lice can be transferred in the egg, instar, and adult stages. Lice have now been shown in the laboratory to be readily dislodged by air movements such as blow-drying one's hair, combing, and toweling. Moreover, passive transfer to adjoining fabric is also frequently observed. Louse transmission by fomites occurs more frequently than has been commonly believed. Close proximity suffices to increase the likeliness of a new infestation. Thus louse control measures should take account of fomite transmission and include screening of all individuals within an infested person's immediate circle of contact, laundering of everything within the infested individuals' bed or quarantining of such material for 10 days, thorough vacuuming of floors, carpets, upholstery, with a standard vacuum cleaner.

Animals↗

Disinfection of fabrics and carpets artificially contaminated with calicivirus: relevance in institutional and healthcare centres.

Fabrics and carpets are used widely as surface coverings or linens in healthcare settings and are prone to contamination with infectious agents such as noroviruses (NoVs). Laundering, water cleaning and vacuuming are considered to be adequate for routine cleaning of these materials, but no standard procedure for their disinfection is available in case of contamination. Testing disinfectants for their efficacy against NoVs is difficult because these viruses cannot be cultivated in vitro. Therefore, feline calicivirus (FCV) has gained acceptance as a surrogate model for NoVs in disinfectant efficacy testing. The present study evaluated five disinfectants against FCV on various fabrics or carpets. FCV was dried on fabrics and carpets, followed by treatment with a given disinfectant for a defined contact time of 1, 5 or 10 min. The surviving virus was then eluted and titrated in Crandell-Reese feline kidney cells to determine virus inactivation. A disinfectant was considered to be effective if it inactivated at least 99% of the applied virus. Metricide, an activated dialdehyde-based product, was found to be the most effective disinfectant on all types of fabric and carpet, inactivating more than 99.99% of the virus in 1-10 min. In general, effectiveness of disinfectants increased with an increase in exposure time from 1 to 10 min. The disinfection of carpets was more difficult than the disinfection of fabrics; 100% polyester was the least amenable to disinfection. Only Metricide and Microbac-II (a phenolic compound) were able to inactivate 99% of FCV on 100% polyester. In summary, activated dialdehyde was found to be uniformly active against FCV on all types of material tested.

Animals↗

Evaluation of non-lead-based protective radiological material in spinal surgery.

BACKGROUND CONTEXT: Traditionally, lead-based garments are the standard method of intraoperative radiation protection during fluoroscopy. Unfortunately, the lead used is heavy, lacks durability, is difficult to launder, and its disposal is associated with environmental hazards. PURPOSE: An evaluation of the protective radiation efficiency of three commercially available radiation protective garments compared with a standardized lead protective shield. STUDY DESIGN/SETTING: Measured radiation transmission through lead and three commercially available lightweight radiological protective garments (Xenolite, EarthSafe, and Demron) was performed using a standard, calibrated dosimeter. METHODS: Radiation transmission, attenuation, lead equivalencies as well as garment weight comparisons were measured. The tests were repeated through a range of voltage and tube current settings that are common to clinical radiological applications (60-120 keV). RESULTS: All materials tested demonstrated effectiveness at common clinically relevant energy exposures (100 keV). EarthSafe and Xenolite demonstrated 0.5 mm lead equivalency protection at 80 and 100 keV X-ray energies but not at higher energy levels (>100 keV), which is where most radiological procedures are performed utilizing more advanced technological imaging equipment. Demron was best able to effectively shield ionizing radiation at higher energy levels (>100 keV). The lightweight nature of these lead-free materials may result in less fatigue and musculoskeletal complaints by the wearer. CONCLUSIONS: Of the tested lead-free garments, Demron appears to offer equivalent levels of protection to standard lead-based shields within traditional energy zones but with less weight than standard lead-based shields.

Humans↗

Indoor allergen levels in day nurseries.

BACKGROUND: Because allergic sensitization seems to occur especially during infancy, we decided to evaluate such an exposure in day nurseries. METHODS: Thirty day nurseries in Marseilles, which were selected at random, were visited during 2 weeks in April 1993. Routine cleaning includes daily cleaning of smooth floors, weekly laundering of sheets, and monthly cleaning of soft toys. Mattresses are encased in synthetic covers. Dust samples were collected from four settings: infants' mattresses and pillows, smooth floors, and soft toys. Levels of mite, cockroach, cat, and dog allergens were analyzed with a monoclonal antibody-based ELISA. RESULTS: Mite allergen levels were lower than the proposed threshold level for sensitization (2 micrograms/gm of dust) on 94% of mattresses and soft toys and on 100% of floors and pillows. Cat allergen levels in mattresses ranged from less than 0.1 to 4.5 micrograms/gm dust. On floors, cat allergen levels ranged from less than 0.1 to 2.4 micrograms/gm dust. Only 10% of pillows and soft toys had levels greater than 2 micrograms/gm of dust. Fel d I levels were significantly higher (p < 0.03) in mattresses from nurseries with curtains and were correlated with the percentage of children with a cat at home. In almost all day nurseries, cockroach allergen (Bla g I and Bla g II) levels were very low. Only three samples from mattresses had dog allergen levels greater than 2 micrograms of Can f I allergen per gram of dust. On floors the level was always lower than 2 micrograms/gm. CONCLUSIONS: These data clearly show that indoor allergen levels are much lower in day nurseries than in most houses. Most samples contain allergen levels below threshold levels for sensitization. Thus children of atopic parents are less likely to become sensitized to indoor allergens in day nurseries than in their own homes. In addition, this study emphasizes the efficacy of avoidance measures such as use of synthetic protective mattress covers, frequent washing of sheets and soft toys, and avoidance of carpets and curtains.

Allergens↗

House dust mite (Dermatophagoides farinae and Dermatophagoides pteronyssinus) prevalence in the rooms and hallways of a tertiary care hospital.

BACKGROUND: House dust mites, Dermatophagoides farinae and Dermatophagoides pteronyssinus, are important components in the development of asthma. OBJECTIVE: We measured the prevalence of house dust mites in a tertiary care hospital located in a temperate geographic region where dust mites were prevalent in homes. METHODS: The density of Dermatophagoides spp. was measured in hospital hallways, carpeted patients' rooms, and noncarpeted patients' rooms by vacuuming the floor in the summer and winter seasons. Bedrooms in the homes of employees were sampled as a summer control group. A total of 141 dust samples was obtained. RESULTS: No D. farinae or D. pteronyssinus was found in 60 hospital dust samples that were obtained during the winter season. Although mites were found in some locations in the hospital during the summer dust collection, mite density in these locations and the average mite density for all samples were insignificant. During the summer dust samples from the bedroom carpets of all employees' homes sampled were positive for mites, with many homes having moderate or high populations (range, 22 to 8340 mites per gram of dust). CONCLUSIONS: The dust mite prevalence in a hospital could be kept very low even though mite levels in employees' homes were moderate to high. The factors responsible for the low mite density in the hospital were maintenance of low relative humidity, use of low-pile carpets, and good housekeeping and laundering practices.

Animals↗

Anti-mite measurements in mite-sensitive adult asthma. A controlled trial.

A cross-over controlled trial has been conducted among 32 adult patients with mite-sensitive asthma. The bedclothes and pillows of each subject were laundered and vacuum-cleaned and a plastic cover applied to the mattress for six weeks in an attempt to reduce exposure to mites. No improvement in daily peak-flow reading or drug usage was found in comparison with a control period.

Adult↗

Use of quantitative microbial risk assessment for evaluation of the benefits of laundry sanitation.

The goal of this study was to evaluate the risk assessment process for quantifying the contribution of contamination in the home to microbial infections. Whereas risks of enteric pathogens spread through food has been assessed, the spread of fecal-oral pathogens through surfaces likely at low rates would be difficult to address through epidemiologic studies. An alternative is quantitative risk assessment. The 4-step process of hazard identification, dose-response, exposure assessment, and risk characterization can be used; however, exposure assessment may follow a complicated pathway consisting of survival and transference. Microbial hazards in the home have focused primarily on enteric bacteria. Dose-response data are available; however, the transfer from the hands to the dose is uncertain. Through day care studies, Shigella has been shown to be transferred in this manner, and a dose-response model is available. By using these data and information on the transference of bacteria between clothing and hands, risk estimates were made for contaminated laundry. Risks were calculated as high as 10 per million population to much lower levels associated with lower excretion rates of the bacteria in the feces. Approximately a 90% and 99% reduction in the probability of disease through laundering and use of a sanitizing detergent, respectively, were suggested by the models. Better data are needed on incidence of disease in the population, excretion rates over the course of an infection, amount of feces spread in the home, distribution of bacteria, survival, and the transfer of the bacteria from surfaces to the hands and to the mouth.

Clothing↗

Methods and effectiveness of indoor environmental control.

LEARNING OBJECTIVES: The purpose of this review is to describe recommended methods of decreasing exposure to indoor allergens. DATA SOURCES: Data were obtained from published studies and reviews. STUDY SELECTION: The reviewed studies met these criteria: 1) measurement of environmental allergens; 2) selection of participants with clearly defined allergic airway disease confirmed by detection of allergen-specific immunoglobulin E; and 3) clearly defined clinical and environmental outcomes. The studies were conducted as controlled clinical trials and the results between treated and control groups were compared with appropriate statistics. RESULTS: The results of these studies show that installing allergen proof encasings and washing bedding frequently reduces house-dust mite exposure by 10-fold or more and significantly improves clinical measures of asthma. Washing pets reduces allergen levels temporarily. Excluding the pet from the bedroom while installing allergen-proof encasings and operating air cleaner reduces airborne allergens although having no significant effect on allergic symptoms. Cockroach populations can be controlled for over 6 months and allergens can be reduced with controlled pesticide application and cleaning, but clinical correlates have not been reported. Methods to improve adherence to environmental control measures have not been tested but effective methods can be recommended from literature on medication adherence. CONCLUSIONS: For patients allergic to indoor allergens, reasonable recommendations include installation of allergen-impermeable encasings, frequent laundering of bedding, removing furred pets from the home, and controlling of cockroach populations with effective pesticides using the principles of integrated pest management.

Air Pollution, Indoor↗

The relationship between rainfall and well water pollution in a West African (Gambian) village.

Water pollution was monitored in six Gambian village wells over a period of 8 months spanning the 5-month monomodal rains and the pre- and post-rains dry periods. Faecal coliform (FC) and faecal streptococci (FS) counts were high throughout and there was a massive increase associated with the onset of the rains, maximum counts exceeding 5 x 10(5)/100 ml. This pattern was largely sustained throughout the rainy season. Some individual variations in patterns of pollution could be ascribed to well design, in particular lining of the shaft, but no well was protected from the seasonal increase in faecal pollution. The source of the increased pollution appeared to be a flushing in of faecal material of indeterminate or mixed human and animal origin, probably over considerable distances. Peaks of pollution not associated with rainfall episodes could have resulted from the practice of communal laundering in the near vicinity of the wells. Specific pathogens including Salmonella spp. were isolated only intermittently. Attention has been drawn to a problem complicating the standard method for assessing FC counts.

Animals↗

An instrument for measuring bacterial penetration through fabrics used for barrier clothing.

A new instrument has been designed to measure the penetration by rubbing of bacteria from cloth contaminated in the nursing of burn patients through fabrics designed for barrier garments. Most fabrics tested dry reduced the transfer of bacteria from the source cloth to about 10%, irrespective of the results of air filter tests, which agrees with mock nursing results. When the fabrics were tested against a wet surface, the transfer of bacteria rapidly reached 100% if the fabrics had a high wettability, but was slower for fabrics with a low wettability. Through closely woven waterproofed cotton, transfer was 5--25%, but increased three- to four-fold after ten launderings, in line with the water absorption. Transfer through plastic-laminated material was less than 1%. The results suggest that barrier garments should be made either of plastic or of recently waterproofed closely woven cotton at points of contact between nurse and patient where the clothes may be wetted by bacteria-containing wound secretions.

Asepsis↗