thesynergist | NEWSWATCH
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CDC Study Shows mRNA Vaccines Effective Against SARS-CoV-2
A CDC study of prospective cohorts of essential and frontline workers shows that messenger RNA (mRNA) vaccines are effective for preventing SARS-CoV-2 infections in real-world conditions. The agency’s findings are published in the March 29 issue of CDC’s Morbidity and Mortality Weekly Report (MMWR). The study found BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) COVID-19 vaccines to be 90 percent effective against symptomatic and asymptomatic SARS-CoV-2 infection at least 14 days after the workers’ second dose. Partially immunized workers also received protection: mRNA vaccines were found to be 80 percent effective against SARS-CoV-2 infection at least 14 days after the workers’ first dose but before they received the second.
During Dec. 14, 2020–March 13, 2021, CDC routinely tested 3,950 workers in eight U.S. locations who represented a range of occupational categories, including healthcare personnel; first responders; workers in hospitality, delivery, and retail; teachers; and other occupations that routinely require contact within three feet of coworkers or members of the public. The workers were enrolled in the study in July 2020. Participants were surveilled for COVID-19 symptoms through weekly text messages, emails, and direct participant or medical record reports. They also self-collected weekly nasal swabs regardless of symptom status, plus additional nasal swabs at the onset of any illness associated with COVID-19. These specimens were tested by reverse transcription-polymerase chain reaction (RT-PCR) assay for SARS-CoV-2 infection. Participants’ receipt of COVID-19 vaccines was also documented; by the end of the study period, 75 percent had received at least one dose of the Pfizer-BioNTech or Moderna mRNA vaccines and 62.8 percent had received both doses.
One hundred sixty-one PCR-confirmed SARS-CoV-2 infections were identified while participants were unvaccinated. When participants’ immune status was considered indeterminate—within 13 days of their first or second vaccine doses—researchers identified 33 PCR-confirmed infections, which were excluded from the results. Eight infections occurred in participants who were considered “partially immunized”: five infections were confirmed among participants who were at least 14 days beyond their first dose but did not receive their second dose within the study period, and an additional three infections were confirmed among participants at least 14 days after receipt of their first dose and through their receipt of the second. Finally, three infections were confirmed among participants with full immunization who had received their second vaccine doses at least 14 days prior to their positive test.
While the Pfizer-BioNTech and Moderna mRNA vaccines have been shown through randomized trials to be effective in preventing symptomatic COVID-19, it was not previously understood how well these vaccines worked under real-world conditions. According to CDC, the report demonstrates that mRNA vaccines can reduce the risk of SARS-CoV-2 infections regardless of symptom status. The agency stresses that this finding is especially important for healthcare personnel, first responders, and other essential workers , who have potential to transmit the virus due to frequent close contacts with patients, coworkers, and the public.
CDC’s report encourages caution when interpreting estimates of vaccine effectiveness due to moderately wide confidence intervals, partly a result of the low number of postimmunization PCR-confirmed infections, and limitations related to the self-collection of specimens. CDC researchers also recommend further research to determine the number of days required for vaccinated people to develop immunity. For a more complete discussion, see the full MMWR report.
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NIOSH Updates ErgoMine App
A new version of a NIOSH app for ergonomics audits in the mining industry is now available for iOS and Android devices. ErgoMine 2.0 is intended to help mine health and safety professionals identify, record, and track ergonomics and safety hazards at work sites. The latest version of ErgoMine allows users to identify and evaluate risk factors for musculoskeletal disorders using forms that focus on hand tools, manual tasks, and ergonomic task improvements. The app also includes checklists to identify slip, trip, and fall hazards and can be used to document corrective actions needed to address work site deficiencies. ErgoMine’s new “fix list” manager allows users to track changes needed at their work sites using photos and text.
ErgoMine asks users questions about work tasks and work site conditions to make recommendations for mitigating existing hazards and improving ergonomics. For more information or to download the app, visit NIOSH's website.
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CDC Updates Webpage on Ventilation in Buildings
CDC has updated its webpage on building ventilation strategies to mitigate occupants’ exposure to and the transmission of SARS-CoV-2. The webpage, which was created to help building owners, operators, and occupants reduce airborne concentrations of viral particles indoors, was amended on March 23 to include simplified language regarding ventilation tools, three new FAQs, and additional information on emerging ventilation technologies and high-efficiency particulate air (HEPA) cleaning units.
The three new FAQs cover the use of carbon dioxide monitors to provide information on a room’s ventilation, the use of indoor temperature and humidity to help control disease transmission, and the use of fans to improve room air mixing. CDC notes that the use of fixed carbon dioxide monitors can be informative in some well-designed and maintained environments but cautions that limited information exists to show a direct link between carbon dioxide concentrations and risk of COVID-19 transmission. The agency also cautions against adjusting room temperature or humidity as means to control COVID-19. CDC does recommend fans to increase the effectiveness of open windows as long as users avoid high-speed settings, switch ceiling fans to the reverse-flow direction, and direct fan discharge toward unoccupied areas.
In addition to FAQs, CDC’s ventilation webpage provides a list of tools to improve ventilation. CDC’s ventilation tools are intended to apply across indoor environments, but the practicality of implementation varies across building types, occupancies, intended activities, and environmental and seasonal changes. For more information, visit CDC’s website.
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FDA Recommends Limited Use of Decontaminated Disposable Respirators
Healthcare workers and facilities should move away from using decontaminated disposable respirators, the U.S. Food and Drug Administration (FDA) says in a letter dated April 9. FDA, together with CDC, “[believes] there is adequate supply of respirators to transition away from use of decontamination and bioburden reduction systems,” the letter states. These systems have been used to support the reuse of respirators in healthcare settings in response to respirator shortages stemming from the COVID-19 public health emergency.
FDA’s letter states that healthcare facilities should only use decontaminated respirators and respirators that have undergone bioburden reduction when there are insufficient supplies of new filtering facepiece respirators (FFRs) or if facilities are unable to obtain new respirators. The agency also urges facilities to increase their inventory of available NIOSH-approved respirators, including N95s and other FFRs, elastomeric respirators, and powered air-purifying respirators (PAPRs). If reusable respirators are needed, FDA recommends that healthcare facilities first try to acquire respirators that are designed to be reusable, like elastomeric respirators and PAPRs, before decontaminating or reducing the bioburden of disposable respirators.
FDA is not yet revoking its emergency use authorizations (EUAs) for decontamination and bioburden reduction systems and will continue to monitor respirator availability as facilities transition away from taking the most extreme measures for respirator conservation. FDA’s EUAs for decontamination systems for personal protective equipment are collected on the administration’s website.
For more information, see FDA’s letter to healthcare personnel and facilities.
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NIOSH to Expand Lab for PPE Research and Development
An upcoming renovation and expansion of NIOSH’s National Personal Protective Technology Laboratory in Pittsburgh, Pennsylvania, will support NPPTL’s Human Performance and Physiology Research Branch, its respirator certification program, and the research and development of new personal protective equipment technologies. The agency intends to begin developing plans for the renovation this autumn and to begin construction in summer 2022. CDC anticipates occupancy of the new lab space will begin in fall 2023.
“These upgrades will advance NIOSH’s research capabilities, facilitate innovation, and enhance our certification program,” said NIOSH Director John Howard, MD. “This is an important step forward in improving the safety of healthcare workers, first responders, and all workers who rely on these technologies to remain safe and healthy while on the job.”
Further details are available from a news article published recently in the Pittsburgh Post-Gazette.
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NIOSH Program Releases COVID-19 Research Agenda
NIOSH’s Disaster Science Responder Research (DSRR) Program has published its COVID-19 Research Agenda (PDF), which is intended to serve as a framework for planning the agency’s occupational health research efforts relevant to the ongoing pandemic response. The agenda describes nine “critical topic areas” identified by the DSRR Program leadership as significant for protecting worker safety and health amid the COVID-19 pandemic: economics, engineering controls, epidemiology and surveillance, mental health, occupational environment and exposure assessment, occupational violence, personal protective equipment, SARS-CoV-2 transmission and occupational health, and zoonoses, or diseases that can be transmitted to humans from animals. For each topic area, a team of NIOSH subject matter experts has developed a list of prioritized goals—needs that must be addressed for research to move forward in that area.
The new research agenda complements and expands on areas of CDC’s Science Agenda for COVID-19. The authors emphasize that COVID-19 research should focus on issues relevant to essential workers who conduct operations and services that ensure the continuity of the country’s most critical functions. They also stress the need to identify and address health inequities experienced by populations that have been disproportionately affected by COVID-19, such as workers from racial and ethnic minority groups, workers with limited English language proficiency, workers with lower incomes, workers with disabilities, and workers who are immigrants.
NIOSH founded its DSRR Program in 2015 to develop timely, scalable approaches for occupational health research so that research may be started quickly in the event of a disaster or public health emergency. Its goals include identifying the most important areas of research; addressing logistical, technical, and administrative challenges; identifying data collection capabilities and information resources; and communicating research findings.
More information can be found on NIOSH’s webpages for its COVID-19 Research Agenda and DSRR Program.
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Biden Nominates Cal/OSHA Chief to Head Federal OSHA
On April 9, President Joe Biden announced his nomination of Doug Parker, chief of California’s Division of Occupational Safety and Health (Cal/OSHA), as the new assistant secretary of labor for OSHA. Parker has served as chief of Cal/OSHA since 2019 and earlier was executive director of Worksafe, a legal services provider based in Oakland, California. A statement from the White House notes that Parker worked as a member of the Biden-Harris transition team focused on worker health and safety issues and previously served as deputy assistant secretary for policy at MSHA during the Obama administration. He also held positions as a senior policy advisor and special assistant at the Department of Labor.
OSHA has been without a permanent administrator since David Michaels resigned in 2017. When this issue of The Synergist went to print in early May, Parker had not yet been confirmed as OSHA head.
AIHA member Jim Frederick currently serves as OSHA’s principal deputy assistant secretary of labor. According to OSHA’s website, Frederick has three decades of experience providing occupational health and safety leadership to North American labor unions as an advocate and a resource to workers, employers, and regulatory agencies.
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European Chemicals Agency to Assess Potential Exposure Limits for 1,4-Dioxane
The European Chemicals Agency is seeking evidence related to the scientific evaluation of occupational exposure limits for the solvent 1,4-dioxane. According to ECHA, the European Commission has tasked the agency with evaluating 1,4-dioxane to assess the option of an airborne occupational exposure limit, other limit values such as biological limit values and biological guidance values, and notations. ECHA intends to use the information it gathers on 1,4-diozane’s uses, exposure, health effects, toxicology, epidemiology, and modes of action to draft a report related to exposure limits for the substance in the workplace. ECHA’s call for evidence provides stakeholders an opportunity to express their views and concerns while the agency is in the early phases of developing its scientific report on OELs for 1,4-dioxane. The deadline for comments is June 22, 2021.
ECHA’s Committee for Risk Assessment provides opinions on OELs under the Carcinogens and Mutagens Directive, which sets maximum concentrations for cancer-causing chemicals in workplace air, and the Chemical Agents Directive, which covers risks related to chemical agents at work. A table on the agency’s website summarizes ECHA’s work related to OELs. More information about 1,4-dioxane is available from the ECHA website.
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Nominations for Safe-in-Sound Awards Due June 8
The deadline to nominate organizations or individuals to receive a Safe-in-Sound Award in 2022 is June 8, 2021. The Safe-in-Sound Awards are presented annually by NIOSH in partnership with the National Hearing Conservation Association (NHCA) and the Council for Accreditation in Occupational Hearing Conservation (CAOHC). The awards recognize those who demonstrate by example the benefits of developing or following good hearing loss prevention practices. Two awards are given: the Excellence Award, which honors employers who implement exemplary hearing loss prevention programs, and the Innovation Award, which recognizes those who create innovative solutions to real workplace hearing loss prevention challenges.
NIOSH, NHCA, and CAOHC are accepting nominations for the next round of awards. To start the nomination process, interested individuals should submit a letter via email to Safe-in-Sound Review Committee Coordinator Scott Schneider by June 8, 2021, that describes the noise control or other hearing loss prevention intervention that suggests excellence or innovation. Self-nominations are encouraged. Completed nominations will be due by July 15, 2021. Additional information on the nomination process is available on the Safe-in-Sound website.
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Health Canada Recalls Masks Containing Graphene
Editor's note: Health Canada has allowed the sale of four mask models containing graphene to resume following a risk assessment and review of scientific literature prompted by the concerns described below. The department's update was published on July 13.
An advisory issued on April 2 by Health Canada, the Canadian federal department responsible for national public health, urges individuals not to use face masks that contain graphene, a novel nanomaterial reported to have antiviral and antibacterial properties. These masks have been sold with COVID-19 claims and may have been distributed in healthcare settings. According to the advisory, mask wearers could potentially inhale graphene particles, which may pose health risks. Health Canada has directed all known distributors, importers, and manufacturers to stop selling and to recall the affected products, which include face masks labeled as containing graphene or biomass graphene. The department explains its action as a precaution until it completes a scientific assessment and has established the products’ safety and effectiveness.
The advisory states that while Health Canada’s preliminary assessment of the available research has identified some potential for inhaled graphene particles to cause lung toxicity in animals, the potential for humans to inhale graphene from face masks and any related health risks are not yet known. These may be affected by several variables, including the amount and duration of exposure and the type and characteristics of the graphene material used.
In a statement (PDF) issued April 9, the Graphene Council, an organization of graphene producers, researchers, and end-users, said that Health Canada’s action “potentially denies the public access to graphene-enabled products that have been properly designed, tested, and registered to be effective against pathogens.”
On April 15, Health Canada posted a separate recall for masks and KN95 respirators containing biomass graphene that also refers to the potential for wearers to inhale graphene particles. For further details, see Health Canada’s advisory and recall.
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Healthcare Union, OSHA Raise Awareness of Counterfeit Respirators
A new guide created by the Health Professionals and Allied Employees (HPAE) union is intended to help healthcare workers identify counterfeit N95 respirators. According to HPAE, counterfeit respirators made to look like the teal-colored, cup-shaped N95 models manufactured by 3M are being distributed in healthcare facilities. The union’s guide provides information for health workers on identifying fakes and what to do if they suspect a respirator is counterfeit. The document also includes visual examples of counterfeit respirators.
High demand for respirators in healthcare facilities during the COVID-19 pandemic has led to what CDC calls an “unprecedented” number of counterfeit or deficient respirators on the market. One common problem noted by the agency is the alteration of documents intended to falsely suggest a respirator meets a particular performance standard. In addition, many devices have counterfeit certification marks or manufacturers’ names, logos, and model numbers.
Respirator users, purchasers, and manufacturers can find listings of counterfeit respirators and those that misrepresent NIOSH approval on NIOSH’s National Personal Protective Technology Laboratory website. NPPTL posts photos and explanations of counterfeit respirators as it becomes aware of them on the market. Safety managers, industrial hygienists, and others should use NIOSH’s certified equipment list to determine whether respirators they are currently using or considering using are NIOSH-certified.
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Federal Agency Publishes Three New Toxicological Profiles
New final toxicological profiles for the chemicals hexachlorobutadiene, 1,1,2-trichloroethane, and endrin are now available from the Agency for Toxic Substances and Disease Registry. Hexachlorobutadiene is primarily used to make rubber compounds, and 1,1,2-trichloroethane is used in chemical production and as a solvent. Endrin, a pesticide used to control insects, rodents, and birds, has not been produced or used in the U.S. in 30 years. According to ATSDR, most people do not need to take special steps to avoid hexachlorobutadiene and endrin in their daily lives, but workers who use or produce 1,1,2-trichloroethane should use appropriate personal protective equipment. Similarly, consumers using solvents or adhesives containing the chemical should avoid breathing in fumes and skin contact with these products.
EPA has classified both hexachlorobutadiene and 1,1,2-trichloroethane as possible human carcinogens but states that endrin’s human carcinogenicity cannot be classified. The NIOSH Pocket Guide to Chemical Hazards provides information about exposure limits for hexachlorobutadiene, 1,1,2-trichloroethane, and endrin.
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NIOSH to Study Lighting Interventions for Underground Mines
A new project proposed by NIOSH would examine the effect of lighting interventions on circadian disruption and well-being among underground mineworkers—particularly those working in shifts. According to the agency, underground miners’ lack of exposure to daylight can lead to fatigue and circadian disruption, which can cause sleep loss and reduce alertness. NIOSH warns that this increases the risk of accidents in mines and can result in health problems such as obesity, diabetes, and cancer. The agency’s proposed study would evaluate how blue- and red-light treatment at the beginning of workers’ shifts affects task performance, sleepiness and alertness, subjective well-being, sleep efficiency, and circadian rhythms among underground mine workers. Researchers intend to administer surveys and collect biometric data while conducting the study.
NIOSH hopes that the study's findings can be used to reduce fatigue and circadian disruption among underground mineworkers through new recommendations and interventions, possibly including “human-centric lighting,” an experimental intervention that mine companies can commercialize and use in underground coal and metal mines.
See the Federal Register notice about the project for further details.