thesynergist | NEWSWATCH
CDC Highlights Increase in Mesothelioma Deaths Among Women
Mesothelioma deaths among women increased significantly over the last 20 years even as asbestos use declined, according to a report published on May 13 in CDC’s Morbidity and Mortality Weekly Report (MMWR). The report states that the annual number of women who died from malignant mesothelioma increased by approximately 25 percent from 1999, when there were 489 deaths, to 2020, during which 614 deaths were recorded. Malignant mesothelioma was listed as the underlying cause of death for more than 12,000 women during 1999–2020. CDC notes that the increase in the annual number of mesothelioma deaths among women coincides with a decrease in the age-adjusted death rate for mesothelioma per one million women during the same time period. According to the agency’s report, the age-adjusted death rate declined from 4.83 in 1999 to 4.15 in 2020. These trends “suggest that changes in underlying annual age distributions of the population over time are contributing to the observed increases in total mesothelioma deaths in women,” the authors explain. Occupational exposure to asbestos is most often recognized among men in industrial settings such as construction, where women are less likely to be employed. But women are also at risk for exposure to asbestos, CDC stresses. The agency estimates that about 23 percent of mesotheliomas among women were attributable to work-related asbestos exposure, compared to about 85 percent of mesotheliomas among men. Information about industry and occupation was available for 567 of the mesothelioma deaths among women in 2020. The industry groups with the highest numbers of mesothelioma deaths were healthcare and social assistance, education services, and manufacturing, while the occupations with the most deaths were home-makers, elementary and middle school teachers, and registered nurses. Women can also be exposed to asbestos indoors when older building materials containing asbestos are present. For example, exposures may occur when previously installed asbestos-containing materials are disturbed during maintenance or renovation, or when activities such as sweeping or cleaning cause settled fibers to resuspend in the air. Take-home exposures from family members who were exposed to asbestos fibers in workplaces outside the home are also of concern and are an example of how women can be exposed to asbestos indirectly. One study referenced in CDC’s MMWR found that the relative risk for mesothelioma increased tenfold for women with a spouse or father employed in an asbestos-related industry. Findings that mesothelioma death rates among women are highest in states with shipyard industries or that are associated with mining and processing asbestos-contaminated vermiculite further suggest that take-home asbestos exposure may affect cancer development. The authors of the report caution that its findings have several limitations. For example, complete information regarding all industries and occupations in which decedents worked during their lives and information about their family members’ work was not available. Another limitation is that information about asbestos exposure or work tasks is not available on death certificates. CDC’s report stresses the importance of maintaining efforts to limit exposure to asbestos fibers, including among women. “Ensuring future decreases in mortality because of malignant mesothelioma will require meticulous control of exposures in activities such as ship and building renovation and demolition, and in asbestos remediation and disposal,” the report says. The full MMWR report is available from CDC’s website.
Draft Toxicological Profiles for Mercury, Other Chemicals Published
A new draft toxicological profile for mercury is now available from the Agency for Toxic Substances and Disease Registry. According to ATSDR, mercury is used in the manufacture of electronics and fluorescent lighting and in dental products such as fillings. Occupational exposures to mercury are of concern among industrial and dental workers. ATSDR warns that mercury can affect the nervous system and the kidneys, leading to health effects such as tremors, incoordination, impaired vision, impaired learning and memory, and mood changes. New draft toxicological profiles are also available for copper; the synthetic chemical nitrobenzene, which is used to produce other chemicals or to dissolve chemicals during manufacturing; and nitrophenols, which include three chemical compounds. Nitrophenols are manufactured and used in the production of dyes, rubber, photographic chemicals, medicines, pesticides, and fungicides, ATSDR explains. Learn more from ATSDR's website.
Researchers Describe Welder’s Anthrax, a Newly Identified Occupational Disease
In an article published this March in the journal Pathogens, researchers from NIOSH and CDC’s Bacterial Special Pathogens Branch highlight seven cases of welder’s anthrax that affected six welders and a metalworker during 1994–2020. Welder’s anthrax is severe pneumonia in a metalworker caused by Bacillus cereus group bacteria that produce anthrax toxin. In a NIOSH Science Blog post, the authors of the Pathogens paper characterize welder’s anthrax as “a newly identified, deadly occupational disease.” Although welder’s anthrax is rare, researchers believe that cases may have been missed due to several factors, including limited detection and understanding of this pathogen.
A CDC report published in October describes B. cereus group bacteria as “gram-positive facultative anaerobes, often toxin-producing, that are ubiquitous in the environment and reside naturally in soil and dust.” The Pathogens journal article discusses possible mechanisms of infection and disease, including the hypothesis that the risk of infection is primarily from occupational exposure to metal fumes. The authors note that previous research findings suggest that inhalation of metal fumes may predispose workers to lung infections.
Researchers urge communication and cooperation between clinicians, employers, and public health practitioners to identify cases of welder’s anthrax and identify occupational and personal risk factors. They also recommend future research to examine the possibility of increased susceptibility to and severity of lung infection among welders and metal-workers.
The full text of the Pathogens article is available to read online.
CSB: Mixture of Incompatible Chemicals Caused Fatal 2019 Explosion
A 15-minute video by the U.S. Chemical Safety and Hazard Investigation Board (CSB) discusses a May 2019 chemical explosion that occurred after two incompatible chemicals were mixed at a Waukegan, Illinois, facility operated by AB Specialty Silicones. The incident caused the deaths of four workers, injured a fifth, destroyed AB Specialty’s facility, and extensively damaged nearby businesses.
The video includes animations demonstrating how, on May 3, 2019, an operator unintentionally mixed two incompatible chemicals that had been stored in identical drums. As the chemical mixture overflowed its tank, the operator and other workers realized an adverse reaction had occurred but not that the reaction had released flammable hydrogen gas into the production building. Two workers were instructed to vent the building, but before they could do so, the hydrogen gas ignited.
CSB’s investigation found that the facility lacked written procedures for safe storage of incompatible chemicals, did not implement local exhaust ventilation, and needed a functioning hazardous gas detection system. AB Specialty also did not have an effective hazard analysis program that could have identified safety issues.
Although AB Specialty used chemicals capable of causing dangerous reactions, the company was not required by existing regulations to implement process safety measures. CSB reiterated recommendations for OSHA to amend its process safety management standard and for EPA to revise the accidental release prevention requirements of its risk management plan rule to cover reactive hazards.
For more information, read CSB’s news release.
European Agency Adds Substance Used in Polymers to Hazardous Chemicals List
In June, the European Chemicals Agency (ECHA) announced the addition of the compound N-(hydroxymethyl)acrylamide to its Candidate List of substances of very high concern for authorization. N-(hydroxymethyl)acrylamide is used in polymers as well as in the manufacture of other chemicals and products such as textiles, leather, or fur, according to ECHA. The substance was added to the hazardous chemicals list due to its carcinogenic and muta-genic properties. An “infocard” published by ECHA stresses that N-(hydroxymethyl)acrylamide may also cause an allergic skin reaction; a majority of companies that have submitted data to ECHA about the substance agree that it is skin sensitizing, the agency explains. Identifying a chemical as a substance of very high concern and including it in the Candidate List is the first step of the authorization procedure under REACH, the European Union’s Regulation on Registration, Evaluation, Authorization and Restriction of Chemicals. Learn more on ECHA’s website.
CDC Examines Ventilation Strategies in Public Schools
A CDC report published in June found that while “substantial federal resources” are available to improve ventilation in schools, schools more frequently employ lower-cost strategies such as inspecting and validating existing heating, ventilation, and air conditioning (HVAC) systems and opening doors or windows rather than implementing more resource-intensive strategies. According to the National School COVID-19 Prevention Study, a survey that provides a nationally representative sample of kindergarten through grade 12 (K–12) public schools in the United States, only 38.5 percent of schools have replaced or upgraded their HVAC systems since the beginning of the COVID-19 pandemic. Even smaller proportions of schools reported the use of high-efficiency particulate air (HEPA) filtration systems in classrooms (28.2 percent) or areas where students eat (29.8 percent).
CDC’s analysis found that the use of ventilation strategies in schools differed based on location and poverty level. For example, mid-poverty schools—those with one-quarter to three-quarters of students eligible for free or reduced-price meals—were less likely than higher-poverty schools to implement resource-intensive ventilation strategies, such as replacing or upgrading HVAC systems. Researchers posit that one reason mid-poverty schools may be less likely to implement such strategies is that they may have less experience in accessing and using federal funds than higher poverty schools.
As improved ventilation can reduce the transmission of SARS-CoV-2 and other infectious diseases in schools, the report urges public health professionals to support schools’ implementation of resource-intensive strategies to improve ventilation and indoor air quality. The full report can be found on CDC's website.
Report Describes Significant Enforcement, Data Challenges Facing OSHA
OSHA faces significant challenges in its efforts to enforce workplace safety and health standards and collect injury and illness data, according to a report issued in May by the U.S. Government Accountability Office. GAO states that it conducted this study due to concerns about OSHA’s crisis preparedness arising from its efforts to protect workers from COVID-19.
The report notes that from February 2020 through June 2021, OSHA responded to the pandemic mainly through enforcing its existing applicable standards, such as those related to respiratory protection, and its general duty clause, which can be applied for hazards that lack specific standards when certain criteria are met. But GAO found that OSHA inspectors experienced difficulties with both strategies, in part because citing general duty clause violations requires significant documentation.
GAO also identified obstacles to OSHA’s data collection efforts. Between 2016 and 2018, GAO estimates that employers for more than 50 percent of establishments did not report required injury and illness data. The GAO study also found that OSHA issued significantly fewer citations for recordkeeping violations after a 2012 court decision that limited the time period in which OSHA was allowed to cite these violations, and that the agency has few procedures for encouraging compliance and penalizing noncompliance to recordkeeping requirements. GAO’s report explains that these challenges are significant because OSHA uses injury and illness data to target inspections.
For more information and to download a PDF of the report, visit GAO's website.
Tool for Estimating N95 Needs of Essential Workers Developed by NIOSH
NIOSH researchers have developed a spreadsheet-based tool for estimating the number of N95 respirators needed to protect essential workers in nonhealthcare occupations during a future pandemic. According to the agency’s June 2022 e-newsletter, estimates generated using this tool can assist public health officials and policymakers in preparing for future emergencies. The tool can also be applied to other types of personal protective equipment.
Researchers estimate about 85 million nonhealthcare essential workers could need N95 respirators during another pandemic spread through aerosol transmission. For a minimum possible scenario—a pandemic lasting 15 to 40 weeks, requiring one N95 respirator per worker per week—NIOSH’s tool estimates that these workers would need about 1.3 billion N95 respirators during the first 15 weeks. Estimates increase to 2.6 and 6.4 billion respirators needed for the first 15 weeks for intermediate (two N95s per week) and maximum (five N95s per week) scenarios, respectively. The tool estimates that a 40-week-long pandemic would require 3.4 billion respirators for the minimum scenario, 6.8 billion for the intermediate scenario, and 17 billion for the maximum scenario.
The sources and methods used to develop the tool are described in an article in the journal Health Security. The tool may be accessed for free in the article’s supplemental material.
MSHA to Increase Inspections, Silica Sampling at Mines
A new enforcement initiative launched by the Department of Labor’s Mine Safety and Health Administration (MSHA) is intended to improve U.S. miners’ protections from respirable crystalline silica hazards. In a press release published on June 8, MSHA explains that the initiative will involve mine inspections related to silica dust and expanded silica sampling at mines. The agency says it will also renew efforts to notify miners of their right to report hazardous working conditions and assist mine operators in compliance and implementation of best practices. MSHA’s webpage for its silica enforcement initiative further outlines the program’s components.
According to MSHA, thousands of miners per year are exposed to respirable crystalline silica during common mining activities such as cutting, sawing, grinding, drilling, and crushing stone and rock. Without proper protection and engineering controls in place, the agency stresses that miners face increased risks for serious, potentially fatal illnesses such as coal workers’ pneumoconiosis, progressive massive fibrosis, silicosis, lung and other cancers, chronic obstructive pulmonary disease, and kidney disease.
OSHA Initiative Aims to Reduce Noise-Induced Hearing Loss in Manufacturing
In May, OSHA began the enforcement phase of a Regional Emphasis Program intended to identify, reduce, and eliminate occupational exposures to hazardous noise levels in the states of Colorado, Montana, North Dakota, and South Dakota. The program targets manufacturing industries with high rates of occupational hearing loss. According to OSHA’s program directive (PDF), enforcement activities include inspection and review of operations and working conditions, injury and illness records, and safety and health programs.
OSHA used Bureau of Labor Statistics (BLS) data to select industry sectors with incident rates for hearing loss of at least nine per 10,000 full-time workers for inclusion in the emphasis program. These sectors include food manufacturing, wood product manufacturing, primary metal manufacturing, and fabricated metal product manufacturing. According to BLS, in 2019, wood product manufacturing had an incident rate for hearing loss of 21.7 per 10,000 full-time workers, while the subsector of prefabricated wood building manufacturing had a rate of 31.1. BLS data for 2019 indicate that the incident rate for hearing loss for all industries in the United States was 1.4 per 10,000 full-time workers.
More information on occupational noise exposure can be found on OSHA’s website.
New EPA Rule Would Require More Comprehensive Reporting on Asbestos
A proposed rule announced by EPA in May would include reporting and recordkeeping requirements for asbestos under the Toxic Substances Control Act. The agency is proposing a one-time reporting obligation under which asbestos manufacturers and processors would be required to report certain use and exposure information on asbestos, including asbestos that is a component of a mixture, from the last four years. EPA would seek exposure-related information such as quantities of asbestos or asbestos-containing articles that were manufactured or processed, types of uses, and employee data. The agency says the data collected through this proposed rule would be used to inform future EPA actions involving asbestos.
The proposed rule would require the reporting of employee data such as the number of workers associated with the activity, whether personal protective equipment was used, and any workplace exposure measurement assessment data.
EPA’s proposed requirements for asbestos were announced in the Federal Register. Information on additional EPA activities involving asbestos can be found on the agency's website.