thesynergist | NEWSWATCH
EPA Proposal Seeks to Reduce Ethylene Oxide Exposures
EPA is proposing new health standards to reduce occupational and community exposures to ethylene oxide (EtO), the agency announced in an April 11 press release. These draft standards would require more stringent air emission controls and additional protections for workers exposed to EtO, such as those employed in facilities where the gas is used to sterilize medical equipment and a range of other products. If finalized, the proposed standards are expected to cut EtO air emissions from commercial sterilization facilities by 80 percent per year and address concerns associated with EtO pollution, such as cancer risks. OSHA and the Agency for Toxic Substances and Disease Registry both warn that EtO is associated with a range of acute health effects, including lung irritation, and may be a carcinogen. However, EPA is advancing its new protections due to a recent assessment that found cancer risks from occupational exposures to EtO to be more significant than previously understood. According to EPA’s analysis, workers who apply EtO in sterilization and healthcare facilities over the course of a 35-year career are at increased risk for certain cancers. Workers in such facilities who do not use EtO directly and community members who live or attend schools nearby may also have increased cancer risks. More information can be found on EPA’s webpage for human health risks associated with EtO. As EtO is considered a hazardous air pollutant, EPA is proposing revisions to the National Standards for Hazardous Air Pollutants specifically to address EtO emissions from commercial sterilization facilities. If finalized, the revised standards would require 86 commercial sterilization facilities nationwide, as well as all new facilities in this sector, to follow stricter pollution controls and employ advanced source monitoring methods to confirm these controls are operating effectively. These facilities would be required to report monitoring results to EPA twice per year. This proposed rule on EtO emissions may be read in the Federal Register. Products containing EtO that are used for sterilization purposes are classified as pesticides under federal law. Therefore, the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) grants EPA the authority to require stronger control measures to protect the health of workers at facilities where EtO is used to sterilize products or equipment. Specifically, EPA is proposing measures that include prohibiting certain uses of EtO where alternatives exist, such as in museums, archival settings, beekeeping, some cosmetics, and musical instruments. Facilities would be required to reduce the amount of EtO used for medical device sterilization, while still meeting applicable standards to ensure sterility, and to implement engineering controls to reduce worker exposures. Workers in commercial sterilization facilities would be required to use personal protective equipment if monitoring technology detects EtO emissions greater than 10 ppb. EPA’s proposal sets different timelines for implementing these controls, given their varied complexity and feasibility. EPA’s proposed interim registration review decision and draft risk assessment addendum for ethylene oxide may be read in the Federal Register, with the agency’s website providing additional information about these actions. EPA encourages stakeholders in the community, industry, and public health to provide comments on the proposed standards. The public comment periods for the agency’s proposals will be open until June 12, 2023. More information can be found in EPA’s press release and on its webpage for EtO resources.
NIOSH Mining Program Publishes Heat Stress Training Module
A training module published by NIOSH in March helps workers recognize the signs of heat-related illness and provide appropriate first aid. The training was developed by the NIOSH Mining Program, but the agency notes it is applicable for anyone who works in a hot environment. NIOSH explains that the training module, called “Keeping Cool,” was designed to be led by an instructor but can also provide value for individual learners. The module covers topics including how to self-regulate behaviors while off shift to enhance the body’s ability to handle heat stress and how to assess the risk of heat stress on the job. Protective actions such as maintaining hydration, taking rest breaks, and taking first aid actions when feeling symptoms of heat-related illness are also discussed. Further information about this course can be found on NIOSH’s website. The “Keeping Cool” software is freely available online.
NIOSH Issues Guidance on Verifying Respirator Shelf Life
In March, NIOSH published a new fact sheet on assessing the shelf lives of filtering facepiece respirators (FFRs). Although the agency does not currently require providers of approved FFRs to designate shelf lives for their products, a recent NIOSH study has “noted numerous challenges that the PPE community experiences when trying to locate FFR shelf life information,” the fact sheet states.
According to the fact sheet, respiratory protection program (RPP) and stockpile managers may not be certain whether a product can be used when information about shelf life is absent or difficult to find. NIOSH recommends that users contact the approval holder to inquire about the equipment’s shelf life. Users will first need to identify the FFR’s approval, model or part, and lot numbers, which may be found on respirator units, packaging, or approval labels.
Shelf life information, when determined, should be incorporated into users’ RPPs, stockpile documentation, and other procedures. Users may employ a “first-in, first-out” approach in which FFRs that are purchased first are used first. The fact sheet also recommends users replace FFRs that are damaged, soiled, wet, or difficult to breathe through, as required by OSHA’s respiratory protection standard.
The fact sheet is part of a series titled “Personal Protective Equipment Conformity Assessment Studies and Evaluations Notes” or “PPE CASE Notes,” which aims to inform respirator users about trends identified by NIOSH related to agency-approved respirators. NIOSH’s website provides more information and a link to download the new fact sheet.
Ontario Bill Would Protect Against Airborne Pandemics
A bill introduced in the Legislative Assembly of Ontario in March would establish a committee to ensure indoor air quality in non-residential workplaces and public settings across the province. The “Advisory Committee to Protect Ontario’s People and Economy from Airborne Pandemics” would comprise occupational hygienists, building ventilation specialists, IAQ researchers, aerosol scientists, and other professionals including epidemiologists, healthcare workers, engineers, and architects. The proposed legislation defines “airborne disease transmission” as “the spread of diseases through the inhalation of infectious respiratory aerosols that remain suspended in the air after being transmitted from an infected person.” If the bill becomes law, the committee would make recommendations related to ventilation, filtration, and other methods to reduce airborne disease transmission. The committee would also consider ways to educate the public about IAQ, cover the costs of IAQ improvements for small businesses, and ensure that personal protective equipment is available during future pandemics. The committee would be required to consult with several stakeholder groups, including the Canadian Aerosol Transmission Coalition, which formed in December 2020 to promote scientifically-based solutions to airborne and aerosol virus transmission. CATC, which supports the bill, includes several AIHA members in its leadership group, including Marianne Levitsky, CIH, ROH; Elham Ahmadpour, MIng; Lydia Renton, CIH, ROH; Simon Smith, PhD; Laurence Svirchev, CIH; and Krista Thompson, ROH. "The proposed legislation is a breakthrough because it recognizes the vital importance of an inter-disciplinary approach to pandemic preparedness and response,” Svirchev said. The website of the Legislative Assembly of Ontario provides the text of Bill 86, the Advisory Committee to Protect Ontario's People and Economy from Airborne Pandemics Act.
OSHA Contest Seeks New Heat Awareness Tools
OSHA has launched a new competition, “Beat the Heat,” to encourage stakeholders in all industries to submit their best tools and resources for informing workers about the dangers of heat exposure in both indoor and outdoor workplaces. The contest’s goals include educating workers and employers about occupational heat hazards, raising public awareness of heat hazards faced by workers, and motivating employers and workers to act to prevent heat illness. Awareness tools submitted to the contest may take many forms; for example, OSHA will accept submissions of infographics, social media toolkits, phone apps, training curriculums, informational videos, or podcasts. Winning submissions will be chosen in the categories of most innovative, most creative, strongest message, best non-English submission, highlighting indoor heat hazards, and emphasis on young workers.
The contest will close on June 9, 2023. Further information regarding eligibility, judging, prizes, and terms and conditions can be found on the Beat the Heat page.
Studies Examine Inhalation Toxicity of Flavoring Compounds
A technical report published in March by the National Toxicology Program details a series of studies to evaluate the inhalation toxicity of acetoin and 2,3-pentanedione, which NTP describes as highly volatile components of artificial butter flavoring. Occupational exposures to 2,3-pentanedione and other substances used in such flavoring have been linked to decreased lung function and the severe, irreversible lung disease obliterative bronchiolitis, as well as irritation of the skin, eyes, and respiratory tract. According to NTP, both acetoin and 2,3-pentanedione are used as ingredients in synthetic flavoring formulations for food additives.
Researchers conducted studies to evaluate the two‑week inhalation toxicity of acetoin and the three‑month inhalation toxicity of acetoin and 2,3‑pentanedione as administered to rats and mice via whole-body inhalation. No significant adverse effects related to exposure occurred among the rats and mice exposed to acetoin for two weeks or three months as part of this inhalation study. But researchers identified significant adverse effects—primarily in the respiratory tract but also in the eyes—in the rats and mice exposed to 2,3‑pentanedione for three months.
“The [no-observed-effect level] of 2,3-pentanedione for this study overall was 12.5 ppm on the basis of adverse respiratory tract effects in rats and mice,” NTP’s report concludes. “These 3-month inhalation exposure data, including NOELs for adverse respiratory tract effects, can inform regulatory agencies to help mitigate exposure risks to 2,3-pentanedione vapors.”
NTP’s full report can be found on the program’s website. Additional information on artificial butter flavorings is also available.
Many School Districts Have Not Implemented COVID-19 Ventilation Controls, CDC Finds
Results of a survey assessing COVID-19 prevention policies suggest that many U.S. public school districts have failed to implement ventilation improvement strategies, according to CDC’s April 7 Morbidity and Mortality Weekly Report (MMWR). Conducted between August and December 2022, the survey obtained responses from 8,410 kindergarten through grade 12 public school districts, representing 64.2 percent of public school districts and 61.7 percent of enrolled public school students nationwide. Just over half, or 50.7 percent, of school districts reported that they had maintained continuous airflow through school buildings during active hours. For the other strategies assessed in the survey, 33.9 percent of school districts reported replacing or upgrading heating, ventilation, and air conditioning systems; 28.0 percent reported installing or using in-room air cleaners with high-efficiency particulate air filters; and 8.2 percent reported installing ultraviolet germicidal irradiation devices.
The report cautions that the survey had a high proportion of “unknown” or missing responses, possibly because the administrative staff who responded to the survey may have had limited awareness of ventilation strategies used within their districts. Therefore, implemented ventilation improvements were likely underreported. The survey also did not examine school-level ventilation improvements within districts, and schools may have implemented ventilation strategies other than the four assessed by the survey.
The survey’s findings highlight “the ongoing opportunity to improve indoor air quality among K–12 school buildings in the United States,” the MMWR states. More information is available in the full report.
New Training Tool Focuses on Respiratory Infections at Work
A new training tool developed by the National Institute of Environmental Health Sciences (NIEHS) Worker Training Program (WTP) is intended to improve workers’ and employers’ understanding of infectious agents and measures that can protect workers from respiratory infections. Available in PowerPoint and PDF formats, the training tool aims to enable participants to describe types of agents that can cause respiratory infections or illnesses; how respiratory agents are transmitted from people, animals, insects, and other vectors or sources; respiratory infections and illnesses that are common in workplaces; and how to prevent the spread of infectious agents and protect themselves from respiratory infections and illnesses.
WTP notes that the guidance contained in this training is not intended for workplaces that deal directly with infected persons, animals, or other contaminated sources such as water. It is also not suitable for public health and medical guidance for “significant infectious disease outbreaks,” including pandemics. According to WTP, these events “require frequent updates specific to the nature of the event[s].”
The new training tool and additional resources for protecting workers in industries with the potential for exposure to infectious diseases can be found on the NIEHS website.
OSHA Certifies Maine's State Plan
Federal OSHA has certified Maine’s state plan, the agency announced in a March news release. OSHA’s certification means that Maine has in place all the necessary structural components for its state plan, which covers approximately 2,400 state and local government employers; close to 80,000 employees working in state, county, and local governments as well as in quasi-municipal agencies; and volunteers under the direction of state or local government employers. The certification by federal OSHA also verifies that Maine has satisfactorily completed the plan’s required aspects since it was first approved as a developmental state plan in August 2015.
Maine’s state plan is administered by the Maine Department of Labor's Workplace Safety and Health Division. It’s one of seven state plans that only administer health and safety programs for state and local government workers. Twenty-two state plans currently cover private sector workers in addition to workers in state and local governments.
State plans are OSHA-approved workplace safety and health programs operated by individual states or U.S. territories. They are monitored by federal OSHA, which provides up to 50 percent of each program’s funding. More information on state plans can be found on OSHA’s website.
Eurpean Union to Assess Exposure Limits for 1,3-Butadiene, Bisphenol A
The European Chemicals Agency (ECHA), which works to implement the European Union’s chemicals legislation to protect human health and the environment, seeks information related to the substances 1,3-butadiene and 4,4-isopropylidenediphenol, also known as bisphenol A. 1,3-Butadiene is classified as a carcinogen and mutagen, and bisphenol A is classified as a reprotoxic substance, according to the agency. The European Commission has tasked ECHA with evaluating exposure to these substances to assess and revise the option of airborne occupational exposure limits, other limit values such as biological limit values and biological guidance values, and notations.
OSHA says 1,3-butadiene is produced through the processing of petroleum, and NIOSH describes it as a “colorless gas with a mild aromatic or gasoline-like odor.” Bisphenol A is primarily used in making polycarbonate plastic and some epoxy resins, according to a NIOSH Science Blog post. A NIOSH skin notation profile of bisphenol A explains that the substance is “potentially capable of causing adverse health effects following skin contact,” including skin allergy and photoallergy.
ECHA intends to use the information it gathers on uses, exposure, health effects, toxicology, epidemiology, and modes of action of these substances to help the agency support regulatory initiatives in the workplace. ECHA’s calls for evidence provide stakeholders an opportunity to convey their views and concerns while the agency is in the early phases of developing its reports for 1,3-butadiene and bisphenol A. The deadline for comments is June 15. Learn more on ECHA’s website.
Proposed Standard Targets Heat Illness Among Indoor Workers in California
California’s Occupational Safety and Health Standards Board, the standards-setting agency within Cal/OSHA, has proposed a regulation intended to prevent heat-related illness and injury among workers in indoor places of employment. The rulemaking is in response to California State Senate Bill 1167, which added section 6720 to the state’s labor code, directing Cal/OSHA to propose and implement such a standard “based on environmental temperatures, work activity levels, and other factors.”
The proposed standard applies to all indoor work areas in California where the temperature equals or exceeds 82 F when employees are present. A subsection of the proposed regulation further describes conditions under which employees in indoor work areas face higher risk of heat illness. Requirements in the proposal cover access to drinking water and cool-down areas, assessment and control measures, emergency response procedures, acclimatization, and training for both employees and supervisors. The proposal would also require employers to establish, implement, and maintain effective heat illness prevention plans.
The proposed requirements are intended to ensure that employees working indoors receive protection and preventive measures equivalent to those working outdoors, the standards board’s notice explains. Additional anticipated benefits include avoided costs related to morbidity and mortality caused by occupational exposure to extreme heat.
The text of the proposed regulation is available as a PDF. For more information, see the Occupational Safety and Health Standards Board’s notice for the regulation (PDF) and webpage on indoor heat.
NIOSH Looks Ahead to End of COVID-19 Public Health Emergency
NIOSH will continue to support activities related to occupational safety and health and COVID-19 after the end of the United States’ public health emergency, the agency stated in its April e-newsletter. As this issue of The Synergist went to press, the U.S. government was planning for the COVID-19 public health emergency to expire at the end of the day on May 11. The separate national emergency, which allowed the federal government to take sweeping steps to respond to COVID-19, was terminated on April 10. NIOSH’s e-newsletter helps answer some questions regarding COVID-19 data tracking and how the end of the emergency will affect workplaces.
According to NIOSH, CDC is assessing surveillance needs as well as potential revisions to surveillance systems to track COVID-19 after the end of the public health emergency. CDC’s COVID Data Tracker Weekly Review explains that the agency is “transitioning to sustainable national COVID-19 surveillance.” The agency stated that most data activities on its COVID Data Tracker wouldn’t be affected by the end of the public health emergency but that the May 12 issue of the Weekly Review would provide updates regarding where users could find COVID-19 data. As of April 28, 104,538,730 cases of COVID-19 had been reported in the U.S., with 1,130,662 total reported deaths. Also on April 28, COVID-19 hospitalizations in the U.S. totaled 9,167.
A fact sheet (PDF) published by the Health Action Alliance, which seeks to help employers navigate evolving health challenges like COVID-19, provides some information about how the end of the public health emergency will affect workplaces.
Survey Finds Support for Actions to Protect Hearing at Venues, Events
More than half of respondents to a survey conducted in September 2022 agreed that venues or events where amplified music is played should take at least one of the following actions: limiting sound levels, posting warning signs, and providing hearing protection when music reaches potentially hazardous levels. The survey results, which are discussed in the March 31 issue of CDC’s Morbidity and Mortality Weekly Report (MMWR), indicate that U.S. adults are generally aware of the hazards posed by high sound levels at concerts and other events and are open to protective actions, CDC explains.
The survey aimed to assess attitudes toward hearing loss protection at events and venues among a nationally representative panel of 4,514 U.S. adults. Respondents were asked questions about sound levels at venues and events they attended primarily for the enjoyment of amplified music and rated their responses on a five-point scale ranging from “strongly agree” to “strongly disagree.” CDC’s analysis found that 54.1 percent of respondents agreed that sound levels should be limited at venues or events to reduce hearing loss, 75.4 percent agreed that venues or events should post warning signs if sound could exceed safe levels, and 61.2 percent agreed that they would wear hearing protection if provided by events or venues.
However, CDC cautions that “stated intent to take protective action does not always result in the action being taken.” More information can be found in CDC’s MMWR.
ADG Requests Return of Certain PAPR Blower Units
The manufacturer AirBoss Defense Group (ADG) requests the return of certain C420 powered air-purifying respirator (PAPR) blower units due to “the potential for internal impeller disengagement from the blower motor[s],” according to a user notice published in April. ADG explains that in these instances, the respirators will maintain user protection while they are unpowered; however, users will experience increased breathing resistance. The notice affects C420 blower units with serial numbers including the first four digits 2008 through 2109 and includes instructions for inspecting units for these serial numbers.
“Returned units will receive new blower motors and will be reassembled using improved production processes,” ADG says. “These refurbished units will then be returned with a new serial number to identify that remediation has occurred.”
Further details can be found in the user notice (PDF). This notice is also available from the NIOSH National Personal Protective Technology Laboratory website.