Diana Maria Ceballos

Numerous workplaces handle solvent-based products, exposing workers to complex and changing mixtures of volatile organic compounds (VOCs), many of which are neurotoxic. In this commentary, we highlight key findings from research on VOC exposures in the workplace and their consequences for the central nervous system (CNS). We also provide a case study of nail salons as exposure sites. A few nail salon studies have suggested adverse health effects at low-level complex mixture VOC exposures, including significant neurological symptoms such as headaches, dizziness, difficulty concentrating, and memory loss, even when VOC exposures are below occupational exposure limits. Limited evidence specific to the health effects on nail salon workers relies on self-reported health outcomes or broad tests of mental abilities, using self-reported exposure surrogates that can lead to exposure misclassification. Unfortunately, assessing risk one chemical at a time with its respective threshold limit—or even using the traditional industrial hygiene mixtures approach—has not been sufficient to identify key VOCs or groups of VOCs most strongly linked to CNS health outcomes in nail salon workers. Scientific methodology used to understand low-level VOC mixture health effects in this population must evolve to measure chemical mixtures more easily and accurately, employ sensitive and culturally appropriate methods to assess neurological health effects, use advanced statistical methods, and develop strategies to prevent these debilitating health outcomes. Research evaluating possible health consequences at low exposure levels is still critical for guaranteeing the health of workers exposed to VOC, even with ongoing safer alternative substitution efforts.

Background Lead home investigations following the confirmation of a lead-poisoned child in the home require a lead-certified technician using an X-ray-fluorescence (XRF) portable analyzer, but XRFs are not always available. Colorimetric surface wipes that immediately change color on a gradient from yellow-to-red with lead could address this gap, but they have not been tested or utilized extensively in non-occupational settings. Objective To understand the usability of colorimetric wipes in lead home investigations with different potential sources of lead. Methods We collected 104 colorimetric wipes to assess lead levels on surfaces from nine homes and seven vehicles from lead-exposed construction workers living with children. Colorimetric wipe results (n = 81) were compared with inductively coupled plasma optical emission spectroscopy laboratory analysis. Results Lead was detected on 46(58%) of home surface wipes, with highest percentage of red wipes from surfaces in kitchen, followed by entrance, living room, bedroom, and laundry room samples. For vehicle surface wipes, 17 (71%) detected lead, with the highest percent of red wipes in the trunk, followed by back and front seat areas. Wipe color readings were significantly and positively correlated with laboratory analysis (Kendall’s τ = 0.42). At the 18 μg/sample threshold (i.e., level at which the wipe is expected to turn pink/red), the method showed high specificity (87%), moderate accuracy (78%), high negative predictive value (87%), and low false positive rate (13%). Of the wipes above 10 µg/sample public-health lead guideline, 80% changed color, suggesting high sensitivity. Impact The dissemination of colorimetric wipes for lead home investigations can reduce costs and improve the immediate screening of lead dust-contaminated surfaces in residential settings. Colorimetric wipes proved invaluable in identifying sources from lead take-home and lead-in-paint in the homes and vehicles of lead-exposed construction workers.

Traditional eyeliners contain high concentrations of lead, a neurotoxic metal. In King County, Washington (WA), United States (US), several refugee and immigrant populations continue to use these products, some containing up to 800,000 parts per million (ppm) lead. Lead is toxic, especially in young children where it can cause neurological defects and growth delays. We investigated lead in eyeliners used by these communities, including traditional and nontraditional products. We conducted community-based participatory research (CBPR) to understand the use of traditional eyeliners in the local Afghan community. Our study revealed that Afghan community members were largely unaware of the dangers of lead in traditional eyeliners, but once made aware, most were willing to change their behaviors. We found that traditional eyeliners contained significantly higher median lead concentrations (10 ppm) than nontraditional eyeliners (0.06 ppm). Eyeliners manufactured in the US and the European Union (EU) had significantly lower median lead concentrations (0.94 ppm) than those from Afghanistan (29 ppm) and other low- and middle-income countries (LMICs) (2.8 ppm). Some traditional eyeliners labeled as “lead-free” contained very high lead concentrations (up to 610,000 ppm), well above the US Food and Drug Administration’s (FDA) guideline of 10 ppm and the WA safety guideline of 1 ppm. Our findings suggest that traditional eyeliners currently used in the US still contain hazardous materials.

We characterized experiences and strategies used by frontline healthcare workers to prevent severe-acute-respiratory-syndrome-related coronavirus transmission at work and to household members during the coronavirus disease pandemic. Alongside an online questionnaire (n = 234), remote semi-structured interviews (n = 23: 15 clinicians, 8 non-clinicians) were conducted in 2021. Mitigation challenges and facilitators were identified from data to represent experiences as a process considering the before, during, and after work shifts. Journey mapping was utilized to visually describe how healthcare workers experienced the stages of the work environment, leaving work, commuting home, and the home environment, and strategies implemented to stay safe. Major facilitators included the uptake of coronavirus disease vaccines and testing, information regarding virus transmission, and adequate personal protective equipment. The most critical challenges identified included a lack of designated areas for end-of-day disinfection, changing rooms, showers, and lockers in the leaving work stage. Psychosocial and environmental factors must be considered in future hospital pandemic preparations.

Take-home exposures occur when workers accidentally bring workplace contaminants home. Regular job responsibilities may expose construction workers to lead, which extends to their households via the take-home pathway. The present study aimed to develop and evaluate 2 educational sessions addressing take-home lead exposure tailored to construction workers and their families. Educational materials on take-home lead exposure and prevention strategies were designed following guidance from US government institutions and experts on construction work, lead exposure, and educational interventions. The educational materials were pilot-tested with construction workers and their family members during in-person or online sessions in English or Spanish. Changes in knowledge of take-home lead exposure were assessed through pre- and post-testing and open-ended feedback was collected from both participants and session facilitators. The study sample comprised 44 participants, including 33 workers and 11 family members. Among all participants, 81% were male, 46% were Hispanic or Latino, and the average age was 29 years. Post-test scores (µ = 93%, SD = 10%) were higher than pre-test scores (µ = 82%, SD = 19%), and younger participants (<30 years) were more likely to have a lower pre-test score compared to older participants (≥30 years). Overall, feedback from participants and facilitators was positive, indicating appropriate duration, appealing visuals, and ease of engagement through the training activities. Effective public health education for lead-exposed construction workers and their families is needed to reduce lead exposure disparities, especially among children of workers. Interventions must recognize that take-home exposures are not isolated to occupational or home environments.

Acrylates, including those cured by ultraviolet (UV), visible light, or electron-beam (EB), are widely used in many occupational and industrial applications, including medicine (e.g., orthopedic cement), dentistry (e.g., dental guards), cosmetology (e.g., acrylic nails), electronics, coatings, and printing. One distinct advantage of many acrylates is the replacement of solvent evaporation with reactive monomers that are incorporated into the polymer during a crosslinking phase, which can result in improved chemical and physical properties of the coating. A key element in the success of acrylates is that these are highly reactive molecules. This, however, has dermatological consequences, as these acrylates may react with biomolecules in the skin, as well. This sometimes results in occupational dermatological disorders, mainly irritant contact dermatitis and allergic contact dermatitis. Adequate industrial hygiene should therefore be ensured in every occupational or industrial use of acrylates, and protective gloves are necessary whenever workers handling products containing acrylates may be exposed to skin contact. This chapter provides an overview of acylates and their uses, including those cured by ultraviolet, light, or electron beam, associated dermatological issues, glove chemical permeation and permeability studies, and recommendations for protective gloves for work with acrylates.

Disposable gloves are personal protective equipment that should be considered only as a last resort, or a last line of defense, in terms of dermal protection. Gloves should always be used when chemicals are handled and other workplace controls fail to provide sufficient dermal protection. Minor risks can sometimes be averted by using disposable gloves that are disposed of often or immediately after first contact with the chemical, but it is necessary to know what polymer type and thickness of gloves can give protection against the chemicals used, as well as how long the gloves should be used to provide adequate protection. Chemical resistance and permeation information for disposable gloves has become more and more available. This chapter provides a summary of the test methods used to evaluate disposable gloves, as well as permeation results for disinfectants and cytostatic compounds common to healthcare settings, and isocyanate compounds, solvents, other chemicals, mixtures, and formulations common to several industries.