On March 8-10, 2018, ERC students and faculty visited Chicago Illinois for the Education and Research Center Regional Symposium hosted by the University of Illinois at Chicago ERC. The groups met with the ERC students and faculty from the University of Illinois at Chicago and University of Michigan as well as with representatives the NIOSH Training Program Grant from Purdue University. The symposium offered excellent opportunities to network and share current research pursuits.
 

Conference Session 1: Making Healthcare Jobs Healthy

Author: Ashley Turner

The first session titled “Making Healthcare Jobs Healthy” featured three speakers including Dr. Rachel Jones from the University of Illinois at Chicago, Dr. Kermit Davis from the University of Cincinnati, and Dr. Christopher Friese from the University of Michigan, whom covered the topic of healthcare workers and various challenges in employee health. Dr. Jones began with a talk on exposure to infectious disease, a major burden in acute care employees. Unfortunately, in this setting, the best option for control (elimination) is not possible as the patients cannot be eliminated from hospitals. Dr. Jones and her team used field work along with mixed methods to measure magnitude and determinants of pathogen emission. One specific example was the use of interviews and surveys to determine level of preparation during the Ebola outbreak. The results from the survey indicated workers preferred hands-on training, but there was a huge barrier in refresher training due to turnover rates.

The second speaker, Dr. Davis, focused solely on the unique work environment of home healthcare, the fastest growing sector in healthcare. In this environment, employees are faced with very diverse hazards and are at the whim of the homeowner to provide a safe work area. Dr. Davis and his team measured differences between perceptions of tasks of home health nurses and home health aids. The five exposures measured were ergonomic stressors, clinical procedures, biological exposures, chemical exposures, and environmental exposures. One stressor I was not aware of is the ingress and egress of heavy medical equipment into the patient’s house. While nurses frequently perform this task much more than aids, the aids handle patients more often, which is more physically demanding and may be a risk for low back disorders. Results of the study also showed an increase in exposure to cleaning chemicals.

The final speaker of the session, Dr. Friese, gave an interesting talk on considerations for researchers to complete intervention studies within the healthcare field. One point he made was to increase consolidations of health care settings, oversight, and review from management. Two other important factors to consider were clinician burnout, turnover rates, and the anticipation of poor performance participants. One example of this type of study was based upon oncology nurse’s exposure to hazardous drugs to improve personal protective equipment (PPE) use. Using videos, nurse messages, and the study results, Dr. Friese concluded these nurses still had only baseline PPE knowledge and low expectations. There are still many barriers to achieving optimal PPE that will need to be addressed.

Conference Session 2: Innovations in Exposure Assessment

Authors: Michael Benjamin and Yao Addor

The second session of the day focused on innovations in exposure assessment.

Mary Turyk from the University of Illinois at Chicago gave a presentation on “Mercury Exposure from Seafood Consumption in Chicago Asian Communities.” Seafood was investigated because it is a good source of omega-3 fatty acids but also contains mercury. Participants were recruited from Asian communities in Chicago, who historically have large dietary fish consumption. Subjects reported the sources and types of fish consumed and submitted hair for mercury analysis. Several fish species in Chicago markets had higher mercury levels than previously reported but results indicated no significant differences in hair mercury content from subjects of different ethnicities, despite differences in type of fish consumed.

Jennie Cox from the University of Cincinnati gave a presentation on “Sensors for Assessing Exposure to Traffic Related Aerosols.” Particulate matter (PM2.5) and black carbon (BC) pollution can cause adverse health effects such as asthma, respiratory diseases, lung cancer, and cardiovascular effects. The purpose of this study was to compare two real-time air sampling devices, the MicroAeth BC sensor and the MicroPEM PM2.5 sensor, to traditional methods. While the real-time devices did tend to match more established methods for most data sets, some conditions did produce dissimilar results. To better correlate results, correction factors were developed using linear regression models, which appeared more promising for the PM2.5 sensor than for the black carbon sensor.

Edward Zellers from the University of Michigan gave a presentation on “Wearable Microsystem for Direct Measurement of Multi-VOC Exposures.” Volatile organic compounds (VOCs) are produced from a variety of processes, often in mixtures, but each individual compound can potentially cause different health effects. The purpose of this study was to develop a micro-chip system that could measure individual VOC compounds in a mixture accurately. For a mixture of 21 compounds, the device was able to separate and measure the individual compounds at concentrations equal to 0.1-2 times the occupational exposure limit, with a few exceptions where overlap of similar individual compounds occurred. This early success can be improved upon in future versions of the instrument.

Overall, this session gave everyone a good overview of exposure assessment innovations being developed by the three universities taking part in the symposium.

Keynote Address: Melding Worker Safety and Corporate Sustainability

Author: Jennie Cox

David Michaels is an epidemiologist from Department of Environmental and Occupational Health at Milken Institute School of Public Health, George Washington University and was the  keynote presenter.  He previously served as the Assistant Secretary of Labor for the Occupational Safety and Health Administration (OSHA). Michaels served as OSHA’s 12th Assistant Secretary from December 2009 until January 2017 and is the longest serving Assistant Secretary in OSHA's history.

The presentation described where we have been in respects to worker safety and how he sees worker safety moving forward. One of the goals of OSHA is to provide safe workplaces, which is a constant challenge as there are more than 4000 workers dying from workplace injuries, 50,000 workers dying from illnesses and 3 million non-fatal workplace injuries occurring annually. OSHA can level the playing field for employers, which actually reduces the costs associated with worker injuries and illnesses. In a recent study, 76% of the population believe the government is doing a good job of setting standards for workplaces (2nd after natural disasters). The employer’s commitment to workplace safety ranges from great to little with most employers being in the middle relying on inspections and civil penalties. OSHA regulations save lives and do not mean they will be an economic burden that will kill jobs. In 1974, vinyl chloride standard was called by a manufacturer to be “medically unnecessary, technologically unfeasible and would lead to the loss of as many as 2.2 million jobs.” This however, was shown not to be the case.  Fines imposed by OSHA are not impactful enough especially to larger corporations; instead, public shaming tends to motivate corporations more. OSHA standards make a workplace safer but not 'safe'; the standards do not cover all hazards. Many standards are out of date; compliance is static and safety is dynamic. Most employers believe there is a trade-off between safety and profitability; even though there is no evidence to support this. We need a profitable safe operational culture. If change comes from the top (CEO or board members), and the proper adjustments and right safety choices are made, it actually costs less in the long run. When a company has decided to utilize a safe operational culture, the lack of injuries in the workplace are evidence of operational excellence.

Poster Sessions

Author: Kelechi Isiugo

After a series of podium presentations, students, postdoctoral fellows, and faculty gave poster presentations in two sessions. Jurate Virkutyte, Evan Frank, Michael Benjamin, Christine Uebel-Niemeier, Elizabeth Bien and Kelechi Isiugo represented Cincinnati ERC in the poster sessions.

In total there were 24 posters. Figure 1 shows a breakdown of the number of posters by research area and Figure 2 shows a breakdown of the posters from the different universities. From Figure 1, research on occupational exposures such as heavy metals from e-waste recycling facilities took the lead in terms of number of posters. Next, were posters on aerosols and ergonomics (Figure 1). The University of Cincinnati had the maximum number of posters on aerosols, and the University of Michigan had the highest number of posters on occupational exposures and ergonomics (Figure 2). The only posters on respirator fit testing, and sustainability came from UIC. Similarly, the only poster on medical physics was from Purdue University.

Figure 1: Total Number of Posters According to the Research Area

Figure 2: Total Number of Posters According to Research Area and University

In general, there was a wide variety of posters on environmental and occupational health and safety fields. Attendees of the symposium took advantage of the wealth of information on the represented research areas by learning from experienced scientists in their respective areas of research. For subsequent regional ERC symposiums, it may be helpful to invite researchers from neighboring Universities that have specialties that were not well represented in previous ERC symposiums.