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Article ; Online: Peak Inhalation Exposure Metrics Used in Occupational Epidemiologic and Exposure Studies.

Virji, M Abbas / Kurth, Laura

2021 Volume 8, Page(s) 611693

Abstract: Peak exposures are of concern because they can potentially overwhelm normal defense mechanisms and induce adverse health effects. Metrics of peak exposure have been used in epidemiologic and exposure studies, but consensus is lacking on its definition. ... ...

Abstract	Peak exposures are of concern because they can potentially overwhelm normal defense mechanisms and induce adverse health effects. Metrics of peak exposure have been used in epidemiologic and exposure studies, but consensus is lacking on its definition. The relevant characteristics of peak exposure are dependent upon exposure patterns, biokinetics of exposure, and disease mechanisms. The objective of this review was to summarize the use of peak metrics in epidemiologic and exposure studies. A comprehensive search of Medline, Embase, Web of Science, and NIOSHTIC-2 databases was conducted using keywords related to peak exposures. The retrieved references were reviewed and selected for indexing if they included a peak metric and met additional criteria. Information on health outcomes and peak exposure metrics was extracted from each reference. A total of 1,215 epidemiologic or exposure references were identified, of which 182 were indexed and summarized. For the 72 epidemiologic studies, the health outcomes most frequently evaluated were: chronic respiratory effects, cancer and acute respiratory symptoms. Exposures were frequently assessed using task-based and full-shift time-integrated methods, qualitative methods, and real-time instruments. Peak exposure summary metrics included the presence or absence of a peak event, highest exposure intensity and frequency greater than a target. Peak metrics in the 110 exposure studies most frequently included highest exposure intensity, average short-duration intensity, and graphical presentation of the real-time data (plots). This review provides a framework for considering biologically relevant peak exposure metrics for epidemiologic and exposure studies to help inform risk assessment and exposure mitigation.
MeSH term(s)	Benchmarking ; Epidemiologic Studies ; Inhalation Exposure/adverse effects ; Risk Assessment
Language	English
Publishing date	2021-01-08
Publishing country	Switzerland
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S. ; Review
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2020.611693
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Individualized monitoring of longitudinal heading exposure in soccer.

Kenny, Rebecca / Elez, Marko / Clansey, Adam / Virji-Babul, Naznin / Wu, Lyndia C

Scientific reports

2024 Volume 14, Issue 1, Page(s) 1796

Abstract: There is growing concern that repetitive soccer headers may have negative long-term consequences on brain health. However, inconsistent and low-quality heading exposure measurements limit past investigations of this effect. Here we conducted a ... ...

Abstract	There is growing concern that repetitive soccer headers may have negative long-term consequences on brain health. However, inconsistent and low-quality heading exposure measurements limit past investigations of this effect. Here we conducted a comprehensive heading exposure analysis across all players on a university women's soccer team for over two calendar years (36 unique athletes), quantifying both game and practice exposure during all in-season and off-season periods, with over ten thousand video-confirmed headers. Despite an average of approximately 2 headers per day, players' daily exposures ranged from 0 to 45 headers, accumulating to highly variable total exposure of 2-223 headers over each in-season/off-season period. Overall, practices and off-season periods accounted for 70% and 45% of headers, respectively. Impact sensor data showed that heading kinematics fell within a tight distribution, but sensors could not capture full heading exposure due to factors such as compliance. With first-of-its-kind complete heading exposure data, we recommend exposure assessments be made on an individual level and include practice/off-season collection in addition to games and competitive seasons. Commonly used group statistics do not capture highly variable exposures, and individualized complete heading exposure tracking needs to be incorporated in future study designs for confirming the potential brain injury risk associated with soccer heading.
MeSH term(s)	Humans ; Female ; Soccer ; Brain Concussion/complications ; Head ; Athletes ; Brain
Language	English
Publishing date	2024-01-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-024-52163-8
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Article ; Online: Editorial: Investigating exposures and respiratory health in coffee workers.

Virji, Mohammed Abbas / Cummings, Kristin J / Cox-Ganser, Jean M

Frontiers in public health

2022 Volume 10, Page(s) 1026430

MeSH term(s)	Coffee ; Cross-Sectional Studies ; Humans ; Occupational Exposure/analysis
Chemical Substances	Coffee
Language	English
Publishing date	2022-09-08
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2022.1026430
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Article ; Online: Characterization of Cleaning and Disinfection Product Use, Glove Use, and Skin Disorders by Healthcare Occupations in a Midwestern Healthcare Facility.

Kobos, Lisa / Anderson, Kim / Kurth, Laura / Liang, Xiaoming / Groth, Caroline P / England, Lucy / Laney, A Scott / Virji, M Abbas

Buildings (Basel, Switzerland)

2024 Volume 12, Issue 12

Abstract: Healthcare facility staff use a wide variety of cleaning and disinfecting products during their daily operations, many of which are associated with respiratory or skin irritation or sensitization with repeated exposure. The objective of this study was to ...

Abstract	Healthcare facility staff use a wide variety of cleaning and disinfecting products during their daily operations, many of which are associated with respiratory or skin irritation or sensitization with repeated exposure. The objective of this study was to characterize the prevalence of cleaning and disinfection product use, glove use during cleaning and disinfection, and skin/allergy symptoms by occupation and identify the factors influencing glove use among the healthcare facility staff. A questionnaire was administered to the current employees at a midwestern Veterans Affairs healthcare facility that elicited information on cleaning and disinfection product use, glove use during cleaning and disinfection, skin/allergy symptoms, and other demographic characteristics, which were summarized by occupation. The central supply/environmental service workers (2% of the total survey population), nurses (26%,), nurse assistants (3%), and laboratory technicians (5%) had the highest prevalence of using cleaning or disinfecting products, specifically quaternary ammonium compounds, bleach, and alcohol. Glove use while using products was common in both patient care and non-patient care occupations. The factors associated with glove use included using bleach or quaternary ammonium compounds and using cleaning products 2-3 or 4-5 days per week. A high frequency of glove use (≥75%) was reported by workers in most occupations when using quaternary ammonium compounds or bleach. The use of alcohol, bleach, and quaternary ammonium compounds was associated with skin disorders (
Language	English
Publishing date	2024-04-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2661539-3
ISSN	2075-5309 ; 2075-5309
ISSN (online)	2075-5309
ISSN	2075-5309
DOI	10.3390/buildings12122216
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Article ; Online: Peak Inhalation Exposure Metrics Used in Occupational Epidemiologic and Exposure Studies

M. Abbas Virji / Laura Kurth

Frontiers in Public Health, Vol

2021 Volume 8

Abstract	Peak exposures are of concern because they can potentially overwhelm normal defense mechanisms and induce adverse health effects. Metrics of peak exposure have been used in epidemiologic and exposure studies, but consensus is lacking on its definition. The relevant characteristics of peak exposure are dependent upon exposure patterns, biokinetics of exposure, and disease mechanisms. The objective of this review was to summarize the use of peak metrics in epidemiologic and exposure studies. A comprehensive search of Medline, Embase, Web of Science, and NIOSHTIC-2 databases was conducted using keywords related to peak exposures. The retrieved references were reviewed and selected for indexing if they included a peak metric and met additional criteria. Information on health outcomes and peak exposure metrics was extracted from each reference. A total of 1,215 epidemiologic or exposure references were identified, of which 182 were indexed and summarized. For the 72 epidemiologic studies, the health outcomes most frequently evaluated were: chronic respiratory effects, cancer and acute respiratory symptoms. Exposures were frequently assessed using task-based and full-shift time-integrated methods, qualitative methods, and real-time instruments. Peak exposure summary metrics included the presence or absence of a peak event, highest exposure intensity and frequency greater than a target. Peak metrics in the 110 exposure studies most frequently included highest exposure intensity, average short-duration intensity, and graphical presentation of the real-time data (plots). This review provides a framework for considering biologically relevant peak exposure metrics for epidemiologic and exposure studies to help inform risk assessment and exposure mitigation.
Keywords	peak metrics ; epidemiologic studies ; exposure assessment (EA) ; acute effects ; chronic effects ; Public aspects of medicine ; RA1-1270
Subject code	333
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Eye and airway symptoms in hospital staff exposed to a product containing hydrogen peroxide, peracetic acid, and acetic acid.

Blackley, Brie Hawley / Nett, Randall J / Cox-Ganser, Jean M / Harvey, Robert Reid / Virji, Mohammed Abbas

American journal of industrial medicine

2023 Volume 66, Issue 8, Page(s) 655–669

Abstract: Background: Sporicidal products containing hydrogen peroxide (HP), peracetic acid (PAA), and acetic acid (AA) are used widely in multiple industries, including healthcare. Despite widespread use in healthcare, few studies have assessed associations ... ...

Abstract	Background: Sporicidal products containing hydrogen peroxide (HP), peracetic acid (PAA), and acetic acid (AA) are used widely in multiple industries, including healthcare. Despite widespread use in healthcare, few studies have assessed associations between exposures to HP, PAA, and AA, and work-related symptoms in these settings. Methods: In 2018, we performed a health and exposure assessment at a hospital where a sporicidal product consisting of HP, PAA, and AA, was used as the primary cleaner on hospital surfaces. We collected 56 personal and mobile air samples for HP, PAA, and AA on participants while they performed their regular cleaning duties; collected area samples for HP (n = 28), PAA (n = 28), and AA (n = 70) in multiple hospital locations where cleaning was performed; and administered a postshift survey to assess eye, skin, and upper and lower airway symptoms that occurred cross-shift or in the previous 4 weeks. Results: Full-shift exposure levels for HP (range: <3-559 ppb), PAA (range: <0.2-8 ppb), and AA (range: <5-915 ppb) were all below US occupational exposure limits. We observed positive associations (p < 0.05) between shift, departmental average, and departmental 95th percentile exposures to HP, PAA, and AA vapors, and work-related acute (cross-shift) and chronic (previous 4 weeks) eye, upper airway, and lower airway symptoms after adjusting for age, gender, smoking status, use of other cleaning products containing sensitizers and irritants, allergic status, and stress. Conclusions: Our observations of work-related upper and lower airway symptoms among hospital workers exposed to vapors from a sporicidal product containing HP, PAA, and AA indicate a need for a combination of engineering, administrative, and PPE controls to reduce exposure. Additionally, alternative nonchemical disinfection technologies should be further investigated as a means to simultaneously reduce healthcare workers' exposure to disinfectants while also minimizing costly healthcare-acquired infections.
MeSH term(s)	Humans ; Peracetic Acid ; Acetic Acid ; Hydrogen Peroxide ; Disinfectants ; Personnel, Hospital
Chemical Substances	Peracetic Acid (I6KPI2E1HD) ; Acetic Acid (Q40Q9N063P) ; Hydrogen Peroxide (BBX060AN9V) ; Disinfectants
Language	English
Publishing date	2023-05-23
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	604538-8
ISSN	1097-0274 ; 0271-3586
ISSN (online)	1097-0274
ISSN	0271-3586
DOI	10.1002/ajim.23488
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Article ; Online: Comparison of light transmittance and color changes between polyurethane and copolyester retainer materials after staining and destaining.

Viana, Grace / Virji, Insia / Susarchick, Laurie / Allareddy, Veerasathpurush / Lown, Sullivan / Gruber, Max / Lukic, Henry / Megremis, Spiro / Atsawasuwan, Phimon

BMC oral health

2024 Volume 24, Issue 1, Page(s) 144

Abstract: Background: Retainers are the only effective approach to prevent orthodontic relapse. The aim of this study was to compare the changes in color and light-transmittance of rough and smooth thermoformed polyurethane and copolymer retainer samples after ... ...

Abstract	Background: Retainers are the only effective approach to prevent orthodontic relapse. The aim of this study was to compare the changes in color and light-transmittance of rough and smooth thermoformed polyurethane and copolymer retainer samples after staining in different solutions and destaining with different approaches. Methods: Four hundred copolyester (Essix® ACE) and 400 polyurethane (Zendura®) samples with different surface textures, smooth and rough, were stained in 4 different solutions (n = 100 per solution) over 28 days. Each of the four groups of 100 stained samples of each material was subdivided into 5 groups of 20 samples and subjected to different destaining solutions. Light transmittance and color changes were evaluated using a spectrometer and a spectrophotometer. Mean differences were compared using a two-way analysis of variance (ANOVA) and posthoc multiple comparison tests at P = 0.05. Results: No significant differences in light transmittance were found between both untreated materials. Both materials were stained in a similar fashion and showed no significant differences between two materials after staining. Coffee and tea stained both materials more significantly than wine, but there was a significant difference of changes of color and light transmittance between rough and smooth surfaces during the destaining in coffee- and tea-stained samples of copolyester material. All destaining solutions were effective at removing all stains on the samples. The surface roughness of the material plays a significant role in the ability of the materials to be destained, demonstrating a more significant greater effect on cleaning rough samples for improvements in light-transmittance and greater changes in color. Conclusions: This study concluded that the surface of materials plays a significant role in the material destaining and staining. In addition, the different polymers used for retainer fabrication exhibited different responses during the destaining process depending on types of stains.
MeSH term(s)	Humans ; Coffee ; Polyurethanes ; Spectrophotometry ; Staining and Labeling ; Coloring Agents ; Tea ; Materials Testing ; Color ; Surface Properties ; Composite Resins
Chemical Substances	Coffee ; Polyurethanes ; Coloring Agents ; Tea ; Composite Resins
Language	English
Publishing date	2024-01-31
Publishing country	England
Document type	Journal Article
ZDB-ID	2091511-1
ISSN	1472-6831 ; 1472-6831
ISSN (online)	1472-6831
ISSN	1472-6831
DOI	10.1186/s12903-024-03887-6
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Article ; Online: A Strategy for Field Evaluations of Exposures and Respiratory Health of Workers at Small- to Medium-Sized Coffee Facilities.

Virji, M Abbas / Cummings, Kristin J / Cox-Ganser, Jean M

Frontiers in public health

2021 Volume 9, Page(s) 705225

Abstract: Coffee production is a global industry with roasteries throughout the world. Workers in this industry are exposed to complex mixtures of gases, dusts, and vapors including carbon monoxide, carbon dioxide, coffee dust, allergens, alpha-diketones, and ... ...

Abstract	Coffee production is a global industry with roasteries throughout the world. Workers in this industry are exposed to complex mixtures of gases, dusts, and vapors including carbon monoxide, carbon dioxide, coffee dust, allergens, alpha-diketones, and other volatile organic compounds (VOCs). Adverse respiratory health outcomes such as respiratory symptoms, reduced pulmonary function, asthma, and obliterative bronchiolitis can occur among exposed workers. In response to health hazard evaluations requests received from 17 small- to medium-sized coffee facilities across the United States, the National Institute for Occupational Safety and Health conducted investigations during 2016-2017 to understand the burden of respiratory abnormalities, exposure characteristics, relationships between exposures and respiratory effects, and opportunities for exposure mitigation. Full-shift, task-based, and instantaneous personal and area air samples for diacetyl, 2,3-pentanedione and other VOCs were collected, and engineering controls were evaluated. Medical evaluations included questionnaire, spirometry, impulse oscillometry, and fractional exhaled nitric oxide. Exposure and health assessments were conducted using standardized tools and approaches, which enabled pooling data for aggregate analysis. The pooled data provided a larger population to better address the requestors' concern of the effect of exposure to alpha-diketones on the respiratory heath of coffee workers. This paper describes the rationale for the exposure and health assessment strategy, the approach used to achieve the study objectives, and its advantages and limitations.
MeSH term(s)	Bronchiolitis Obliterans/etiology ; Coffee/adverse effects ; Diacetyl/adverse effects ; Diacetyl/analysis ; Food Industry ; Humans ; Occupational Exposure/adverse effects ; Occupational Exposure/analysis ; United States
Chemical Substances	Coffee ; Diacetyl (K324J5K4HM)
Language	English
Publishing date	2021-11-11
Publishing country	Switzerland
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2021.705225
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Article ; Online: Efficacy of dental evacuation systems for aerosol exposure mitigation in dental clinic settings.

Blackley, Brie Hawley / Anderson, Kimberly R / Panagakos, Fotinos / Chipps, Tammy / Virji, M Abbas

Journal of occupational and environmental hygiene

2022 Volume 19, Issue 5, Page(s) 281–294

Abstract: Dental personnel are ranked among the highest risk occupations for exposure to SARS-CoV-2 due to their close proximity to the patient's mouth and many aerosol generating procedures encountered in dental practice. One method to reduce aerosols in dental ... ...

Abstract	Dental personnel are ranked among the highest risk occupations for exposure to SARS-CoV-2 due to their close proximity to the patient's mouth and many aerosol generating procedures encountered in dental practice. One method to reduce aerosols in dental settings is the use of intraoral evacuation systems. Intraoral evacuation systems are placed directly into a patient's mouth and maintain a dry field during procedures by capturing liquid and aerosols. Although multiple intraoral dental evacuation systems are commercially available, the efficacy of these systems is not well understood. The objectives of this study were to evaluate the efficacy of four dental evacuation systems at mitigating aerosol exposures during simulated ultrasonic scaling and crown preparation procedures. We conducted real-time respirable (PM
MeSH term(s)	Aerosols ; COVID-19/prevention & control ; Dental Clinics ; Humans ; SARS-CoV-2 ; Specimen Handling
Chemical Substances	Aerosols
Language	English
Publishing date	2022-04-06
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	2131820-7
ISSN	1545-9632 ; 1545-9624
ISSN (online)	1545-9632
ISSN	1545-9624
DOI	10.1080/15459624.2022.2053140
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Article ; Online: The Long-Term Effects of Cleaning on the Lungs.

Cummings, Kristin J / Virji, M Abbas

American journal of respiratory and critical care medicine

2017 Volume 197, Issue 9, Page(s) 1099–1101

MeSH term(s)	Airway Obstruction ; Disinfection ; Humans ; Lung ; Respiratory Physiological Phenomena
Language	English
Publishing date	2017-09-01
Publishing country	United States
Document type	Editorial ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.201801-0138ED
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