A participatory workplace health and safety training program for ethylene oxide

The Occupational Safety and Health Administration (OSHA) has regulated ethylene oxide (EtO) on the basis of its acute toxicity and its potential carcinogenic and reproductive effects since 1971. OSHA's 1984 EtO standard and its 1988 revisions focused new attention on health and safety training and other preventive measures. An EtO health and safety training program for hospital sterilization workers was developed by the staff of an independent occupational and environmental health clinic. Participatory and empowerment training methods were central to the approach. Also included were hands-on, demonstration, interactive presentation, and other methods. An EtO Health and Safety Training Manual was developed based on the training experiences. This paper presents the challenges, benefits, and limitations of incorporating participatory and empowerment approaches in the design, implementation, and evaluation of EtO health and safety training.

Determinants of the provision of ethylene oxide medical surveillance in Massachusetts hospitals

An in-depth survey of ethylene oxide (EtO) health and safety was conducted in Massachusetts hospitals (n = 92) to investigate the determinants of the provision of medical surveillance for EtO exposure. We have evaluated the relationships between provision of EtO medical surveillance and (1) activating OSHA-specified triggers for providing EtO medical surveillance, (2) worker training on EtO health and safety, and (3) various public policy, organizational, group, and individual characteristics. Among the Occupational Safety and Health Administration's (OSHA) five specified triggers for provision of EtO medical surveillance, only accidental worker exposures were related to provision of surveillance (RR = 2.56, P < 0.001). Exceeding the Action Level for 30 or more days, one of OSHA's EtO triggers that is also used in a number of other standards, was not related to provision of surveillance (RR = 0.84, P = 0.714). Reports of coverage of EtO medical surveillance issues in worker training were also correlated with the provision of EtO medical surveillance (RR = 3.68, P < 0.001), supporting OSHA's premise that worker training plays an important role in medical surveillance implementation. The presence of detailed written EtO medical surveillance policies was positively related to the provision of EtO medical surveillance (RR = 1.81, P < 0.001). The relationships between these potential determinants and provision of medical surveillance were also validated in multivariate analyses. Implications for improvement of OSHA medical surveillance implementation through revised trigger schemes, improved worker training efforts, and other measures are discussed. Findings are relevant to the future development of medical surveillance and exposure monitoring policies and practices in both substance-specific and generic contexts.

Evaluating OSHA's ethylene oxide standard: employer exposure-monitoring activities in Massachusetts hospitals from 1985 through 1993

This study characterized exposure-monitoring activities and findings under the Occupational Safety and Health Administration's (OSHA's) 1984 ethylene oxide (EtO) standard. In-depth mail and telephone surveys were followed by on-site interviews at all EtO-using hospitals in Massachusetts (n = 92, 96% participation rate). By 1993, most hospitals had performed personal exposure monitoring for OSHA's 8-hour action level (95%) and the excursion limit (87%), although most did not meet the 1985 implementation deadline. In 1993, 66% of hospitals reported the installation of EtO alarms to fulfill the standard's "alert" requirement. Alarm installation also lagged behind the 1985 deadline and peaked following a series of EtO citations by OSHA. From 1990 through 1992, 23% of hospitals reported having exceeded the action level once or more; 24% reported having exceeded the excursion limit; and 33% reported that workers were accidentally exposed to EtO in the absence of personal monitoring. Almost a decade after passage of the EtO standard, exposure-monitoring requirements were widely, but not completely, implemented. Work-shift exposures had markedly decreased since the mid-1980s, but overexposures continued to occur widely. OSHA enforcement appears to have stimulated implementation.

Evaluating OSHA's ethylene oxide standard : exposure determinants in Massachusetts hospitals

This study sought to identify determinants of workplace exposures to ethylene oxide to assess the effect of the Occupational Safety and Health Administration's (OSHA's) 1984 ethylene oxide standard. An in-depth survey of all hospitals in Massachusetts that used ethylene oxide from 1990 through 1992 (96% participation, N = 90) was conducted. Three types of exposure events were modeled with logistic regression: exceeding the 8-hour action level, exceeding the 15-minute excursion limit, and worker exposures during unmeasured accidental releases. Covariates were drawn from data representing an ecologic framework including direct and indirect potential exposure determinants. After adjustment for frequencies of ethylene oxide use and exposure monitoring, a significant inverse relation was observed between exceeding the action level and the use of combined sterilizer-aerators, an engineering control technology developed after the passage of the OSHA standard. Conversely, the use of positive-pressure sterilizers that employ ethylene oxide gas mixtures was strongly related to both exceeding the excursion limit and the occurrence of accidental releases. These findings provide evidence of a positive effect of OSHA's ethylene oxide standard and specific targets for future prevention and control efforts.

Long-term ethylene oxide exposure trends in US hospitals : relationship with OSHA regulatory and enforcement actions

We assessed long-term trends in ethylene oxide (EtO) worker exposures for the purposes of exposure surveillance and evaluation of the impacts of the Occupational Safety and Health Administration (OSHA) 1984 and 1988 EtO standards. We obtained exposure data from a large commercial vendor and processor of EtO passive dosimeters. Personal samples (87 582 workshift [8-hr] and 46 097 short-term [15-min] samples) from 2265 US hospitals were analyzed for time trends from 1984 through 2001 and compared with OSHA enforcement data. Exposures declined steadily for the first several years after the OSHA standards were set. Workshift exposures continued to taper off and have remained low and constant through 2001. However, since 1996, the probability of exceeding the short-term excursion limit has increased. This trend coincides with a decline in enforcement of the EtO standard. Results indicate the need for renewed intervention efforts to preserve gains made following the passage and implementation of the 1984 and 1988 EtO standards.

Medical surveillance for ethylene oxide exposure : practices and clinical findings in Massachusetts hospitals

The medical surveillance requirements of the Occupational Safety and Health Administration's (OSHA) ethylene oxide (EtO) standard became effective in 1985. However, little is known about the nature of the response of EtO users to this regulatory requirement. In an effort to begin to understand this, we conducted a survey of EtO health and safety in Massachusetts hospitals (n = 92). We determined the cumulative incidence of provision of EtO medical surveillance, the characteristics of the surveillance interventions provided, and the clinical findings of EtO medical surveillance efforts in Massachusetts hospitals. From 1985 to 1993, medical surveillance for EtO exposure was provided one or more times in 62% of EtO-using hospitals. Sixty-five percent of EtO medical surveillance providers reported performance of all five medical surveillance procedures required by OSHA's EtO standard. Medical surveillance provider certification in occupational medicine or nursing, and a greater extent of coverage of written medical surveillance policies, were related to higher likelihoods of fulfillment of OSHA-required procedures. Twenty-seven percent of medical surveillance providers reported detection of EtO-related symptoms or conditions, ranging from mucous membrane irritation to peripheral neuropathy. These findings reveal widespread implementation of OSHA-mandated EtO medical surveillance, with concomitant incomplete fulfillment of OSHA-specified procedures. From the provider-based survey, we estimate that one or more workers at 19% of EtO-using Massachusetts hospitals have experienced EtO-related health effects

A simple and effective method to ameliorate the interfacial properties of cellulosic fibre based bio-composites using poly (ethylene glycol) based amphiphiles

In order to overcome interfacial incompatibility issues in natural fibre reinforced polymer bio-composites, surface modifications of the natural fibres using complex and environmentally unfriendly chemical methods is necessary. In this paper, we demonstrate that the interfacial properties of cellulose-based bio-composites can be tailored through surface adsorption of polyethylene glycol (PEG) based amphiphilic block copolymers using a greener alternative methodology. Mixtures of water or water/acetone were used to form amphiphilic emulsions or micro-crystal suspensions of PEG based amphiphilic block copolymers, and their deposition from solution onto the cellulosic substrate was carried out by simple dip-coating. The findings of this study evidence that, by tuning the amphiphilicity and the type of building blocks attached to the PEG unit, the flexural and dynamic thermo-mechanical properties of cellulose-based bio-composites comprised of either polylactide (PLA) or high density polyethylene (HDPE) as a matrix, can be remarkably enhanced. The trends, largely driven by interfacial effects, can be ascribed to the combined action of the hydrophilic and hydrophobic components of these amphiphiles. The nature of the interactions formed across the fibre-matrix interface is discussed. The collective outcome from this study provides a technological template to significantly improve the performance of cellulose-based bio-composite materials.

Retention of the original LLC structure in a cross-linked poly(ethylene glycol) diacrylate hydrogel with reinforcement from a silica network

Cross-linked poly(ethylene glycol) diacrylate (PEGDA) hydrogels with uniformly controlled nanoporous structures templated from hexagonal lyotropic liquid crystals (LLC) represent separation membrane materials with potentially high permeability and selectivity due to their high pore density and narrow pore size distribution. However, retaining LLC templated nanostructures is a challenge as the polymer gels are not strong enough to sustain the surface tension during the drying process. In the current study, cross-linked PEGDA gels were reinforced with a silica network synthesized via an in situ sol-gel method, which assists in the retention of the hexagonal LLC structure. The silica precursor does not obstruct the formation of hexagonal phases. After surfactant removal and drying, these hexagonal structures in samples with a certain amount of tetraethoxysilane (TEOS) loading are well retained while the nanostructures are collapsed in samples without silica reinforcement, leading to the hypothesis that the reinforcement provided by the silica network stabilizes the LLC structure. The study examines the conditions necessary for a sufficient and well dispersed silica network in PEGDA gels that contributes to the retention of original LLC structures, which potentially enables broad applications of these gels as biomedical and membrane materials.

Nano-capsules of amphiphilic poly (ethylene glycol)-block-poly (bisphenol A carbonate) copolymers via thermodynamic entrapment

The synthesis of amphiphilic poly(ethylene glycol)-block-poly(bisphenol A carbonate) (PEG-b-PC) block copolymer is presented here using a simple bio-chemistry coupling reaction between poly(bisphenol A carbonate) (PC) with a monomethylether poly(ethylene glycol) (mPEG-OH) block, mediated by dicyclohexylcarbodiimide/4-dimethylaminopyridine. This method inherently allows great flexibility in the choice of starting materials as well as easy product purification only requiring phase separation and water washing. Collective data from Fourier transform infrared spectroscopy (FTIR), nuclear magnetic resonance spectroscopy (NMR) and modulated dynamic scanning calorimetry (MDSC) confirmed the successful attachment of the poly(ethylene glycol) (mPEG-OH) and poly(bisphenol A carbonate) (PC) blocks. The preparation of nano-capsules was carried out by sudden addition of water to PEG-b-PC copolymers dispersed in THF, resulting in the controlled precipitation (i.e. thermodynamic entrapment) of the copolymer. Nano-capsules as small as 85 nm ± 30 nm were produced using this simple and fast methodology. We also demonstrate that encapsulating a water-insoluble bisphenol A diglycidyl ether (DGEBA) epoxy resin is possible highlighting the potential use of these capsules as a chemical delivery system.

Tailoring of interface of polypropylene/polystyrene/carbon nanofibre composites by polystyrene-block-poly(ethylene-ran-butylene)-block-polystyrene

Mechanical and physical properties of polypropylene (PP)/polystyrene (PS) blend, PP/PS/polystyrene-block-poly(ethylene-ran-butylene)-block-polystyrene (SEBS) ternary blend and their composites with carbon nanofibers (CNF) were investigated. Composites of ternary blend exhibited superior properties compared to those of binary blends. Mechanical performance of nanocomposites was intimately related to their phase morphology. PP/PS/SEBS/0.1 wt% CNF hybrid composites exhibited excellent impact strength (Four-fold increase compared to PP/PS blend) and ductility (12-fold increase in elongation at break, with respect to PP/PS blend). Moreover, these composites displayed good tensile strength and modulus (15% increase in Young's modulus, compared to PP/PS/SEBS blend) and are suitable for various end-use applications including automobile applications. Although crystallinity of PP phase is decreased by the incorporation of CNF, thermal stability of the composites remained almost unaffected. Contact angle measurements revealed that ternary composites exhibited maximum hydrophobicity.

Synthesis and self-assembly behaviour of poly(Nα-Boc-l-tryptophan)-block-poly(ethylene glycol)-block-poly(Nα-Boc-l-tryptophan)

We report for the first time the use of Nα-Boc-l-tryptophan for the synthesis of amphiphilic BAB triblock copolymers for potential drug delivery applications. A library of poly(Nα-Boc-l-tryptophan)-block-poly(ethylene glycol)-block-poly(Nα-Boc-l-tryptophan) (PBoclTrp-b-PEG-b-PBoclTrp) amphiphilic copolymers were synthesized through the ring opening polymerization of Nα-Boc-l-tryptophan Nα-carboxy anhydride as initiated by diamino-terminated PEG of fixed molecular weight (Mn 3350). The influence of the hydrophobic block length over self-assembly was investigated for 4 of the BAB copolymers of molecular weights varying between Mn 5000 and Mn 17000. It was found that an increase in hydrophobic block length led to an increase in hydrodynamic size of aggregates in solution, as well as a decrease in critical micelle concentration. TEM analysis showed the formation of spherical micelles with the largest of the copolymers forming interconnected networks of spherical micelles. The influence of hydrophobic block length over the formation of secondary structure was analyzed using circular dichroism and infrared spectroscopy. Collectively we found that the presence of t-Boc protected l-tryptophan leads to the preferential formation of α-helix secondary structure through hydrogen bonding, which, in a drug delivery vehicle context, could help in controlling drug release. Also, it is believed that the use of novel Nα-Boc-l-tryptophan could improve drug stabilization in the hydrophobic core via π-π interactions between indole rings.