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Environment International - vol. 181

"Background
A World Health Organization (WHO) and International Labour Organization (ILO) systematic review reported sufficient evidence for higher risk of non-melanoma skin cancer (NMSC) amongst people occupationally exposed to solar ultraviolet radiation (UVR). This article presents WHO/ILO Joint Estimates of global, regional, national and subnational occupational exposures to UVR for 195 countries/areas and the global, regional and national attributable burdens of NMSC for 183 countries, by sex and age group, for the years 2000, 2010 and 2019.
Methods
We calculated population-attributable fractions (PAFs) from estimates of the population occupationally exposed to UVR and the risk ratio for NMSC from the WHO/ILO systematic review. Occupational exposure to UVR was modelled via proxy of occupation with outdoor work, using 166 million observations from 763 cross-sectional surveys for 96 countries/areas. Attributable NMSC burden was estimated by applying the PAFs to WHO's estimates of the total NMSC burden. Measures of inequality were calculated.
Results
Globally in 2019, 1.6 billion workers (95 % uncertainty range [UR] 1.6–1.6) were occupationally exposed to UVR, or 28.4 % (UR 27.9–28.8) of the working-age population. The PAFs were 29.0 % (UR 24.7–35.0) for NMSC deaths and 30.4 % (UR 29.0–31.7) for disability-adjusted life years (DALYs). Attributable NMSC burdens were 18,960 deaths (UR 18,180–19,740) and 0.5 million DALYs (UR 0.4–0.5). Men and older age groups carried larger burden. Over 2000–2019, attributable deaths and DALYs almost doubled.
Conclusions
WHO and the ILO estimate that occupational exposure to UVR is common and causes substantial, inequitable and growing attributable burden of NMSC. Governments must protect outdoor workers from hazardous exposure to UVR and attributable NMSC burden and inequalities."
"Background
A World Health Organization (WHO) and International Labour Organization (ILO) systematic review reported sufficient evidence for higher risk of non-melanoma skin cancer (NMSC) amongst people occupationally exposed to solar ultraviolet radiation (UVR). This article presents WHO/ILO Joint Estimates of global, regional, national and subnational occupational exposures to UVR for 195 countries/areas and the global, regional and national ...

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Environment International - vol. 86

"Triphenyl phosphate (TPHP) is primarily used as either a flame retardant or plasticizer, and is listed as an ingredient in nail polishes. However, the concentration of TPHP in nail polish and the extent of human exposure following applications have not been previously studied. We measured TPHP in ten different nail polish samples purchased from department stores and pharmacies in 2013–2014. Concentrations up to 1.68% TPHP by weight were detected in eight samples, including two that did not list TPHP as an ingredient. Two cohorts (n = 26 participants) were recruited to assess fingernail painting as a pathway of TPHP exposure. Participants provided urine samples before and after applying one brand of polish containing 0.97% TPHP by weight. Diphenyl phosphate (DPHP), a TPHP metabolite, was then measured in urine samples (n = 411) and found to increase nearly seven-fold 10–14 h after fingernail painting (p < 0.001). To determine relative contributions of inhalation and dermal exposure, ten participants also painted their nails and painted synthetic nails adhered to gloves on two separate occasions, and collected urine for 24 h following applications. Urinary DPHP was significantly diminished when wearing gloves, suggesting that the primary exposure route is dermal. Our results indicate that nail polish may be a significant source of short-term TPHP exposure and a source of chronic exposure for frequent users or those occupationally exposed."
"Triphenyl phosphate (TPHP) is primarily used as either a flame retardant or plasticizer, and is listed as an ingredient in nail polishes. However, the concentration of TPHP in nail polish and the extent of human exposure following applications have not been previously studied. We measured TPHP in ten different nail polish samples purchased from department stores and pharmacies in 2013–2014. Concentrations up to 1.68% TPHP by weight were ...

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Environment International - vol. 87

"Sensory effects in eyes and airways are common symptoms reported by aircraft crew and office workers. Neurological symptoms, such as headache, have also been reported. To assess the commonality and differences in exposures and health symptoms, a literature search of aircraft cabin and office air concentrations of non-reactive volatile organic compounds (VOCs) and ozone-initiated terpene reaction products were compiled and assessed. Data for tricresyl phosphates, in particular tri-ortho-cresyl phosphate (ToCP), were also compiled, as well as information on other risk factors such as low relative humidity.

A conservative health risk assessment for eye, airway and neurological effects was undertaken based on a “worst-case scenario” which assumed a simultaneous constant exposure for 8 h to identified maximum concentrations in aircraft and offices. This used guidelines and reference values for sensory irritation for eyes and upper airways and airflow limitation; a tolerable daily intake value was used for ToCP. The assessment involved the use of hazard quotients or indexes, defined as the summed ratio(s) (%) of compound concentration(s) divided by their guideline value(s).



The concentration data suggest that, under the assumption of a conservative “worst-case scenario”, aircraft air and office concentrations of the compounds in question are not likely to be associated with sensory symptoms in eyes and airways. This is supported by the fact that maximum concentrations are, in general, associated with infrequent incidents and brief exposures. Sensory symptoms, in particular in eyes, appear to be exacerbated by environmental and occupational conditions that differ in aircraft and offices, e.g., ozone incidents, low relative humidity, low cabin pressure, and visual display unit work. The data do not support airflow limitation effects. For ToCP, in view of the conservative approach adopted here and the rareness of reported incidents, the health risk of exposure to this compound in aircraft is considered negligible."
"Sensory effects in eyes and airways are common symptoms reported by aircraft crew and office workers. Neurological symptoms, such as headache, have also been reported. To assess the commonality and differences in exposures and health symptoms, a literature search of aircraft cabin and office air concentrations of non-reactive volatile organic compounds (VOCs) and ozone-initiated terpene reaction products were compiled and assessed. Data for ...

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Environment International - vol. 37 n° 6 -

"Production volumes and the use of engineered nanomaterials in many innovative products are continuously increasing, however little is known about their potential risk for the environment and human health. We have reviewed publicly available hazard and exposure data for both, the environment and human health and attempted to carry out a basic risk assessment appraisal for four types of nanomaterials: fullerenes, carbon nanotubes, metals, and metal oxides (ENRHES project 2009(1)). This paper presents a summary of the results of the basic environmental and human health risk assessments of these case studies, highlighting the cross cutting issues and conclusions about fate and behaviour, exposure, hazard and methodological considerations. The risk assessment methodology being the basis for our case studies was that of a regulatory risk assessment under REACH (ECHA, 2008(2)), with modifications to adapt to the limited available data. If possible, environmental no-effect concentrations and human no-effect levels were established from relevant studies by applying assessment factors in line with the REACH guidance and compared to available exposure data to discuss possible risks. When the data did not allow a quantitative assessment, the risk was assessed qualitatively, e.g. for the environment by evaluating the information in the literature to describe the potential to enter the environment and to reach the potential ecological targets. Results indicate that the main risk for the environment is expected from metals and metal oxides, especially for algae and Daphnia, due to exposure to both, particles and ions. The main risks for human health may arise from chronic occupational inhalation exposure, especially during the activities of high particle release and uncontrolled exposure. The information on consumer and environmental exposure of humans is too scarce to attempt a quantitative risk characterisation. It is recognised that the currently available database for both, hazard and exposure is limited and there are high uncertainties in any conclusion on a possible risk. The results should therefore not be used for any regulatory decision making. Likewise, it is recognised that the REACH guidance was developed without considering the specific behaviour and the mode of action of nanomaterials and further work in the generation of data but also in the development of methodologies is required."
"Production volumes and the use of engineered nanomaterials in many innovative products are continuously increasing, however little is known about their potential risk for the environment and human health. We have reviewed publicly available hazard and exposure data for both, the environment and human health and attempted to carry out a basic risk assessment appraisal for four types of nanomaterials: fullerenes, carbon nanotubes, metals, and ...

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Environment International - vol. 37

"Recent exponential growth in the development of nanomaterials (NMs) and nanoproducts is premised on the provision of novel benefits to the society-through the exploitation of their unique industrial and biomedical applications like medical imaging, fabrics in textiles, tissue engineering, nanocomposites, bioremediation, and biomedicine. These NMs and nanoproducts have increased in quantity and volume from few kilograms to thousands of tonnes over the last fifteen to twenty years, and their uncontrolled release into the environment is anticipated to grow dramatically in future. However, their potential impacts to the biological systems are unknown. Among the key present challenges in the waste management sector include the emergence of nanowastes; however, the effectiveness and the capability of the current systems to handle them are yet to be established. Because of limited studies on nanowastes management, in this paper, three-fold objectives are pursued, namely; (i) to raise concerns related to the alarming increases of uncontrolled releases of NMs into the environment through nanowastes, (ii) examine the unique challenges nanowastes pose to the waste management systems-both from technological and legislative perspectives, and (iii) summarize results of the first nanowastes classification formalism in order to elucidate the potential challenges of waste streams containing nanoscale dimension materials to the present waste management paradigm. Finally, the article closes by summarizing several proactive steps of enhancing effective long-term and responsible management of nanowastes."
"Recent exponential growth in the development of nanomaterials (NMs) and nanoproducts is premised on the provision of novel benefits to the society-through the exploitation of their unique industrial and biomedical applications like medical imaging, fabrics in textiles, tissue engineering, nanocomposites, bioremediation, and biomedicine. These NMs and nanoproducts have increased in quantity and volume from few kilograms to thousands of tonnes ...

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Environment International - vol. 135 n° 105349 -

"Workers in several industries are occupationally exposed to flame retardants. This study characterizes flame retardant exposure for nine industries through air and hand wipe measures for 105 workers. Specifically, we analyzed 24 analytes from three chemical classes: organophosphate flame retardants (OFRs), polybrominated diphenyl ethers (PBDEs), and non-PBDE brominated flame retardants (NPBFRs). The industries were: carpet installation, chemical manufacturing, foam manufacturing, electronic scrap, gymnastics, rigid board installation, nail salons, roofing, and spray polyurethane foam. Workers wore personal air samplers for two entire workdays and provided hand wipe samples before and after the second work day. Bulk products were also analyzed. The air, hand wipe and bulk samples were evaluated for relevant flame retardants. Spray polyurethane foam workers' tris(1-chloro-2-propyl) phosphate air (geometric mean = 48,500 ng/m3) and hand wipe (geometric mean = 83,500 ng per sample) concentrations had the highest mean industry concentration of any flame retardant analyzed in this study, followed by triphenyl phosphate air concentration and tris(1,3-dichloro-2-propyl) phosphate hand wipe concentration from chemical manufacturers. Overall, OFR air and hand wipe concentrations were higher and more prevalent than PBDEs or non-PBDE brominated flame retardants. Some industries including spray polyurethane foam application, chemical manufacturing, foam manufacturing, nail salons, roofing, and rigid polyiso board installation had high potential for both air and hand exposure to OFRs. Carpet installers, electronic scrap workers, and gymnastic workers had exposures to all three classes of flame retardants including PBDEs, which were phased out of production in 2013. Air and dermal exposures to OFRs are prevalent in many industries and are replacing PBDEs in some industries."
"Workers in several industries are occupationally exposed to flame retardants. This study characterizes flame retardant exposure for nine industries through air and hand wipe measures for 105 workers. Specifically, we analyzed 24 analytes from three chemical classes: organophosphate flame retardants (OFRs), polybrominated diphenyl ethers (PBDEs), and non-PBDE brominated flame retardants (NPBFRs). The industries were: carpet installation, ...

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Environment International - vol. 139

"Hand washing and maintaining social distance are the main measures recommended by the World Health Organization (WHO) to avoid contracting COVID-19. Unfortunately, these measured do not prevent infection by inhalation of small droplets exhaled by an infected person that can travel distance of meters or tens of meters in the air and carry their viral content. Science explains the mechanisms of such transport and there is evidence that this is a significant route of infection in indoor environments. Despite this, no countries or authorities consider airborne spread of COVID-19 in their regulations to prevent infections transmission indoors. It is therefore extremely important, that the national authorities acknowledge the reality that the virus spreads through air, and recommend that adequate control measures be implemented to prevent further spread of the SARS-CoV-2 virus, in particularly removal of the virus-laden droplets from indoor air by ventilation."
"Hand washing and maintaining social distance are the main measures recommended by the World Health Organization (WHO) to avoid contracting COVID-19. Unfortunately, these measured do not prevent infection by inhalation of small droplets exhaled by an infected person that can travel distance of meters or tens of meters in the air and carry their viral content. Science explains the mechanisms of such transport and there is evidence that this is a ...

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Environment International - vol. 144

"As public health teams respond to the pandemic of coronavirus disease 2019 (COVID-19), containment and understanding of the modes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is of utmost importance for policy making. During this time, governmental agencies have been instructing the community on handwashing and physical distancing measures. However, there is no agreement on the role of aerosol transmission for SARS-CoV-2. To this end, we aimed to review the evidence of aerosol transmission of SARS-CoV-2. Several studies support that aerosol transmission of SARS-CoV-2 is plausible, and the plausibility score (weight of combined evidence) is 8 out of 9. Precautionary control strategies should consider aerosol transmission for effective mitigation of SARS-CoV-2."
"As public health teams respond to the pandemic of coronavirus disease 2019 (COVID-19), containment and understanding of the modes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is of utmost importance for policy making. During this time, governmental agencies have been instructing the community on handwashing and physical distancing measures. However, there is no agreement on the role of aerosol transmission for ...

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Environment International - vol. 142

"During the rapid rise in COVID-19 illnesses and deaths globally, and notwithstanding recommended precautions, questions are voiced about routes of transmission for this pandemic disease. Inhaling small airborne droplets is probable as a third route of infection, in addition to more widely recognized transmission via larger respiratory droplets and direct contact with infected people or contaminated surfaces. While uncertainties remain regarding the relative contributions of the different transmission pathways, we argue that existing evidence is sufficiently strong to warrant engineering controls targeting airborne transmission as part of an overall strategy to limit infection risk indoors. Appropriate building engineering controls include sufficient and effective ventilation, possibly enhanced by particle filtration and air disinfection, avoiding air recirculation and avoiding overcrowding. Often, such measures can be easily implemented and without much cost, but if only they are recognised as significant in contributing to infection control goals. We believe that the use of engineering controls in public buildings, including hospitals, shops, offices, schools, kindergartens, libraries, restaurants, cruise ships, elevators, conference rooms or public transport, in parallel with effective application of other controls (including isolation and quarantine, social distancing and hand hygiene), would be an additional important measure globally to reduce the likelihood of transmission and thereby protect healthcare workers, patients and the general public."
"During the rapid rise in COVID-19 illnesses and deaths globally, and notwithstanding recommended precautions, questions are voiced about routes of transmission for this pandemic disease. Inhaling small airborne droplets is probable as a third route of infection, in addition to more widely recognized transmission via larger respiratory droplets and direct contact with infected people or contaminated surfaces. While uncertainties remain regarding ...

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Environment International - vol. 155 n° 106629 -

"Background
The World Health Organization (WHO) and the International Labour Organization (ILO) are developing the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury (WHO/ILO Joint Estimates), supported by a large number of individual experts. Evidence from previous reviews suggests that exposure to long working hours may cause depression. In this article, we present a systematic review and meta-analysis of parameters for estimating (if feasible) the number of deaths and disability-adjusted life years from depression that are attributable to exposure to long working hours, for the development of the WHO/ILO Joint Estimates.

Objectives
We aimed to systematically review and meta-analyse estimates of the effect of exposure to long working hours (three categories: 41–48, 49–54 and ≥55 h/week), compared with exposure to standard working hours (35–40 h/week), on depression (three outcomes: prevalence, incidence and mortality).

Data sources
We developed and published a protocol, applying the Navigation Guide as an organizing systematic review framework where feasible. We searched electronic academic databases for potentially relevant records from published and unpublished studies, including the WHO International Clinical Trial Registers Platform, Medline, PubMed, EMBASE, Web of Science, CISDOC and PsycInfo. We also searched grey literature databases, Internet search engines and organizational websites; hand-searched reference lists of previous systematic reviews; and consulted additional experts.

Study eligibility and criteria
We included working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (aged <15 years) and unpaid domestic workers. We included randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of exposure to long working hours (41–48, 49–54 and ≥55 h/week), compared with exposure to standard working hours (35–40 h/week), on depression (prevalence, incidence and/or mortality).

Study appraisal and synthesis methods
At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. Missing data were requested from principal study authors. We combined odds ratios using random-effects meta-analysis. Two or more review authors assessed the risk of bias, quality of evidence and strength of evidence, using Navigation Guide and GRADE tools and approaches adapted to this project.

Results
Twenty-two studies (all cohort studies) met the inclusion criteria, comprising a total of 109,906 participants (51,324 females) in 32 countries (as one study included multiple countries) in three WHO regions (Americas, Europe and Western Pacific). The exposure was measured using self-reports in all studies, and the outcome was assessed with a clinical diagnostic interview (four studies), interview questions about diagnosis and treatment of depression (three studies) or a validated self-administered rating scale (15 studies). The outcome was defined as incident depression in all 22 studies, with first time incident depression in 21 studies and recurrence of depression in one study. We did not identify any study on prevalence of depression or on mortality from depression. For the body of evidence for the outcome incident depression, we had serious concerns for risk of bias due to selection because of incomplete outcome data (most studies assessed depression only twice, at baseline and at a later follow-up measurement, and likely have missed cases of depression that occurred after baseline but were in remission at the time of the follow-up measurement) and due to missing information on life-time prevalence of depression before baseline measurement.

Compared with working 35–40 h/week, we are uncertain about the effect on acquiring (or incidence of) depression of working 41–48 h/week (pooled odds ratio (OR) 1.05, 95% confidence interval (CI) 0.86 to 1.29, 8 studies, 49,392 participants, I2 46%, low quality of evidence); 49–54 h/week (OR 1.06, 95% CI 0.93 to 1.21, 8 studies, 49,392 participants, I2 40%, low quality of evidence); and ≥ 55 h/week (OR 1.08, 95% CI 0.94 to 1.24, 17 studies, 91,142 participants, I2 46%, low quality of evidence).

Subgroup analyses found no evidence for statistically significant (P < 0.05) differences by WHO region, sex, age group and socioeconomic status. Sensitivity analyses found no statistically significant differences by outcome measurement (clinical diagnostic interview [gold standard] versus other measures) and risk of bias (“high”/“probably high” ratings in any domain versus “low”/“probably low” in all domains).

Conclusions
We judged the existing bodies of evidence from human data as “inadequate evidence for harmfulness” for all three exposure categories, 41–48, 48–54 and ≥55 h/week, for depression prevalence, incidence and mortality; the available evidence is insufficient to assess effects of the exposure. Producing estimates of the burden of depression attributable to exposure to long working appears not evidence-based at this point. Instead, studies examining the association between long working hours and risk of depression are needed that address the limitations of the current evidence."
"Background
The World Health Organization (WHO) and the International Labour Organization (ILO) are developing the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury (WHO/ILO Joint Estimates), supported by a large number of individual experts. Evidence from previous reviews suggests that exposure to long working hours may cause depression. In this article, we present a systematic review and meta-analysis of parameters for ...

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