Particle Size on Respiratory Protection Provided by Two Types of N95 Respirators on Agricultural Settings

The objective of this study was to compare size-selective workplace protection factors (WPFs) of an N95 elastomeric respirator (ER) and an N95 filtering facepiece respirator (FFR) in agricultural environments. Twenty-five healthy farm workers ranging in age from 20 to 30 years voluntarily participated in the study. Altogether eight farms were included representing three different types: two horse farms, three pig barns, and three grain handling sites. Subjects wore the ER and FFR while performing their daily activities, such as spreading hay, feeding livestock, and shoveling. Aerosol concentrations in an optical particle size range of 0.7–10 µm were determined simultaneously inside and outside of the respirator during the first and last 15 minutes of a 60-minute experiment. For every subject, size-selective WPFs were calculated in one-minute intervals and averaged over 30 minutes. For the ER, geometric mean WPFs were 172, 321, 1013, 2097 and 2784 for particles of 0.7–1.0, 1.0–2.0, 2.0–3.0, 3.0–5.0, and 5.0–10.0 µm, respectively. Corresponding values for the FFR were 69, 127, 324, 893, and 1994. The 5th percentiles for the ER and FFR were higher than the Assigned Protection Factor of 10 and varied from 28 to 250 and from 16 to 225, respectively. The results show that the N95 ER and FFR tested in the study provided expected level of protection for workers on agricultural farms against particles ranging from 0.7 to 10 µm. The WPFs for the ER were higher than those for the FFR in all size ranges, and the WPFs for both respirators increased with increasing particle size

15–19-vuotiaiden nuorten epäspesifin niskakivun itsehoito : artikkelisarja

Opinnäytetyön tarkoituksena oli selvittää mitä epäspesifi niskakipu on, sen riskitekijät ja sen itsehoito-ohjeita. Tavoitteena oli yleistajuisten artikkelien kirjoittaminen 15–19-vuotiaiden nuorten niskakivusta ja sen itsehoidosta. Yhteistyökumppanina toimi Selkäliitto. Opinnäytetyö toteutettiin kuvailevana kirjallisuuskatsauksena ja kehittämistyönä. Kirjallisuuskatsaus tehtiin käyttäen PubMed- ja PEDro-tietokantoja. Opinnäytetyöhön valittiin 15 tutkimusta, jotka olivat RCT-tutkimuksia, meta-analyyseja ja systemaattisia kirjallisuuskatsauksia. Artikkelit kirjoitettiin kirjallisuuskatsauksesta saatujen tietojen ja tulosten perusteella. Kirjallisuuskatsauksen mukaan epäspesifi niskakipu on yleistä nuorilla. Epäspesifi niskakipu on mekaanista kipua, joka voi syntyä eri riskitekijöiden aiheuttamana. Riskitekijät voidaan jakaa fyysisiin tekijöihin, inaktiivisuuteen ja psykososiaalisiin tekijöihin. Tutkimusten perusteella suurimpana riskitekijänä korostui huonoista asennoista johtuva lihasten kuormitus. Epäspesifin niskakivun itsehoidossa toimivin hoitomuoto on itsenäinen harjoittelu. Harjoittelu voi olla spesifiä anaerobista lihasvoimaharjoittelua tai epäspesifiä aerobista kestävyysharjoittelua. Yhtä tiettyä harjoittelumuotoa niskakivun hoitoon ei ole. Opinnäytetyön tuloksia voidaan käyttää hyödyntämällä kirjoitettuja artikkeleita, jotka ovat vapaasti luettavissa Selkäliiton sivuilla. Niskakivun itsehoitokeinoja voisi tutkia jatkossa keskittyen 15–19-vuotiaiden ikäryhmään

Comparison of Workplace Protection Factors for Different Biological Contaminants

This study compared workplace protection factors (WPFs) for five different contaminants (endotoxin, fungal spores, (1→3)-β-D-glucan, total particle mass, and total particle number) provided by an N95 elastomeric respirator (ER) and an N95 filtering facepiece respirator (FFR). We previously reported size-selective WPFs for total particle numbers for the ER and FFR, whereas the current article is focused on WPFs for bioaerosols and total particle mass. Farm workers (n = 25) wore the ER and FFR while performing activities at eight locations representing horse farms, pig barns, and grain handling facilities. For the determination of WPFs, particles were collected on filters simultaneously inside and outside the respirator during the first and last 15 min of a 60-min experiment. One field blank per subject was collected without actual sampling. A reporting limit (RL) was established for each contaminant based on geometric means (GMs) of the field blanks as the lowest possible measurable values. Depending on the contaminant type, 38–48% of data points were below the RL. Therefore, a censored regression model was used to estimate WPFs (WPFcensored). The WPFcensored provided by the two types of respirators were not significantly different. In contrast, significant differences were found in the WPFcensored for different types of contaminants. GMs WPFscensored for the two types of respirators combined were 154, 29, 18, 19, and 176 for endotoxin, fungal spore count, (1→3)-β-D-glucan, total particle mass, and total particle number, respectively. The WPFcensored was more strongly associated with concentrations measured outside the respirator for endotoxin, fungal spores, and total particle mass except for total particle number. However, when only data points with outside concentrations higher than 176×RL were included, the WPFs increased, and the association between the outside concentrations and the WPFs became weaker. Results indicate that difference in WPFs observed between different contaminants may be attributed to differences in the sensitivity of analytical methods to detect low inside concentrations, rather than the nature of particles (biological or non-biololgical)

Application of the environmental relative moldiness index in Finland

The environmental relative moldiness index (ERMI) metric was previously developed to quantify mold contamination in U.S. homes. This study determined the applicability of the ERMI for quantifying mold and moisture damage in Finnish residences. Homes of the LUKAS2 birth cohort in Finland were visually inspected for moisture damage and mold, and vacuumed floor dust samples were collected. An ERMI analysis including 36 mold-specific quantitative PCR assays was performed on the dust samples (n = 144), and the ERMI metric was analyzed against inspection-based observations of moisture damage and mold. Our results show that the ERMI was significantly associated with certain observations of visible mold in Finnish homes but not with moisture damage. Several mold species occurred more frequently and at higher levels in Finnish than in U.S. homes. Modification of the ERMI toward Finnish conditions, using a subsample of LUKAS2 homes with and without moisture damage, resulted in a simplified metric based on 10 mold species. The Finnish ERMI (FERMI) performed substantially better in quantifying moisture and mold damage in Finnish homes, showing significant associations with various observations of visible mold, strongest when the damage was located in the child's main living area, as well as with mold odor and moisture damage. As shown in Finland, the ERMI as such is not equally well usable in different climates and geographic regions but may be remodeled to account for local outdoor and indoor fungal conditions as well as for moisture damage characteristics in a given country.Peer reviewe

Mold and Endotoxin Levels in the Aftermath of Hurricane Katrina: A Pilot Project of Homes in New Orleans Undergoing Renovation

BACKGROUND: After Hurricane Katrina, many New Orleans homes remained flooded for weeks, promoting heavy microbial growth. OBJECTIVES: A small demonstration project was conducted November 2005–January 2006 aiming to recommend safe remediation techniques and safe levels of worker protection, and to characterize airborne mold and endotoxin throughout cleanup. METHODS: Three houses with floodwater lines between 0.3 and 2 m underwent intervention, including disposal of damaged furnishings and drywall, cleaning surfaces, drying remaining structure, and treatment with a biostatic agent. We measured indoor and outdoor bioaerosols before, during, and after intervention. Samples were analyzed for fungi [culture, spore analysis, polymerase chain reaction (PCR)] and endotoxin. In one house, real-time particle counts were also assessed, and respirator-efficiency testing was performed to establish workplace protection factors (WPF). RESULTS: At baseline, culturable mold ranged from 22,000 to 515,000 colony-forming units/m(3), spore counts ranged from 82,000 to 630,000 spores/m(3), and endotoxin ranged from 17 to 139 endotoxin units/m(3). Culture, spore analysis, and PCR indicated that Penicillium, Aspergillus, and Paecilomyces predominated. After intervention, levels of mold and endotoxin were generally lower (sometimes, orders of magnitude). The average WPF against fungal spores for elastomeric respirators was higher than for the N-95 respirators. CONCLUSIONS: During baseline and intervention, mold and endotoxin levels were similar to those found in agricultural environments. We strongly recommend that those entering, cleaning, and repairing flood-damaged homes wear respirators at least as protective as elastomeric respirators. Recommendations based on this demonstration will benefit those involved in the current cleanup activities and will inform efforts to respond to future disasters

Effect of remdesivir post hospitalization for COVID-19 infection from the randomized SOLIDARITY Finland trial

We report the first long-term follow-up of a randomized trial (NCT04978259) addressing the effects of remdesivir on recovery (primary outcome) and other patient-important outcomes one year after hospitalization resulting from COVID-19. Of the 208 patients recruited from 11 Finnish hospitals, 198 survived, of whom 181 (92%) completed follow-up. At one year, self-reported recovery occurred in 85% in remdesivir and 86% in standard of care (SoC) (RR 0.94, 95% CI 0.47-1.90). We infer no convincing difference between remdesivir and SoC in quality of life or symptom outcomes (p > 0.05). Of the 21 potential long-COVID symptoms, patients reported moderate/major bother from fatigue (26%), joint pain (22%), and problems with memory (19%) and attention/concentration (18%). In conclusion, after a one-year follow-up of hospitalized patients, one in six reported they had not recovered well from COVID-19. Our results provide no convincing evidence of remdesivir benefit, but wide confidence intervals included possible benefit and harm.Peer reviewe