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Abstract

Introduction
Recycling of domestic waste and a number of employees in the recycling industry is expected to increase. This study aims to quantify current exposure levels of inhalable dust, endotoxin, and microorganisms and to identify determinants of exposure among recycling workers.


Methods
This cross-sectional study included 170 full-shift measurements from 88 production workers and 14 administrative workers from 12 recycling companies in Denmark. The companies recycle domestic waste (sorting, shredding, and extracting materials from waste). We collected inhalable dust with personal samplers that were analysed for endotoxin (n = 170) and microorganisms (n = 101). Exposure levels of inhalable dust, endotoxin, and microorganisms and potential determinants of exposure were explored by mixed-effects models.


Results
The production workers were 7-fold or higher exposed to inhalable dust, endotoxin, bacteria, and fungi than the administrative workers. Among production workers recycling domestic waste, the geometric mean exposure level was 0.6 mg/m3 for inhalable dust, 10.7 endotoxin unit (EU)/m3 for endotoxin, 1.6 × 104 colony forming units (CFU)/m³ of bacteria, 4.4 × 104 CFU/m³ of fungi (25 °C), and 1.0 × 103 CFU/m³ of fungi (37 °C). Workers handling paper or cardboard had higher exposure levels than workers handling other waste fractions. The temperature did not affect exposure levels, although there was a tendency toward increased exposure to bacteria and fungi with higher temperatures. For inhalable dust and endotoxin, exposure levels during outdoor work were low compared to indoor work. For bacteria and fungi, indoor ventilation decreased exposure. The work task, waste fraction, temperature, location, mechanical ventilation, and the company size explained around half of the variance of levels of inhalable dust, endotoxin, bacteria, and fungi.


Conclusion
The production workers of the Danish recycling industry participating in this study had higher exposure levels of inhalable dust, endotoxin, bacteria, and fungi than the administrative workers. Exposure levels of inhalable dust and endotoxin among recycling workers in Denmark were generally below established or suggested occupational exposure limits (OEL). However, 43% to 58% of the individual measurements of bacteria and fungi were above the suggested OEL. The waste fraction was the most influential determinant for exposure, and the highest exposure levels were seen during handling paper or cardboard. Future studies should examine the relationship between exposure levels and health effects among workers recycling domestic waste.

AbstractOccupational noise exposure is a known risk factor for hearing loss and also adverse cardiovascular effects have been suggested. A job exposure matrix (JEM) would enable studies of noise and health on a large scale. The objective of this study was to create a quantitative JEM for occupational noise exposure assessment of the general working population. Between 2001–2003 and 2009–2010, we recruited workers from companies within the 10 industries with the highest reporting of noise-induced hearing loss according to the Danish Working Environment Authority and in addition workers of financial services and children day care to optimize the range in exposure levels. We obtained 1343 personal occupational noise dosimeter measurements among 1140 workers representing 100 different jobs according to the Danish version of the International Standard Classification of Occupations 1988 (DISCO 88). Four experts used 35 of these jobs as benchmarks and rated noise levels for the remaining 337 jobs within DISCO 88. To estimate noise levels for all 372 jobs, we included expert ratings together with sex, age, occupational class, and calendar year as fixed effects, while job and worker were included as random effects in a linear mixed regression model. The fixed effects explained 40% of the total variance: 72% of the between-jobs variance, −6% of the between-workers variance and 4% of the within-worker variance. Modelled noise levels showed a monotonic increase with increasing expert score and a 20 dB difference between the highest and lowest exposed jobs. Based on the JEM estimates, metal wheel-grinders were among the highest and finance and sales professionals among the lowest exposed. This JEM of occupational noise exposure can be used to prioritize preventive efforts of occupational noise exposure and to provide quantitative estimates of contemporary exposure levels in epidemiological studies of health effects potentially associated with noise exposure.

Abstract

Introduction
Upper respiratory tract infections (URTI) are common and a common cause of sick-leave for healthcare workers, and furthermore pose a threat especially for patients susceptible to other diseases. Sufficient use of respiratory protective equipment (RPE) may protect both the workers and the patients. The COVID-19 pandemic provided a unique opportunity to study the association between use of RPE and URTI in a real-life setting. The aim of this study was to examine if failure of RPE or non-compliance with RPE guidelines increases the risk of non-COVID-19 URTI symptoms among healthcare workers.


Methods
In a longitudinal cohort study, we collected self-reported data daily on work tasks, use of RPE, and URTI symptoms among healthcare workers with patient contact in 2 Danish Regions in 2 time periods during the COVID-19 pandemic. The association between failure of RPE or non-compliance with RPE guidelines and URTI symptoms was analyzed separately by generalized linear models. Persons tested positive for severe acute respiratory syndrome coronavirus 2 were censored from the analyses. The 2 waves of data collection were analyzed separately, as there were differences in recommendations of RPE during the 2 waves.


Results
We found that for healthcare workers performing work tasks with a risk of transmission of viruses or bacteria, failure of RPE was associated with an increased risk of URTI symptoms, RR: 1.65[0.53–5.14] in wave 1 and RR: 1.30[0.56–3.03] in wave 2. Also non-compliance with RPE guidelines was associated with an increased risk of URTI symptoms compared to the use of RPE in wave 1, RR: 1.28[0.87–1.87] and wave 2, RR: 1.39[1.01–1.91]. Stratifying on high- versus low-risk tasks showed that the risk related to failure and non-compliance was primarily associated with high-risk tasks, although not statistically significant.


Discussion
The study was conducted during the COVID-19 pandemic and thus may be affected by other preventive measures in society. However, this gave the opportunity to study the use of RPE in a real-life setting, also in departments that did not previously use RPE. The circumstances in the 2 time periods of data collection differed and were analyzed separately and thus the sample size was limited and affected the precision of the estimates.


Conclusion
Failures of RPE and non-compliance with RPE guidelines may increase the risk of URTI, compared to those who reported use of RPE as recommended. The implications of these findings are that the use of RPE to prevent URTI could be considered, especially while performing high-risk tasks where other prevention strategies are not achievable.

Abstract

Objective
To assess light exposure during days with indoor, outdoor, and night work and days off work.


Methods
Light intensity was continuously recorded for 7 days across the year among indoor (n = 170), outdoor (n = 151), and night workers (n = 188) in Denmark (55–56°N) equipped with a personal light recorder. White light intensity, duration above 80, 1000, and 2500 lux, and proportion of red, green, and blue light was depicted by time of the day and season for work days and days off work.


Results
Indoor workers' average light exposure only intermittently exceeded 1000 lux during daytime working hours in summer and never in winter. During daytime working hours, most outdoor workers exceeded 2500 lux in summer and 1000 lux in winter. Night workers spent on average 10–50 min >80 lux when working night shifts. During days off work, indoor and night workers were exposed to higher light intensities than during work days and few differences were seen between indoor, outdoor, and night workers. The spectral composition of light was similar for indoor, outdoor, and night workers during days at and off work.


Conclusion
The night workers of this study were during night hours on average exposed for a limited time to light intensities expected to suppress melatonin. The indoor workers were exposed to light levels during daylight hours that may reduce general well-being and mood, especially in winter. Outdoor workers were during summer daylight hours exposed to light levels comparable to those used for the treatment of depression.

Abstract

Introduction
To treat and properly care for COVID-19 patients it is vital to have healthy healthcare workers to ensure the continued function of the healthcare system and to prevent transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to patients, co-workers, and the community. Personal protective equipment (PPE) can prevent healthcare workers from being infected with and transmitting SARS-CoV-2. Experience and training are pivotal to ensure optimal protection. This study aims to examine the use and failure of PPE and compliance with PPE guidelines during the first and the second wave of the COVID-19 pandemic among Danish healthcare workers.


Methods
Healthcare workers from the Central Denmark Region and the Capital Region of Denmark were invited to participate April–June 2020 during the first wave and November 2020–April 2021 during the second wave. Day-by-day, participants reported work procedures, use and failure of PPE, and compliance with PPE guidelines. Register-based information on sex, age, department, and profession was available for all participants.


Results
In total, 21 684 and 10 097 healthcare workers participated during the first and the second wave, respectively. During the first wave, 1.7% used filtering face piece-2 or -3 (FFP2 or FFP3) respirators and 8.2% used face masks [fluid resistant (type IIR) masks, masks with visor (typically type IIR), and other unspecified face masks] during physical contact with patients. During the second wave, the corresponding figures increased to 17.8% and 80.7%. During respiratory procedures, the use of FFP2 or FFP3 respirators increased from 5.6 to 24.3%, and the use of face masks from 14.7 to 77.8%. The no PPE use decreased from 21.3% during the first wave to 0.4% in the second wave, during respiratory procedures. Total PPE failures decreased from 0.7 to 0.4% from the first to second wave. The proportion not complying with PPE guidelines declined from 3.6 to 2.2% during physical contact with patients and from 6.5 to 4.6% during respiratory procedures. PPE failure and non-compliance varied by age, sex and type of department. Frequent reasons for non-compliance were forgetfulness and lack of time, and during the first but not during the second wave, limited availability of PPE.


Conclusion
We found a substantial increase in the use of PPE and a substantial decrease in PPE failures from the first to the second wave of COVID-19 in Denmark. However, there is still a need for continuous focus on compliance in use of PPE among healthcare workers.

AbstractHigh daytime light levels may reduce the risk of affective disorders. Outdoor workers are during daytime exposed to much higher light intensities than indoor workers. A way to study daytime light exposure and disease on a large scale is by use of a general population job exposure matrix (JEM) combined with national employment and health data. The objective of this study was to develop a JEM applicable for epidemiological studies of exposure response between daytime light exposure, affective disorders, and other health effects by combining expert scores and light measurements. We measured light intensity during daytime work hours 06:00–17:59 for 1–7 days with Philips Actiwatch Spectrum® light recorders (Actiwatch) among 695 workers representing 71 different jobs. Jobs were coded into DISCO-88, the Danish version of the International Standard Classification of Occupations 1988. Daytime light measurements were collected all year round in Denmark (55–56°N). Arithmetic mean white light intensity (lux) was calculated for each hour of observation (n = 15,272), natural log-transformed, and used as the dependent variable in mixed effects linear regression models. Three experts rated probability and duration of outdoor work for all 372 jobs within DISCO-88. Their ratings were used to construct an expert score that was included together with month of the year and hour of the day as fixed effects in the model. Job, industry nested within job, and worker were included as random effects. The model estimated daytime light intensity levels specific for hour of the day and month of the year for all jobs with a DISCO-88 code in Denmark. The fixed effects explained 37% of the total variance: 83% of the between-jobs variance, 57% of the between industries nested in jobs variance, 43% of the between-workers variance, and 15% of the within-worker variance. Modeled daytime light intensity showed a monotonic increase with increasing expert score and a 30-fold ratio between the highest and lowest exposed jobs. Building construction laborers were based on the JEM estimates among the highest and medical equipment operators among the lowest exposed. This is the first quantitative JEM of daytime light exposure and will be used in epidemiological studies of affective disorders and other health effects potentially associated with light exposure.