Health
National Institutes of Health | 20 September 2017

Gulf Spill Oil Dispersants Associated With Health Symptoms in Cleanup Workers

Workers who were likely exposed to dispersants while cleaning up the 2010 Deepwater Horizon oil spill experienced a range of health symptoms including cough and wheeze and skin and eye irritation, according to scientists at the National Institutes of Health (NIH). The study appeared online on 15 September in Environmental Health Perspectives and is the first research to examine dispersant-related health symptoms in humans.

In May 2010, cleanup workers in Venice, Louisiana, pressure washed oil booms to remove oil, debris, and dispersants. Credit: James Remington/NIEHS.

Oil dispersants are a blend of chemical compounds used to break down oil slicks into smaller drops of oil, making them easily degraded by natural processes or diluted by large volumes of water. The study estimated the likelihood of exposure to dispersants, based on the types of jobs the workers did and where. Individuals who handled dispersants, worked near where dispersants were being applied, or had contact with dispersant equipment reported the symptoms they experienced during oil spill cleanup as part of the Gulf Long-Term Follow-Up (GuLF) Study.

The research team found that workers exposed to dispersants were more likely to experience certain symptoms—cough; wheeze; tightness in the chest; and burning in the eyes, nose, throat, or lungs—than those who were not exposed to dispersants.

Dale Sandler, the lead GuLF Study researcher at the National Institute of Environmental Health Sciences (NIEHS), part of NIH, said the findings only apply to workers involved in the cleanup effort and not the general public.

“The health effects that we see in the workers don’t necessarily apply to the community at large, although many of the workers live in affected areas,” Sandler said.

After the oil spill, two chemical dispersants, Corexit EC9500A and Corexit EC9527A, were used in some areas where oil was present. Sandler said that, because it was the first time oil dispersants had been used on such a large scale, it was important to examine the possible health effects. Most of the previous research on dispersants focused on how well the compounds dispersed oil and the potential environmental effects. Several small animal studies that tested the chemicals in dispersants suggested some of the compounds were toxic.

Read the full story here.

Read the GuLF Study here.

Reuters | 14 September 2017

Meth, Coke, and Oil: A Drug Boom in the Texas Shale Patch

When Joe Forsythe returned to the West Texas oilfields last year after a stint in a drug rehab facility, he figured he had beaten his addiction to methamphetamine.

The 32-year-old rig worker and equipment handler lasted about a year before relapsing.

“It’s easy to get back into that mentality,” said Forsythe, of Midland, Texas, who said he no longer uses drugs after several stints in rehab since 2015. “I’d work 24 hours … I was just plagued with fatigue and needed something to improve my work ethic.”

Forsythe’s experience and others like it reflect a painful flip side of the nation’s shale oil boom—a parallel increase in substance abuse, drug crime, and related social ills.

While drug use is a problem among industrial workers nationwide, it raises particular concern in the oil patch as US production surges to record levels in what is already one of the nation’s most dangerous sectors—with a fatality rate about three times the average for other industries, according to 2015 federal statistics.

Drug use is a significant factor in workplace injuries and crimes involving oilfield workers, according to drug counselors, hospital and police officials, and court records in West Texas, the epicenter of the US shale sector.

As the shale revolution has spawned waves of hiring here since 2010, law enforcement authorities have tracked a boom in drug trafficking and related crime. In Midland and Ector counties, home to many Permian Basin oil workers, state and local police in 2016 seized more than 95 pounds of methamphetamine—up from less than four pounds in 2010.

Meth and cocaine are stimulants of choice in the oil patch to get though long oilfield shifts, but alcohol and pain killers such as opioids are also widely abused—often to soften the crash after taking stimulants, drug addicts and counselors said.

Drug charges in the industry town of Midland more than doubled between 2012 and 2016, to 942 from 491, according to police data. In neighboring Odessa, total drug arrests doubled between 2010 and 2016, to 1291 from 756, according to Odessa Police Department data.

Read the full story here.

Skill Builder | 25 August 2017

Seven Things You Need to Know About Silica Dust

According to the UK Health and Safety Executive, respirable crystalline silica, often referred to as silica dust, is the second biggest risk to construction workers, following asbestos. Knowledge is power when it comes to staying protected, which is why Skill Builder has joined forces with Scott Safety to create this educational video.

If you, or anyone you know, works with silica dust, please make sure you understand the risks and how to stay protected.

JPT | 14 August 2017

Company’s Integrated Approach Tackles Fatigue Management

In an effort to establish practical solutions to fatigue-related risk, Petronas created a task force that included specialists, plant-operation personnel, shift supervisors, and information-technology (IT) team members. Discussions with stakeholders included a detailed review of the shift-manning procedure and work-process evaluation to address fatigue risks, and an analysis was performed to determine common issues that require further mitigation efforts. This paper describes the integrated approach taken by the company to reinforce effective management of fatigue.

Introduction
Investigations into some of the worst industrial and environmental accidents have identified fatigue as a major contributor, although, in some of these cases, fatigue was not the only cause. Petronas has put in place a number of key controls to ensure that fatigue risks are managed accordingly at the workplace. These include a technical standard on management of fatigue, site procedures at operating units (e.g, shift-manning procedures, journey-management plans, and health-promotion programs), and audits to ensure compliance. Nonetheless, opportunities exist for improvement, particularly to reinforce the effective implementation of the program through integrated approaches that leverage IT and standardized work processes. Embedding fatigue management in day-to-day work processes is essential to achieve significant results in managing the risks.

Statement of Theory and Definitions
Fatigue is a progressive decline in ­alertness and performance caused by insufficient quality or quantity of sleep. This may result from extended work hours, overtime, shift work, insufficient opportunities for sleep, or the effects of sleep disorders or medical conditions that reduce sleep or increase sleepiness. Fatigue affects the ability to assess risk, increases willingness to accept risk, and decreases the ability to maintain attention. When fatigued, people find it more difficult to divide their attention adequately between multiple tasks and to plan for future actions. ­Fatigued people are more likely to suffer lapses in concentration and are more easily distracted from the task at hand. The more tired people become, the more likely they are to cut corners and to accept lower standards in accuracy and performance.

Fatigue contributes to accidents by impairing performance and, at the extreme end of the scale, by causing people to fall asleep while working. Human error resulting from fatigue is now widely acknowledged as the cause of numerous workplace disasters. Many disasters began with initial difficulties such as technical faults, but, because of fatigue, the operators did not manage the situation adequately, allowing the situation to escalate to an accident.

The company’s fatigue-management program (FMP) includes the following key activities:

  • Fatigue risk assessment at site
  • Establishment of a procedure to implement the FMP for the identified work groups
  • Implementation of the FMP for the identified work group or the group at risk, which includes
    • A review of manpower planning
    • Controls of workplace fatigue
    • Training and communication
    • Monitoring
    • Periodic review
  • The establishment and implementation of an assurance program
  • Incident investigations
  • Record keeping

Description and Application of Equipment and Processes
The main objective of the intervention is to develop a fit-for-purpose and effective fatigue-management program, structure, and system for practical use. In addition, the process enhances awareness of the importance of fatigue management among employees. The intervention will be able to deliver a more-effective FMP for the company.

Key deliverables were identified, including the development of a standardized work process in managing shift work and fatigue and the development of communication materials with clear messages to reinforce the understanding of and actions in fatigue management for employees and supervisors. The messages formulated in the communication materials were simple in order to facilitate better understanding of the subject of fatigue and, most importantly, of actions required from employees to manage fatigue. The intervention also promoted the use of an IT tool in monitoring, and tracking compliance to, hours-of-service limits.

As part of an effort to establish guidelines for practical solutions to fatigue-related risk, a task force was formed that consisted of specialists, plant-­operation personnel, shift supervisors, and IT-team members, and a situational-analysis survey was conducted. Survey feedback included information regarding the availability of site procedures to manage fatigue at work, communication and training tools, compliance to hours-of-service limits, and monitoring and tracking of performance indicators. The study included group discussion with various stakeholders to obtain feedback on the implementation of the FMP and its challenges on-site. The discussion also included a detailed review of shift-manning procedure and evaluation of the work processes to address fatigue risks among shift workers during normal plant operation and during turnaround.

Data and Results
An analysis of the survey identified several areas for improvements (Fig. 1). Regarding site procedure, most of the operating units already had developed specific procedures for fatigue management. However, the procedures for fatigue management were not embedded in the day-to-day shift-manning procedures at some of the operating units. Communication tools related to fatigue management were available in most of the operating units; however, the survey revealed that the material lacked action-oriented messages regarding what employees were expected to do in order to mitigate fatigue risks.

Fig. 1—Results of fatigue-management survey. HSE=health, safety, and environment. KPI=key performance indicators.

More contract workers are present at the worksite during turnaround. Gate-access systems at entry points were available at most operating units to ensure compliance to hours-of-service limits. The systems enable the safety-management team to monitor and track the number of working days of each contract worker and automatically deny entry to those who have exceeded the hours-of-service limits.

Survey results revealed that the operating units require improvement in the work processes and systems used to monitor and track compliance to hours-of-service limits among shift workers. Key performance indicators for fatigue need to be established and monitored regularly.

One of the main outcomes of the survey was the development of communication materials that emphasize the risks of fatigue, the signs of fatigue, actions to be taken by employees and supervisors to mitigate fatigue risks, and compliance to hours-of-service limits. A 4-minute awareness video with attractive animation communicated a condensed version of all the important facts. The short video is suitable for use as part of a safety briefing package. Standard posters on fatigue awareness also were made available to reinforce the message on fatigue-risk mitigation.

A standardized work process was developed that embeds steps to be taken to address fatigue risks as part of shift-manning management. It clearly prescribes the roles and responsibilities of various parties involved in fatigue management during shifts and turnaround. The work process also provides guidance on the use of IT tools as a system for effective shift manning and fatigue management.


This article, written by Special Publications Editor Adam Wilson, contains highlights of paper SPE 185226, “Integrated Approach in Fatigue Management,” by M. Nizam Jemoin and Ahmad Khairi Abdullah, Petronas, prepared for the 2017 SPE Asia Pacific Health, Safety, Security, Environment, and Social Responsibility Conference, Kuala Lumpur, 4–6 April. The paper has not been peer reviewed.

PubMed | 9 August 2017

Evaluation of Occupational Ocular Trauma: Are We Doing Enough To Promote Eye Safety in the Workplace?

The aim of this study was to document the use of eye personal protective equipment (PPE) by patients who had sustained an eye injury in the workplace and to evaluate the characteristics and outcomes of these patients.

All adult patients who had sustained an eye injury in the workplace and presented to the urgent ophthalmology clinic of a tertiary care hospital from 1 October 2013 to 30 November 2014 were eligible for inclusion.

Medical records were reviewed to obtain occupational eye injury data, including etiology, type, and severity of injury as per the Ocular Trauma Score. Use of eye PPE at the time of injury was recorded. Outcome data, including disposition, duration of follow-up, and return to baseline best-corrected visual acuity, were also recorded.

This study included 169 patients . The median age of the cohort was 31 years, and 92.9% were male. Chemical exposure (31.4%); grinding (17.9%); and injuries sustained by a sharp-object, metal, or nail (13.1%) were overall the most common etiologies of injury. Eye PPE was not worn by 66.9% of the cohort, with 33.1% of the cohort sustaining an occupational eye injury despite the use of eye PPE.

The use of eye PPE among workers who sustain an eye injury in the workplace remains low; yet, its use does not preclude a significant proportion of such workers from injury. Increasingly advocating for both the use and appropriate selection of eye PPE in the workplace is an important public health initiative that should therefore be encouraged.

Find the full paper here.

Occupational and Environmental Medicine | 8 August 2017

Estimating the Burden of Occupational Cancer: Assessing Bias and Uncertainty

The authors of this paper aimed to estimate credibility intervals for the British occupational cancer burden to account for bias uncertainty, using a method adapted from Greenland’s Monte Carlo sensitivity analysis.

The attributable fraction (AF) methodology used for the cancer burden estimates requires risk estimates and population proportions exposed for each agent/cancer pair. Sources of bias operating on AF estimator components include nonportability of risk estimates, inadequate models, inaccurate data including unknown cancer latency and employment turnover, and compromises in using the available estimators. Each source of bias operates on a component of the AF estimator. Independent prior distributions were estimated for each bias, or graphical sensitivity analysis was used to identify plausible distribution ranges for the component variables, with AF recalculated following Monte Carlo repeated sampling from these distributions. The methods are illustrated using the example of lung cancer because of occupational exposure to respirable crystalline silica in men.

Results are presented graphically for a hierarchy of biases contributing to an overall credibility interval for lung cancer and respirable crystalline silica exposure. An overall credibility interval of 2.0 to 16.2% was estimated for an AF of 3.9% in men. Choice of relative risk and employment turnover were shown to contribute most to overall estimate uncertainty. Bias from using an incorrect estimator makes a much lower contribution.

The method illustrates the use of credibility intervals to indicate relative contributions of important sources of uncertainty and identifies important data gaps. Results depend greatly on the priors chosen.

Find the full paper here.

Occupational and Environmental Medicine | 8 August 2017

Blue-Enriched Light Intervention To Improve Alertness and Performance in Night Shift Workers

Night workers often experience high levels of sleepiness because of misalignment of the sleep/wake cycle from the circadian pacemaker, in addition to acute and chronic sleep loss.

Exposure to light, in particular short-wavelength light, can improve alertness and neurobehavioral performance. This randomized controlled trial examined the efficacy of blue-enriched polychromatic light to improve alertness and neurobehavioral performance in night workers.

Participants were 71 night shift workers (42 males; 32.8 ±10.5 years) who worked at least 6 hours between 2200 and 0800. Sleep/wake logs and wrist actigraphy were collected for 1–3 weeks, followed by 48-hour urine collection to measure the circadian 6-sulphatoxymelatonin (aMT6s) rhythm. On the night following at least two consecutive night shifts, workers attended a simulated night shift in the laboratory, which included subjective and objective assessments of sleepiness and performance. Workers were randomly assigned for exposure to one of two treatment conditions from 2300 to 0700 hours: blue-enriched white light (17 000 K, 89 lux; = 36) or standard white light (4000 K, 84 lux; = 35).

Subjective and objective sleepiness increased during the night shift in both light conditions, but no significant effects of light condition were observed. The 17 000 K light, however, did improve subjective sleepiness relative to the 4000 K condition when light exposure coincided with the time of the aMT6s peak.

This study suggests that, while blue-enriched light has potential to improve subjective sleepiness in night shift workers, further research is needed in the selection of light properties to maximize the benefits.

Find the full paper here.

PubMed | 14 July 2017

Exposure to Benzene in a Pooled Analysis of Petroleum Industry Case-Control Studies

Cases of lymphohematopoietic cancer from three petroleum industry cohorts, matched to controls from the respective cohort, were pooled into single study. Average benzene exposure was quantitatively estimated in part per million (ppm) for each job on the basis of measured data from the relevant country, adjusted for the specific time period, site, and job exposure characteristics and the certainty of the exposure estimate scored. The probability of dermal exposure and of peak exposure was also assessed.

Before risk was examined, an exposure estimate comparison and rationalization exercise was performed across the studies to ensure accuracy and consistency of approach. This paper evaluates the final exposure estimates and their use in the risk assessments.

Overall benzene exposure estimates were low; 90% of participants accumulated less than 20 ppm-years. Mean cumulative exposure was estimated as 5.15 ppm-years, mean duration was 22 years, and mean exposure intensity was 0.2 ppm. 46% of participants were allocated a peak exposure (>3 ppm at least weekly). 40% of participants had a high probability of dermal exposure (based on the relative probability of at least weekly exposure). There were differences in mean intensity of exposure, probability of peak or dermal exposure associated with job category, job site, and decade of exposure.

Terminal operators handling benzene-containing products were the most highly exposed group, followed by tanker drivers carrying gasoline. Exposures were higher around 1940–1950 and lower in more recent decades. Overall confidence in the exposure estimates was highest for recently held jobs and for white collar jobs.

The authors used sensitivity analyses that included and excluded case sets on the basis of exposure certainty scores to inform the risk assessment. The analyses demonstrated that the different patterns of exposure across the three studies are largely attributable to differences in jobs, site types, and time frames rather than study. This provides reassurance that the previous rationalization of exposures achieved interstudy consistency and that the data could be confidently pooled.

Journal of Travel Medicine | 28 June 2017

Medical Evacuations in the Oil and Gas Industry: A Retrospective Review With Implications for Future Evacuation and Preventative Strategies

Businesses increasingly conduct operations in remote areas where medical evacuation (medevac) carries more risk. Royal Dutch Shell developed a remote healthcare strategy whereby enhanced remote healthcare is made available to the patient through use of telemedicine and telemetry. To evaluate that strategy, a review of medevacs of Shell International employees was undertaken.

A retrospective review of medevac data that were similar in operational constraints and population profile was conducted. Employee records and human resource data were used as a denominator for the population. Analogous medevac data from specific locations were used to compare patterns of diagnoses.

A total of 130 medevacs were conducted during the study period, resulting in a medevac rate of 4 per 1,000 people with 16 per 1,000 for women and 3 per 1,000 for men. The youngest and oldest age-groups required medevacs in larger proportions. The evacuation rates were highest for countries classified as high or extreme risk. The most frequent diagnostic categories for medevac were trauma, digestive, musculoskeletal, cardiac, and neurological. In 9% of the total, a strong to moderate link could be made between the pre-existing medical condition and diagnosis leading to medevac.

This study uniquely provides a benchmark medevac rate (4 per 1,000) and demonstrates that medevac rates are highest from countries identified as high risk; there is an age and gender bias, and pre-existing medical conditions are of notable relevance. It confirms a change in the trend from injury to illness as a reason for medevac in the oil and gas industry and demonstrates that diagnoses of a digestive and traumatic nature are the most frequent. A holistic approach to health (as opposed to a predominant focus on fitness to work), more attention to female travelers, and the application of modern technology and communication will reduce the need for medevacs.

Find the full paper here.

PubMed | 19 June 2017

Low Personal Exposure to Benzene and 1,3-Butadiene in the Swedish Petroleum Refinery Industry

Petroleum refinery workers are exposed to the carcinogens benzene and 1,3-butadiene. Declining exposures have been reported internationally, but information on current exposure in the Swedish refinery industry is limited. The aim was to examine refinery workers’ personal exposure to benzene and 1,3-butadiene and increase awareness of exposure conditions by collaboration with involved refineries.

Altogether, 505 repeated personal exposure measurements were performed among workers at two refineries. Full-shift measurements were conducted in different exposure groups using Perkin Elmer diffusive samplers filled with Carbopack X. Mean levels were calculated using mixed-effects models. A large fraction of measurements below the limit of detection required imputation of computer-generated data.

Low benzene and 1,3-butadiene levels were found among refinery workers. Mean benzene exposure was about 1% of the Swedish occupational limit and for 1,3-butadiene, exposure was even lower.

Find the full paper here.