A Summary of health hazard evaluations: issues related to occupational exposure to isocyanates, 1989 to 2002

"The unique feature common to all diisocyanates is that they consist of two N=C=O (isocyanate) functional groups attached to an aromatic or aliphatic parent compound. Because of the highly unsaturated nature of the isocyanate functional group, the diisocyanates readily react with compounds containing active hydrogen atoms (electrophiles). Thus, the diiso-cyanates readily react with water (humidity), alcohols, amines, etc.; diisocyanates also react with themselves to form either dimers or trimers. When a diisocyanate species reacts with a primary, secondary, or tertiary alcohol, a carbamate (NHCOO-) group is formed, which is commonly referred to as a urethane. Reactions involving a diisocyanate species and a polyol result in the formation of cross-linked polymers; i.e., polyurethanes. Hence, they are used in surface coatings, polyurethane foams, adhesives, resins, elastomers, binders, and sealants. Many material safety data sheets (MSOSs) use isocyanate-related terms interchangeably. For the purpose of this report, terms are defined as follows. Diisocyanates (Monomers): The difunctional isocyanate species from which poly- isocyanates and polyurethanes are derived. Common examples of monomeric iso-cyanates include 1,6-hexamethylene diiso- cyanate (HOI), 2,4- and/or 2,6-toluene diiso-cyanate (TOI), 4,4' diphenylmethane diisocyanate (MOl), methylene bis (4-cyclohexylisocyanate) (HMOI), isophorone diiso-cyanate (IPOI), and 1,5-naphthalene diiso- cyanate (NOI). Commercial-grade TOI is an 80:20 or 65:35 mixture of the 2,4- and 2,6-isomers of TOI, respectively. Polyisocyanates: Species possessing free isocyanate groups and derived from monomeric isocyanates either by directly linking these monomeric units (a homopolymer) or by reacting these monomers with di- or poly-functional alcohols or amines (a copolymer). Prepolymers: Species possessing free iso-cyanate groups, prepared from the reaction of a polyol with an excess of di- or polyiso-cyanate. Commercially available isocyanate products frequently contain pre polymers in lieu of more volatile isocyanate monomers. Oligomeric Isocyanates (Oligomers): Relatively low molecular weight polyiso-cyanates. Intermediates: Species possessing free isocyanate groups, formed during use of an isocyanate product by partial reaction of the isocyanate species with a polyol. In general, the types of exposures encountered during the use of iso-cyanates (i.e., monomers, prepolymers, polyisocyanates, and oligomers) in the workplace are related to the vapor pressures of the individual compounds. The lower molecular weight isocyanates tend to volatilize at room temperature, creating a vapor inhalation hazard. Conversely, the higher molecular weight isocyanates do not readily volatilize at ambient temperatures but are still an inhalation hazard if aerosolized or heated in the work environment. The latter is important since many reactions involving isocyanates are exothermic in nature, thus providing the heat for volatilization. As exposure limits decrease, the volatility of solid materials becomes an issue. To reduce the vapor hazards associated with the lower molecular weight diiso-cyanates, prepolymer and polyisocyanate forms of these diisocyanates were developed and have replaced the monomers in many product formulations. An example is the biuret of t1DI, which consists of three molecules of t1DI monomer joined together to form a higher molecular weight oligomer having similar characteristics to those found in the monomer. Also, many MDI product formulations consist of a combination of MDI monomer and a MDI-based polyiso-cyanate (such as polymethylene polyphenyl isocyanate). Many prepolymer and polyiso-cyanate formulations contain a small fraction (usually less than 1 %) of unreacted monomer." - NIOSHTIC-2"Prepared by Beth Donovan ; editor, Jane Weber"--P. iv."Hazard Evaluations and Technical Assistance Branch (HETAB) collaborates with appropriate personnel in other divisions of the National Institute for Occupational Safety and Health (NIOSH)"-- P. iii.Includes bibliographical references (p. 34-37)

Randomized controlled trial of SPIRIT: An effective approach to preparing African-American dialysis patients and families for end of life

This randomized controlled trial tested an intervention, Sharing Patients’ Illness Representations to Increase Trust (SPIRIT), designed to enhance communication regarding end-of-life care between African Americans with end-stage renal disease (ESRD) and their chosen surrogate decision makers (N = 58 dyads). We used surveys and semi-structured interviews to determine the feasibility, acceptability, and preliminary effects of SPIRIT on patient and surrogate outcomes at 1 week and 3 months post-intervention. We also evaluated patients’ deaths and surrogates’ end-of-life decision making to assess surrogates’ perceptions of benefits and limitations of the SPIRIT while facing end-of-life decisions. We found that SPIRIT promoted communication between patients and their surrogates and was effective and well received by the participants

Electronic vapor product use and suicidal behavior in adolescents

Objective: To determine whether an association exists between electronic vapor product use (EVP) and suicidal behavior in middle and high school students Methods: Multilevel logistic regression analysis for suicidal behaviors using data from the 2017 Vermont Youth Risk Behavior Survey. Results: Middle school EVP users were significantly more likely to report suicidal behavior than non-users. No statistically significant association was found in high school students. Discussion: While further study is necessary to clarify the relationship between EVP use and suicidal behavior, these findings highlight the need for suicide prevention and smoking cessation efforts

Flipping the Model: A Values-Based Consortial Approach to Journal Negotiations

When negotiating journal pricing, the disadvantages libraries face are well documented. In addition to financially incompatible acquisition models that are out of sync with both library budgets and any predicted growth, libraries are also presented with rising inflationary costs, content added to an already overloaded system, and vendor consolidation. Pricing issues are further exacerbated by traditional negotiations, where libraries begin negotiations based on the offers made by publishers and vendors. These offers too often are predicated on historical spend and coupled with list prices that come with few explanations for their sums. Big package deals, that arguably expand access to resources and may lower costs on an article basis, have also increased overall costs and pushed out diverse resources. In attempting to move away from such deals institutions are faced with similar pricing for dramatically reduced access. The difficulties in navigating our way to a sustainable model become clear when the loss of researcher access is coupled with the increased staffing needed to manage individual subscriptions. New, and potentially viable pathways are beginning to emerge, including open access initiatives and the application of new models, such as read/publish. Although these pathways are not yet fully formed, they are promising developments that attempt to more holistically account for the contributions of the academy, the public good, and the costs of publishing. This presentation detailed the efforts of a task force within VIVA (Virginia’s academic library consortium) to create a bridge-solution between the current acquisition model and the future vision of its members. It creates a space to rethink what these deals could be and relies on consortial criteria to determine the value of content. The approach remains conscious of the real long-term institutional trust and communication risks to such endeavors, and is built on concerted, collective action

StormStore: A feasibility study examining stormwater credit trading in Cook County

Grand Victoria FoundationChicago Community TrustJoyce FoundationOpe

Southeastern Association of Law Libraries Annual Meeting

The 2009 SEAALL Annual Meeting was held in Athens Georgia, April 16-18, 2009

Ten-year mortality, disease progression, and treatment-related side effects in men with localised prostate cancer from the ProtecT randomised controlled trial according to treatment received

Background The ProtecT trial reported intention-to-treat analysis of men with localised prostate cancer randomly allocated to active monitoring (AM), radical prostatectomy, and external beam radiotherapy. Objective To report outcomes according to treatment received in men in randomised and treatment choice cohorts. Design, setting, and participants This study focuses on secondary care. Men with clinically localised prostate cancer at one of nine UK centres were invited to participate in the treatment trial comparing AM, radical prostatectomy, and radiotherapy. Intervention Two cohorts included 1643 men who agreed to be randomised and 997 who declined randomisation and chose treatment. Outcome measurements and statistical analysis Analysis was carried out to assess mortality, metastasis and progression and health-related quality of life impacts on urinary, bowel, and sexual function using patient-reported outcome measures. Analysis was based on comparisons between groups defined by treatment received for both randomised and treatment choice cohorts in turn, with pooled estimates of intervention effect obtained using meta-analysis. Differences were estimated with adjustment for known prognostic factors using propensity scores. Results and limitations According to treatment received, more men receiving AM died of PCa (AM 1.85%, surgery 0.67%, radiotherapy 0.73%), whilst this difference remained consistent with chance in the randomised cohort (p = 0.08); stronger evidence was found in the exploratory analyses (randomised plus choice cohort) when AM was compared with the combined radical treatment group (p = 0.003). There was also strong evidence that metastasis (AM 5.6%, surgery 2.4%, radiotherapy 2.7%) and disease progression (AM 20.35%, surgery 5.87%, radiotherapy 6.62%) were more common in the AM group. Compared with AM, there were higher risks of sexual dysfunction (95% at 6 mo) and urinary incontinence (55% at 6 mo) after surgery, and of sexual dysfunction (88% at 6 mo) and bowel dysfunction (5% at 6 mo) after radiotherapy. The key limitations are the potential for bias when comparing groups defined by treatment received and changes in the protocol for AM during the lengthy follow-up required in trials of screen-detected PCa. Conclusions Analyses according to treatment received showed increased rates of disease-related events and lower rates of patient-reported harms in men managed by AM compared with men managed by radical treatment, and stronger evidence of greater PCa mortality in the AM group. Patient summary More than 95 out of every 100 men with low or intermediate risk localised prostate cancer do not die of prostate cancer within 10 yr, irrespective of whether treatment is by means of monitoring, surgery, or radiotherapy. Side effects on sexual and bladder function are better after active monitoring, but the risks of spreading of prostate cancer are more common

Shared heritability and functional enrichment across six solid cancers

Correction: Nature Communications 10 (2019): art. 4386 DOI: 10.1038/s41467-019-12095-8Quantifying the genetic correlation between cancers can provide important insights into the mechanisms driving cancer etiology. Using genome-wide association study summary statistics across six cancer types based on a total of 296,215 cases and 301,319 controls of European ancestry, here we estimate the pair-wise genetic correlations between breast, colorectal, head/neck, lung, ovary and prostate cancer, and between cancers and 38 other diseases. We observed statistically significant genetic correlations between lung and head/neck cancer (r(g) = 0.57, p = 4.6 x 10(-8)), breast and ovarian cancer (r(g) = 0.24, p = 7 x 10(-5)), breast and lung cancer (r(g) = 0.18, p = 1.5 x 10(-6)) and breast and colorectal cancer (r(g) = 0.15, p = 1.1 x 10(-4)). We also found that multiple cancers are genetically correlated with non-cancer traits including smoking, psychiatric diseases and metabolic characteristics. Functional enrichment analysis revealed a significant excess contribution of conserved and regulatory regions to cancer heritability. Our comprehensive analysis of cross-cancer heritability suggests that solid tumors arising across tissues share in part a common germline genetic basis.Peer reviewe