Towards an optimal adaptation of exposure to NOAA assessment methodology in Multi-Source Industrial Scenarios (MSIS): the challenges and the decision-making process

It is expected a progressive increase of the industrial processes that manufacture of intermediate (iNEPs) and end products incorporating ENMs (eNEPs) to bring about improved properties. Therefore, the assessment of occupational exposure to airborne NOAA will migrate, from the simple and well-controlled exposure scenarios in research laboratories and ENMs production plants using innovative production technologies, to much more complex exposure scenarios located around processes of manufacture of eNEPs that, in many cases, will be modified conventional production processes. Here will be discussed some of the typical challenging situations in the process of risk assessment of inhalation exposure to NOAA in Multi-Source Industrial Scenarios (MSIS), from the basis of the lessons learned when confronted to those scenarios in the frame of some European and Spanish research projects.This paper exploits the results of the research developed by projects SCAFFOLD and EHS Advance. Project SCAFFOLD received funding from the European Union's FP7 research and innovation programme, under grant agreement No. 280535. Project EHS Advance received funding from the Basque Government research programme (Etortek). The authors would also like to express their grateful to companies BOSTLAN (Bizkaia, Spain) and TECNAN (Navarra, Spain) for the support provided to carry out the exposure measurements in their respective facilities

Exposure to graphene in a pilot production plant

Workers exposure to graphene was measured in a pilot production plant. Reduced graphene oxide was produced through graphite oxidation and posterior thermal reduction. The monitoring was performed using two handheld on-line devices covering the particle size range from 10 nm to 10 μm (CPC3007 and OPS3330). Simultaneously, personal and area filter samples were collected for off line analysis, including gravimetric, elemental carbon analysis and SEM/EDX. Significant releases of particles were identified in two tasks, during the graphene oxide washing, and during its milling. However, the analysis of the particles size distribution and of their morphology suggested that the released particles were not the target nanomaterial but engine generated nanoparticles. The mass of elemental carbon in the collected filters was below the quantification limit and the calculated graphene mass concentrations were quite below the selected reference exposure limit. Overall, this work showed that worker exposure to graphene was low in this pilot plant, contributing to guarantee a safe process, prior to its industrialization.This research was carried out as part of the project FAST- Functionally Graded Additive Manufacturing Scaffolds by Hybrid Manufacturing. The project FAST has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 685825

Analysis of multivariate stochastic signals sampled by on-line particle analyzers: Application to the quantitative assessment of occupational exposure to NOAA in multisource industrial scenarios (MSIS)

In multisource industrial scenarios (MSIS) coexist NOAA generating activities with other productive sources of airborne particles, such as parallel processes of manufacturing or electrical and diesel machinery. A distinctive characteristic of MSIS is the spatially complex distribution of aerosol sources, as well as their potential differences in dynamics, due to the feasibility of multi-task configuration at a given time. Thus, the background signal is expected to challenge the aerosol analyzers at a probably wide range of concentrations and size distributions, depending of the multisource configuration at a given time. Monitoring and prediction by using statistical analysis of time series captured by on-line particle analyzersin industrial scenarios, have been proven to be feasible in predicting PNC evolution provided a given quality of net signals (difference between signal at source and background). However the analysis and modelling of non-consistent time series, influenced by low levels of SNR (Signal-Noise Ratio) could build a misleading basis for decision making. In this context, this work explores the use of stochastic models based on ARIMA methodology to monitor and predict exposure values (PNC). The study was carried out in a MSIS where an case study focused on the manufacture of perforated tablets of nano-TiO2 by cold pressing was performed.Research carried out by projects SCAFFOLD and EHS Advance were made possible thanks to funding from European Commission through FP7 (GA 319092) and Basque Country Government through ETORTEK Programme

Occupational exposure to nano-TiO2 in the life cycle steps of new depollutant mortars used in construction

The present work is focused on the measurement of workers exposure to nano-TiO2 in the life cycle steps of depollutant mortars. It has been done in the framework of the SCAFFOLD project, which aims at the management of potential risks arising from the use of manufactured nanomaterials in construction. Main findings can be summarized as follows: (1) The occupational exposure to nano- TiO2 is below 0.3 mg/m3 for all measured scenarios. The highest concentrations were measured during the cleaning task (in the nano- TiO2 manufacturing process) and during the application (spraying) of depollutant coatings on a wall. (2) It was found a high release of particles above the background in several tasks as expected due to the nature of the activities performed. The maximum concentration was measured during drilling and during adding powder materials (mean total particle concentration up to 5.591E+04 particles/cm3 and 5.69E+04 particles/cm3). However, considering data on total particle concentration released, no striking differences have been observed when tasks have been performed using conventional materials in the sector (control) and when using materials doped with nano-objects.European Commission's FP

The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with >80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

High quality SiO 2 /diamond interface in O-terminated p-type diamond MOS capacitors

International audienceMetal oxide semiconductor (MOS) capacitors were fabricated based on oxygen-terminated p-type (100) oriented diamond and SiO 2 grown by atomic layer deposition. A detailed electrical characterization consisting of I–V, C–V, and C–F was performed in order to analyze the electrical properties of the structure. The MOS capacitor presented no detectable leakage current in forward and very low leakage current in reverse sustaining at least 6 MV/cm without degradation. The C–V measurements showed depletion and deep depletion regimes in forward and accumulation regimes in reverse, with a low density of interface states of [Formula: see text] along the diamond bandgap. The latter results were further validated by conductance and capacitance vs frequency measurements

Exposure assessment to engineered nanoparticles handled in industrial workplaces: The case of alloying nano-TiO2 in new steel formulations

This experimental study addresses the occupational exposure assessment to nano-TiO2 (AEROXIDE ® TiO2 P 25, EVONIK GmbH) along the processing steps of ingot steelmaking at three sites, whose characteristics range from conditioned room to multi-source industrial environments (MSIS). In Site A, which is a MSIS of multiproduct flexible production, the alloying tablets are manufactured through compression of bulk nano-powder at room temperature. Tablets are then assembled in Site B, which is a lab room equipped with local exhaust ventilation (LEV). The alloying of steel takes place in Site C, which is a full-scale casting hall where substantial amounts of material per batch (3000 kg steel/batch) are processed in open-face molds and severe working conditions prevail. A comprehensive experimental strategy based on simultaneous measurements using direct reading instruments (DRI) and time integrated filter-based sampling has been set up. The main goal of this unusual campaign at an industrial site was to determine the suitability of the various options within the decision frame of the current methodological approaches, mainly chemical- and site-dependent. In Site A the DRI were of limited applicability for the quantification of exposure, because of a high-variability of the background and a characteristic low but unstable counting in the coarse size range where agglomerates of nano-TiO2 are present. In Site B, under controlled environmental conditions no interferences were relevant. Therefore, real-time devices showed no change in the total particle concentration suggesting that tasks performed did not result in any detectable release of the nano-powder. Readings in the size range>0.3 µm showed low-signals, in the order of the device accuracy, that could not be linked to any potential release. However, the mass concentration of TiO2, as obtained by the off-line analysis of personal breathing zone (PBZ) samples, spans from 0.021 to 0.296 mg/m3 in both Sites, which seems to be due to big agglomerates observed by scanning electron microcopy (SEM). In Site C (steel foundry) the on-line instruments could not be used due to access restrictions and severe working conditions. Therefore, only personal sampling approach was used, including the comparative study with and without nanomaterial, which indicates no additional or TiO2 specific workers exposure. This work highlights how, in this particular case, occupational exposure to engineered nanoparticles (ENP) is better assessed through off-line analysis of personal filter samples. The DRI, however, are of unquestionable applicability as real-time monitors to quantify engineering controls efficiency and, thus, for risk management activities and decision making. The need for a scientific consensus in performing such an exposure assessment in industrial contexts is stressed