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| 2. |
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| 3. |
- Gren, Louise, et al.
(författare)
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Lung function and self-rated symptoms in healthy volunteers after exposure to hydrotreated vegetable oil (HVO) exhaust with and without particles
- 2022
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Ingår i: Particle and Fibre Toxicology. - : Springer Science and Business Media LLC. - 1743-8977. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Diesel engine exhaust causes adverse health effects. Meanwhile, the impact of renewable diesel exhaust, such as hydrotreated vegetable oil (HVO), on human health is less known. Nineteen healthy volunteers were exposed to HVO exhaust for 3 h in a chamber with a double-blind, randomized setup. Exposure scenarios comprised of HVO exhaust from two modern non-road vehicles with 1) no aftertreatment system ('HVOPM+NOx' PM1: 93 mu g-m(-3), EC: 54 mu g-m(-3), NO: 3.4 ppm, -NO2: 0.6 ppm), 2) an aftertreatment system containing a diesel oxidation catalyst and a diesel particulate filter ('HVONOx' PM1: similar to 1 mu g-m(-3), NO: 2.0 ppm, -NO2: 0.7 ppm) and 3) filtered air (FA) as control. The exposure concentrations were in line with current EU occupational exposure limits (OELs) of NO, -NO2, formaldehyde, polycyclic aromatic hydrocarbons (PAHs), and the future OEL (2023) of elemental carbon (EC). The effect on nasal patency, pulmonary function, and self-rated symptoms were assessed. Calculated predicted lung deposition of HVO exhaust particles was compared to data from an earlier diesel exhaust study. Results: The average total respiratory tract deposition of PM1 during -HVO(PM+ NO)x was 27 mu g-h(-1). The estimated deposition fraction of HVO PM1 was 40-50% higher compared to diesel exhaust PM1 from an older vehicle (earlier study), due to smaller particle sizes of the -HVOPM+ NOx exhaust. Compared to FA, exposure to -HVOPM+ NOx and -HVONOx caused higher incidence of self-reported symptoms (78%, 63%, respectively, vs. 28% for FA, p < 0.03). Especially, exposure to -HVOPM+ NOx showed 40-50% higher eye and throat irritation symptoms. Compared to FA, a decrement in nasal patency was found for the -HVONOx exposures (- 18.1, 95% CI: - 27.3 to - 8.8 L-min(-1), p < 0.001), and for the -HVOPM+ NOx (- 7.4 (- 15.6 to 0.8) L -min(-1), p = 0.08). Overall, no clinically significant change was indicated in the pulmonary function tests (spirometry, peak expiratory flow, forced oscillation technique). Conclusion: Short-term exposure to HVO exhaust concentrations corresponding to EU OELs for one workday did not cause adverse pulmonary function changes in healthy subjects. However, an increase in self-rated mild irritation symptoms, and mild decrease in nasal patency after both HVO exposures, may indicate irritative effects from exposure to HVO exhaust from modern non-road vehicles, with and without aftertreatment systems.
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| 4. |
- Hedmer, Maria, et al.
(författare)
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Real-Time Emission and Exposure Measurements of Multi-walled Carbon Nanotubes during Production, Power Sawing, and Testing of Epoxy-Based Nanocomposites
- 2022
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Ingår i: Annals of Work Exposures and Health. - : Oxford University Press (OUP). - 2398-7308 .- 2398-7316. ; 66:7, s. 878-894
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Tidskriftsartikel (refereegranskat)abstract
- The use of manufactured nanomaterials is increasing globally. Although multi-walled carbon nanotubes (CNTs) are used in a wide range of applications, only limited data are available on emissions and exposures during CNT composite production. No exposure data using portable aethalometers in the personal breathing zone (PBZ) to monitor occupational exposure to CNTs have yet been published. The aim of this study was to characterize emissions of and exposures to CNTs during CNT composite production, sawing, and shear testing. We also investigated whether real-time aethalometer measurements of equivalent black carbon (eBC) could be used as a proxy filter sampling of elemental carbon (EC). The presence of CNTs as surface contamination in the production facility was monitored since this could contribute to airborne exposure.Methods: During CNT composite production in an industrial setting including both chemical and manufacturing laboratories, different work tasks (WTs) were studied with a combination of directreading instruments (aethalometer, aerodynamic particle sizer, condensation particle counter) and filter-based methods. Measurements were performed to monitor concentrations in the emission zone (EZ), PBZ, and background zone. The filter samples were analysed for EC and fibre concentration of CNTs using scanning electron microscopy (SEM). Additionally, surfaces in the facility were tape sampled for monitoring of CNT contamination, and analysed with SEM.Results: Clear eBC peaks were observed in the PBZ during several WTs, most clearly during open handling of CNT powder. Power sawing emitted the highest particle number concentration in the EZ of both nanoparticles and coarse particles, but no individual airborne CNTs, agglomerates, or aggregates were detected. Airborne CNTs were identified, for example, in a filter sample collected in the PBZ of a worker during mixing of CNT epoxy. The airborne CNT particles were large agglomerates which looked like porous balls in the SEM images. Significant EC exposures were found in the inhalable fraction while all respirable fractions of EC were below detection. The highest inhalable EC concentrations were detected during the composite production. No significant correlation was found between inhalable EC and eBC, most likely due to losses of large EC containing particles in the sampling lines and inside the eBC monitor. In total, 39 tape samples were collected. Surface contamination of CNTs was detected on eight surfaces in the chemical and manufacturing laboratories, mainly in the near-field zone. Elongated CNT-like features were detected in the sawdust after sawing of CNT composite.Conclusions: Characterization of a workplace producing CNT composite showed that open handling of the CNT powder during weighing and mixing of CNT powder material generated the highest particle emissions and exposures. The portable direct-reading aethalometer provided time-resolved eBC exposure data with complementary information to time-integrated EC filter samples by linking peak exposures to specific WTs. Based on the results it was not possible to conclude that eBC is a good proxy of EC. Surface contamination of CNTs was detected on several surfaces in the near-field zone in the facility. This contamination could potentially be resuspended into the workplace air, and may cause secondary inhalation exposure.
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| 5. |
- Isaxon, Christina, et al.
(författare)
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Workplace Emissions and Exposures During Semiconductor Nanowire Production, Post-production, and Maintenance Work
- 2020
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Ingår i: Annals of Work Exposures and Health. - : Oxford University Press (OUP). - 2398-7308 .- 2398-7316. ; 64:1, s. 38-54
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundNanowires are a high-aspect-ratio material of increasing interest for a wide range of applications. A new and promising method to produce nanowires is by aerotaxy, where the wires are grown in a continuous stream of gas. The aerotaxy method can grow nanowires much faster than by more conventional methods. Nanowires have important properties in common with asbestos fibers, which indicate that there can be potential health effects if exposure occurs. No conclusive exposure (or emission) data from aerotaxy-production of nanowires has so far been published.MethodsDifferent work tasks during semiconductor nanowire production, post-production, and maintenance were studied. A combination of direct-reading instruments for number concentration (0.007–20 µm) and filter sampling was used to assess the emissions (a couple of centimeter from the emission sources), the exposure in the personal breathing zone (max 30 cm from nose–mouth), and the concentrations in the background zone (at least 3 m from any emission source). The filters were analyzed for metal dust composition and number concentration of nanowires. Various surfaces were sampled for nanowire contamination.ResultsThe particle concentrations in the emission zone (measured with direct-reading instruments) were elevated during cleaning of arc discharge, manual reactor cleaning, exchange of nanowire outflow filters, and sonication of substrates with nanowires. In the case of cleaning of the arc discharge and manual reactor cleaning, the emissions affected the concentrations in the personal breathing zone and were high enough to also affect the concentrations in the background. Filter analysis with electron microscopy could confirm the presence of nanowires in some of the air samples.ConclusionsOur results show that a major part of the potential for exposure occurs not during the actual manufacturing, but during the cleaning and maintenance procedures. The exposures and emissions were evaluated pre- and post-upscaling the production and showed that some work tasks (e.g. exchange of nanowire outflow filters and sonication of substrates with nanowires) increased the emissions post-upscaling.
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| 6. |
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| 7. |
- Lovén, Karin, et al.
(författare)
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Characterization of airborne particles from cleaning sprays and their corresponding respiratory deposition fractions
- 2019
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Ingår i: Journal of Occupational and Environmental Hygiene. - : Informa UK Limited. - 1545-9624 .- 1545-9632. ; 16:9, s. 656-667
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Tidskriftsartikel (refereegranskat)abstract
- Cleaning workers are exposed to many risk factors, including handling of cleaning products. Epidemiological studies show that they have a high incidence of asthma and other respiratory symptoms. Some studies have indicated an even higher incidence of asthma in individuals using cleaning sprays regularly. It is known that sprays produce an aerosol that can expose the respiratory system to chemicals. Knowledge of the physical characteristics of the airborne particles, as well as the characteristics of the gas phase, is needed to determine how they affect the respiratory tract and why they cause airway symptoms. The aim of this study was to characterize the aerosols from seven different ready-to-use trigger cleaning sprays in terms of total airborne mass fraction, particle size distribution, and new particle formation from ozone reactions. An additional aim was to calculate the respiratory deposition fraction of the measured particles. The total airborne mass fraction was determined by comparing the mass deposited on the chamber wall with the mass emitted from the bottle during spraying. Particle number concentration and size distribution of the airborne particles were measured using an aerodynamic particle sizer and a fast aerosol mobility size spectrometer. The total airborne mass fraction was between 2.7% and 32.2% of the mass emitted from the bottle, depending on the product. Between 0.0001% and 0.01% of the total airborne mass fraction consisted of residual particles. However, these particles had a mass median aerodynamic diameter between 1.9 µm and 3.7 µm, constituting a total respiratory deposition of up to 77%. New particle formation in the presence of ozone was also shown to vary between 5,000 cm−3 and 35,000 cm−3 depending on the product, in the studied settings. These findings confirm that a substantial part (up to 1/3) of the mass sprayed from the bottle does not reach the intended surface. Thus, the use of cleaning sprays can result in chemical airway exposure, with particles in the relevant size range for both nasal and alveolar deposition.
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| 8. |
- Lovén, Karin, et al.
(författare)
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Effects of cleaning spray use on eyes, airways, and ergonomic load
- 2023
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundCleaning workers are exposed to chemicals and high physical workload, commonly resulting in airway problems and pain. In this study the response in the upper airways and the physical workload following airborne and ergonomic exposure of cleaning spray was investigated.MethodsA survey was answered by professional cleaning workers to investigate their use of cleaning sprays and the perceived effects on eyes, airways and musculoskeletal pain. A human chamber exposure study was then conducted with 11 professional cleaning workers and 8 non-professional cleaning workers to investigate the airborne exposure, acute effects on eyes and airways, and physical load during cleaning with sprays, foam application and microfiber cloths premoistened with water. All cleaning products used were bleach, chlorine, and ammonia free. The medical assessment included eye and airway parameters, inflammatory markers in blood and nasal lavage, as well as technical recordings of the physical workload.ResultsA high frequency of spray use (77%) was found among the 225 professional cleaning workers that answered the survey. Based on the survey, there was an eight times higher risk (p < 0.001) of self-experienced symptoms (including symptoms in the nose, eyes and throat, coughing or difficulty breathing) when they used sprays compared to when they cleaned with other methods. During the chamber study, when switching from spray to foam, the airborne particle and volatile organic compound (VOC) concentrations showed a decrease by 7 and 2.5 times, respectively. For the whole group, the peak nasal inspiratory flow decreased (-10.9 L/min, p = 0.01) during spray use compared to using only water-premoistened microfiber cloths. These effects were lower during foam use (-4.7 L/min, p = 0.19). The technical recordings showed a high physical workload regardless of cleaning with spray or with water.ConclusionSwitching from a spraying to a foaming nozzle decreases the exposure of both airborne particles and VOCs, and thereby reduces eye and airway effects, and does not increase the ergonomic load. If the use of cleaning products tested in this study, i.e. bleach, chlorine, and ammonia free, cannot be avoided, foam application is preferable to spray application to improve the occupational environment.
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| 9. |
- Lovén, Karin, et al.
(författare)
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Emissions and exposures of graphene nanomaterials, titanium dioxide nanofibers, and nanoparticles during down-stream industrial handling
- 2021
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Ingår i: Journal of Exposure Science & Environmental Epidemiology. - : Springer Science and Business Media LLC. - 1559-064X .- 1559-0631. ; 31:4, s. 736-752
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Tidskriftsartikel (refereegranskat)abstract
- Today, engineered nanomaterials are frequently used. Nanosized titanium dioxide (TiO2) has been extensively used for many years and graphene is one type of emerging nanomaterial. Occupational airborne exposures to engineered nanomaterials are important to ensure safe workplaces and to extend the information needed for complete risk assessments. The main aim of this study was to characterize workplace emissions and exposure of graphene nanoplatelets, graphene oxide, TiO2 nanofibers (NFs) and nanoparticles (NPs) during down-stream industrial handling. Surface contaminations were also investigated to assess the potential for secondary inhalation exposures. In addition, a range of different sampling and aerosol monitoring methods were used and evaluated. The results showed that powder handling, regardless of handling graphene nanoplatelets, graphene oxide, TiO2 NFs, or NPs, contributes to the highest particle emissions and exposures. However, the exposure levels were below suggested occupational exposure limits. It was also shown that a range of different methods can be used to selectively detect and quantify nanomaterials both in the air and as surface contaminations. However, to be able to make an accurate determination of which nanomaterial that has been emitted a combination of different methods, both offline and online, must be used.
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| 10. |
- Lovén, Karin
(författare)
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Exposing the Exposures : Assessing occupational aerosol exposures and their possible health and toxicological effects
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- According to the Global Burden of Disease study, occupational exposures to particulates, gases and fumes were responsible for 0.36 million deaths and 8.8 million disability-adjusted life years globally in 2015. This thesis focuses on two occupational groups that are at risk for developing adverse health effects from the time they spend in their working environments: cleaning workers and workers in the nanotechnology industry. For both of these occupational groups, who are affected by the introduction of new products into their occupational environments, knowledge is needed about the present exposure situations, as well as evaluations of the potential health and toxicological effects of these exposures.The overall aim of the research presented in this thesis was to provide a basis for the implementation of improvements of the working environments for these two occupational groups by addressing the research needs within them. Aerosol emissions and exposures present in the two occupational settings were characterized, and the potential health and toxicological effects that can possibly arise from these types of exposures were evaluated. Extensive methodological approaches were used, divided into the three overall categories of contextual information gathering, aerosol characterization, and health/toxicity assessment.To assess the working environment of cleaning workers, with a specific focus on the possible aerosol exposure generated during spray use, an initial phone inquiry of cleaning companies (n = 20) with a following survey among professional cleaning workers (n = 225) were conducted. Characterizations of the spray aerosol were performed with both off-line and on-line methods. A human chamber exposure study was then conducted to evaluate acute health effects due to the use of different cleaning methods.To assess the working environment in the nanotechnology industry, three different companies were studied. Contextual information was collected from the companies about the type of materials and processes they were handling. Workplace measurements were then conducted to characterize the current engineered nanomaterial (ENM) emission and exposure situations. Relevant toxicological assessments are also needed to evaluate the potential ENMs’ hazards. A comparative study of the toxicity of a common ENM assessed with different cell exposure systems was therefore carried out. The more advanced Nano Aerosol Chamber for In Vitro Toxicity (NACIVT) system was compared with two traditionally submerged toxicological exposure systems to understand the similarities and differences between them.Worker’s exposures could be determined within both occupations. We showed that the use of cleaning sprays results in an aerosol exposure, but with a large variety between different products. Between 2.7 and 32.2% of the liquid leaving the bottle during spraying remained airborne and could constitute potential airway exposure. We also showed that the nose was the part of the respiratory system most affected by spray use, but that switching to a foaming application method greatly reduced both the aerosol concentration and the observed negative health effects.At the nanotechnology companies, emissions and exposures were found from all three fibrous nanomaterials that were handled, foremost during the manual cleaning of the ENM production reactor and during the handling of both dry ENM powder and ENM-containing liquid. Comparing the different toxicological exposure systems revealed a higher sensitivity in the NACIVT system than the two traditionally submerged systems. This result encourages the use of more physiologically realistic cell exposure systems.The knowledge generated by the thesis research can be used to promote safe working environments. Exposure data together with hazard/toxicity information can be used to provide improved risk assessments. The comparison and evaluation of measurement techniques can be used in recommendations to occupational hygienists. The identification of processes that cause exposure events can be used by companies to implement suitable mitigation systems. All this can be done to achieve healthier workplace conditions!
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| 11. |
- Lovén, Karin, et al.
(författare)
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Size-resolved characterization of particles >10 nm emitted to air during metal recycling
- 2023
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Ingår i: Environment International. - : Elsevier Ltd. - 0160-4120 .- 1873-6750. ; 174
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Tidskriftsartikel (refereegranskat)abstract
- Background: In the strive towards a circular economy, metal waste recycling is a growing industry. During the recycling process, particulate matter containing toxic and allergenic metals will be emitted to the air causing unintentional exposure to humans and environment. Objective: In this study detailed characterization of particle emissions and workplace exposures were performed, covering the full size range from 10 nm to 10 µm, during recycling of three different material flows: Waste of electrical and electronic equipment (WEEE), metal scrap, and cables. Methods: Both direct-reading instruments (minute resolution), and time-integrated filter measurements for gravimetric and chemical analysis were used. Additionally, optical sensors were applied and evaluated for long-term online monitoring of air quality in industrial settings. Results: The highest concentrations, in all particle sizes, and with respect both to particle mass and number, were measured in the WEEE flow, followed by the metal scrap flow. The number fraction of nanoparticles was high for all material flows (0.66–0.86). The most abundant metals were Fe, Al, Zn, Pb and Cu. Other elements of toxicological interest were Mn, Ba and Co. Significance: The large fraction of nanoparticles, and the fact that their chemical composition deviate from that of the coarse particles, raises questions that needs to be further addressed including toxicological implications, both for humans and for the environment. © 2023 The Authors
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| 12. |
- Lovén, Karin, et al.
(författare)
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Toxicological effects of zinc oxide nanoparticle exposure : an in vitro comparison between dry aerosol air-liquid interface and submerged exposure systems
- 2021
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Ingår i: Nanotoxicology. - : Taylor and Francis Ltd.. - 1743-5390 .- 1743-5404. ; 15:4, s. 494-510
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Tidskriftsartikel (refereegranskat)abstract
- Engineered nanomaterials (ENMs) are increasingly produced and used today, but health risks due to their occupational airborne exposure are incompletely understood. Traditionally, nanoparticle (NP) toxicity is tested by introducing NPs to cells through suspension in the growth media, but this does not mimic respiratory exposures. Different methods to introduce aerosolized NPs to cells cultured at the air-liquid-interface (ALI) have been developed, but require specialized equipment and are associated with higher cost and time. Therefore, it is important to determine whether aerosolized setups induce different cellular responses to NPs than traditional ones, which could provide new insights into toxicological responses of NP exposure. This study evaluates the response of human alveolar epithelial cells (A549) to zinc oxide (ZnO) NPs after dry aerosol exposure in the Nano Aerosol Chamber for In Vitro Toxicity (NACIVT) system as compared to conventional, suspension-based exposure: cells at ALI or submerged. Similar to other studies using nebulization of ZnO NPs, we found that dry aerosol exposure of ZnO NPs via the NACIVT system induced different cellular responses as compared to conventional methods. ZnO NPs delivered at 1.0 µg/cm2 in the NACIVT system, mimicking occupational exposure, induced significant increases in metabolic activity and release of the cytokines IL-8 and MCP-1, but no differences were observed using traditional exposures. While factors associated with the method of exposure, such as differing NP aggregation, may contribute toward the different cellular responses observed, our results further encourage the use of more physiologically realistic exposure systems for evaluating airborne ENM toxicity. © 2021 The Author(s).
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| 13. |
- Malmborg, Vilhelm, et al.
(författare)
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Aerosol formation and emissions from realistic compartment fires
- 2022
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Ingår i: ; , s. 10-10
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Konferensbidrag (refereegranskat)abstract
- Firefighters are occupationally exposed to a large number of toxic compounds (IARC 2010). The occupational exposure of firefighters has been classified as potentially carcinogenic (class 2B, IARC; (Straif K. et al. 2007)). Poorly quantified emission factors and low understanding of when various aerosol emissions are likely to form during a fire event (initiation, combustion, extinguishing) inhibit efforts to reduce exposure by interventions to the firefighting strategy. The study was designed to evaluate firefighters’ exposure to air pollutants and to allow identification of how aerosol emissions respond to burning conditions and interventions of the firefighting. The study was conducted at the MSB firefighter training facility in Revinge outside Lund, Sweden. Eight small (5x3x2 m) sheds were built to imitate small compartment environments: apartment, bedroom, workshop, etc. These sheds were ignited under realistic fire scenarios (e.g., accident, arson) and later used for training new fire investigators (forensic police). Firefighter students and teachers monitored and extinguished the fires in similar procedures to real fire events. A supervisor monitored the combustion conditions, allowing or restricting fresh-air flow into the fire by opening or closing of the main door.Fire emissions were extracted from the fire through a 10 m (Ø 6 mm) stainless steel pipe, diluted ~1:50 with HEPA and active charcoal filtered air. The diluted emissions were monitored with a battery of aerosol monitoring instruments. Instrumentation included an aerosol mass spectrometer (Aerodyne SP-AMS, Billerica USA), an aethalometer (AE33, Magee Sci. USA), a differential mobility spectrometer (DMS500, Cambustion, UK), CO2 monitor (LI-COR, USA), and a NO/NO2 monitor (2BTech, USA). Complementary background measurements were positioned downwind or sidewind of the fires. With this equipment we collected data with the aim to resolve relationships between combustion conditions and pollution formation during different phases of a fire response. The results showed that total particle mass (PM1) emissions correlated with CO2 emissions and thus fire intensity. The emissions were speciated according to equivalent black carbon (eBC), organic aerosol (OA) and polycyclic aromatic hydrocarbon (PAH) derived from AMS data. When speciated, different particle emissions were found to depend on activities of the firefighting and the supervisor responsible for allowing or restricting fresh air into the combustion environment. Most evidently, we found that restricting the access to O2 by closing the door resulted in a sharp increase of OA and even more pronounced, PAH. PAH increased by several orders of magnitude, suggesting that PAH exposure-risks may increase drastically when fires become under-ventilated. Extinguishing the fire with water quickly decreased all particle emissions. The results described are illustrated in Figure 1.Further analysis involves additional off-line analyses, derivation of emission factors, time-resolved speciated emission analysis and evaluation of relationships between emissions, burning conditions and firefighting strategies.
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| 14. |
- Nosratabadi, Ali Reza, 1964-, et al.
(författare)
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Airway contraction and cytokine release in isolated rat lungs induced by wear particles from the road and tire interface and road vehicle brakes
- 2023
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Ingår i: Inhalation Toxicology. - : Taylor & Francis. - 0895-8378 .- 1091-7691. ; 35:13-14, s. 309-323
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Tidskriftsartikel (refereegranskat)abstract
- The dominant road traffic particle sources are wear particles from the road and tire interface, and from vehicle brake pads. The aim of this work was to investigate the effect of road and brake wear particles on pulmonary function and biomarkers in isolated perfused rat lungs. Particles were sampled from the studded tire wear of three road pavements containing different rock materials in a road simulator; and from the wear of two brake pad materials using a pin-on-disk machine. Isolated rat lungs inhaled the coarse and fine fractions of the sampled particles resulting in an estimated total particle lung dose of 50 μg. The tidal volume (TV) was measured during the particle exposure and the following 50 min. Perfusate and BALF were analyzed for the cytokines TNF, CXCL1 and CCL3. The TV of lungs exposed to rock materials was significantly reduced after 25 min of exposure compared to the controls, for quartzite already after 4 min. The particles of the heavy-duty brake pads had no effect on the TV. Brake particles resulted in a significant elevation of CXCL1 in the perfusate. Brake particles showed significant elevations of all three measured cytokines, and quartzite showed a significant elevation of TNF in BALF. The study shows that the toxic effect on lungs exposed to airborne particles can be investigated using measurements of tidal volume. Furthermore, the study shows that the choice of rock material in road pavements has the potential to affect the toxicity of road wear PM10.
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| 15. |
- Ottosson, Barbro, et al.
(författare)
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Patient satisfaction after expenditure cutback and intervention to improve nursing care at a surgical clinic. At two-year follow-up.
- 1997
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Ingår i: International Journal for Quality in Health Care. - : Oxford University Press (OUP). - 1464-3677 .- 1353-4505. ; 9:1, s. 43-53
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Tidskriftsartikel (refereegranskat)abstract
- Between 1991 and 1994 the number of beds in the surgical clinic at a central hospital in Southern Sweden was cut back by almost 50%. To develop the nursing care and to control the effects of the budgetary cuts, an intervention, including nursing care development, of an organization that would secure continuity in the nurse-patient relationship, individually planned care and quality assurance for aspects believed to be crucial to the quality of nursing care was implemented. The aim of this study was to analyse patients’ satisfaction with surgical nursing care between, under and after the last cut in expenditure and the concluded intervention. A patient satisfaction questionnaire covering such areas as: patient satisfaction with information and decisionmaking; patient satisfaction with contact and the staff-patient relationship; patient satisfaction with ward facilitles and the physical treatment or examination and patient satisfaction with various other aspects of care, was administered (1993 {pi}=131; 1994 {pi}=128). Subsample analysis showed lower scores for patient satisfaction if the respondents were women, young, or acutely ill when admitted. While surveys carried out between 1991 and 1993 showed an overall improvement in the quality of care, as measured by patient satisfaction, it remained at the same level in 1994 as in 1993, or decreased, regarding patient contacts with staff and physicians, involvement in decision-making, anxiety before examination/treatment, anxiety regarding professional secrecy, opportunity to influence the solution to their physical problems, chance to get sleep without being disturbed, physical nursing care and preparations before discharge. Thus a deterioration in quality seemed to take place in 1994 indicating that the cuts in expenditure may have been too hard and had been made at the expense of patient satisfaction.
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| 16. |
- Ottosson, Barbro, et al.
(författare)
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Patients' satisfaction with surgical care impaired by cuts in expenditure and after interventions to improve nursing care at a surgical clinic
- 1997
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Ingår i: International Journal for Quality in Health Care. - : Oxford University Press (OUP). - 1353-4505 .- 1464-3677. ; 9:1, s. 43-53
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Tidskriftsartikel (refereegranskat)abstract
- Between 1991 and 1994 the number of beds in the surgical clinic at a central hospital in Southern Sweden was cut back by almost 50%. To develop the nursing care and to control the effects of the budgetary cuts, an intervention, including nursing care development, of an organization that would secure continuity in the nurse-patient relationship, individually planned care and quality assurance for aspects believed to be crucial to the quality of nursing care was implemented. The aim of this study was to analyse patients' satisfaction with surgical nursing care between, under and after the last cut in expenditure and the concluded intervention. A patient satisfaction questionnaire covering such areas as: patient satisfaction with information and decision-making; patient satisfaction with contact and the staff-patient relationship; patient satisfaction with ward facilities and the physical treatment or examination and patient satisfaction with various other aspects of care, was administered (1993 n = 131; 1994 n = 128). Subsample analysis showed lower scores for patient satisfaction if the respondents were women, young, or acutely ill when admitted. While surveys carried out between 1991 and 1993 showed an overall improvement in the quality of care, as measured by patient satisfaction, it remained at the same level in 1994 as in 1993, or decreased, regarding patient contacts with staff and physicians, involvement in decision-making, anxiety before examination/treatment, anxiety regarding professional secrecy, opportunity to influence the solution to their physical problems, chance to get sleep without being disturbed, physical nursing care and preparations before discharge. Thus a deterioration in quality seemed to take place in 1994 indicating that the cuts in expenditure may have been too hard and had been made at the expense of patient satisfaction.
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