Future Environment Designs Training Center specializes in asbestos, indoor air quality, industrial hygiene, and occupational safety training programs. We offer New York State asbestos and mold certification courses. We design, develop, and maintain the various indoor air quality, asbestos, and safety programs that are Keeping Your Employees Safe.
As an industrial hygienist, we found this book a fascinating read. So you can understand why we say "as an industrial hygienist" let's discuss what industrial hygiene is. "Industrial Hygiene (IH) is a science and art devoted to the anticipation, recognition, evaluation, control, and confirmation of protection from those environmental factors or stresses arising in or from the workplace which may cause sickness, impaired health, and well-being, or significant discomfort among workers or among citizens of the community." To learn more about IH click here.
Air Quality Sampling tools for the IH
Since the COVID-19 pandemic has been the most significant environmental factor of modern times it was interesting to read the number of meetings and the decisions made. The book goes through discussions with many of the people making the decisions during COVID and was interesting how then Vice President Mike Pence understood the need to let the scientists do their job. The section of the book covering how vaccinations work especially these newer mRNA vaccines and how they help the immune system repel invaders was informational and understandable.
Part 2 of the book, gives common sense recommendations for becoming pandemic-proof. Becoming pandemic P.R.O.O.F. is actually an acronym for:
P - Plan ahead.
R - Rethink and rewire risk in your brain.
O - Optimize health.
O - Organize Family
F - Fight for the future of us.
Obviously, part 2 goes into each of these giving recommendations. These recommendations came from the "hundreds of hours of the writer's conversations with experts from all disciplines of our society." Some of these recommendations are for our country but others are recommendations many of us could put into place for ourselves. One of our favorite chapters was the chapter on "Rethink and Rewire Risk in Your Brain." Obviously, at the beginning of this pandemic, very few of us had the knowledge of how to evaluate the risk involved. But now we do. The section specifically on avoiding traps was very interesting because of how many of us have these traps and how many friends and clients when discussing COVID had these traps.
If you're into reading readable scientific books we recommend reading this one.
It only took the United States Senate 1747 days to confirm a new head of the Occupational Safety and Health Administration (OSHA). OSHA has been without a head since January 2017. President Joseph Biden nominatedMr. Doug Parker on April 9, 2021, and the Senateconfirmed him on October 25, 2021. We have to remember that former President Donald Trunp nominated Scott Mugno in October 2017, but Mr. Mugno withdrew in May 2019 after waiting for 19 months for the Senate to confirm him.
Mr. Doug Parker, Assistant Secertary to OSHA
Mr. Parker had his Senateconfirmation hearing held on May 27. Obviously, many of the questions posed to Mr. Parker were related to the pandemic and the soon to be released OSHAemergency temporary standard regarding protecting workers from COVID-19 for General Industry.
Mr. Parker has served as the head of California Division of Occupational Safety and Health (CAL/OSHA) since September 2019. In his confirmation hearing he defended CAL/OSHA'semergency temporary standard on COVID-19 and strongly defended OSHA's plans for a new emergency temporary standard. Currently, OSHA'semergency temporary standard for COVID-19 only applies to healthcare and healthcare support service workers.
It is obvious from his experince at CAL/OSHA and other similar safety-related organizations he has the skill set and leadership abilities to be the new head at OSHA.
We recently read two articles in The Atlantic called "Why Are Americans Still - Still! - Wearing Cloth Masks?" and "Why Aren't We Wearing Better Masks?" and another in Scientific American called "Why We Need to Upgrade Our Face Masks - and Where to Get Them". All three articles discuss why Americans are still wearing cloth face-coverings now that N95 respirators (or the KN95 respirators, these respirators are made in China and are not approved by the National Institute of Occupational Safety and Health (NIOSH)) are more readily available (The NIOSH Science Blog discusses the roles NIOSH, Occupational Safety and Health Administration (OSHA) and the Food and Drug Administration (FDA) play regarding respiratory protection). The articles mention a new study not peer-reviewed yet from Bangladesh which claims that wearing surgical masks decrease COVID-19 symptoms and antibodies by 11.2 percent, while cloth masks only led to a 5 percent decrease. It proceeds to give several reasons why we continue to use face-coverings from public-health agencies not prioritizing surgical masks and N95 respirators to price to supporting one's sports team. Two of the articles describe how face-coverings are far better than nothing and also saying how cloth masks are more eco-friendly (The Covid Crisis Is Now a Garbage Crisis, Too) giving face-coverings a backhanded credit for helping when nothing else was available. The articles, in my opinion, even support the notion that we should be buying KN95 respirators even though they are not approved by NIOSH. If anything shouldn't we be buying American-made N95 respirators so we can increase the demand and hence increase the supply of masks that are made here? This was the subject of a New York Times article "Can't Find an N95 Mask? This Company Has 30 Million That It Can't Sell" and the Washington Post article "In the early days of the pandemic, the U.S. government turned down an offer to manufacture millions of N95 masks in America."
Let us first say as a person, who believes in the use of respirators and their importance in protecting individuals from exposure to hazardous substances (see all our posts regarding 9/11), we agree that N95 respirators or surgical masks would protect people better from SARS-CoV-2 than cloth face-coverings if worn correctly. However, we would need to be able to provide each person N95 respirators (in their size either small, medium, or large) or surgical masks, make sure they had a sufficient supply to meet their needs, make sure the N95 respirator fits each person, make sure they understand how to wear the N95 respirator or surgical masks correctly, and finally, they are provided a means of disposal for the respirators or the surgical masks. As you can imagine that would be a significant cost to the government (or tax-payers) and would require a significant undertaking to make sure every American would be protected by using N95 respirators or surgical masks. Meanwhile, the biggest issue is whether we are talking N95 respirators, surgical masks, or face coverings they must be worn correctly to protect you, and remember facial hair reduces the effectiveness of all these face coverings. See the chart below for various ways of improperly using face coverings. The Centers for Disease Control and Prevention (CDC) website "Types of Masks and Respirators" was updated as of September 23, 2021, and provides information on types of masks and when to wear them and now includes a section on considerations for children.
Both these articles treat surgical masks and N95 respirators as simple items to wear and that anyone can wear them. However, this is not a fact as we mentioned above N95 respirators require medical clearance, fit testing, and training all mandated by OSHA for individuals that are required to wear them. As for surgical masks, we have to remember the ones that are typically sold to the public aren't actually surgical masks. Surgical masks are cleared by the FDA, see the chart below for the difference between the N95 respirators and surgical masks. Note that surgical masks do not provide the wearer with a reliable level of protection from inhaling smaller airborne particles. This is for FDA-cleared surgical masks, which means the ones the public purchases probably aren't reliable either considering they are not cleared by FDA.
Surgical Masks vs N95 respirators
However, the use of cloth face-coverings has been shown to reduce the emission of virus-laden droplets (source control) and help reduce inhalation of these droplets. The CDC website "Use of Cloth Masks to Control the Spread of SARS-CoV-2" which was last updated on May 7, 2021, provides some significant research on how the use of cloth face-coverings block the transmission of respiratory droplets with some face-coverings performing on par with surgical masks as barriers for source control. In the section "Human Studies of Masking and SARS-CoV-2 Transmission" data regarding the "real-world" effectiveness of community masking is limited to observational and epidemiological studies with many of these showing significant levels of protection from wearing face coverings. An example of one of these was "A study of an outbreak aboard the USS Theodore Roosevelt, an environment notable for congregate living quarters and close working environments, found that use of face coverings on-board was associated with a 70% reduced risk of transmission.
Note the circled area of the package (which means they are not surgical masks).
It is our opinion, one of the main reasons face-coverings are better is because they are easier to use, easier to breathe through, light-weight, and because of these things more likely to be used and used correctly. Wearing the face-covering correctly and using the face covering is what is helping reduce transmission of SARS-CoV-2. So follow the CDC guidelines on when to use face-coverings and let's stop the spread!
New York State Governor Andrew Cuomo announced that public schools can decide to open as long as they are in a region where the average rate of positive coronavirus tests is below 5 percent over a two-week period. To read Governor Cuomo's announcement click here. It is interesting to note that still means School Districts will have to figure out how to open, handle busing, and all the other parts of the schooling process. There is plenty of information that indicates that children are very efficient spreaders of viruses. Forbes magazine recently published an article "New Evidence Suggests Young Children Spread Covid-19 More Efficiently Than Adults", which is about two studies, one published in The Journal of the American Medical Association (JAMA) and the other is a pre-print manuscript awaiting peer-review. The JAMA study shows young children who have mild to moderate Covid-19 symptoms have 10 to 100 times as much SARS-CoV-2 in the nasopharynx as older children and adults. The other study showed that children age 14 and younger risk of transmitting Covid-19 was 22.4 percent—more than twice that of adults aged 30 to 49, whose rate of contagiousness was about 11 percent. As an industrial hygienist and a certified indoor environmental consultant, we believe school administration/boards of education need to use some basic industrial hygiene and indoor air quality principles to open safely. It will mean that quite a few things need to change to be able to keep students, teachers, and staff safe. Like any basic industrial hygiene problem, we should use the hierarchy of controls to protect workers by reducing the potential exposure to SARS-CoV-2.
Hierarchy of Control Methods
The first hierarchy of control is the elimination or the substitution of the hazard. This control is about prevention if we can eliminate the exposure then we eliminate the hazard. So if we can make sure individuals with Covid-19 do not attend school we can eliminate the exposure. To accomplish this most facilities are doing a combination of questionnaires and temperature taking to ensure people who are sick stay home and out of the workplace. However, this does not capture asymptomatic individuals who can also spread SARS-CoV-2. A recent study discussed in STAT's article "Fever checks are a flawed way to flag Covid-19 cases", indicated that Covid-19 patients were 27 times more likely than others to have lost their sense of smell. But they were only 2.6 times more likely to have fever or chills, suggesting that anosmia (the loss of sense of smell) produces a clearer signal and may, therefore, be a better Covid-19 catching net than fever. The idea of using a smell test is supported by a USA Today article "Why do so many COVID-19 patients lose their sense of smell? Scientists now know." Testing to determine if an individual has lost their sense of smell can be done in several ways (for example, having a person smell a scratch-and-sniff card and pick the correct odor out of four choices) with the gold standard being the University of PennsylvaniaSmell Identification Test called UPSIT. The scents are released by scratching the microencapsulated scents with a pencil. The test taker has a choice of 4 answers for each and the test takes 10 to 15 minutes. This would prevent individuals from entering the school and hence eliminate the hazard. Unfortunately, it doesn't totally eliminate the hazard. So we must add additional controls to continue to reduce the exposure.
SARS-CoV-2
The next level of control would be engineering controls. According to the Environmental Protection Agency (EPA)'s website "Indoor Air and Coronavirus (COVID-19)" there is growing evidence that the SARS-CoV-2 remains airborne in indoor environments for hours, potentially increasing in concentration over time. Due to this evidence, we would use the engineering controls ventilation (bringing fresh air from outside) and air filtration (removing the virus from the air inside the building) to reduce the potential exposure to SARS-CoV-2. The purpose of the heating ventilation and air conditioning (HVAC) system of a building is to bring fresh air from outside the building to dilute the contaminants that may build-up in a building. Humans produce CO2 and body odor plus other contaminants (i.e., moisture, if we're sick viruses & bacteria) and other processes in the building produce other contaminants (i.e., cleaning chemicals, copiers, uncontrolled moisture can produce mold, etc.). The HVAC system should be designed to reduce these contaminants and provide a certain amount of fresh air per person in the building. When we are concerned about the indoor air quality (IAQ) of a space we use carbon dioxide (CO2) as an indicator of how well the ventilation system is ventilating a space. In other words how well the ventilation system, is reducing the contaminants in the space. The American Society of Heating, Refrigeration, Air-Conditioning Engineers (ASHRAE) publishes a standard 62.1-2010 "Ventilation for Acceptable Indoor Air Quality" as a guideline for determining acceptable IAQ (for the purposes of comfort). This guideline recommends maintaining CO2 levels in a space no greater than 700 parts per million (ppm) above outdoor air levels. However, a recent article in The Conversation titled "How to use ventilation and air filtration to prevent the spread of coronavirus indoors" discusses research that showed the effects of ventilation on a tuberculosis outbreak at Taipei University. The study showed when engineers improved air circulation in the rooms and got the CO2 levels in the rooms reduced to under 600 ppm (from above 3,000 ppm) the outbreak stopped. This shows that if we use CO2 detectors in rooms to ensure the rooms are properly ventilated and we can keep CO2 levels below 600 ppm we have a better chance of reducing transmission of the virus in these rooms. The same article also discusses using air cleaners for air filtration there are several items to understand when using air cleaners. First, you want an air cleaner that has a high-efficiency particulate air filter (HEPA) that is capable of filtering the particles at 99.97% of all particles at 5 microns and greater. The next thing to consider is how powerful it is and finally how reliable are its claims. The Conversation article provides some excellent links for the Association of Home Appliance Manufacturers (AHAM) that certifies air cleaners and a Harvard-Colorado University Boulder Air Cleaner Calculator for Schools tool for helping to decide the best air cleaner for a particular classroom. This too may not completely eliminate the hazard so we will have to go to the next control - Administrative and work practice controls.
According to The Centers for Disease Control and Prevention (CDC)'s website "How COVID-19 Spreads" the virus is thought to spread mainly from person-to-person:
Between people who are in close contact with one another (within about 6 feet).
Through respiratory droplets produced when an infected person coughs, sneezes, or talks.
These droplets can land in the mouths or noses of people who are nearby or possibly inhaled into the lungs.
COVID-19 may be spread by people who are not showing symptoms.
It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes. This is not thought to be the main way the virus spreads.
Administrative controls to reduce this exposure would include social distancing, surface cleaning and disinfecting, and handwashing (we discussed handwashing in our blog post regarding Future Environment Design's Pandemic Policy). The CDC website "Strategies for Protecting K-12 School Staff from COVID-19" has a lot of information and resources on handling social distancing, and surface cleaning and disinfecting for schools for everything including sports, music, and busing. Another idea some schools are considering is holding in-person classes outdoors. An article in the magazine Fast Company titled "Inside the Quest to Reopen Schools-By Moving Classes Outside" discusses the work of the nonprofit organization called Green Schoolyards America. Green Schoolyards America with other organizations has created the National COVID-19 Outdoor Learning Initiative which has been working with schools to create outdoor learning spaces. This is an outgrowth from a webinar held on June 4, 2020, entitled "Outdoor Spaces as Essential Assets for School Districts's COVID-19 Response".
The final level of control would be personal protective equipment (PPE). Though face coverings are not truly considered PPE but for the purposes of public health and the fact we want the person to wear something, we will take the liberty to consider it this level of control which is the last and least effective control.
Face Covering, not a surgical mask
If you have read our previous blog post "Filtering Facepiece Respirator or a Dust Mask or N95 Respirator versus a Surgical Mask" on the difference between N95 respirators/filtering facepieces/dust masks vs surgical masks. You know there is a big difference between surgical masks and N95 respirators. In our blog post, we mentioned face coverings but there still seems to be some confusion. We blame the media for not using consistent wording or terminology. They go back and forth utilizing the wording face coverings and masks. A face covering is not a mask (though they are now making things that look like a surgical mask but specifically say not for medical use (see picture above), which tells you that it is not a surgical mask but just a face covering). The Occupational Safety and Health Administration (OSHA) has a website devoted to "COVID-19 Frequently Asked Questions". This website has some basic points regarding cloth face coverings:
May be commercially produced or improvised (i.e., homemade) garments, scarves, bandanas, or items made from t-shirts or other fabrics.
Are worn in public over the nose and mouth to contain the wearer's potentially infectious respiratory droplets produced when an infected person coughs, sneezes, or talks and to limit the spread of SARS-CoV-2, the virus that causes Coronavirus Disease 2019 (COVID-19), to others.
Are not considered personal protective equipment (PPE).
Will not protect the wearer against airborne transmissible infectious agents due to loose fit and lack of seal or inadequate filtration.
Are not appropriate substitutes for PPE such as respirators (e.g., N95 respirators) or medical face masks (e.g., surgical masks) in workplaces where respirators or face masks are recommended or required to protect the wearer.
May be used by almost any worker, although those who have trouble breathing or are otherwise unable to put on or remove a mask without assistance should not wear one.
By using the hierarchy of controls we discussed above, schools could open to in-person schooling. But these are significant changes to the way schools have been run for years. The question really is does the school have the resources to change and can it adapt to these changes. Very tough questions for administrators, teachers, and parents, and students.
Future Environment Designs is proud to announce the development of several new e-learning and virtual training courses. The first virtual training course is this Friday, May 1, 2020, at 10 AM. We will be providing training on SARS-CoV-2 (coronavirus) the virus that causes Covid-19. This training course will include three modules covering Covid-19 awareness, Covid-19 Pandemic Response Plan, and Cleaning, Disinfecting, and Personal Protective Equipment (PPE) for SARS-CoV-2. Click here to register for this course. If you can't make the virtual learning course, we also created an e-learning Covid-19 course which also includes the three modules. Click here to register for the e-learning course. We created both courses to cover the Occupational Safety and Health Administration (OSHA) and the Centers for Disease Control (CDC) training requirements for workers that have the potential to be exposed to SARS-CoV-2.
SARS-CoV-2 (coronavirus)
We also created a four-hour e-learning course for bloodborne pathogens to meet the requirements of the OSHA bloodborne pathogen standard and NYS's Nassau County training requirement for the Environmental Hazard Remediation Contractors License. See our blog post for more on the Nassau County requirements. In addition, we created a Respirator Hierarchy course to try and clarify some of the confusion out there regarding respirators. You can register to take either of these e-learning courses or any of the other courses we created at https://futureenvironmentdesigns.com/online-courses.html. Also, remember if you take a number of training courses with Future Environment Designs the best value and price would be to sign-up for a training subscription at our patron page https://www.patreon.com/fedtc.
