Dissertationen zum Thema „National Institute for Occupational Safety and Health“

Thesis (MScEng) Stellenbosch University, 2014
ENGLISH ABSTRACT: This thesis brings together productivity and risk assessments through innovative design, development and evaluation of a unique system for retrieving and analysing data. In the past, although the link between them is well-documented, these assessments have largely been dealt with as separate antagonist entities. A broad evaluation of the existing traditional and technological support systems has been conducted to identify suitable methodologies along with a common technological platform for automation. The methodologies selected for the productivity and risk assessments were; work sampling and the revised NIOSH lifting equation respectively. The automation of these procedures is facilitated through computer vision and the use of a range imaging Kinect™ camera. The standalone C++ application integrates two tracking approaches to extract real-time positional data on the worker and the work-piece. The OpenNI and OpenCV libraries are used to perform skeletal tracking and image recognition respectively. The skeletal tracker returns positional data on specific joints of the worker, while the image recognition component, a SURF implementation, is used to identify and track a specific work-piece within the capture frame. These tracking techniques are computationally expensive. In order to enable real time execution of the program, Nvidia’s CUDA toolkit and threading building blocks have been applied to reduce the processing time. The performance measurement system is a continuous sampling derivative of work sampling. The speed of the worker’s hand movements and proximity to the work-piece are used to classify the worker in one of four possible states; busy, static, idle, or out of frame. In addition to the worker based performance measures, data relating to work-pieces are also calculated. These include the number of work-pieces processed by a specific worker, along with the average and variations in the processing times. The risk assessment is an automated approach of the revised NIOSH lifting equation. The system calculates when a worker makes and/or breaks contact with the work-piece and uses the joint locations from the skeletal tracker to calculate the variables used in the determination of the multipliers and ultimately the recommended weight limit and lifting index. The final calculation indicates whether the worker is at risk of developing a musculoskeletal disorder. Additionally the information provided on each of the multipliers highlights which elements of the lifting task contribute the most to the risk. The user-interface design ensures that the system is easy to use. The interface also displays the results of the study enabling analysts to assess worker performance at any time in real time. The automated system therefore enables analysts to respond rapidly to rectify problems. The system also reduces the complexity of performing studies and it eliminates human errors. The time and costs required to perform the studies are reduced and the system can become a permanent fixture on factory floors. The development of the automated system opens the door for further development of the system to ultimately enable more detailed assessments of productivity and risk.
AFRIKAANSE OPSOMMING: Produktiwiteit en risiko evaluerings word in hierdie tesis saam hanteer deur die innoverende ontwerp, ontwikkeling en evaluering van 'n unieke stelsel vir die meting en ontleding van data. Alhoewel die skakel tussen hulle goed gedokumenteer is, word hierdie evaluering as afsonderlike antagonistiese entiteite hanteer. 'n Breë studie van die bestaande tradisionele en tegnologiese ondersteuningstelsels is gedoen om toepaslike metodes te identifiseer, om 'n gemeenskaplike tegnologiese platform vir outomatisering daar te stel. Die metodes wat gekies is vir die produktiwiteit en risiko bepalings is onderskeidelik werk monsterneming en die hersiende NIOSH opheffing vergelyking. Die outomatisering van hierdie prosedures word gefasiliteer deur middel van rekenaar visie en die gebruik van 'n Kinect™ 3D kamera. Die selfstandige C++ program integreer ‘n dubbelvolgings benadering om in reële tyd posisionele data van die werker en die werk-stuk te kry. Die OpenNI en OpenCV biblioteke word onderskeidelik gebruik om skeletale volging en beeld erkenning uit te voer. Die skeletale volger bepaal posisionele data van spesifieke gewrigte van die werker, terwyl die beeld erkenning komponent, 'n SURF implementering gebruik om 'n spesifieke werk-stuk binne die opname raam te identifiseer en te volg. Hierdie volgings tegnieke is berekenings intensief. Om werklike tyd uitvoering van die program te verseker, is Nvidia se CUDA gereedskapstel en liggewig boublokke geimplementeer. Die produktiwiteit meting-stelsel is 'n aaneenlopende monsterneming benadering van werk monsterneming. Die spoed van die werker se handbewegings en nabyheid aan die werkstuk word gebruik om die werker te klassifiseer as in een van vier moontlike toestande; besig, staties, onaktief of buite die raam. Benewens die werker gebaseerde metings, word daar ook data oor werkstukke bereken. Dit sluit in die aantal werkstukke verwerk deur 'n spesifieke werker, sowel as die gemiddelde en variasie in verwerkings tye. Die risiko-berekening is 'n outomatiese benadering van die hersiende NIOSH opheffing vergelyking. Die stelsel bereken wanneer die werker kontak maak en/of breek met die werkstuk en maak gebruik van die gewrigsposisies wat die skeletale volger aandui om die veranderlikes wat in die vermenigvuldigers gebruik word te bepaal. Die vermenigvuldigers word gebruik om die aanbevole maksimum gewig en die opheffing indeks te bereken. Die opheffing indeks dui aan of daar ‘n risiko vir die werker is om muskuloskeletale versteuring te ontwikkel. Benewens dui die vermenigvuldigers aan watter elemente die grootste bydra tot die risiko van die opheffingstaak maak. Die gebruiker-koppelvlak-ontwerp verseker dat die stelsel maklik is om te gebruik. Die koppelvlak vertoon ook die resultate van die studie sodat ontleders op enige tyd werker prestasie kan evalueer in reële tyd. Die outomatiese stelsel stel dus ontleders in staat om vinnig te reageer sodat probleme reggestel kan word. Die stelsel verminder ook die kompleksiteit vir die uitvoering van studies en dit elimineer menslike foute. Die tyd en koste vereis om die studie te doen, word verminder en die stelsel kan ‘n permanente instelling op fabriekvloere geword. Die ontwikkeling van die outomatiese stelsel maak die deur oop vir verdere ontwikkeling van die stelsel om uiteindelik daartoe te lei dat meer gedetailleerde evaluering van produktiwiteit en risiko bepaal kan word.

The importance ascribed by a nation to the subject of occupational safety and health is reflective in the growth, sustainability and the national development of an economy. Besides the economic benefits stood to be derived from an occupational safety and health structure that is constantly nurtured, there is also the human rights issue. Less industrialised nations still grapple with fundamental challenges brought about by occupational health and safety, challenges which more advanced nations seem to effortlessly address. Nigeria falls into the former category, hence, the interest of this thesis. The knowledge of this menace has been in the consciousness of stakeholders in Nigeria particularly in the recent past years. However, no significant action has been taken to alleviate the situation. There are instruments that deal with the subject of occupational health and safety but they all seem to have their attendant issues which make them either inoperable or of insignificant benefit to the situation of workers in Nigeria. The tardy attitude of the Nigerian Law makers also does not help the situation. This thesis is therefore of the view that until the period the Nigerian Government is able to get its bearing right in designing a suitable piece of legislation that shall address the challenges caused by occupational health and safety, it is possible to seek an alternative approach that shall serve as a safety net towards the protection of workers particularly those that are most vulnerable. This alternative approach that the thesis proposes is the National Industrial Court of Nigeria (NICN), a Court that recently acquired the status of a superior court of record and conferred with extensive Constitutional powers over occupational safety and health matters amongst others. It is the anticipation of this thesis that the Court shall make a positive impact where legislation had failed to succeed in its bidding.

Auditing in health care has been recommended by many national organisations to improve patient safety and quality of care, despite inconclusive evidence to support its effectiveness. In South Africa, the National Core Standards for health establishments in South Africa (NCS) was published in 2011. The NCS recognises that staff are vital to ensuring that the health system delivers quality health care and therefore require protection against the risk of injury, infection and other occupational hazards, consistent with the South African Occupational Health and Safety act of 1993. The aim of this study was to determine: (a) the compliance of public sector primary healthcare (PHC) facilities with the NCS for occupational health and safety (OHS) and infection prevention and control (IPC), (b) the impact of the audits three years after baseline audits, at follow up self-assessment audits and (c) the reliability of self-assessment audits when compared to external audit results. This dissertation is divided in three parts. Part A is the study protocol which received ethics approval in March 2015. Part B is a structured literature review covering standards for health care, the impact and effectiveness of accreditation/certification/auditing in health care, interrater reliability and factors associated with OHS/IPC compliance. Previous studies have failed to address whether evaluating occupational health and safety or infection prevention and control standards using accreditation/certification in a primary healthcare, low and middle income setting is effective or reliable. Part C is the journal ready manuscript presenting the results of the study in the form of a manuscript for an article for a named peer reviewed journal. This was a cross-sectional study of NCS OHS/IPC audit data, with a longitudinal component, of a sample of public sector PHC facilities in the Western Cape province of South Africa between 2011 and 2015. Baseline PHC facility compliance with OHS/IPC measures was low. There was no significant improvement in compliance after three years. Poor inter-rater reliability indicates a large degree of measurement error. Practical implications of these results are the need to improve reliability of assessments and a process to convert low compliance scores into implemented improvement actions.

Introduction: Non-compliance with respiratory protection programs among firefighters may put them at increased risk of injury and illness from occupational exposures during fire extinguishing activities. This research aims to characterize respiratory protection practices among Florida firefighters. This information will allow better understanding of factors that are associated with non-compliance with respiratory protection guidelines.

Methods: Survey questionnaire was used to characterize Florida fire departments in this cross sectional study. Four hundred and seventy-seven surveys were administered to Florida firefighters both in person and electronically to collect information regarding firefighter knowledge and participation in their respective respiratory protection programs during the past twelve months. Survey questions were developed from the model set by the National Fire Protection Association which provides standards and regulations regarding firefighter protections. Collected data were used to produce summary statistics regarding firefighter department size, coverage area, and firefighter employment type. Further data analysis used Statistical Analysis Software to compute multinomial logistic regression analysis.

Results: The 477 respondents were 91% male with a mean age 39 years old (range 21–65 years). The majority of respondents, 76%, were non-smokers, 21% former smokers, and 3% current smokers. In regards to ethnicity, respondents were 77% Caucasian, 13% Hispanic, 3% African-American, and 4% other. Most respondents were career firefighters, 97%, with less than ten years of experience, 44%, working in a fire department with at least 21 firefighters, 98%. Most respondents, 80%, had a written respiratory program in place. The most cited reason for not having implemented a written respiratory program was lack of knowledge related to the program. Multinomial logistic regression analysis of departments with response areas of at least 250,000 square miles produced a statistically significant 0.44 odds ratio for having a written respiratory program as compared to those with a less than 10,000 square miles response area.

Conclusion: Additional resources need to be given to Florida fire departments to ensure that all firefighters receive adequate respiratory protection in accordance with National Fire Protection Association guidelines. There is an association between fire departments with large response areas and non-compliance with respiratory protection guidelines in regards to: having a written respiratory program, the frequency of respiratory fit testing, and the frequency of medical fitness testing. This suggests that rural fire departments need additional resources to ensure fire fighters are adequately protected. Additional research should focus on why these differences exist in the rural fire departments. Respondents stating a lack of knowledge or no requirement for a written respiratory program suggest that future efforts should focus on respiratory protection education and training.

As a theme for my Master's Thesis I chose the theme of problems which are connected with application of Occupational Safety and Health Protection principles in practice. The aim of the Master's Thesis is to outline possible problems which we could come across while implementing the Occupational Safety and Health Protection policy and to map a major part of important legal enactments covering sphere of Occupational Safety and Health Protection. The Master's Thesis is divided into two parts, theoretical and practical one. In the theoretical part I at first briefly outline historical development of legal regulation in the Czech Republic then I proceed to a summary and characteristics of the most important contemporary legal enactments whereas I don' t omit an European legal regulation and legal regulation within the framework of International Labour Organisation. Another important part of the theoretical part is devoted to national policy of occupational safety and health protection at work. In the practical part I present the Occupational Safety and Health Protection problematic in practice and I focus on training, analysis and risk classification and formation of risk register in company Hella Autotechnik, s.r.o.

The primary purpose of this study is to identify those people at most risk of being bullied at work. While much research is being conducted on school bullying, little has been conducted on workplace bullying. Using data gathered from a 2004 study conducted by the National Opinion Research Center for the General Social Survey, which included a Quality of Work Life (QWL) module for the National Institute for Occupational Safety and Health (NIOSH), linear regressions indicated significant findings. As predicted, workers in lower level occupations, as ranked by prestige scoring developed at National Opinion Research, are more likely to be victimized. Data also suggest that being young, Black, and relatively uneducated may contribute to being bullied in certain situations. Future research is needed to examine influences of socio-economic, legal, and other demographic factors that may predict the chance of being bullied.
M.A.
Department of Sociology
Sciences
Applied Sociology MA

The significance of risk is growing in many Western societies, a phenomenon linked to increasing individualism, personal choice, and outcome uncertainty in multiple spheres of life. Despite being healthier and more physically protected from harm than any previous society, a serious concern for safety and risk control is emerging as a defining characteristic of modern social life. Within the context of a risk-averse society, this thesis investigates the nature and relevance of risk in natural resource recreation and tourism settings. Millions of people every day visit national parks and other protected areas around the world in which natural hazards inhere. Many visitors fail to recognise these hazards, creating moral, legal, and ethical issues for natural resource managers. People travel to national parks anticipating a degree of adventure, to escape routines, and to witness the grandeur of nature. Ironically, the very qualities that attract people to natural areas may also put them at risk. Managers of natural resource tourism and recreation areas in New Zealand are confronted with a paradox born out of visitor demand for nature experiences, a legal obligation to facilitate free access, and a growing social emphasis on health and safety. In particular, this study assesses the risk perceptions of visitors to the Fox and Franz Josef glaciers, popular tourist attractions on the West Coast of New Zealand's South Island, and explores the risk perceptions and beliefs of resource management agency staff. The study also investigates the issue of risk communication at these two sites, and the degree to which existing hazard messages are successful at encouraging appropriate visitor behaviour. Pictorial hazard warning signs are introduced to the sites and their effectiveness evaluated. The findings show that many visitors (especially international visitors) have relatively poor awareness of natural hazards, and behave in ways which potentially compromise physical safety. It is argued that perceptions and behaviour are a consequence of diverse individual and situational factors including limited knowledge of the sites, beliefs about management, poor comprehension of hazard warning signs, and freedom from the normative constraints of everyday life. In contrast to visitors, managers at the glacier sites consider the risks to be significant, and, potentially, severe. It is argued that managers' perceptions of risk are influenced by several important social and site-specific factors, including their own experiences of hazards at the glaciers, perceived legal and moral obligations, the organisational culture, and impressions of high societal expectation concerning safety. The situation is further complicated by the freedom of access principle in national parks, and increasing tourist demand for nature-based experiences. These factors governed beliefs about the subject of risk. This study identifies several dimensions of risk in nature-based recreation and tourism settings. Visitors are at risk of personal accident or injury at certain tourism attractions. Awareness of hazards is limited, visitor behaviour compromises safety, and existing communication strategies are only partially effective. Risk is also apparent in the agency responsible for management of outdoor recreation areas. Site managers perceive a risk in their failure to prevent visitors from harm, whereas senior managers identify risk as primarily financial, legal, and political. Collectively, these factors demonstrate that the phenomenon of risk is increasingly important in the tourism and recreation context, and has the potential to influence significantly both management and experience of protected natural areas in New Zealand.

Research report in partial fulfillment for the degree of MMed (Occupational Medicine)
Background Occupational asthma is one of the most commonly reported occupational respiratory diseases in industrialized countries. Literature suggests that about 15% of all adult-onset asthma is caused by workplace exposures. It is potentially preventable and the prognosis is good with early diagnosis and adequate treatment. However, occupational asthma is under-diagnosed and under-reported. Identification of common causative agents and employment of preventative measures are necessary for proper management and control. Objectives 1. To characterize occupational asthma cases assessed at NIOH Occupational Medicine Clinic from 1st January 1997 to 31st December 2007 in terms of: • types of industries, occupations and agents • duration of exposure prior to onset of occupational asthma • time from onset of symptoms to diagnosis • nature of exposure e.g. intermittent, daily, etc. 2. To investigate factors influencing latency period in cases of sensitizer-induced asthma 3. To investigate factors influencing lag time to diagnosis in cases of sensitizer-induced asthma Methods A record review of a series of cases of occupational asthma was done. All cases of occupational asthma diagnosed from 1st January 1997 to 31st December 2007 by NIOH doctors were identified from the Clinic’s electronic database. All the records of patients who had a final diagnosis of occupational asthma were assessed using a standard data capture sheet. Doubtful cases were presented at the NIOH Occupational Medicine clinical discussion meeting for a consensus decision as to whether they qualified to be included in the study or not. Ethical approval was granted by the University of the Witwatersrand Human Research Ethics Committee (Medical). vi Results One hundred and forty two cases of occupational asthma were identified. Of these, 131 were sensitizer-induced and 11 were irritant-induced asthma. Low molecular-weight agents were in the majority with isocyanates, welding fumes, vanadium being the most common. Within the high molecular weight category, wheat was the most common. The majority of cases emanated from the Engineering, Chemical, Smelter and Food industries. Latency period from first exposure to development of symptoms was surprisingly long: a mean of 9.8 years and a median of seven years. The time from onset of symptoms to diagnosis was also long (mean of 4.9 years and median of three years). Younger cases had a shorter latency period and a longer delay in diagnosis. Agents and jobs for irritant-induced asthma cases varied widely and some came from unexpected industries. Discussion This review of asthma referrals to the NIOH Occupational Medicine Clinic has highlighted causative industries and identified exposure agents implicated in cases of occupational asthma. The very wide range of industries, occupations and agents associated with these cases is suggestive of a wide-spread occupational asthma problem in the region referring cases to the Clinic. The long latency period and delay in diagnosis are of concern since prompt diagnosis and removal from exposure is associated with a better prognosis. Irritant-induced asthma is infrequently reported in the local literature, but the range of agents and jobs is possibly indicative of under-diagnosis. Conclusion Occupational asthma is potentially preventable. New cases still arise particularly in poorly controlled workplaces which are capable of employing basic measures to control exposures. Medical surveillance, prompt diagnosis, proper medical management and application of workplace preventative measures are essential in decreasing the burden of disease and impairment

MMed (Community Health), Faculty of Health Sciences, University of the Witwatersrand
Introduction Occupational contact dermatitis (OCD) is the most common occupational skin disease. OCD can be either due to irritants or allergens or a combination of these two agents. Irritant contact dermatitis (ICD) tends to be more common than allergic contact dermatitis (ACD). Skin diseases affect the financial, psychosocial and occupational lives of people. Productivity in the work place is detrimentally affected. OCD is regulated under the Compensation for Occupational Injuries and Disease Act (COID Act) which is administered by the Commissioner. The OCD cases seen at the dermatology clinic at the National Institute of Occupational Health (NIOH) sees a number of cases from a wide spectrum of industries with a variety of exposures but, these are not well described. Aims and objectives Aims: 1. To describe the cases seen at the occupational dermatology clinic at the National Institute for Occupational Health (NIOH). 2. To describe the industries and exposure agents of cases diagnosed with occupational contact dermatitis (OCD). 3. To describe the psychosocial, financial and occupational impact and compensation outcomes of cases diagnosed with OCD. Objectives: 1. To describe the age, sex, diagnosis, site of dermatosis and skin patch test results of cases seen at the occupational dermatology clinic from August 2005 to December 2007. 2. To describe the jobs, the industries and suspected exposure agents of cases with OCD and dermatosis not related to vocation. 3. To determine the duration of exposure to a suspected agent before a diagnosis was made. iv 4. To describe the psychosocial, financial and occupational impact of the skin conditions. 5. To describe compensation outcomes including claim status, outstanding documentation; the experience of claimants with the Commissioner’s office; the delay from submission to resolution. Methods Data were collected from the medical records of patients seen at the NIOH dermatology clinic from August 2005 to December 2007 (n=129). Telephone interviews were done with all participants that could be contacted (n=94). A questionnaire was administered by telephone enquiring about their current occupational status and occupational exposures; the impact of their skin disease on their finances, personal lives and vocation; and their experience with the Commissioner’s office. The status of claims submitted to the Commissioner’s office (n=64) was verified by reviewing the electronic records of the Commissioner’s office. Descriptive and analytical analysis was done using STATA 10. Multivariate analysis was done to examine factors that might determine the compensation outcome. Results One hundred and twenty eight medical records were reviewed. The mean age of OCD patients was 41.9 years and 48 (75%) were males. ACD was diagnosed in 35 OCD participants and ICD in 29 participants. The rash occurred on the hands in 36 (56.3%) of the 64 OCD patients. The median duration of exposure to a suspected agent was 96.8 months. The median duration from diagnosis to the visit to the Commissioner’s office was 19 months. Dermatosis on the hands had an odds ratio of 2.33 for loss of income. There was a greater chance of a claim being resolved if the skin patch test was positive. Only eight of the 64 cases were resolved at the time of the visit to the Commissioner’s office. v Discussion The impact of a skin dermatosis was similar in OCD and non OCD participants and impacted on their social lives and work performance. ICD and ACD were equally represented in the cohort. Workers generally reported a negative impression of the compensation process. There were many systems issues identified in the compensation process. This resulted in few cases being resolved. Many pieces of documentation required for the compensation process to be finalised were missing. Conclusion The financial, psychosocial and occupational impact of a skin disease was significant and similar between cases who were diagnosed with OCD and non OCD patients. The COID Act Commissioner had failed to administer the Compensation Fund effectively and to provide compensation to workers diagnosed with OCD.

Mestrado em Ergonomia
O presente relatório de estágio decorreu numa empresa da indústria cervejeira, através de um pedido relacionado com as exigências físicas associadas ao transporte e MMC de tubos no Sector de Recuperação, Tratamento e Enchimento de CO2. O objectivo geral prende-se com a realização de uma Análise Ergonómica da actividade dos operadores. Para a análise da exposição biomecânica recorreu-se a instrumentos observacionais (REBA, equação de NIOSH), de medida directa (electromiografia de superfície e acelerometria) e de simulação (HARSim). Como resultados, verificou-se que as tarefas contribuem de diferentes modos para o agravamento da exposição biomecânica, tendo a manipulação do produto, seja em transporte ou depósito deste (em paletes/ contentores) para armazenamento/encomendas, um maior destaque. No entanto, as tarefas de decapagem, provas hidráulicas, pintura e identificação/verificação de fugas nos tubos estabelecem variações significativas nesta exposição. Concluiu-se que a exposição biomecânica ocupacional é elevada e determinada pelas estratégias operatórias praticadas, em que os pesos limite recomendados para tarefas de levantamento/depósito de cargas não são maioritariamente respeitados. As recomendações propostas para a melhoria das situações de trabalho analisadas foram classificadas em dois grupos: o organizacional com referência a acções de formação/informação e o técnico/processual que apresenta protótipos de equipamentos, máquinas ou ainda linhas de produção.

The introduction of the National OHS Strategy 2002-2012 into Australia signified a new direction in occupational health and safety (OHS) policy development. It represented the first policy in which Australia’s institutional stakeholders had reached a formal agreement to achieve targeted reductions in injuries and fatalities across Australian workplaces. However, despite its significance, the National OHS Strategy remains largely unexplored throughout the literature, as have national OHS strategies in other countries. This research seeks to contribute to narrowing this gap in knowledge by investigating the OHS policy process associated with the National OHS Strategy, with the intention of better understanding how OHS policies are developed, implemented, and evaluated. Applying a qualitative framework comprised of documentary analysis and semi-structured interviews with government, trade unions, employer associations, and manufacturing businesses in New South Wales, this thesis explores one of the National OHS Strategy’s five objectives – improving the capacity of employers to manage OHS. Ostrom’s Institutional Analysis and Development (IAD) framework, which is grounded in institutional rational choice theory, provides the key theoretical framework in which the research findings are analysed. The IAD framework has allowed for policy evaluation that is different from the traditional and descriptive approach associated with examining policy through various stages of the policy cycle. Rather than describing stages, the IAD framework guides analysis on stakeholder interactions and behaviours, and highlights the influence of external factors and rules. The analysis of Australia’s National OHS Strategy is deepened through international comparisons with the United Kingdom, New Zealand, Denmark, and Finland. The comparisons provide greater insight into the policy development, implementation, and evaluation possibilities that could have been undertaken for Australia’s 2002-2012 National OHS Strategy. As it is the intention of Australia to continue to develop and implement future strategies to improve OHS, the findings of this thesis help to identify the elements necessary for effective strategy making and implementation. In summary, the research highlights that the National OHS Strategy did not appear to have a significant impact in encouraging increased activity in improving employer capacity to manage OHS. The 2002 – 2012 Strategy’s shortcomings were uncovered in each aspect of the policy process. The main problems were, firstly, that stakeholders’ energy and attention was drawn away from the National OHS Strategy and into other areas of priority such as changing OHS legislation rather than implementing the Strategy. While stakeholders saw value in having the National OHS Strategy, it did not elicit sufficient motivation or commitment. Furthermore, a lack of clearly identifiable roles for each of the stakeholders resulted in responsibility for the Strategy being shifted to government, thereby diminishing the concept of the stakeholders ‘working together’. Knowledge and awareness of the National OHS Strategy diminished over the life of the Strategy; partly as a consequence of changes in personnel across the stakeholder groups, as well as a declining reference to the Strategy more broadly. The research also highlights the importance of resources to policy development. The National OHS Strategy was developed on weak foundations as the paring back of resources to Australia’s peak OHS body heightened jurisdictional responsibility for OHS, including implementation of the National OHS Strategy. The thesis’ contribution is multifaceted. It contains a history of the development of Australia’s first national policy for OHS, incorporating perspectives of employer associations, trade unions, and government relative to the Strategy’s objective of developing employer capacity. The thesis is particularly innovative in applying theory from the political science field to analyse the Strategy. Moreover, it utilises the IAD framework to evaluate the policy process relative to the National OHS Strategy’s goal of developing employer capacity. The application of a theoretical framework to analyse the National OHS Strategy brings rigour to the OHS discipline where there has generally been a dearth of theoretical policy evaluation of OHS policy. OHS has been an important area for public policy for decades. Through a thorough and theoretically informed evaluation of the National OHS Strategy’s impact on employer capacity to manage OHS, the thesis’ findings around institutional arrangements and the role of the actors provides guidance to improve policy development, implementation, and evaluation in future decades.

Annoyance due to relatively high levels of sound and noise, above 50 dB, has been well documented in noise assessment literature. The potential for annoyance or disturbance from low amplitude sound, below 50 dB to the threshold of an individual’s hearing, is not as well documented. The thesis presents a new approach to the measurement and assessment of intrusive noise and low amplitude sound. Acoustical and sound quality measures are integrated with measures of loudness, pitch, dissonance and tonality to provide physical measures of sound. Individual amenity is assessed with respect to personal noise sensitivity and personal attitudes to sound in the environment, the environment itself and the perceived qualities of the audible sound. A decision-support methodology to integrate perceived noise with noise performance indicators, annoyance criteria, personal noise sensitivity and amenity is presented. A method for rating intrusive noise is derived. Designs for sound measurement and calibration instrumentation are described. Methods to measure and assess low amplitude sound are presented. Keywords annoyance, intrusive-noise, noise-sensitivity, sound-quality, soundscape

This dissertation examines lead exposure and effects across the lifespan among vulnerable populations. The vulnerable population that this dissertation focuses on are the elderly, newcomers to the US, which represents immigrants, as well as adolescents and women of childbearing age. The first chapter gives an introduction and highlights the history of lead as it relates to environmental and occupational exposure having deleterious effects on the human system. The second chapter highlights the association between blood lead level and subsequent Alzheimer’s disease (AD) mortality in those 65 years and older. Chapter 3 looks at whether length of time in the United States is a predictor of adolescent and adult blood lead levels. The fourth chapter assesses whether early life lead exposure is associated with AD mortality later in life. Adaptations of Chapter 2 and Chapter 3 of this dissertation have been submitted for publication.

Chapter 2 presents a longitudinal study of 8080 elders (≥60 years) with BLL data from the 1999-2008 National Health and Nutrition Examination Survey, where mortality was determined from linked 1999-2014 National Death Index data. In this study, a causal diagram presented causal assumptions and identified a sufficient set of confounders: age, sex, poverty, race/ethnicity, and smoking. Cox proportional hazard models were used to determine the association between BLL and subsequent AD mortality. Impacts of competing risks and design effect were also assessed. Adjusted hazard rate ratio (HRR) and 95% confidence interval (CI) were reported. Results showed that those with BLL of 1.5 μg/dL and 5 μg/dL had 1.2 (95% CI: 0.70, 2.1) and 1.4 (95% CI: 0.54, 3.8) times the rate of AD mortality compared to those with BLL of 0.3 μg/dL, respectively, after accounting for competing risks. Adjusted HRRs were 1.5 (95% CI 0.81, 2.9) and 2.1 (95% CI 0.70, 6.3), respectively, after considering design effect. This longitudinal study demonstrated a positive, albeit statistically non-significant association between BLL and AD mortality, after adjustment for competing risks or design effect.

Chapter 3 included cross-sectional 1580 women of childbearing age (15-45 years) and 5933 men and women (≥15 years) from the 2013-2016 United States National Health and Nutrition Examination Survey. Linear regression models adjusted for race/ethnicity, education, blood cotinine, age, sex (as appropriate) and accounted for complex survey design. Results showed that women of childbearing age who have lived 0-4 years in the US have, on average, a 43% (95% confidence interval (CI): 31%, 56%) higher BPb compared to women born in the US. Corresponding results for all adults and adolescents was 40% (95% CI: 28%, 51%). Similar, statistically significant, results were observed for other time periods (5-9 years, 10-19 years, and ≥20 years); the magnitude of the association decreased with increasing time in the US. Higher BPb was also significantly associated with Asian (vs. white), lower education, higher age, and male (vs. female).

Chapter 4 is an ecologic study utilizing data from the United States Census Bureau and American Fact Finder. This ecologic study uses publicly available data from the 1930s US census and the Centers for Disease Control and Prevention to compare estimated historic lead exposure with AD mortality rates among US states and Indiana counties. Occupations were assigned a numeric weight based on the likelihood of lead exposure. The proportion of workers in each occupation multiplied by this weight was used to create a historic lead exposure index; quintiles of this index were used in analyses. AD mortality rates among persons ≥ 65 years old from 1999-2016 were obtained from the Centers for Disease Control and Prevention. The relationship between the historic exposure index and mortality was evaluated using correlation coefficients and linear regression models adjusting for age, sex, education, socioeconomic status (SES). Maps to characterize spatial pattern of historic lead exposure and AD mortality were completed using Geographic Information System (GIS) spatial analysis tools for the U.S. at state level and at county level for Indiana. Results showed that among states, the average AD mortality rate was 202.2 per 100,000 (SD=44.4). Within Indiana, the average AD mortality rate was 209.6 per 100,000 (SD= 64.9). Among Indiana counties, the unadjusted model shows an association of higher HEI with higher AD mortality, with the fifth quintile reaching statistical significance. Results for the adjusted model were not statistically significant. Results for US states for both unadjusted and adjusted regression models show that the third, fourth, and fifth quintiles of the historic exposure index were associated with a significantly lower AD mortality rate when compared to the lowest quintile.

Conclusion: The first study, using a longitudinal design, shows a positive but non-significant association between BLL and subsequent AD mortality after adjustments for competing risks or design effects. The second study, using a cross-sectional design, showed that newcomers to the US may be a population at higher risk for elevated BPb. The third, ecological study, did not find any significant association between historic lead exposure and AD mortality rates for Indiana counties, however there was a significant association of higher historic lead exposure index with lower AD mortality rates for states in the US.

碩士
國立陽明大學
環境與職業衛生研究所
101
Instead of antifungal efficiency, most of these studies focused on the bactericidal effectiveness. Since the fungi, especially their spores, are comparatively more resistant than bacteria. In this study, we assessed antifungal effects of the nano-metals (Ag, Cu and Ni) loaded titanium dioxide (TiO2) on Aspergillus niger spore. 　　The antifungal experiments were conducted under four situations: in the darkness (Dark), illuminated with ultraviolet lamp (UV), exposure to 5 ppm of ozone (O3), exposure to 5-ppm ozone and illuminated with ultraviolet lamp simultaneously (UV+O3).In the case of Dark, the antifungal effect of the 0.5wt% nano-Ag loaded TiO2 was better than that of 2wt% nano-Cu and 5wt% nano-Ni loaded ones. In the case of UV and O3, the antifungal effects of the quartz chips coated with TiO2 and nano-metals loaded TiO2 were worse than the bare chip. 　　Accordingly, nano-Ag supported TiO2 catalysts were better than nano-Cu supported ones on the inactivation of Aspergillus niger spores However, the nano-Cu could be a low-cost alternative for the inactivation of Aspergillus niger spores, since silver is much more expensive than copper. Overall, the antifungal effect of these four situations on the Aspergillus niger spore is in the order of: UV+O3>UV>O3>Dark.