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Both the physical properties of the fabric materials used in clothing and the effective design of the clothing, primarily in terms of the air gap thickness, restrict the transmission of the thermal energy from the heat source to the firefighter’s body. The air gap distribution over the body in real deployment conditions of firefighters will vary, and is likely to be different from the air gap distribution in standardised manikin tests in standing upright posture. In this study, we investigated differences in the distribution of air layers in firefighters' clothing in three postures reflecting realistic on-duty exposure conditions (crawling, hose-holding, and standing upright used in laboratory tests) using 3D body scanning technology. The body posture induced substantial changes in the air gap thickness on the upper body (chest and back) and lower body. These changes were reflected in both the thermal and evaporative resistance of the ensemble, and consequently, in their potential thermal performance in the field. Therefore, it is recommended to consider body postures during the evaluation of clothing protective performance. Secondly, the knowledge of local clothing properties in real-life exposure provides a true protection mapping and gives design inputs to improve the local protective properties of firefighters' clothing.

The basic principles of the need to develop a methodology for determining the level of protection of the rescuer's head during search and rescue operations in mountainous areas under conditions of low temperatures have been substantiated in this paper. The shortcomings of the existing system for ensuring the safe mode of search and rescue operations of rescuers in mountainous areas at low temperatures have been identified. Based on the statistical analysis of search and rescue operations, it was established that the greatest number of them occurs in the fall-winter period. It was determined that on the territory of the Carpathian Mountains the largest number of search and rescue operations is carried out in Zakarpattia, Ivano-Frankivsk, and Lviv oblasts. An analysis of working conditions was carried out. The results of studies into the effectiveness of thermal insulation of protective clothing of a mountain rescuer were analyzed. Mathematical modeling of heat and mass transfer in the body of a mountain rescuer was carried out using MATLAB software. Modeling of changes in temperature processes in the volume of the rescue head model was carried out under the influence of environmental temperatures: –10°C, –20°C, –30°C, and a metabolic rate of 600W/m2. Modeling was carried out on a 4-layer segment of the head. It was established that the effect of low temperatures on the face, head and, accordingly, the hypothalamus through the frontal part of the rescuer's skull leads to disability already at minute 17 in the absence of head protection equipment. The use of a model for predicting a decrease in body temperature as a result of exposure to the external environment and the level of protection by the rescuer's individual means will determine the time of risky decrease in brain temperature (up to +32°C) and prevent a negative impact on the health of the rescuer

High-performance fibers developed since the 1960s have a wide range of appli-cations including firefighters' protective clothing. Firefighters' protective cloth-ing made of inherently flame-resistant high-performance fibers offers excellentprotection in the new condition. However, these fibers experience aging as anypolymer material. The situation is amplified due to the severe conditions asso-ciated with the firefighters' activities. And the consequences of a loss in theperformance of the protective clothing can be dramatic for the firefighter'ssafety. This article provides a comprehensively review of the aging behavior ofhigh-performance fibers used in firefighters' protective clothing. Residual per-formance data have been identified both for used firefighter garments as wellas fabric specimens subjected to accelerated aging. Research shows that differ-ent aging conditions affect the different fibers to a different degree. The specificconditions in which the aging is applied also affects the outcome in terms ofloss in performance. Techniques successfully used to quantify the effect ofaging on the performance of fire-resistant fabrics are also briefly mentioned.Finally, the knowledge gained from this analysis of the literature as well asresearch gaps and further areas of investigation are discussed in this neglectedyet critical topic of firefighters' protective clothing aging.

Children and adolescents have high rates of sunburn and high levels of ultraviolet radiation (UVR) exposure and are therefore at risk of developing skin cancer in later life. Minimizing UVR exposure in childhood and adolescence may be the most important component of skin cancer prevention efforts. Thus, age-adapted prevention campaigns, targeting children, adolescents and caregivers, are needed to change sun protection behaviour among individuals in these age groups. In the first part of this review, we describe the 'SunPass' programme, which was initiated in Germany in 2010 as the first nationwide educational intervention for sun safety designed to teach kindergarten children and their caregivers how to protect themselves from overexposure to the sun. Implemented in 55 kindergartens, this programme has been shown to be effective at improving sun protection behaviour (P 0.001) and hat use (P = 0.029) among kindergarten children, as well as at improving shade practices and increasing demand for protective clothing (P 0.001). Up to 40 000 children, 50 000 parents/grandparents and 2500 kindergarten caregivers took part in the SunPass programme in Germany from 2019 to June 2021. The programme has also been adapted and implemented in several other European countries and could be readily adapted for use elsewhere. In the second part of this review, we discuss the specific challenges faced by adolescents and consider how these issues may impact their sun protection behaviour. Adolescents have difficulties suppressing responses to reward-related cues and projecting themselves into the future. They also place a lot of importance on social acceptance and cosmetic appearance, and their higher risk of depression, addiction and impulsivity make them vulnerable to tanning addiction. These specificities need to be acknowledged by dermatologists, so they can adapt their therapeutic relationship and develop effective sun protection interventions for this generation.

This proceedings book contains the extended abstracts from the 10th European Conference on Protective Clothing, May 9-12, 2023, Arnhem, The Netherlands. The aim of the European Conference on Protective Clothing series is to promote research and cooperation in the area of personal protection. Functional and comfortable protective clothing is a key element for successful implementation of preventive and protective measures at the workplaces. The 10th ECPC covers a broad spectrum of the subject protective clothing, and has turned into an internationally qualified source of new, valuable, and useful information for the advancement of knowledge and the application of protective clothing. The conference has become a platform to disseminate, exchange and discuss the results of research, project developments and implementation programmes related to protective clothing, with a strong focus on user protection and well-being. Ergonomics is still a strong component of the conference within the new challenges related to climate change, pandemics, and development of digital technology with new smart functions being an integrated part of textiles and modern PPE. Issues related to sustainability, durability of the products and consideration of the full life cycle of PPE is high up on the agenda today. The changing business needs support from legislation and work with standardization must keep up the pace so that the innovative and safe products can reach the market. This conference acts as a forum for industries, public authorities and academic organizations – researchers, designers, manufacturers, purchasers, health and safety experts, human factors experts and procurement specialists and end-users to exchange and discuss research and project development for personal protective clothing (PPC) and equipment (PPE).

The aim of this study is to evaluate the personal dose equivalent Hp(10) in the most frequent (non-cardiac) paediatric interventional radiology (PIR) procedures: central venous catheters (CVC), hepatic/biliary and sclerotherapy interventions. i2 active solid-state dosemeters placed over the lead apron were used to monitor the exposure of three interventional radiologists over 18 months. A database was created to register all procedures performed by each radiologist (including the type of procedure and the kerma-area product, PKA). The mean Hp(10) per procedure for CVC, sclerotherapy and hepatic/biliary interventions was respectively 0.01 ± 0.01 mSv, 0.18 ± 0.13 mSv and 0.12 ± 0.06 mSv (k = 2). A similar value of Hp(10)/PKA was found despite the type of procedure or the patient weight (~10 μSv/Gy·cm2). There was high variability among individual interventions, probably due to the variable level of complexity, which led to uncertainties in the measurements’ mean higher than those associated with the dosemeter’s angular and energy dependence. i2 therefore proved suitable for monitoring Hp(10) in PIR procedures.

Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has changed the lives of most humans worldwide. The aim of this study was to evaluate the impact of the SARS-CoV‑2 pandemic on health care professionals (HCPs) in radiation oncology facilities. Methods We distributed an online survey to HCPs in radiation oncology (physicians, medical physics experts, radiology assistants/radiation therapists, nurses, and administrative personnel). The survey was completed by 334 participants between May 23 and June 9, 2020. Results In 66.2% of the cases, HCPs reported a shortage of protective clothing. The protective measures were regarded as very reasonable by 47.4%, while 0.8% regarded them as not reasonable (rather reasonable: 44.0%; less reasonable 7.8%). 29.0% of the participants had children who needed care. The most frequently used care options were public emergency childcare (36.1%) and private childcare (e.g. relatives/friends). HCPs reported about additional work burden (fully agreed: 27.2%, rather agreed: 34.4%, less agreed: 28.2%, not agreed: 10.2%), and reduced work satisfaction (fully agreed: 11.7%, rather agreed: 29.6%, less agreed: 39.8%, not agreed: 18.9%). 12.9% and 29.0% of the participants were fully or rather mentally strained (less mentally strained: 44.0%, not mentally strained: 14.1%). Conclusion We must learn from this pandemic how to prepare for further outbreaks and similar conditions. This includes the vast availability of protective clothing and efficient tracing of infection chains among the HCPs, but also secured childcare programs and experienced mental health support are crucial. Further, work satisfaction and appreciation by employers is essential.

Clothing is recognized by leading health agencies as a primary method to protect against the harmful effects of photodamage caused by ultraviolet (UV) radiation and visible light. The photoprotective capacity of clothing is commonly measured as the ultraviolet protective factor (UPF). While the technology driving photoprotective clothing has been well-established, there continues to be efforts to discover new materials to improve the UPF of clothing. Here, we show increased Google searches for photoprotective clothing over the last decade, suggesting a high level of public interest in photoprotective clothing. In addition, we investigate the frequency of UPF-graded photoprotective clothing sold by large retail stores featured in Fortune 1000. We review factors that alter the UPF of clothing and describe emerging textile technologies used to increase clothing's photoprotective capacity. Finally, we compare how photoprotective clothing is regulated among different countries, the importance of photoprotective clothing in occupational health, and research in visible light and clothing photoprotection.

Lead aprons, as a type of individual radiological shields, are designed to protect the body against the negative effects of ionizing radiation. In order for the individual shields to fulfill their task, the weakening of the X-ray beam should be as high as possible. Previous reports have indicated the possibility of significant defects even among newly purchased aprons. The aim of the study was to analyze the influence of storage conditions and usage time on the permeability of lead aprons.The analysis covered 11 lead aprons used by the staff and patients of the Department of Radiodiagnostics and Interventional Radiology of the Central Clinical Hospital in Katowice, Poland. The dependent variable was the average pixel value, and the grouping variables included the storage method, age and thickness of the apron, and the type of its user.Statistically significant differences were found between the weakening value of the X-ray beam of individual aprons, and their storage conditions and age.Aprons stored in a hanging position show a greater degree of weakening of the X-ray beam, and thus a higher degree of worker protection, compared to aprons stored otherwise. The age of the apron affects its protective properties. Med Pr. 2022;73(1):13-7.Fartuchy ołowiane – jako jeden z typów indywidualnych osłon radiologicznych – mają za zadanie chronić ciało przed szkodliwym działaniem promieniowania jonizującego. Aby osłony indywidualne spełniały swoje zadanie, wartość osłabienia wiązki promieniowania rentgenowskiego (RTG) powinna być jak najwyższa. Dotychczasowe doniesienia wskazują na możliwość występowania istotnych defektów nawet w nowo zakupionych fartuchach. Celem tej pracy była analiza wpływu warunków przechowywania i czasu użytkowania fartuchów ołowianych na wartość osłabienia przez nie wiązki promieniowania RTG.Analizie poddano 11 fartuchów ołowianych wykorzystywanych przez personel i pacjentów Zakładu Radiodiagnostyki i Radiologii Zabiegowej Uniwersyteckiego Centrum Klinicznego im. prof. K. Gibińskiego w Katowicach. Zmienną zależną była średnia wartość piksela, a za zmienne grupujące przyjęto sposób przechowywania fartucha, jego wiek i grubość oraz typ jego użytkownika.Wykazano istotne statystycznie różnice pomiędzy wartością osłabienia wiązki promieniowania RTG poszczególnych fartuchów a ich warunkami przechowywania i wiekiem.Fartuchy przechowywane w pozycji wiszącej wykazują większy stopień osłabienia wiązki promieniowania RTG, a tym samym lepszą ochronę pracownika, w stosunku do fartuchów składowanych w inny sposób. Wiek fartucha wpływa na jego właściwości ochronne. Med. Pr. 2022;73(1):13–17.

The damaging effects of solar ultraviolet (UV) radiation exposure to human skin are well known and can reach from accelerated skin aging (photoaging) to skin cancer. Much of the damaging effects of solar UVA (320–400 nm) radiation is associated with the induction of reactive oxygen species (ROS), which are capable to cause oxidative damage to DNA like the oxidized guanosine 8-hydroxy-2' -deoxyguanosine (8-OHdG). Therefore, new UV protective strategies, have to be tested for their efficiency to shield against UV induced damage. We investigated the protective effects of HelioVital sun protection filter foil against UVA1 irradiation in skin cells. It could be shown, that HelioVital sun protection filter foil has protective effects against UVA1 irradiation induced changes in matrix metalloproteinase (MMP) expression. Furthermore a UVA1-dependant regulation of MMP15 in human fibroblasts could be shown for the first time in this context. In addition, this study demonstrated the protective effect of the HelioVital filter film against UVA1-induced ROS production and DNA damage. These results could pave the way for clinical studies with HelioVital filter foil shielding against the damaging effects of phototherapy and other forms of irradiation therapy, thereby increasing the safety and treatment opportunities of these forms of therapy. Graphical abstract

The use of effective shielding materials against radiation is important among medical staff in nuclear medicine. Hence, the current study investigated the shielding effects of a commercially available tungsten apron using gamma ray measuring instruments. Further, the occupational radiation exposure of nurses during 131I-meta-iodo-benzyl-guanidine (131I-MIBG) therapy for children with high-risk neuroblastoma was evaluated. Attachable tungsten shields in commercial tungsten aprons were set on a surface-ray source with 131I, which emit gamma rays. The mean shielding rate value was 0.1 ± 0.006 for 131I. The shielding effects of tungsten and lead aprons were evaluated using a scintillation detector. The shielding effect rates of lead and tungsten aprons against 131I was 6.3% ± 0.3% and 42.1% ± 0.2% at 50 cm; 6.1% ± 0.5% and 43.3% ± 0.3% at 1 m; and 6.4% ± 0.9% and 42.6% ± 0.6% at 2 m, respectively. Next, we assessed the occupational radiation exposure during 131I-MIBG therapy (administration dose: 666 MBq/kg, median age: 4 years). The total occupational radiation exposure dose per patient care per 131I-MIBG therapy session among nurses was 0.12 ± 0.07 mSv. The average daily radiation exposure dose per patient care among nurses was 0.03 ± 0.03 mSv. Tungsten aprons had efficient shielding effects against gamma rays and would be beneficial to reduce radiation exposures per patient care per 131I-MIBG therapy session.

This study aimed to evaluate a clothing prototype that incorporates sensors for the evaluation of pressure, temperature, and humidity for the prevention of pressure injuries, namely regarding physical and comfort requirements. A mixed-method approach was used with concurrent quantitative and qualitative data triangulation. A structured questionnaire was applied before a focus group of experts to evaluate the sensor prototypes. Data were analyzed using descriptive and inferential statistics and the discourse of the collective subject, followed by method integration and meta-inferences. Nine nurses, experts in this topic, aged 32.66 ± 6.28 years and with a time of profession of 10.88 ± 6.19 years, participated in the study. Prototype A presented low evaluation in stiffness (1.56 ± 1.01) and roughness (2.11 ± 1.17). Prototype B showed smaller values in dimension (2.77 ± 0.83) and stiffness (3.00 ± 1.22). Embroidery was assessed as inadequate in terms of stiffness (1.88 ± 1.05) and roughness (2.44 ± 1.01). The results from the questionnaires and focus groups’ show low adequacy as to stiffness, roughness, and comfort. The participants highlighted the need for improvements regarding stiffness and comfort, suggesting new proposals for the development of sensors for clothing. The main conclusions are that Prototype A presented the lowest average scores relative to rigidity (1.56 ± 1.01), considered inadequate. This dimension of Prototype B was evaluated as slightly adequate (2.77 ± 0.83). The rigidity (1.88 ± 1.05) of Prototype A + B + embroidery was evaluated as inadequate. The prototype revealed clothing sensors with low adequacy regarding the physical requirements, such as stiffness or roughness. Improvements are needed regarding the stiffness and roughness for the safety and comfort characteristics of the device evaluated.

Long lasting permethrin-impregnated (LLPI) clothing can retain permethrin and repel ticks for up to three months and without exceeding EPA-approved safe levels; however, little is known about longer term effects of wearing LLPI clothing. Here, permethrin content was measured in new forester pants soon after initial impregnation (Insect Shield) and again one year later after being repeatedly worn by foresters in the field. Urine samples were collected from foresters for biomonitoring of permethrin metabolites at multiple time intervals (pre-use, one-month, three-to-four-months, and one-year post-use). Lethality against nymphal Ixodes scapularis Say was measured in clothing after one year of wear by foresters. Furthermore, to test potential variability in permethrin impregnation of different batches of clothing, separate sets of clothing were anonymously sent to Insect Shield for permethrin treatment over a period of three months and permethrin was quantified. Results demonstrated 33% of participants’ pants had no measurable permethrin after one year of wear and permethrin content and tick mortality varied significantly between clothing. Only two of the participants’ clothing resulted in ≥ 30% tick mortality after one year of wear. Significant differences were observed in 3-PBA and trans-DCCA, but not cis-DCCA metabolites in participants over the four measured time points and were higher than general United States population levels. This study provides practical information on the safety (measured by urinary metabolites) over time of LLPI clothing. It also provides snapshots (pre-washing and after one year of wear) of effectiveness of LLPI clothing as personal protective equipment against ticks for outdoor workers.

The objective of the work was to analyze the impact of selected factors concerning the use and maintenance of firefighters' protective clothing worn during rescue operations on the hazard of contamination by chemical substances.The participants were firefighters (N = 688) from rescue and firefighting units of the State Fire Service in Poland, aged30, 31-40, 41-50 or60 years, with different seniority: up to21 years of service. The survey questionnaire developed by the authors was used. The questionnaire was available online. The Statistica 10.0 statistical package using the χAs reported by the vast majority (60%) of the firefighters, the maintenance was carried out after recording an average or a high level of contamination. It was pointed out that removal of the contaminants from protective clothing was difficult (83%). The surfaces of the legs and sleeves of protective clothing were the most contaminated areas. A feeling of discomfort was observed (90%) after returning from firefighting operations due to fire, smoke, or combustion residues.It is necessary to conduct training and information actions concerning the use and maintenance of protective clothing and the harmfulness of chemicals contaminating the garments used by firefighters. Int J Occup Med Environ Health. 2022;35(2):235-48.

Applying flame retardant finish on jute makes flame protective jute products that can be another diversified use of it. The target of this experiment is to observe the flame retardancy improvement of the fabric properties after finishing treatment with various flame retardant chemicals. The untreated (raw) and H2O2 bleached jute fabrics having plain weave were used in this experiment. Borax, diammonium phosphate (DAP) and thiourea were used as flame retardant chemicals. The combinations of these chemicals were applied to the fabrics by the pad-dry-cure method with various concentrations. Vertical flammability, breaking load percentage, and weight gain percentage were performed on all samples to observe the change in fabric properties. Significant improvement was found for all chemical combinations compared to untreated fabrics. Here, the flame spread time and weight gain percentage increase, but the breaking load percentage decreases for every combination. Among all combinations, the borax and DAP combination especially at 6% concentration shows the 305% improvement of flame spread time for raw jute and 276% for bleached jute fabric. In contrast, the borax and thiourea combination showed the progress of weight gain percentage. Besides, better wash durability was reported for all samples after five washing cycles. These flame-retardant jute fabrics have prospective industrial applications as brattice cloth in mines and many other potential fields of applications such as flame-retardant kitchen aprons, furnishings for a public hall, theater and hospitals.

In medical institutions, radiation shielding is an effective strategy to protect medical personnel and patients from exposure. Reducing the weight of the shield worn by medical personnel in the radiation generating area plays a key role in improving their productivity and mobility. In this study, a new lightweight radiation shield was developed by electrospinning a polymer-tungsten composite material to produce nanofibers with a multi-layered thin-film structure similar to that of a morpho butterfly wing. The fabricated shield was in the form of 0.1 mm thick flexible shielding paper. The multi-layer structure of the thin shielding paper was obtained through nanofiber pattern formation via electrospinning a dispersion of tungsten particles. At 0.1 mm thickness, the paper’s shielding rate was 64.88% at 60 keV. Furthermore, at 0.3 mm thick and arranged in a laminated structure, the shielding rate was 90.10% and the lead equivalent was 0.296 mmPb. When used as an apron material, the weight can be reduced by 45% compared to existing lead products. In addition, the material is highly processable and can be used to manufacture various flexible products, such as hats, gloves, underwear, and scarves used in medical institutions.

The study examined the impact of clothing and textile for construction of protective clothing kitchen use within Rivers State. Descriptive survey design was adopted. The construction of this work was carried out in Home Economics Laboratory in Federal College of Education (Technical) Omoku, Rivers state. Five research questions were constructed to guide the study. The population of the study was drawn from all families in Ogba/Egbema/Ndoni (ONELGA) local government area of Rivers state. Random sample was used to select a sample 200 members from a population of 500 adult between the ages of 20-40 years . Structured questionnaire was used to elicit data from the respondent. Data was collected and was analyzed using mean. The findings revealed that protective clothing protects home maker against accidents. The findings showed that inadequate materials, poor attitude and lack of competent instructors in most colleges and universities, poorly equipped clothing and textiles laboratories and lack of interest hinders the use and production of protective clothing in families in ONELGA, thereby giving room for various forms of accidents in the kitchen. It was recommended that lecturers handling clothing and textile courses should be those who are interested and are practically oriented in the courses so as to be able to encourage and motivate students constructing protective clothing in clothing and textile, students should be encouraged to give time to practical clothing work. Moreso, they should be orientated on the importance and benefit of practical works on clothing.

Skin cancer rates have been steadily increasing among the American public for decades, but multiple studies have demonstrated that the U.S. military suffers from higher rates of skin cancer than the general public. As with so many aspects of health, simple preventive measures made early on can dramatically improve long-term health outcomes. Ample research has demonstrated that ultraviolet protection reduces skin damage and cancer rates. Although further research is needed to fully understand current barriers to soldiers’ use of sun protection, we recommend a variety of simple measures the U.S. military can implement to reduce skin cancer risk for our soldiers. Early education and intervention to reduce skin cancer risk and promote sun-protective strategies is critical. These include improving sun protection offered by uniform items, such as increasing the availability of the sun hat, using eye protection with tinted inserts, and testing and publicizing the ultraviolet protection level of uniform items. We also recommend increasing sunscreen access for soldiers. Options to do so include issuing soldiers small portable packets or bottles of sunscreen to carry on their person, incorporating small packets of sunscreen in MREs, and issuing sunscreen to commands to distribute before field exercises. Unit and medical leadership should encourage the use of sunscreen and sun-protective strategies when possible; leadership engagement is critical to overcoming current behavioral barriers to change. Finally, we recommend that units attempt to reduce sun exposure during training by encouraging soldiers to seek shade and avoiding outdoor training in the middle of the day.

Background In the COVID-19 pandemic context, a massive shortage of personal protective equipment occurred. To increase the available stocks, several countries appealed for donations from individuals or industries. While national and international standards to evaluate personal protective equipment exist, none of the previous research studied how to evaluate personal protective equipment coming from donations to healthcare establishments. Our aim was to evaluate the quality and possible use of the personal protective equipment donations delivered to our health care establishment in order to avoid a shortage and to protect health care workers throughout the COVID-19 crisis. Methods Our intervention focused on evaluation of the quality of donations for medical use through creation of a set of assessment criteria and analysis of the economic impact of these donations. Results Between 20th March 2020 and 11th May 2020, we received 239 donations including respirators, gloves, coveralls, face masks, gowns, hats, overshoes, alcohol-based hand rubs, face shields, goggles and aprons. A total of 448,666 (86.3%) products out of the 519,618 initially received were validated and distributed in health care units, equivalent to 126 (52.7%) donations out of the 239 received. The budgetary value of the validated donations was 32,872 euros according to the pre COVID-19 prices and 122,178 euros according to the current COVID-19 prices, representing an increase of 371.7%. Conclusions By ensuring a constant influx of personal protective equipment and proper stock management, shortages were avoided. Procurement and distribution of controlled and validated personal protective equipment is the key to providing quality care while guaranteeing health care worker safety.

Background Individuals who participate in outdoor sports are subject to an increased risk of developing skin cancer. To date, there has been no review examining skin cancer and sun protective behaviours specific to outdoor, water based sports. Therefore, this scoping reviews objectives were to (1) summarise volume and type of scientific literature available relating to skin cancer, (2) examine current sun protective behaviours and (3) identify knowledge gaps to inform future research. Method A scoping review was conducted to address the objectives following the PRISMA guidelines. Seven databases were searched; identified studies were screened based on title, abstract and full-text for outdoor water based sports which examined skin cancer and/or sun protective behaviours. Data was extracted, synthesised and critically appraised using a modified AXIS tool. Percentage frequencies were calculated, and key results were placed in tabular or graphical presentation. Results Nine cross sectional studies were identified, all defined as low level evidence. A combined sample of 4,377 participants across six countries and five water based sports showed BCC (71%) was the most common skin cancer, followed by melanoma (18%) and SCC (10%). The head (41%) and upper-limbs (27%) were the most common location. Conclusion This review highlights the minimal research available and demonstrates those in water based sports are at high risk of developing skin cancer. Due to difficulty adhering to sun protective behaviours, the most prevalent location is the upper body. Included studies were of low level evidence, providing opportunity for future research to expand upon the gaps in the current literature.

Objective: To inform skin cancer prevention policies and campaigns, we investigated changes over time in sun protection behaviours, sunburn, sun exposure and shade availability in public spaces among people living in New South Wales (NSW), Australia, between 2003 and 2016. Methods: We analysed cross‐sectional data from the NSW Population Health Survey collected in 2003, 2007, 2014 and 2016, which included approximately 15,000 respondents of all ages in each year. Logistic regression models were used to analyse overall changes over time and for different age, sex and sociodemographic groups. Results: The use of sunscreen and protective clothing and the availability of shade increased between 2003 and 2016, but sunburn and sun exposure during peak times of ultraviolet radiation also increased. In subgroup analyses, there was no improvement in sun protection behaviours among adolescents and increases in sunburn and sun exposure were observed only among adults, particularly women and in areas with less social disadvantage. Conclusions: Sun protection behaviours have improved over time among some population subgroups, but over‐exposure to ultraviolet radiation remains prevalent. Implications for public health: Skin cancer prevention initiatives that specifically target adolescents and sun exposure during peak times are needed to help reduce population skin cancer risk.

Cross-country eventing is one of the highest-risk sporting activities for serious injury outcomes. This study investigated relationships between fall characteristics and high-risk falls at jumps in cross-country eventing. A video analysis protocol was systematically developed to analyze 87 video recordings of high-risk rider falls; defined as when the rider's head impacted the ground and/or where there was potential horse impact with the rider. Falls were classified according to competition type, jump type, horse-related, and rider-related factors. At least one high-risk fall characteristic was observed in 45 of 87 examined falls. Multivariable best subsets regression identified five independent variables explaining 38.4% of the variance in the number of high-risk falls. Increased likelihood of high-risk falls was associated with continuation of horse direction or speed upon rider ground impact, higher jump approach speed, changes in rider body posture upon landing, rider air jacket usage, and reduced rider fall time. The Eventing Fall Assessment Instrument (EFAI) video analysis protocol (attached as supplementary material) facilitated systematic examination of multiple characteristics associated with high-risk falls and identified likely influential characteristics. Based on EFAI and subsequent data analyses, findings suggest optimized approach speed for correct striding and take-off; jump design to enable run-out; and rider training could help reduce the occurrence of high-risk falls. Air jacket usage and their design characteristics warrant further investigation.

Epée fencing involves repeated bouts of high-intensity intermittent exercise with competitions lasting 9-11 hours consisting of Poule (3-minute or first to 5 points) and Direct Elimination (DE; 3x3-minute bouts or first to 15 points) fights. Fencers are required to wear thick protective clothing which could create a hot micro-climate and impede heat loss during exercise. Chapter 4 assessed the physiological demands of epée during simulated competition comprising of Poule and DE fights. Results showed epée is reliant on phosphocreatine and aerobic energy systems shown by decreasing blood lactate concentration from Poule to DE (Poule 1 ~4.5 mmol.L-1; DE 7 ~2.0 mmol.L-1). Maximum heart rate, ratings of perceived exertion, peak speed, training load per minute and percentage of zone 2 accelerations were greater in DE than Poule fights indicating greater physiological strain. There was a considerable energy demand (~13 kcal.min-1) exhibited during the competition. Chapter 5 focussed on the thermoregulatory demands of epée, using the same competition protocol as chapter 4. There was a moderate thermoregulatory demand during Poule fights (gastrointestinal temperature (Tgast) ~38.0°C and mean skin temperature (Tskin) ~34.5°C) and high thermoregulatory demand during DE fights (Tgast >38.0°C pre and >38.5°C post fight and Tskin >35.0°C, thermal sensation ~7.0). Mask temperature was greater than ambient temperature highlighting a hot micro-climate created by protective clothing. Mean skin temperature also increased during recovery between fights for Poule and DE. There was a decrease from DE 1 to DE 7 for distance covered (~900m vs. ~600m) and distance covered per minute (~80.6 m.min-1 vs. ~71.4 m.min-1). Previous research has shown thermoregulatory and performance benefits of cooling on exercise performance. Chapter 5 showed a high thermoregulatory demand of epée especially during DE rounds. Therefore, chapter 7 assessed the effects of external (EXT; evaporative cooling vest (ECV)), and mixed-method (MIX; ECV + cold water ingestion) cooling on physiological, thermoregulatory, perceptual, performance, and cognitive components of epée. Results showed there was a significantly lower Tskin ~0.8-0.9°C and thermal sensation in EXT and MIX cooling interventions than control (CON). There was a limited performance benefit of cooling with greater points difference in MIX compared to CON and EXT. Wheelchair fencing competition structure and protective clothing is similar to able-bodied fencing. Physiological, thermoregulatory, and performance variables were recorded during Poule and DE fights during wheelchair fencing. Results showed a need to ensure training intensity mirrors competition when mixing category A and B fencers through appropriate fight durations and work to rest ratios. Individual thermoregulatory responses existed for each participant for Tgast and Tskin. Mask temperature increased during DE fights (0.34-3.04°C) and Tskin increased during recovery between Poule and DE fights. In conclusion, results of this thesis demonstrate a high physiological and thermoregulatory demand of epée. Furthermore, practical cooling methods between fights lowered Tskin and thermal sensation during DE fights and with a limited performance benefit of MIX for points difference. This thesis provides novel data on thermoregulatory responses of able-bodied and wheelchair epée fencing and movement data of epée using an accelerometer-based athlete tracking system.

Introduction Carers and comforters frequently remain with children during paediatric general radiographic examinations. As well as improving the likelihood of overall success of the procedure, this can be important for minimising stress and anxiety of the child. Wearing lead aprons can contribute to additional stress and anxiety about the procedure for both carer and child, specifically due to radiation risk. It also introduces some practical challenges for radiographers. This study quantified a carers exposure to scattered radiation for general radiographic examinations when remaining with a child to assist in positioning or to comfort them. Methods Scattered radiation was measured at four common locations where a carer may stand, with a range of tube potentials (40 kVp to 100 kVp ) and PMMA thicknesses of 2.5-22.5 cm. This was then matched to our clinical protocols to estimate the radiation dose a carer could be exposed to while assisting a patient during general radiographic examinations. Results The effective dose received by a carer standing 20 cm from the centre of the patient varies from 11 min of Australian natural BERT for a finger radiograph on a patient 70 kg. Conclusion This dosimetric data allowed an evidence-based assessment of radiation protection requirements for the carer using the ALARA principle. At our institution, it was decided that a lead apron is not required if the carer is unlikely to receive more than 2 µSv. A new policy, presented here, was developed to implement this decision.

BACKGROUND Standard lead aprons and vests do not adequately shield the most common breast cancer site, the upper outer quadrant (UOQ), from intraoperative radiation. The purpose of the present study was to determine if lead sleeves, wings, and/or axillary supplements decreased intraoperative radiation exposure of the UOQ of the breast. METHODS An anthropomorphic torso phantom (simulating the female surgeon) was placed adjacent to a standard operating room table. Dosimeters were placed bilaterally over the UOQ of the breast. Scatter radiation dose equivalent rates (mrem/hr) were measured during continuous fluoroscopy of a pelvic phantom (simulating the patient). Five protection configurations (no lead; lead vest; and vest with sleeves, wings, and axillary supplements), 2 surgeon positions (facing the table and perpendicular to the table), and 2 C-arm positions (anteroposterior and cross-table lateral projection) were tested. The t test was utilized with a Bonferroni correction for multiple t tests. RESULTS Lead sleeves and axillary supplements decreased intraoperative radiation exposure to the UOQ of the breast when compared with a well-fitted standard lead vest alone (p < 0.01) across all surgeon and C-arm positions. The addition of wings decreased radiation exposure to a lesser extent than sleeves or axillary supplements, and the difference when compared with the lead vest alone did not reach significance (p = 0.29). Breast radiation exposure in the C-arm cross-table lateral projection was highest across all testing. CONCLUSIONS The UOQ of the breast is not adequately protected by standard lead vests alone or vests with the addition of wings. Axillary supplements and sleeves improved protection of the breast. CLINICAL RELEVANCE Modifications of lead protective vests may improve intraoperative breast radiation protection.

Reuse of disposable personal protective equipment is traditionally discouraged, yet in times of heightened medical applications such as the SARS CoV-2 pandemic, it can be difficult to obtain. In this article we examine the reuse of disposable gowns with respect to still providing personnel protection. XR7, a fluorescent powder, was used to track contamination of gowns after manipulation of rodent cages. Mouse cages were treated with XR7 prior to manipulations. Disposable gowns were labeled for single person use and hung in common procedure spaces within the vivarium between usages. A simulated rack change of 140 cages was completed using XR7-treated cages. One individual changed all cages with a break occurring after the first 70 cages, requiring the gown to be removed and reused once. To simulate research activities, 5 individuals accessed 3 XR7-treated cages daily for 5 d. Each mouse in the XR7-treated cages was manipulated at least once before returning cages to the housing room. Disposable gowns were reused 5 times per individual. Gowns, gloves, clothing, bare arms, and hands were scanned for fluorescence before and after removing PPE. Fluorescence was localized to gloves and gown sleeves in closest contact with animals and caging. No fluorescence was detected on underlying clothing, or bare arms and hands after removing PPE. Fluorescence was not detected in procedure spaces where gowns were hung. The lack of fluorescence on personnel or surfaces indicate that gowns can be reused 1 time for routine husbandry tasks and up to 5 times for research personnel. A method for decontamination of used gowns using Vaporized Hydrogen Peroxide (VHP) was also validated for use in areas where animals are considered high risk such as quarantine, or for fragile immunocompromised rodent colonies.

Resume Au regard des diverses menaces sanitaires observees ou suspectees, la protection des personnels de sante (que ce soit en hospitalier, extrahospitalier ou mission exterieure et humanitaire) est toujours une problematique essentielle a laquelle les equipes sont confrontees. Dans le domaine du biologique, meme si l’agent est identifie, la connaissance des voies de contamination (aeriennes, cutanees, etc.) est limitee dans le cas d’agents emergents (type SARS-CoV-2). De ce fait, les moyens de protection sont souvent sur- ou sous-dimensionnes au depart, soit par meconnaissance du risque, soit par meconnaissance des capacites du moyen de protection lui-meme. La plupart des professions, associees a un risque particulier, sont dotees d’equipements de protection individuelle (EPI) specifiques (militaires, sapeurs-pompiers, industrie, agriculture, etc.) adaptes a leurs contraintes propres. Dans le domaine de la sante, l’offre d’EPI est souvent, a quelques exceptions pres, derivee directement de l’industrie ou des equipements militaires (tenues de protection contre le risque chimique par exemple) mais les contraintes specifiques « sante » sont rarement envisagees, entrainant souvent une inadaptation de ceux-ci. La legislation en matiere d’EPI est complexe nous en resumerons les grands principes. Deux concepts s’affrontent et parfois se completent entre les tenues de type etanches et filtrantes. Au regard d’experiences hospitalieres et humanitaires, nous tenterons de faire ressortir les caracteristiques essentielles qui pourraient definir nos tenues de demain.

During the early stage of a fire, a process operator often acts as the first responder and may be exposed to high heat radiation levels. The present limit values of long- (>15 min) and short-term exposure (2, respectively, have been set using physiological models and manikin measurements. Since human validation is essentially lacking, this study investigated whether operators’ protective clothing offers sufficient protection during a short-term deployment. Twelve professional firefighters were exposed to three radiation levels (1.5, 2.0, and 2.5 kW/m2) when wearing certified protective clothing in front of a heat radiation panel in a climatic chamber (20 °C; 50% RH). The participants wore only briefs (male) or panties and a bra (female) and a T-shirt under the operators’ clothing. Skin temperatures were continuously measured at the chest, belly, forearm, thigh, and knee. The test persons had to stop if any skin temperature reached 43 °C, at their own request, or when 5 min of exposure was reached. The experiments showed that people in operators’ clothing can be safely exposed for 5 min to 1.5 kW/m2, up to 3 min to 2.0 kW/m2, and exposure to 2.5 kW/m2 or above must be avoided unless the clothing can maintain an air gap.

This paper explores the modeling of physical phenomena that occur in clothing that affect the safety and biophysical comfort of the user. Three-dimensional models of textile assemblies with complex morphology used in firefighters’ multilayer protective clothing were designed in a CAD environment. The main goal of the research was to design and experimentally verify (by thermography) the models in terms of simulations when the heat transfer occurs through them in selected ambient conditions using the finite volume method. The designed models took into account the subtle differences in the geometry of selected assemblies determined by high-resolution X-ray microtomography. The designed models made it possible to calculate heat transport with a difference of about 2% to 5% in comparison to experiment that depend on the ambient conditions and the complexity of the model geometry. Moreover, the comparison of the simulation results with the experimental outcomes shows that the mapping of subtle differences in the internal structure of the assemblies in the designed models allows us to observe differences in the modeled heat transfer.

The article presents research on ergonomics, biophysical comfort and safety of protective clothing. The resistance of the structural, thermal and mechanical properties of five fabrics (CBXS400, GG200T, Twaron CT736, Dyneema HB26 and T1790C), differing in geometry and raw material composition used in space suits, to dangerous ionizing radiation (β and γ) occurring in space was tested. For both types of radiation, four identical one-time doses in the range of 25–100 kGy were used. The effect of the applied absorbed doses of β and γ radiation on the parameters of textiles influencing ergonomics and safety of the cosmonaut’s work was verified by structural tests (micro-computed tomography and optical microcopy), thermal resistance tests (sweating guarded-hotplate) and strength tests (tensile testing machine). Experimental studies of thermal properties are supplemented with heat transport simulations using the finite volume method performed with 3D models of real textiles. The greatest reduction of thermal resistance for Twaron CT736 (−0.0667 m2·°C·W−1 for 100 kGy of β-radiation) and Dyneema HB26 (−0.0347 m2·°C·W−1 for 50 kGy of β-radiation) is observed. Strength tests have shown that all tested textiles are resistant to both types of radiation. Three textiles were selected to create a three-layer assembly with potential application in a cosmonaut’s glove (Extravehicular Activity—EVA).

Medical protective materials have broadly drawn attention due to their ability to stop the spread of infectious diseases and protect the safety of medical staff. However, creating medical protective materials that combine excellent liquid shielding performance and outstanding mechanical properties with high breathability is still a challenging task. Herein, a polyester/polyamide 6 (PET/PA6) bicomponent microfilament fabric with tunable porosity for comfortable medical protective clothing was prepared via dip-coating technology and an easy and effective thermal-belt bonding process. The dip coating of the C

Thermal burns are the most common injury sustained during MRI. Textiles such as clothing and blankets, and most recently fabric face masks are emerging as key factors when considering such thermal injuries. Fabric can trap heat and sweat close to the body and fabric containing metallic fibers can interact with MRI's RF waves to induce burns, which represents the majority of reported fabric-related thermal injury cases. This may be exacerbated by a lack of comprehensive labeling when fabrics contain trace amounts of metals. This review outlines case reports and makes suggestions that may reduce the frequency of these burns. The single most effective way to reduce the danger of fabric-induced MRI burns is to require all patients to change into MR-safe clothing, such as approved hospital gowns, prior to imaging.

Madam, surgical site infections are a major cause of postoperative morbidity and mortality and have long been a matter of concern. In the early twentieth century, surgeons were allowed to wear their clothes in the operating room (OR). After it was discovered that the surgical attire could be a source of these infections, surgical scrubs were introduced [1]. With the advent of the COVID-19 pandemic, many hospitals changed their policies, requiring healthcare workers to wear scrubs in wards, special care units (SCU), and intensive care units (ICU) due to their encounters with patients. This measure was taken to protect the healthcare personnel from the virus and t ensure that their contaminated clothing did not become a vector of infection to their families and society. The change was quickly adopted particularly in the private sector, due to the free provision of scrubs by the hospital, hospital-laundering facilities, increased comfort and feasibility of the professionals, and most importantly, for the sake of their own and their families’ safety [2]. The issue arose when doctors were observed wearing the same surgical scrubs in the operating room as they did elsewhere in the hospital. Patients admitted at SCU and ICU are infected with multidrug-resistant and extensively drug-resistant microbes, and wearing scrubs contaminated with these organisms in the operating room can be extremely dangerous. Though many hospitals encourage wearing gowns or white coats over the scrubs outside the OR, there is no evidence that it prevents contamination. According to observations and studies, professionals wear white coats even outside the hospital, and are more contaminated by multidrug-resistant organisms. The extent of contamination depends at the type of fabric, antimicrobicidal coating, and the laundering frequency [3]. The national guidelines for infection prevention and control need to be more precise regarding the surgical attire inside and outside the OR, and it should ensure implementation at every hospital. It is suggested that the colour of the scrubs worn inside and outside the OR be different, surgical scrubs should be provided to all healthcare staff by the hospital, and no one should be allowed to wear his personal scrubs inside the hospital. All professionals should be provided lockers, and wearing surgical scrubs outside the hospital should be prohibited. More frequent audits during the pandemic should be done to ensure the safety of the healthcare workers and patients [4].

The presence of polycyclic aromatic hydrocarbons (PAHs) on firefighters’ personal protective equipment is a concern. One form of preventing from these compounds is to decontaminate proximity firefighting protective clothing (PFPC). Traditional decontamination methods do not promote total removal of pollutants and alter the properties of PFPC. The objective of this work was to evaluate the effectiveness of white light-photolysis (WLP), an advanced oxidation process (AOP), for removing PAHs from PFPC, while maintaining the integrity of the fabric fibers. Experiments were carried out, varying reaction time and concentration of H2O2. With WLP (without H2O2), it was possible to remove more than 73% of the PAHs tested from the outer layer of PFPC in 3 days. The WLP provided the greatest removal of PAHs, compared with the most common mechanical decontamination techniques (laundering and wet-soap brushing). The fibers’ integrity after exposure to the white light was evaluated with infrared spectroscopy and scanning electron microscopy/energy dispersive X-ray spectrometry. In addition, a tearing strength test was performed. No remarkable fabric degradation was observed, indicating a possible, routine-compatible, simple, and inexpensive method of decontamination of PFPC, based on photolysis, which is effective in the degradation of PAHs and maintains the integrity of fabric fibers.

The convective and radiative heat transfer coefficients of clothing are important parameters for human thermoregulation and comfort models. Many researchers have studied convective and radiative heat transfer coefficients of the naked human body. However, there is limited information on convective and radiative heat transfer coefficients for the clothed human body. Therefore, this study aims to confirm whether the convective and radiative heat transfer coefficients vary with different clothing ensembles in addition to clarifying how the difference in clothing heat transfer coefficients affects the prediction of thermal comfort index, such as the predicted mean vote (PMV) index. The convective and radiative heat transfer coefficients for eight sets of clothing ensembles were measured through a manikin experiment. The results demonstrated that (1) the largest difference between convective heat transfer coefficients for various clothing ensembles was 32%, and (2) PMV values differed between the clothing ensembles with the largest value being approximately 0.2, which corresponds nearly 1 °C change in the indoor temperature. Therefore, it is necessary to consider the actual clothing convective heat transfer coefficient for the precise prediction of thermal comfort.

The paper presents the virtual prototyping of protective clothing for oversized female and male subjects, highlighting the importance of personalization and its competitive advantages. Customisation of protective clothing for oversized subjects offered the possibility to individualise the products to each wearer with different conformation and specific work activities. Customized protective clothing involves the dimensional and conformational aspects of the body, respectively the product size as well as the quality-linked functionality criterion, aspects regarding its wearability and protection tested in accredited laboratories, the effects over the individual comfort. The research implementation involved 3D body scanning for analysis and determination of anthropometric measurements and conformation, 3D CAD technology for automatic rapid design of patterns in Made to measure system, modeling and simulation of product in the virtual environment on customized mannequin, highlighting the body-product correspondence. New technologies in the context of Industry 4.0 are the seeds for disruptive innovation in the clothing industry, by increasing the digital capacity and flexibility to satisfy the customer requests and implement more dedicated services.

Firefighters’ protective clothing (FPC) can limit human thermoregulation due to limited water vapor permeability and insulation. This study investigated the effect of cooling on the physiological responses and probability of hyperthermia in subjects wearing FPC during exercise in a hot environment. Twelve males participated in this study. A maximal graded treadmill exercise test was performed to measure maximal oxygen uptake ([Formula: see text]) and to assess subjects’ capacity to perform the assigned exercise. Exercise included treadmill walking at 40% [Formula: see text] in warm ([Formula: see text]) and humid (70% RH) conditions for 40 min while wearing FPC. Subjects participated in two randomly counterbalanced assigned experimental protocols: control (no cooling) and intervention (cooling). The experimental intervention consisted of a cooling garment infused with cooled water ([Formula: see text]) through silastic tubing sewn into the fabric and worn underneath FPC. Each subject served as their own control and, therefore, completed both the control and intervention of the protocol. A logistic regression model was used to analyze the interaction effect of cooling on the probability of progression to hyperthermia ([Formula: see text]). Subjects’ physiological responses increased during exercise in a warm and humid environment. Active cooling decreased (p < 0.05) the thermal stress thereby reducing the probability of hyperthermia while exercising in hot and humid conditions. The results indicate that when cooling was used each subject, on average, was 91% less likely to reach the lower threshold limit of hyperthermia. Exercise in hot environments while wearing FPC results in significant physiological strain, which may lead to hyperthermia. Utilization of a cooling garment reduced physiological strain and the probability of hyperthermia.

This paper describes a Cold Weather Ensemble Decision Aid (CoWEDA) that provides guidance for cold weather injury prevention, mission planning, and clothing selection. CoWEDA incorporates current science from the disciplines of physiology, meteorology, clothing, and computer modeling. The thermal performance of a cold weather ensemble is defined by endurance times, which are the time intervals from initial exposure until the safety limits are reached. These safety limits correspond to conservative temperature thresholds that provide a warning of the approaching onset of frostbite and/or hypothermia. A validated six-cylinder thermoregulatory model is used to predict human thermal responses to cold while wearing different ensembles. The performance metrics, model, and a database of clothing properties were integrated into a user-friendly software application. CoWEDA is the first tool that allows users to build their own ensembles from the clothing menu (i.e., jackets, footwear, and accessories) for each body region (i.e., head, torso, lower body, hands, feet) and view their selections in the context of physiological strain and the operational consequences. Comparison of predicted values to skin and core temperatures, measured during 17 cold exposures ranging from 0 to −40°C, indicated that the accuracy of CoWEDA prediction is acceptable, and most predictions are within measured mean ± SD. CoWEDA predicts the risk of frostbite and hypothermia and ensures that a selected clothing ensemble is appropriate for expected weather conditions and activities. CoWEDA represents a significant enhancement of required clothing insulation (IREQ, ISO 11079) and wind chill index-based guidance for cold weather safety and survival.

Background Isolation gowns are one of the crucial pieces of personal protective equipment (PPE) to prevent the migration of microorganisms and body fluids from patients to health care personnel and vice versa. Underperforming isolation gowns in terms of fluid resistance, could potentially put lives in danger. Wearing multiple layers of isolation gowns could theoretically increase the fluid penetration resistance. This study investigates if 2-layer lower barrier level isolation gowns meet the barrier effectiveness requirements of a single higher barrier level isolation gown. Methods Three commonly used ANSI/AAMI Level 2 isolation gown models were selected and tested in single layer and double layer configurations in accordance with ANSI/AAMI PB70 requirements. Results Total of 240 experiments were conducted to analyze the effects of gown model, fabric region, and the number of gown layers on AATCC 127 and AATCC 42 test results. In regard to AATCC 42, there was a significant difference among the different gown models, and the number of gown layers. Similar to AATCC 42 results, there was a significant difference among the different gown models, and the number of gown layers for AATCC 127; additionally, the gown regions was also significantly different. Conclusion Test results demonstrated that the double layer isolation gown configurations do not always provide equal fluid penetration resistance as required for a single Level 3 isolation gown using the standard test methods specified in ANSI/AAMI PB70.

Purpose: Many individuals drive with uncorrected refractive errors, which has implications for night driving, where poor visibility contributes to the increased crash risk relative to daytime. This study explored how small amounts of refractive blur affects the judgment of the walking direction of night-time pedestrians and whether different types of retro-reflective clothing influence this effect. Methods: Judgement of the walking direction of night-time pedestrians was investigated for 20 young participants with normal vision (mean age, 21.8 ± 1.6 years) for two levels of binocular blur (+0.50DS, +1.00DS) compared to baseline (best-corrected refractive correction). Participants seated in a stationary car with low beam headlamps observed a pedestrian wearing three clothing conditions: retro-reflective vest (1) and retro-reflective biomotion clothing (incorporating thin (2) or thick (3) retro-reflective strips), who walked across the road in three directions (straight across, away or towards the car). The order of conditions was randomised among participants. Participants reported the perceived pedestrian walking direction and how confident they rated their response. Outcome measures included the proportion of correct responses (response accuracy) and confidence ratings. Results: Blur had a significant effect on accuracy in judging pedestrian walking direction; accuracy decreased significantly with increasing blur (p

OBJECTIVE To analyze historical radiation dose data from fluoroscopy users at a major university medical center and compare the impact of two alternate dose monitoring methodologies. MATERIALS AND METHODS Interventional radiologists have traditionally worn two radiation monitoring badges to estimate their radiation dose. This study evaluates if a single badge monitoring system can reduce the administrative burden of radiation monitoring without negatively impacting safety or compliance. This study reviewed the dose history data for a 10-y period including 114,500 individual dose measurements. These individuals were each issued two badges for each wear period, including one worn at the collar (outside a protective garment) and one worn at the chest or waist (beneath a protective garment). The dose for each of the badges was derived from the database of personnel dose records. Badges that could be clearly identified as improperly worn were excluded from the study. The EDE as assigned from the two-badge system and as derived from the wear of the collar badge only were both compared to the thresholds for ALARA notifications currently in use. RESULTS Calculated EDE values are an average of 2.7 times higher when applying a one-badge system as compared to a two-badge system. This is observed to result in a slight increase in the ALARA notification frequency (excluding badges improperly worn in the two-badge system). The overall increase in notification frequency is small because notifications are dominated by dose to the lens of the eye. CONCLUSION Although providing less accurate personnel dose estimates relative to a two-badge system, the use of a one-badge monitoring system for fluoroscopy users may have a minimal effect on radiation dose records and "as low as (is) reasonably achievable" (ALARA) notifications, with potentially significant savings in notifications due to improper badge wear, volume of radiation monitoring badges handled, and cost of the radiation monitoring system.

Protective and sport clothing is governed by protection requirements, performance, and comfort of the user. The comfort and impact performance of protective and sport clothing are typically subjectively measured, and this is a multifactorial and dynamic process. The aim of this review paper is to review the contemporary methodologies and approaches for measuring ergonomic wear comfort, including objective and subjective techniques. Special emphasis is given to the discussion of different methods, such as objective techniques, subjective techniques, and a combination of techniques, as well as a new biomechanical approach called modeling of skin. Literature indicates that there are four main techniques to measure wear comfort: subjective evaluation, objective measurements, a combination of subjective and objective techniques, and computer modeling of human–textile interaction. In objective measurement methods, the repeatability of results is excellent, and quantified results are obtained, but in some cases, such quantified results are quite different from the real perception of human comfort. Studies indicate that subjective analysis of comfort is less reliable than objective analysis because human subjects vary among themselves. Therefore, it can be concluded that a combination of objective and subjective measuring techniques could be the valid approach to model the comfort of textile materials.

Background and objectives The incidence of skin cancer in our society is growing at an alarming rate due to overexposure to solar UV radiation in recreational and occupational settings. The aim of this study was to evaluate sun exposure and protection attitudes, behaviors, and knowledge among mountain ultramarathon runners and to assess risk factors for sunburn in this population. Material and methods Cross-sectional survey of runners who participated in the Gran Trail Aneto-Posets race in Aragon, Spain. Using a validated questionnaire, we collected data on sociodemographic characteristics, running experience, sunburn in the previous summer, and sun exposure and protection behaviors. We calculated descriptive statistics and performed bivariate and multivariate analyses of associations using history of sunburn as the primary outcome. Statistical significance was set at a P level of less than .05. Results We surveyed 657 runners (72.1% men) with a mean age of 39.71 years; 45.1% reported sunburn in the past year. The most common protective measures used were sunglasses (74.7%), sunscreen (sun protection factor ≥ 15) (61.9%), a hat (52.2%), and other protective clothing (7.4%). Risk factors for sunburn were younger age, low Fitzpatrick skin type (I and II), running for 3 or more hours a day, and staying in the shade as a protective measure. By contrast, protective factors were use of sunscreen and seeking shade rather than sun at midday (P Conclusions Sunburn is common among long-distance mountain runners, despite what appears to be adequate sun protection knowledge and behaviors. Targeted strategies are needed to improve sun protection behaviors among mountain runners.

Purpose Electrophysiology procedures pose infection risk and require surgical room sterility. Currently, there is no universally approved protocol for disinfecting lead garments in the electrophysiology laboratory. This study explores the feasibility of using ATP testing to assess the microbial burden of lead aprons and evaluates the impact of a sanitary intervention. Methods Adenosine triphosphate (ATP) testing is a well-established hospital standard to quantify biological matter on a surface and, by proxy, the microbial burden. It is measured in RLU (relative light units). Pre-intervention ATP testing was performed on 34 lead garments after use for electrophysiology procedures. The thyroid collar, mid-chest vest, and left axillary areas of the garments were swabbed using a Hygiena SystemSure II luminometer with ATP swabs (Hygiena, Camarillo, CA). These sites were then disinfected with disinfectant wipes (PDI Super Sani-cloth Germicidal Disposable Wipe) and ATP testing was repeated. Results The mean duration of garment wear was 213 min. The thyroid collars had the highest mean RLU before intervention, followed by the mid-chest vest and the left axillary areas. The intervention was found to significantly decrease ATP readings for all three sites (p = 0.0002, p = 0.0001, p = 0.0002 respectively). Linear regression modeling to assess the impact of intervention showed a significant correlation with pre-intervention ATP values for all three sites but no correlation with fluoroscopy time, fluoroscopy dose, or total time spent within the procedure. Conclusions Lead garments harbor microbial contamination after use according to ATP testing. A sanitary intervention can decontaminate lead garments and potentially reduce rates of hospital infection.

Aim: An extremely important property of firefighters’ special clothing is thermal resistance of the clothing materials to heat transfer from radiation or flame. Performing tests with the use of thermal mannequins may contribute to the improvement of clothing sets, as such tests indicate weak points of the tested products. The review article presents information on the testing of special clothing on mannequins and a short history of test stands with the use of thermal mannequins. Introduction: Using innovative techniques and technologies provides firefighters-rescuers with an appropriate level of safety. Special clothing is a barrier between the human body and the heat and water vapour from the environment. It is this garment that protects the human body from overheating or cooling down. Methodology: The general test procedure for using thermal mannequins is described in ASTM standards (for instance ASTM F2370 – 10 [1], ASTM F2371 – 10 [2]). Testing of special clothing allowing for an accurate assessment of the degree of protection of the human body against the effects of fire, flame and heat was initiated in the United States. The assumption of these works was to create a mannequin for testing the resistance of clothing equipped with heat sensors to flash fires. Currently, there are around 100 different models of thermal mannequins around the world. Technological progress in the post-war period resulted in the rapid development of mannequins built with a multi-segment structure. This allowed to increase the accuracy of the measurements that simulated heat exchange between the human body and the environment. The data obtained in this manner is repeatable, which allows for standardization of the test requirements for thermal insulation of clothing sets. Conclusions: Performing tests using thermal mannequins contributes to the improvement of clothing sets in order to increase the safety of the users. The results obtained under the test conditions very accurately indicate the number, location and degree of burns to which the user of such clothing may be exposed. Keywords: protective clothing, special clothing, thermal mannequin, thermal resistance, test stands to determine thermal loads Type of article: review article

PURPOSE Damage to shielding sheets on X-ray protective clothing may be a cause of increased radiation exposure. To prevent increased radiation exposure, periodic quality control of shielding sheets is needed. For quality management, a record of the size of damage is required after checking for the existence of damage, and this requires a great deal of effort and time. Additionally, the detection model created from the images of the shielding sheets, limited by the number of samples, is predicted to have a low detection precision. The purpose of this study was to automate damage area detection and area measurement using artificial damage images and a damage detection model created using deep learning. METHOD By synthesizing the X-ray protective clothing CT localizer image and the image simulating damage, we created an artificial damage image. We then found the detection precision of the damage detection model created by the artificial damage image and YOLOv5s, and error of the automatically measured damage area. RESULT The accuracy rate of the damage detection model was 0.746, the precision was 0.645, the reproduction rate was 0.741, the F value was 0.690, and 48 mm2 or the detectable area of damage ranged from 2 mm2 to 113 mm2. The mean value of the damage area error was 7.58% for areas not including the hem and 43.39% for areas including the hem. In the areas not including the hem, with a detected damage area of 91%, the damage area error was 0%. Additionally, the process from damage area detection to damage area measurement was completed in 20 seconds. CONCLUSION By using a damage detection model created with only artificial damage areas, it was possible to automate damage detection and damage area measurement, and this saved time for X-ray protective clothing management.

In March 2020, in response to the coronavirus disease 2019 (COVID-19) pandemic, the executive leadership of an academic medical center in Atlanta tasked an interprofessional quality improvement (QI) team with identifying ways to improve staff and patient safety while caring for patients with suspected or confirmed COVID-19 infection. Additional goals of the initiative were to improve workflow efficiency by reducing the amount of time spent donning and doffing personal protective equipment (PPE) and to conserve PPE, which could be in short supply in a prolonged pandemic. The QI team developed a "warm zone model" that allowed staff members to wear the same mask, eye protection, and gown while moving between the rooms of patients who had tested positive for COVID-19. The risk of self-contamination while doffing PPE is well documented. Staff members were trained to conserve PPE and to properly change gloves and perform hand hygiene between exiting and entering patients' rooms. The warm zone model allowed multidisciplinary team members to reduce the times they donned and doffed PPE per shift while maintaining or increasing the times they entered and exited patients' rooms. Staff members believed that the model improved workflow and teamwork while maintaining staff members' personal safety. Daily gown use decreased on the acute care unit where the model was employed, helping to preserve PPE supplies. Once the model was proven successful in acute care, it was modified and instituted on several critical care COVID-19 cohort units.

Gasoline is the most common transportation fuel in Brazil, with up to 1% of benzene. Benzene is a health-damaging organic solvent that is extensively used worldwide, being classified as a human carcinogen by the International Agency for Research on Cancer (Group 1). Many workers at filling stations are exposed to benzene, present in gasoline. The main routes of exposure and absorption of benzene are inhalation, oral, and dermal routes. The penetration and maintenance of benzene and other chemicals on personal protective equipment and clothing of workers who manipulate these solvents may increase their levels of exposure and offer risks to their family members, since contaminated clothing is laundered at their homes, which goes against legislative framework (Annex 2, Regulatory Standard No. 9). This way, the objective of this work was to discuss the importance of periodic changes and cleaning of filling station attendant uniforms performed by employers as preventive measures against the deterioration of the health of workers and their family members. We performed a narrative review; no systematic criteria were used in the search for national and international studies. After critical reading, we observed a lack of consistent data on this theme. Laundering of uniforms worn by filling station attendants should take place outside the domestic environment in order to protect the health of workers and their family members and avoid possible cross-contamination.