Perceived risks for slipping and falling at work during wintertime and criteria for a slip-resistant winter shoe among Swedish outdoor workers

The leading cause of work related accidents in Sweden is falls. Many slips and falls occur on icy and snowy surfaces, but there is limited knowledge about how to prevent accidents during outdoor work in winter conditions. The purpose of this study was to describe risk factors of slips and falls and criteria for slip-resistant winter shoes from a user perspective. The result is based on focus group interviews with 20 men and women working in mail delivery, construction and home care in Sweden. The data was analyzed with qualitative content analysis. Risk factors described were related to physical work environment, risky work situations, individual and organizational factors. User criteria for winter work shoes focused on safety, adaptation to the environment, usability and own priorities. The mechanisms of slips and falls during outdoor work are complex. There is a need for more functional and user friendly work shoes than those available and user preferences should be considered by shoe designers. Future challenges include finding ways to make individually adapted shoes suitable for changing work environments, situations and tasks.

Source: Norlander A, Miller M, Gard G. Safety Sci. 2015; 73: 52-61.

Effect of firefighters' personal protective equipment on gait

The biomechanical experiment with eight male and four female firefighters demonstrates that the effect of adding essential equipment: turnout ensemble, self-contained breathing apparatus, and boots (leather and rubber boots), significantly restricts foot pronation. This finding is supported by a decrease in anterior-posterior and medial-lateral excursion of center of plantar pressure (COP) trajectory during walking. The accumulation of this equipment decreases COP velocity and increases foot-ground contact time and stride time, indicating increased gait instability. An increase in the flexing resistance of the boots is the major contributor to restricted foot pronation and gait instability as evidenced by the greater decrease in excursion of COP in leather boots (greater flexing resistance) than in rubber boots (lower resistance). The leather boots also shows the greatest increase in foot contact time and stride time. These negative impacts can increase musculoskeletal injuries in unfavorable fire ground environments.

Source: Park H, Kim S, Morris K, Moukperian M, Moon Y, Stull. J. Appl. Ergon, 2015; 48: 42-48.

Effects of air bottle design on postural control of firefighters

The purpose of this study was to investigate the effect of firefighter's self-contained breathing apparatus (SCBA) air bottle design and vision on postural control of firefighters. Twenty-four firefighters were tested using four 30-minute SCBA bottle designs that varied by mass and size. Postural sway measures were collected using a forceplate under two visual conditions (eyes open and closed) and two stance conditions (quiet and perturbed stances). For perturbed stance, a mild backward impulsive pull at the waist was applied. In addition to examining center of pressure postural sway measures for both stance conditions, a robustness measure was assessed for the perturbation condition. The results suggest that wearing heavy bottles significantly increased excursion and randomness of postural sway only in medial-lateral direction but not in anterior-posterior direction. This result may be due to stiffening of plantar-flexor muscles. A significant interaction was obtained between SCBA bottle design and vision in anterior-posterior postural sway, suggesting that wearing heavy and large SCBA air bottles can significantly threaten postural stability in AP direction in the absence of vision. SCBA bottle should be redesigned with reduced weight, smaller height, and COM closer to the body of the firefighters. Firefighters should also widen their stance width when wearing heavy PPE with SCBA.

Source: Hur P, Park K, Rosengren KS, Horn GP, Hsiao-Wecksler ET. Appl. Ergon. 2015; 48: 49-55.

Do active safety-needle devices cause spatter contamination?

Exposure to blood and body fluids is an occupational hazard in healthcare. Although the potential for blood-borne virus transmission through needlestick injury has been widely studied, the risk of this occurring through spatter contamination from safety-needle syringes is not well understood. This report examines this risk from three commonly used safety needles and suggests that this presents a new and significant hazard. Further work should be commissioned to quantify this hazard and determine which type of safety needle would minimize spatter contamination following syringe discharge and safety activation.

Source: M. Roffa, S. Basub, A. Adiseshc. Journal of Hospital Infection, Volume 86, Issue 3, March 2014, p. 221–223.

Review of fit test pass criteria for Filtering Facepieces Class 3 (FFP3) respirators

Respiratory Protective Equipment (RPE) is available in a range of types which often include a tight-fitting facepiece which must fit the wearer's face well for the RPE to work effectively. Good fit must be demonstrated by fit testing.
In this study, 25 volunteer test subjects wearing tight-fitting FFP3 (randomly selected from 9 different models) underwent four fit tests (Bitrex qualitative taste test, Portacount particle counting with and without the N95 companion technology and the laboratory chamber method), in random order, according to methodology given in HSE guidance 282/28. The selected FFP3 model worn by each test subject was not adjusted until all four fit tests had been completed.
Results analysed according to the criteria given in the American National Standard for fit test validation, indicate that the Portacount fit test method is more difficult to pass than the other methods. Differences in the methodologies and the potential for bias in the results across the fit test methods are discussed.


Exposure to carcinogens in surface engineering

Supplementary report
This report details work undertaken following HSE research published as RR963 Exposure to hexavalent chromium, nickel and cadmium compounds in the electroplating industry (Keen et al, 2013). This examined the use of biological monitoring (BM) in the surface engineering (electroplating) industry.
The report examines the efficacy of gloves, the use of surfactants and local exhaust ventilation in chromium plating, and the potential for transfer of contaminants outside the workplace.


Precautionary Practices of Healthcare Workers Who Disinfect Medical and Dental Devices Using High-Level Disinfectants

BACKGROUND: High-level disinfectants (HLDs) are used throughout the healthcare industry to chemically disinfect reusable, semicritical medical and dental devices to control and prevent healthcare-associated infections among patient populations. Workers who use HLDs are at risk of exposure to these chemicals, some of which are respiratory and skin irritants and sensitizers.
OBJECTIVE: To evaluate exposure controls used and to better understand impediments to healthcare workers using personal protective equipment while handling HLDs.
DESIGN: Web-based survey.
PARTICIPANTS: A targeted sample of members of professional practice organizations representing nurses, technologists/technicians, dental professionals, respiratory therapists, and others who reported handling HLDs in the previous 7 calendar days. Participating organizations invited either all or a random sample of members via email, which included a hyperlink to the survey.
METHODS: Descriptive analyses were conducted including simple frequencies and prevalences.
RESULTS: A total of 4,657 respondents completed the survey. The HLDs used most often were glutaraldehyde (59%), peracetic acid (16%), and ortho-phthalaldehyde (15%). Examples of work practices or events that could increase exposure risk included failure to wear water-resistant gowns (44%); absence of standard procedures for minimizing exposure (19%); lack of safe handling training (17%); failure to wear protective gloves (9%); and a spill/leak of HLD during handling (5%). Among all respondents, 12% reported skin contact with HLDs, and 33% of these respondents reported that they did not always wear gloves.
CONCLUSION: Findings indicated that precautionary practices were not always used, underscoring the importance of improved employer and worker training and education regarding HLD hazards.

Source: Scott A. Henn, James M. Boiano and Andrea L. Steege. Infection Control & Hospital Epidemiology, Volume 36, Issue 02, February 2015, p.p 180-185.

Fighting Ebola: A Grand Challenge for Development

How NIOSH is Helping Design Improved Personal Protective Equipment for Healthcare Workers
The current Ebola epidemic in West Africa is the largest in history and is unprecedented in many ways, including the large number of healthcare workers who have been infected while treating patients. The large scale of the epidemic, as well as the two healthcare workers who contracted Ebola while caring for the first case in the United States, has directed particular attention to the personal protective equipment (PPE) used by healthcare workers to reduce their risk of infection. PPE is designed to create a barrier to prevent pathogens from entering the body through the mucous membranes or broken skin. Examples of PPE used for Ebola include (but are not limited to) gloves, gown/coverall, mask/respirator, apron, faceshield/goggles, and cap/hood (see Figure 1). Reports from healthcare workers in West Africa indicate that some personnel are able to wear their PPE for only 40 minutes at a time because of the high ambient temperature and humid conditions. Even in the United States, where management of patients with Ebola is done in air-conditioned environments, uncomfortable PPE is a common complaint and causes additional burden for healthcare workers.


Assessment of Personal Protective Equipment Use Among Farmers in Eastern North Carolina

A Cross-sectional Study
Agriculture consistently ranks among the top hazardous occupations, accounting for a significant number of injuries and fatalities in the workplace. Eastern North Carolina has a significant number of small, independent, family-run, owned, and operated farms. However, little is known about perception, behavior, training, accessibility, or purchasing personal protective equipment (PPE) for safety among farmers in the region. In this study, telephone interviews were conducted among participating farmers between March and June 2012 (N = 129). Univariate and bivariate analyses were conducted to examine associations between PPE behavior and workplace hazards, health-related concerns, and wearing and purchasing PPE. Findings indicated that personal behavior of wearing hearing protection devices (HPDs) and protection from the sun among farmers was low. However, a relatively high percentage of farmers reported wearing PPE when working with agricultural chemicals. Most farmers received training from agricultural extension offices. The findings indicate that, in general, farmers are well aware of the risks associated with occupational hazards and recognize concern for health and safety protection in the workplace. Transitioning these concerns into preventative action remains a challenge and priority for the agricultural health professional.

Source: Kearney GD, Xu X, Balanay JA, Allen DL, Rafferty AP. J. Agromed. 2015; 20: 43-54.

A multi factorial analysis of the epidemiology of injuries from falls from heights

BACKGROUND: Fall from height is a common cause of morbidity and mortality in suburban population in India. These cases are either domestic or workplace injuries with different causative factors. We analyzed different aspects of these falls to identify their risk factors.
MATERIALS AND METHODS: We conducted prospective and retrospective epidemiological study to identify various causative, contributory factors, and resultant injuries in cases of fall from height. The study group comprised of semiurban population and involved both domestic and workplace injuries presenting to a tertiary care hospital.
RESULTS: There were 208 cases of workplace (112) and domestic (96) fall from height. In domestic cases absence of parapet on roof was the commonest cause, most of falls occurred during summer and rainy season. Alcohol consumption prior to fall was commonest associated factor in adult males. Children mostly fell while playing on roof and climbing trees. Among workplace cases, civil construction site injuries were commonest and absence of any protective gear and long working and evening hours were commonest associated factors. Mean injury severity score was 10.86 in domestic cases and 14.87 in workplace cases. There were 17 mortalities with head injury being commonest associated cause. Only difference in incidence of alcohol consumption and permanent disability was statistically significant between workplace and domestic falls.
CONCLUSION: Different factors are responsible for domestic and workplace cases of fall from height. Most of these cases are potentially preventable.

Source: Jain V, Jain S, Dhaon B. Int. J. Crit. Illn. Inj. Sci, 2014; 4: p. 283-287.

Hospital unit safety climate

Relationship with nurses' adherence to recommended use of facial protective Equipment
Background : Despite the existence of formal guidelines for the acute health care sector, nurses' adherence to recommended use of facial protective equipment (FPE) to prevent occupational transmission of communicable respiratory disease remains suboptimal. In addition to individual factors such as knowledge and education, group factors such as shared perceptions of organizational support for safety may influence adherence. These group safety climate perceptions can differ depending on the pace and type of work, local leadership, and organizational structure of each unit.
Methods : An analysis of a data set from a cross-sectional survey of 1,074 nurses in 45 units of 6 acute care hospitals was conducted. Variance components analysis was performed to examine the variance in perceptions of safety climate and adherence between units. Hierarchical linear modeling using unit-level safety climate dimensions was conducted to determine if unit-level safety climate dimensions were predictors of nurses' adherence to FPE.
Results : Findings revealed statistically significant unit variances in adherence and 5 of the 6 unit-level safety climate dimensions (P < .05). Furthermore, a hierarchical model suggested that tenure and unit-level communication were significantly associated with increased adherence to FPE (P < .05).
Conclusion : Unit-level safety climate measures varied significantly between units. Strategies to improve unit-level communication regarding safety should assist in improving adherence to FPE.

Source: Diamant Rozenbojm, Michael, Nichol, Kathryn, Spielman, Stephanie, & Holness, Linn. (2014). AJIC : American Journal of Infetion Control. February 1, 2015, Volume 43, Issue 2, Pages 115–120.

Predicting the probability of slip in gait

Methodology and distribution study
The likelihood of a slip is related to the available and required friction for a certain activity, here gait. Classical slip and fall analysis presumed that a walking surface was safe if the difference between the mean available and required friction coefficients exceeded a certain threshold. Previous research was dedicated to reformulating the classical slip and fall theory to include the stochastic variation of the available and required friction when predicting the probability of slip in gait. However, when predicting the probability of a slip, previous researchers have either ignored the variation in the required friction or assumed the available and required friction to be normally distributed. Also, there are no published results that actually give the probability of slip for various combinations of required and available frictions. This study proposes a modification to the equation for predicting the probability of slip, reducing the previous equation from a double-integral to a more convenient single-integral form. Also, a simple numerical integration technique is provided to predict the probability of slip in gait: the trapezoidal method. The effect of the random variable distributions on the probability of slip is also studied. It is shown that both the required and available friction distributions cannot automatically be assumed as being normally distributed. The proposed methods allow for any combination of distributions for the available and required friction, and numerical results are compared to analytical solutions for an error analysis. The trapezoidal method is shown to be highly accurate and efficient. The probability of slip is also shown to be sensitive to the input distributions of the required and available friction. Lastly, a critical value for the probability of slip is proposed based on the number of steps taken by an average person in a single day.

Source: Gragg J, Yang J. Comput. Methods Biomech. Biomed. Eng. 2015, p. 1-8.

The Use and Effectiveness of Powered Air Purifying Respirators in Health Care

Workshop Summary
Protecting 18 million United States health care workers from infectious agents—known and unknown—involves a range of occupational safety and health measures that include identifying and using appropriate protective equipment (CDC, 2014a). The 2009 H1N1 influenza pandemic and the 2014 Ebola virus outbreak in West Africa have called attention to the importance of personal protective equipment (PPE) in different health care settings and have raised questions about how best to ensure appropriate and effective use of different kinds of PPE (such as respirators), not only to promote occupational safety but also to reduce disease transmission, in general.
Since 2005, the National Personal Protective Technology Laboratory (NPPTL) at the National Institute for Occupational Safety and Health (NIOSH) has sponsored the Institute of Medicine (IOM) Standing Committee on Personal Protective Equipment for Workplace Safety and Health. In mid-2014, NPPTL asked the IOM to convene a workshop, “The Use and Effectiveness of Powered Air Purifying Respirators in Health Care,” to help prioritize and accelerate NIOSH activities to update certification requirements for powered air purifying respirators (PAPRs) for use in health care.


Compliance with the ANSI Z133.1 - 2006 safety standard among arborists in New England

INTRODUCTION: Arboriculture is hazardous work. A consensus safety standard exists, but little is known about compliance with it. This study aimed to determine whether accreditation and certification are associated with safety practices and to identify specific safety practices adhered to most and least.
METHOD: Sixty-three tree care companies in southern New England were directly observed on job sites. Adherence to the American National Standards for Arboricultural Operations (ANSI Z133.1 - 2006) was compared across companies that were accredited, non-accredited with certified arborists on staff, and non-accredited without certified arborists on staff.
RESULTS: Companies with accreditation or certified arborists demonstrated greater safety compliance than those without. However, low compliance was found across all company types for personal protective equipment (PPE) use, chain saw safety, and chipper safety.
CONCLUSIONS: Greater attention to PPE, chain saw, and chipper practices is warranted across the industry. Safety in non-accredited companies without certified arborists especially needs improvement. PRACTICAL APPLICATION: Only partial compliance was found among accredited companies and companies with certified arborists. Intervention strategies are needed for all company types for the use of PPE and safer use of chain saws and chippers.

Source: Julius AK, Kane B, Bulzacchelli MT, Ryan HD. J. Saf. Res. 2014; 51: 65-72.

Sun Protection Behaviors Among Latino Migrant Farmworkers in Eastern North Carolina

Objective: Farmworkers are at an increased risk of skin cancer from exposure to excessive amounts of ultraviolet radiation from the sun. The primary objective of this study was to evaluate sun protection behaviors.
Methods: A cross-sectional study of Latino farmworkers in eastern North Carolina was conducted using personal interviews followed by a full-body examination for skin cancers (N = 157).
Results: Participants were predominately, young, males from Mexico who spent 9 or more hours each work day in the sun. Most reported wearing long sleeved shirts (85.7%) and long pants (98.0%). Few workers rarely used sunscreen (90.8%) or wore sunglasses (87.4%). Skin cancers were not identified among workers.
Conclusions: In general, farmworkers lack sufficient information and knowledge about the risks of skin cancer from the sun. Interventions for reducing excessive ultraviolet radiation exposures are warranted.

Source: Kearney, Gregory D. Phillips, Charles; Allen, Daniel Landon; Hurtado, Giovanny A.; Hsia, Ling-Lun Bob. Journal of Occupational & Environmental Medicine: December 2014, Volume 56, Issue 12, p. 1325–1331.

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