Mise à jour du guide technique
Les chutes de hauteur sont encore aujourd'hui une des causes majeures d'accidents du travail. Trop souvent, les travailleurs ne s'attachent pas, faute de point d'ancrage disponible, ou parce qu'ils trouvent que les points d'attache fixes restreignent trop leurs mouvements. Cette restriction peut toutefois être levée grâce aux systèmes de corde d'assurance horizontale (SCAH). Le présent rapport constitue la mise à jour du guide technique T-18 publié en 1991 et rend ce dernier caduc. Cette mise à jour était devenue nécessaire à la suite de l'introduction, en 2001, au Code de sécurité pour les travaux de construction (CSTC), de l'obligation d'équiper les cordons d'assujettissement d'un absorbeur d'énergie. De plus, puisque les ancrages des SCAH sont généralement flexibles, plutôt que rigides (une colonne structurale est un exemple d'ancrage rigide), il nous est apparu important d'en tenir compte dans la présente mise à jour. Ce rapport s'adresse principalement à des ingénieurs responsables de la conception des SCAH.
In epidemics of highly infectious diseases, such as Ebola Virus Disease (EVD) or SARS, healthcare workers (HCW) are at much greater risk of infection than the general population, due to their contact with patients' contaminated body fluids. Contact precautions by means of personal protective equipment (PPE) can reduce the risk. It is unclear which type of PPE protects best, what is the best way to remove PPE, and how to make sure HCWs use PPE as instructed.
To evaluate which type or component of full-body PPE and which method of donning or removing (doffing) PPE have the least risk of self-contamination or infection for HCWs, and which training methods most increase compliance with PPE protocols.
Source: Verbeek JH, Ijaz S, Mischke C, Ruotsalainen JH, Mäkelä E, Neuvonen K, Edmond MB, Sauni R, Kilinc Balci FS, Mihalache RC. Cochrane Database of Systematic Reviews 2016, Issue 4.
Effective abatement of fall hazards is complex, requiring skilled selection and assembly of equipment and systems. The chosen solutions need to be understood and properly used by workers, balancing protection from danger against the practical need to accomplish work. The optimal solution needs to consider the type of work, the frequency of access, the knowledge and skill of the workers, and many other factors. A solution that is effective for one situation can be cumbersome or even dangerous in another.
Coupure et perforation simultanées
Les lacérations de type perforation et coupure représentent une part importante des blessures aux mains dans plusieurs milieux de travail. Les agresseurs mécaniques comme la pointe d'un couteau, des échardes de métal, des pièces mal ébavurées ou des éclats de verre peuvent être très diversifiés et constituer des risques multiples. Le port de gants de protection contribue à réduire ces risques. Cependant, les gants n'offrent pas toujours une résistance adéquate pour tous les types d'agresseurs. Puisqu'il n'y a pas de corrélation entre les résistances à la coupure, à la perforation et à la piqûre, par exemple, un matériau peut être très résistant à un type d'agresseur mécanique et s'avérer très faible à un autre. Les travaux de recherche précédents, menés à l'IRSST, ont porté sur les phénomènes de coupure, de perforation, et plus récemment, de piqûre par des aiguilles médicales. Cependant, les mécanismes de perforation par un objet pointu et tranchant sont encore peu connus. Le manque d'information sur le processus combinant perforation et coupure, ainsi que l'absence de méthodes de caractérisation objective pour cette catégorie d'agresseurs, ne permet pas actuellement d'évaluer la protection qu'offrent les gants contre la perforation/coupure.
Lorsque l'élimination à la source ne peut être envisagée, la protection individuelle demeure la solution la plus utilisée pour protéger les travailleurs exposés à des niveaux de bruit importants en raison de sa facilité et de sa rapidité d'implantation, ainsi que de son faible coût économique. Le port des protecteurs auditifs est néanmoins associé à plusieurs problématiques : (i) ils peuvent être un cofacteur de risque pour les accidents du travail, (ii) leur performance réelle est souvent très différente de celle affichée en laboratoire ce qui peut induire une sous-protection du travailleur, (iii) les méthodes normalisées de déplacement du seuil d'audition (real-ear attenuation at threshold - REAT) et de la perte par insertion (insertion loss - IL) pour évaluer une performance individuelle des protecteurs sont difficiles à mettre en œuvre en milieu de travail, (iv) la technique de mesure avec microphone placé dans une oreille réelle (field microphone-in-real-ear - F-MIRE), plus appropriée à une implantation sur le site, ne permet pas encore d'obtenir une performance individuelle, (v) la durée de port recommandée pour limiter l'exposition au bruit n'est souvent pas respectée à cause de problèmes d'inconfort. Par ailleurs, les protecteurs sont souvent conçus de façon empirique ou à partir de modèles très simplifiés laissant souvent de côté la notion de confort.
Occupational slips, trips and falls on the same level (STFL) result in substantial injuries worldwide. This paper summarises the state of science regarding STFL, outlining relevant aspects of epidemiology, biomechanics, psychophysics, tribology, organisational influences and injury prevention. This review reaffirms that STFL remain a major cause of workplace injury and STFL prevention is a complex problem, requiring multi-disciplinary, multi-faceted approaches. Despite progress in recent decades in understanding the mechanisms involved in STFL, especially slipping, research leading to evidence-based prevention practices remains insufficient, given the problem scale. It is concluded that there is a pressing need to develop better fall prevention strategies using systems approaches conceptualising and addressing the factors involved in STFL, with considerations of the full range of factors and their interactions. There is also an urgent need for field trials of various fall prevention strategies to assess the effectiveness of different intervention components and their interactions.
Source: Chang, Wen-Ruey, Leclercq, Sylvie, Lockart, Thurmon E., Haslam, Roger. (2016). Ergonomics, 2016.
A systematic review and meta-analysis
Background: Conflicting recommendations exist related to which facial protection should be used by health care workers to prevent transmission of acute respiratory infections, including pandemic influenza. We performed a systematic review of both clinical and surrogate exposure data comparing N95 respirators and surgical masks for the prevention of transmissible acute respiratory infections.
Methods: We searched various electronic databases and the grey literature for relevant studies published from January 1990 to December 2014. Randomized controlled trials (RCTs), cohort studies and case–control studies that included data on health care workers wearing N95 respirators and surgical masks to prevent acute respiratory infections were included in the metaanalysis. Surrogate exposure studies comparing N95 respirators and surgical masks using manikins or adult volunteers under simulated conditions were summarized separately. Outcomes from clinical studies were laboratory-confirmed respiratory infection, influenza-like illness and workplace absenteeism. Outcomes from surrogate exposure studies were filter penetration, face-seal leakage and total inward leakage.
Results: We identified 6 clinical studies (3 RCTs, 1 cohort study and 2 case–control studies) and 23 surrogate exposure studies. In the metaanalysis of the clinical studies, we found no significant difference between N95 respirators and surgical masks in associated risk of (a) laboratory-confirmed respiratory infection (RCTs: odds ratio [OR] 0.89, 95% confidence interval [CI] 0.64–1.24; cohort study: OR 0.43, 95% CI 0.03–6.41; case–control studies: OR 0.91, 95% CI 0.25–3.36); (b) influenza-like illness (RCTs: OR 0.51, 95% CI 0.19–1.41); or (c) reported workplace absenteeism (RCT: OR 0.92, 95% CI 0.57–1.50). In the surrogate exposure studies, N95 respirators were associated with less filter penetration, less face-seal leakage and less total inward leakage under laboratory experimental conditions, compared with surgical masks.
Interpretation: Although N95 respirators appeared to have a protective advantage over surgical masks in laboratory settings, our metaanalysis showed that there were insufficient data to determine definitively whether N95 respirators are superior to surgical masks in protecting health care workers against transmissible acute respiratory infections in clinical settings.
Source: Smith, J. D., MacDougall, C. C., Johnstone, J., Copes, R. A., Schwartz, B., & Garber, G. E. (2016). Canadian Medical Association Journal.
Background: Research on fatal work-related traumatic brain injuries (TBIs) is limited. This study describes fatal TBIs in the US construction industry.
Methods: Fatal TBIs were extracted from the Bureau of Labor Statistics Census of Fatal Occupational Injuries.
Results: From 2003 to 2010, 2,210 fatal TBIs occurred in construction at a rate of 2.6 per 100,000 full-time equivalent (FTE) workers. Workers aged 65 years and older had the highest fatal TBI rates among all workers (7.9 per 100,000 FTE workers). Falls were the most frequent injury event (n = 1,269, 57%). Structural iron and steel workers and roofers had the highest fatal TBI rate per 100,000 FTE workers (13.7 and 11.2, respectively). Fall-related TBIs were the leading cause of death in these occupations.
Conclusions: A large percentage of TBIs in the construction industry were due to falls. Emphasis on safety interventions is needed to reduce these fall-related TBIs, especially among vulnerable workers. Am. J. Ind. Med. 59:212–220, 2016. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.
Source: Konda, S., Tiesman, H. M. and Reichard, A. A. (2016). Am. J. Ind. Med., 59: 212–220.
Face shields are personal protective equipment devices that are used by many workers (e.g., medical, dental, veterinary) for protection of the facial area and associated mucous membranes (eyes, nose, mouth) from splashes, sprays, and spatter of body fluids. Face shields are generally not used alone, but in conjunction with other protective equipment and are therefore classified as adjunctive personal protective equipment. Although there are millions of potential users of face shields, guidelines for their use vary between governmental agencies and professional societies and little research is available regarding their efficacy.
Source: Raymond J. Roberge. Journal of Occupational and Environmental Hygiene, Volume 13, Issue 4, 2016, pa. 239-246.
Simulated Workplace Protection Factor Study
Objective: Surgical smoke generated during electrocautery contains toxins which may cause adverse health effects to operating room (OR) personnel. The objective of this study was to investigate the performance of surgical masks (SMs), which are routinely used in ORs, more efficient N95 surgical mask respirator (SMRs) and N100 filtering facepiece respirator (FFRs), against surgical smoke.
Methods: Ten subjects were recruited to perform surgical dissections on animal tissue in a simulated OR chamber, using a standard electrocautery device, generating surgical smoke. Six respiratory protective devices (RPDs) were tested: two SMs, two SMRs, and two N100 FFRs [including a newly developed faceseal (FS) prototype]. Fit testing was conducted before the experiment. Each subject was then exposed to the surgical smoke while wearing an RPD under the tests. Concentrations inside (Cin) and outside (Cout) of the RPD were measured by a particle size spectrometer. The simulated workplace protection factor (SWPF) was determined by the ratio of Cout and Cin for each RPD-wearing subject.
Results: For the SMs, the geometric means of SWPFtotal (based on the total aerosol concentration) were 1.49 and 1.76, indicating minimal protection. The SWPFtotal values of the SMRs and N100 FFRs were significantly higher than those of the SMs: for the two SMRs, the SWPFtotal were 208 and 263; for the two N100s, the SWPFtotal values were 1,089 and 2,199. No significant difference was observed between either the two SMs or the two SMRs. The SWPFtotal for the novel FS prototype N100 FFR was significantly higher than the conventional N100 FFR. The correlation between SWPFtotal and fit factor (FF) determined for two N95 SMRs was not significant.
Conclusions: SMs do not provide measurable protection against surgical smoke. SMRs offer considerably improved protection versus SMs, while the N100 FFRs showed significant improvement over the SMRs. The FS prototype offered a higher level of protection than the standard N100 FFR, due to a tighter seal. While we acknowledge that conventional N100 FFRs (equipped with exhalation valves) are not practical for human OR use, the results obtained with the FS prototype demonstrate the potential of the new FS technology for implementation on various types of respirators.
Source: Shuang Gao, Richard H. Koehler, Michael Yermakov and Sergey A. Grinshpun. Ann Occup Hyg (2016).
The award-winning NIOSH Ladder Safety App is now updated based on our users’ feedback. First introduced in 2013, the app has received much positive feedback. As of the end of 2015, it has more than 52,000 downloads. Among those promoting the app are state officials, industry leaders, and safety professionals. Many companies have even incorporated the use of the app as part of their safety policy. It has also attracted considerable international attention and earned a merit award from the Digital Health Awards, a program that recognizes the world’s best digital health resources for consumers and health professionals.
The Ebola epidemic in West Africa presents a considerable occupational risk to the health personnel involved. The principal mode of virus transmission to health care personnel is through direct contact with the patient, although transmission by aerosols through the air may also occur. Many safety protocols have been suggested relating to personal protection and particularly respiratory protection. It is generally agreed that all health care workers should have easy access to personal protective equipment. However, the degree of respiratory safety escalates from a mask, to an adequate respirator, and finally to a whole body suit with integrated helmet and positive air pressure. Recent publications demonstrate a lack of consensus on the degree of safety necessary. The step from “safe enough” to being “absolutely safe” seems, in most countries, insurmountable because of costs and logistics.
Source: Hanoa, R.O., & Moen, B.E. (2016). Workplace Health & Safety, 64(2), 48-50.
The NIOSH MultiVapor™ tool has been updated and posted to the web. MultiVapor™ is a computer tool for estimating breakthrough times and service lives of air-purifying respirator cartridges for removing toxic organic vapors from breathed air. It can also be used for larger filters and for carbon beds of any size prepared for laboratory studies. MultiVapor™ 2.2.3 replaces the 2.1.3 version.
The relationship among actual angle, method of setup and knowledgee
Ladder inclined angle is a critical factor that could lead to a slip at the base of portable straight ladders, a major cause of falls from heights. Despite several methods established to help workers achieve the recommended 75.5° angle for ladder setup, it remains unclear if these methods are used in practice. This study explored ladder setup behaviors in a field environment. Professional installers of a company in the cable and other pay TV industry were observed for ladder setup at their worksites. The results showed that the actual angles of 265 ladder setups by 67 participants averaged 67.3° with a standard deviation of 3.22°. Although all the participants had training on recommended ladder setup methods, only three out of 67 participants applied these methods in their daily work and even they failed to achieve the desired 75.5° angle. Therefore, ladder setup remains problematic in real-world situations.
Source: Chang WR, Huang YH, Chang CC, et al. Ergonomics, 2015.
This is the third edition of CSA Z96, High-visibility safety apparel. It supersedes the previous editions published in 2009 and 2002. This edition incorporates advice on selection, use, and care of high-visibility safety material taken from the CSA Z96.1 Guideline (see Annex A). It is designed to be in technical harmony with ANSI/ISEA 107 and ISO 20471.
The focus of this Standard is on the performance of retroreflective and background materials incorporated into garments intended to provide the wearer with increased conspicuity under both wellilluminated and low-light or dark work environmental conditions. It sets out levels of retroreflective performance (i.e., light reflected from vehicle headlights as viewed by the vehicle operator), the colours and luminosity of background materials, and the human body coverage of the high-visibility components. Three classes of garments have been defined based on body coverage of bright or fluorescent-coloured materials, and two levels of performance have been specified for retroreflective materials. In addition, special allowances have been made for garments that are primarily intended to provide flame protection.
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