Variation in health care worker removal of personal protective equipment

In the current era of emerging pathogens such as Ebola virus, removal of personal protective equipment (PPE) is crucial to reduce contamination of health care workers. However, current removal practices are not well described. We undertook a systematic evaluation of health care worker removal of PPE for contact isolation to examine variation in removal procedures. Findings indicate that under usual conditions, only about half of health care workers correctly remove their PPE, and very few remove their PPE in the correct order and dispose of it in the proper location.

Source: Zellmer, Caroline, Van Hoof, Sarah, & Safdar, Nasia. (2015). American Journal of Infection Control, 43 (7), p. 750-751.  http://dx.doi.org/10.1016/j.ajic.2015.02.005

The effect of wearer stubble on the protection given by Filtering Facepieces Class 3 (FFP3) and Half Masks

HSE Inspectors routinely come across workers with various degrees of stubble growth using respiratory protective masks, despite guidance to the contrary. This research studied the effect of 0-7 days stubble growth on the protection given by FFP3 filtering facepieces and half masks.
Fifteen male volunteers took part, each testing four masks. For most, three different design FFP3 and one half mask were tested, selected from seven models of FFP3 and 2 half masks. Fit tests were carried out immediately after shaving and repeated six times during the following week, without further shaving.
Results showed that the effect on protection was quite specific to the mask/wearer combination. Protection could be significantly reduced where stubble was present, beginning within 24 hours from shaving, and generally worsening as facial hair grew. Statistical analysis predicted this could reach an unacceptable level for all of the masks tested.

Source: http://www.hse.gov.uk/research/rrhtm/rr1052.htm

Fumigation

Health & safety guidance for employers & technicians carrying out fumigation operations
The guidance is primarily for employers and fumigators/fumigation technicians (including the self-employed) to help them comply with the Control of Substances Hazardous to Health Regulations 2002 (COSHH) when carrying out fumigation activities, both traditional pest control (invertebrate fumigation) and within the laboratory and biosecurity sectors. It will also be useful to their safety representatives.
It outlines the real risks and describes the law that applies to fumigation operations. There is specific advice on procedures common to all fumigation operations, including the use of monitoring equipment, personal protective equipment and respiratory protective equipment, health surveillance and first aid.

Source: http://www.hse.gov.uk/pubns/books/hsg251.htm

N95 Respirators use during pregnancy

Findings from recent research
Recent NIOSH research has shed some light on the topic of the safety of N95 filtering facepiece respirators (FFR) use by pregnant workers. Women make up approximately one-half of the US work force. At any given time, about 10% of those female workers of child-bearing age (15–44 years of age) will be pregnant. Because many women are employed in occupations that require the use of protective facemasks, such as medical/surgical masks and FFR, NIOSH conducted research into the safety of FFR use while pregnant. The most frequently used FFR in the US is the N95 FFR (commonly referred to as “N95 mask”), but little information was previously available about the safety of N95 FFR use during pregnancy. Some individuals complain of difficulty breathing when wearing an N95 FFR or other protective facemasks, and many pregnant women find that they become somewhat shorter of breath as their pregnancy progresses, causing concern that use of N95 FFRs during pregnancy might make breathing even more difficult and possibly harm the woman and her fetus. Beyond the issue of use by pregnant working women on the job, the question also has implications for pregnant women outside the workplace. People sometimes use N95 FFRs as a matter of personal choice during infectious disease outbreaks, during environmental disasters that pollute the air, and even in more common recreational activities that may expose them to airborne allergens, such as gardening and woodworking.

Source: http://blogs.cdc.gov/niosh-science-blog/2015/06/18/respirators-pregnancy/

Passage percutané et protection cutanée vis-à-vis du risque chimique

Deux outils disponibles
L'INRS met à disposition deux outils, en ligne. D'une part, une base de données, IH SkinPerm, développée par l'Association américaine d'hygiène industrielle (AIHA) et traduite en français par l'INRS, permet d'estimer le passage percutané des agents chimiques. D'autre part, un logiciel, ProtecPo, développé en partenariat avec l'Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST) du Québec, aide au choix des matériaux de protection cutanée contre les produits chimiques.

Source: http://www.rst-sante-travail.fr/rst/pages-article/ArticleRST.html?ref=RST.AC 76

Systèmes d'ancrage pour la protection contre les chutes

Ce guide se veut un outil d'information pour les employeurs de la construction qui auront à fabriquer, à installer ou à utiliser des systèmes d'ancrage pour la protection contre les chutes conformes à la nouvelle règlementation du Code de sécurité pour les travaux de construction (RLRQ, chap. S-2.1, r.4).?

Source: http://www.csst.qc.ca/publications/200/Pages/DC_200_1576.aspx

Real-time core body temperature estimation from heart rate for first responders wearing different levels of personal protective equipment

First responders often wear personal protective equipment (PPE) for protection from on-the-job hazards. While PPE ensembles offer individuals protection, they limit one's ability to thermoregulate, and can place the wearer in danger of heat exhaustion and higher cardiac stress. Automatically monitoring thermal-work strain is one means to manage these risks, but measuring core body temperature (Tc) has proved problematic. An algorithm that estimates Tc from sequential measures of heart rate (HR) was compared to the observed Tc from 27 US soldiers participating in three different chemical/biological training events (45-90 min duration) while wearing PPE. Hotter participants (higher Tc) averaged (HRs) of 140 bpm and reached Tc around 39°C. Overall the algorithm had a small bias (0.02°C) and root mean square error (0.21°C). Limits of agreement (LoA ± 0.48°C) were similar to comparisons of Tc measured by oesophageal and rectal probes. The algorithm shows promise for use in real-time monitoring of encapsulated first responders.

Source: Buller MJ, Tharion WJ, Duhamel CM, Yokota M. Ergonomics, 2015.
http://dx.doi.org/10.1080/00140139.2015.1036792

Keeping workers safe

Does provision of personal protective equipment match supervisor risk perceptions?
BACKGROUND: Although farm management may understand agriculture's risks, they may not provide personal protective equipment (PPE). This study describes thoroughbred farm management's risk perceptions, provision of PPE, and factors that influence its provision.
METHODS: Thirty-five representatives from 26 farms participated in a 1-4hr semi-structured interview covering perceived risks associated with horse work and perspectives and provision of PPE. Interviews were audio-recorded, transcribed, entered into ATLAS.ti, and analyzed by three coders.
RESULTS: Management cited horse-related tasks as most dangerous, yet horse-related PPE as least provided because of 1) differences in farm context, 2) the belief that workers were most important agents in their safety, 3) lack of confidence in its effectiveness, and 4) the perception that risk could never be eliminated.
CONCLUSIONS: PPE provision was limited by management's poor perceptions of its efficacy relative to other factors. Future research should explore workers' perceptions and PPE's effectiveness in averting horse-related injury.

Source: Clouser JM, Swanberg JE, Bundy H. Am. J. Ind. Med. 2015.
http://dx.doi.org/10.1002/ajim.22464

Choisir une protection respiratoire contre les bioaérosols

Ce nouvel outil vise à soutenir les intervenants dans le choix d'une protection respiratoire contre les bioaérosols infectieux ou non infectieux présents dans différents milieux de travail.

Source: http://74.123.92.235/bioaerosol/

Characterization of textiles used in chefs' uniforms for protection against thermal hazards encountered in the kitchen environment

Within the kitchen the potential for burn injuries arising from contact with hot surfaces, flames, hot liquid, and steam hazards is high. The chef's uniform can potentially offer some protection against such burns by providing a protective barrier between the skin and the thermal hazard, although the extent to which can provide some protection is unknown. The purpose of this study was to examine whether fabrics used in chefs' uniforms were able to provide some protection against thermal hazards encountered in the kitchen. Fabrics from chefs' jackets and aprons were selected. Flammability of single- and multiple-layered fabrics was measured. Effect of jacket type, apron and number of layers on hot surface, hot water, and steam exposure was also measured.
FINDINGS showed that all of the jacket and apron fabrics rapidly ignited when exposed to a flame. Thermal protection against hot surfaces increased as layers increased due to more insulation. Protection against steam and hot water improved with an impermeable apron in the system. For wet thermal hazards increasing the number of permeable layers can decrease the level of protection due to stored thermal energy. As the hands and arms are most at risk of burn injury increased insulation and water-impermeable barrier in the sleeves would improve thermal protection with minimal compromise to overall thermal comfort.

Source: Zhang H, McQueen RH, Batcheller JC, Ehnes BL, Paskaluk SA. Ann. Occup. Hyg. 2015.
http://dx.doi.org/10.1093/annhyg/mev034

The influence of arc-flash and fire resistant clothing on thermoregulation during exercise in the heat

PURPOSE: We evaluated the effect of arc-flash and fire resistant (AFR) clothing ensembles (CE) on whole-body heat dissipation during work in the heat.
METHODS: On 10 occasions, seven males performed four 15-min cycling bouts at a fixed rate of metabolic heat production (400W) in the heat (35°C), each separated by 15-min of recovery. Whole-body heat loss and metabolic heat production were measured by direct and indirect calorimetry, respectively. Body heat storage was calculated as the temporal summation of heat production and heat loss. Responses were compared in a semi-nude state and while wearing two CE styles: (1) single-piece (coveralls), and (2) two-piece (workpant+long-sleeve shirt). For group 1, there was one non-AFR single-piece CE (CE1STD) and three single-piece CE with AFR properties (CE2AFR, CE3AFR, CE4AFR). For group 2, there was one non-AFR two-piece CE (CE5STD) and four two-piece CE with AFR properties (CE6AFR, CE7AFR, CE8AFR, CE9AFR). The workpants for CE6AFR were not AFR-rated, while a cotton undershirt was also worn for conditions CE8AFR and CE9AFR and for all single-piece CE.
RESULTS: Heat storage for all conditions (CE1STD:328±55, CE2AFR:335±87, CE3AFR:309±95, CE4AFR:403±104, CE5STD:253±78, CE6AFR:268±89, CE7AFR: 302±70, CE8AFR:360±36, CE9AFR:381±99 kJ) was greater than the semi-nude state (160±124 kJ) (all p≤0.05). No differences were measured between single-piece uniforms (p=0.273). Among the two-piece uniforms, heat storage was greater for CE8AFR and CE9AFR relative to CE5STD and CE6AFR (all p≤0.05), but not CE7AFR (both p>0.05). Differences between clothing styles were measured such that greater heat storage was observed in both CE1STD and CE2-4 AFR relative to CE5STD. Further, heat storage was greater in CE2AFR and CE4AFR relative to CE6AFR, while it was greater in CE4AFR compared to CE7AFR.
CONCLUSIONS: Body heat storage during work in the heat was not influenced by the use of AFR fabrics in the single- or two-piece uniforms albeit less heat was stored in the two-piece uniforms when no undershirt was worn. However, heat storage was comparable between clothing styles when an undershirt was worn with the two-piece uniform.

Source: Poirier MP, Meade RD, McGinn R, Friesen BJ, Hardcastle SG, Flouris AD, Kenny GP. J. Occup. Env. Hyg. 2015.
http://dx.doi.org/10.1080/15459624.2015.1029615

NIOSH, OSHA Release New Toolkit to Better Protect Hospital Workers from Transmissible Diseases

The National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA) today released the Hospital Respiratory Protection Toolkit, a resource for health care employers to use to protect hospital staff from respiratory hazards.

Respirators are used to protect against exposures to airborne transmissible infectious diseases as well as chemicals and certain drugs that may be used in healthcare settings. OSHA’s Respiratory Protection Standard requires that health care employers establish and maintain a respiratory protection program in workplaces where workers may be exposed to respiratory hazards.

Source: http://www.cdc.gov/niosh/updates/upd-05-14-15.html

Similarities between work related musculoskeletal disorders and slips, trips and falls

Most occupational risks manifest themselves through movements performed at work, for example musculoskeletal disorders, slips, trips and falls. Research focusing on such risks often differentiates diseases from accidents. All these risks prove to be diffuse, widespread, emergent and devoid of an external harmful hazard, when analysed through their common vector, i.e. through the movements manifesting them. These characteristics have a strong impact on risk perception and on approaches necessary to ensure sustainable prevention. A participative search for local solutions to preventing these risks, integrating shared risk representation and several analysis levels, would seem helpful. A balance between defended and resilience-based conceptions of health and safety should be established. Research should also be extended to enhance in-depth understanding of controls impacting worker movements when performing a task, while safeguarding health and safety.

Source: Leclercq S, Cuny-Guerrier A, Gaudez C, Aublet-Cuvelier A. Ergonomics, 2015.
http://dx.doi.org/10.1080/00140139.2015.1031191

Z94.1-15 - Industrial protective headwear

Performance, selection, care, and use
The latest edition of CSA Z94.1 – Industrial Protective Headwear – Performance, Selection, Care and Use joins our suite of Personal Protective Equipment standards and applies to protective headwear for industrial, construction, mining, utility, and forestry workers. It defines the areas of the head that are to be protected and basic performance requirements.
According to OHS Regulations – Section 12.4, only when there is a foreseeable danger to a worker's head at a work site is industrial headwear required. Employers can help to reduce the risk of head injuries sustained in the workplace by conducting a hazard assessment. Based on the results of the hazard assessment you will then be able to decide if the worksite would require workers to use industrial protective headwear.

Source: http://shop.csa.ca/invt/27000582015

Trends in needlestick injury incidence following regulatory change in Ontario, Canada (2004–2012)

An observational study
Background: A number of jurisdictions have used regulation to promote the adoption of safety-engineered needles as a primary solution to reduce the risk of needlestick injuries among healthcare workers. Regulatory change has not been complemented by ongoing efforts to monitor needlestick injury trends which limits opportunities to evaluate the need for additional investment in this area. The objective of this study was to describe trends in the incidence of needlestick injuries in Ontario prior to and following the establishment of regulation to promote the adoption of safety-engineered needles.
Methods: An observational study of needlestick injuries obtained from two independent administrative data sources (emergency department records for the treatment of work-related disorders and workers' compensation claims) for a population of occupationally-active adults over the period 2004–2012.
Results: Comparing the year prior to the regulation being established (2006) to three years after the regulation came into effect (2011), needlestick injury rates in the health and social services sector that were captured by workers' compensation claims declined by 31% and by 43% in the work-related emergency department records. Rates of workers' compensation claims associated with needlestick injuries declined by 31% in the hospital sector, by 67% in the long-term care sector and have increased by approximately 1% in nursing services over the period 2004–2012.
Conclusions: Two independent administrative data sources documented an overall reduction in needlestick injuries in the province of Ontario following a regulatory requirement to adopt safety-engineered needles; however, a substantial burden of occupational needlestick injuries persists in this setting.

Source: Chambers, Andrea, Mustard, Cameron A., & Etches, Jacob. (2015). BMC Health Services Research, vol. 15, 127.
http://dx.doi.org/10.1186/s12913-015-0798-z 

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