Devices for preventing percutaneous exposure injuries caused by needles in healthcare personnel

Needlestick injuries (NSIs) from devices used for blood collection or for injections expose healthcare workers to the risk of serious infections such as hepatitis or human immunodeficiency virus (HIV). Safety features such as shields or retractable needles can help prevent these injuries. We wanted to find out how effective these devices are. We searched for studies in multiple databases until January 2012 for randomised (RCTs) and non-randomised studies (NRS).


Do We Need to Challenge Respirator Filters With Biological Aerosols?

The purpose of this NIOSH Science Blog is to explain what is currently known about an important aspect of respirator filtration.  For decades, respirator researchers have been asked whether filters need to be tested with aerosols similar to those encountered in the environment (Figure 1).  Common sense suggests that viruses or bacteria are collected differently from engineered nanoparticles, silica dusts, oil mists or other types of workplace aerosols.


New approach to assessing comfort of use of protective footwear with a textile liner and its impact on foot physiology

We propose a new approach to assessing comfort of use of protective footwear with a textile liner. All-rubber footwear with wool liner and cotton/polyamide socks were evaluated in a study involving 30 firefighters. The study was designed to comprehensively assess comfort of use of textiles in the footwear using certain known and new research tools at the same time, that is, measurement of the microclimate inside the footwear (temperature and humidity), weight gain of the footwear, socks, and liner (weighing method), measurement of blood flows in the lower extremities (impedance plethysmography), as well as evaluation of user comfort (questionnaire survey). The influence of the above-mentioned parameters on the comfort of use was analyzed statistically. Following a walk, the temperature in the foot regions was found to increase by 10%, while relative humidity of the air in the plantar region rose by 50%, and the textiles absorbed 28 g/1.5 h of sweat produced by the foot. Due to the unfavorable conditions inside the footwear and as a result of physical exercise, total blood flow in the lower extremities rose significantly (by 33%). The structure and type of the fiber used in the socks and liner influenced the subjective sensations of the subjects. We found very high correlations between the subjective sensations of temperature inside the footwear and the objective measurements of temperature and humidity, blood flow, and liner weight gain. This study is the first step towards a better understanding of the influence of various parameters on the comfort of use of a textile liner and socks in protective footwear.

Source: Emilia Irzmanska, Jacek Konrad Dutkiewicz, Robert Irzmanski. Textile Research Journal, May 2014 84: 728-738

Construction worker fatalities related to trusses

An analysis of the OSHA fatality and catastrophic incident database
This study was conducted to gain a better understanding of the risks associated with truss installation in building projects. The Occupational Safety and Health Administration (OSHA) fatality and catastrophic incident database was analyzed for the years inclusive of 1990-2009. The database includes over 15,000 incidents, 211 of which pertain to trusses. The incidents were analyzed as to the number of fatalities per incident, the type of truss, the truss material, the activity taking place at the time of the accident, the release of the hoisting equipment, the initiation of the accident, the presence of bracing materials, the type of construction, the length of the trusses, the location of the incident, the type of accident (fall, caught-in/between, struck by, or electrocution), and the year the fatality occurred. Many of the accidents occurred at elevation and were initiated in large part by moving or falling objects. The study recommends that further research should focus on the stabilization of incomplete roof structures and the implementation of best practices for fall protection while performing truss-related work.

Source: Grant A, Hinze J. Safety Sci. 2014; 65: 54-62.

Groupe CSA publie une nouvelle édition de la norme sur les dispositifs autorétractables pour la prévention des chutes

Les chutes de hauteurs comptent parmi les causes les plus courantes de blessures graves et de décès liés au travail. Quand des conditions de travail comportent un risque de chute, un système de protection antichute est un élément essentiel des pratiques et procédures en matière de santé et sécurité au travail (SST).
La nouvelle édition de la norme Z259.2.2 Dispositifs autorétractables fait partie de la série de solutions antichute de Groupe CSA. Cette nouvelle édition comprend des mises à jour et des révisions d'une importance cruciale pour maintenir la sécurité des dispositifs autorétractables utilisés comme composantes de connexion des systèmes de protection contre les chutes.


Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings

This document recommends practices for extended use and limited reuse of NIOSH-certified N95 filtering facepiece respirators (commonly called “N95 respirators”). The recommendations are intended for use by professionals who manage respiratory protection programs in healthcare institutions to protect health care workers from job-related risks of exposure to infectious respiratory illnesses.


Needlestick injury prevention

Lessons learned from acute-care hospitals in Ontario
Needlestick injuries have been identified as an important modifiable risk factor associated with the transmission of blood-borne pathogens between patients and health-care workers. A number of jurisdictions, including the province of Ontario, turned to regulation to accelerate the adoption of safety-engineered needles (SENs) for the prevention of needlestick injuries. Yet surveillance data available in work-related emergency department and workers' compensation claims records demonstrates that needlestick injuries have not declined substantially in Ontario.
Case studies were carried out in three acute-care hospitals in Ontario to help stakeholders understand why needlestick injuries continue to occur and what might challenge and support further progress in this area. The findings from these case studies are included in this report.


Gloves, extra gloves or special types of gloves for preventing percutaneous exposure injuries in healthcare personnel

Healthcare workers are at risk of acquiring viral diseases such as hepatitis B, hepatitis C and HIV through exposure to contaminated blood and body fluids at work. Most often infection occurs when a healthcare worker inadvertently punctures the skin of their hand with a sharp implement that has been used in the treatment of an infected patient, thus bringing the patient's blood into contact with their own. Such occurrences are commonly known as percutaneous exposure incidents.


Management of ionizing radiation injuries and illnesses, part 1

Physics, radiation protection, and radiation instrumentation
Ionizing radiation injuries and illnesses are exceedingly rare; therefore, most physicians have never managed such conditions. When confronted with a possible radiation injury or illness, most physicians must seek specialty consultation. Protection of responders, health care workers, and patients is an absolute priority for the delivery of medical care. Management of ionizing radiation injuries and illnesses, as well as radiation protection, requires a basic understanding of physics. Also, to provide a greater measure of safety when working with radioactive materials, instrumentation for detection and identification of radiation is needed. Because any health care professional could face a radiation emergency, it is imperative that all institutions have emergency response plans in place before an incident occurs. The present article is an introduction to basic physics, ionizing radiation, radiation protection, and radiation instrumentation, and it provides a basis for management of the consequences of a radiologic or nuclear incident.

Source: Christensen DM, Jenkins MS, Sugarman SL, Glassman ES. J. Am. Osteopath. Assoc. 2014; 114(3): 189-199.

NIOSH Health and Safety Practices Survey of Healthcare Workers

Training and awareness of employer safety procedures
Background : The Health and Safety Practices Survey of Healthcare Workers describes current practices used to minimize chemical exposures and barriers to using recommended personal protective equipment for the following: antineoplastic drugs, anesthetic gases, high level disinfectants, surgical smoke, aerosolized medications (pentamidine, ribavirin, and antibiotics), and chemical sterilants.
Methods : Twenty-one healthcare professional practice organizations collaborated with NIOSH to develop and implement the web-based survey.
Results : Twelve thousand twenty-eight respondents included professional, technical, and support occupations which routinely come in contact with the targeted hazardous chemicals. Chemical-specific safe handling training was lowest for aerosolized antibiotics (52%, n = 316), and surgical smoke (57%, n = 4,747). Reported employer procedures for minimizing exposure was lowest for surgical smoke (32%, n = 4,746) and anesthetic gases (56%, n = 3,604).
Conclusions : Training and having procedures in place to minimize exposure to these chemicals is one indication of employer and worker safety awareness. Safe handling practices for use of these chemicals will be reported in subsequent papers.

Source: Steege, A. L., Boiano, J. M. and Sweeney, M. H. (2014), NIOSH Health and Safety Practices Survey of Healthcare Workers: Training and awareness of employer safety procedures. Am. J. Ind. Med.

Perceived floor slipperiness and floor roughness in a gait experiment

BACKGROUND: Slips and falls contribute to occupational injuries and fatalities globally. Both floor slipperiness and floor roughness affect the occurrence of slipping and falling. Investigations on fall-related phenomena are important for the safety and health of workers. OBJECTIVE: The purposes of this study were to: compare the perceived floor slipperiness before and after walking on the floor; compare the perceived floor slipperiness with and without shoes for males and females; discuss the perceived floor roughness based on barefoot walking; and establish regression models to describe the relationship between perceived floor slipperiness and actual friction of the floors. METHODS: Male and female subjects walked on 3 m walkways with or without shoes. The perceived floor slipperiness ratings both before and after their walk were collected. RESULTS: The perceived floor slipperiness both before and after walking were significantly affected by both floor and surface conditions. Gender, floor, surface, and footwear conditions were all significant factors affecting the adjustment of perceived floor slipperiness. The subjects made more adjustment on perceived floor slipperiness rating when they had shoes on than when they were barefooted. CONCLUSION: Regression models were established to describe the relationship between perceived floor slipperiness and floor coefficient of friction. These models may be used to estimate perceived floor slipperiness, or in reverse, the coefficient of friction of the floor, so as to prevent slipping and falling in workplaces.

Source : Yu R, Li KW. Work. 2014.

Slips, trips and falls at a chemical manufacturing company

Background Slips, trips and falls (STF) are a major cause of workplace injury.AimsTo examine risk factors for STF at a large US chemical manufacturing company.
Methods We conducted a case-control study of occupational STF. Cases were identified from company injury records between 1 April 2009 and 1 May 2011. Four controls per case were randomly selected from all active company workers employed during the same time. Data were collected through a questionnaire and from company medical examinations. Logistic regression was used to calculate odds ratio (OR) and 95% confidence intervals (95% CI) for personal, environmental and health-related risk factors for STF.
Results There were 74 cases and 309 controls. The response rate was 65% for the cases and 68% for the controls. Most STF were unrelated to production activities. When examining all factors in a logistic regression model, increased OR were observed for increased body mass index (OR = 1.44, 95% CI: 1.03-2.02), having arthritis (OR = 2.11, 95% CI: 1.01-4.37), lack of exercise (OR = 2.25, 95% CI: 1.01-5.05), carrying materials (OR = 3.01, 95% CI: 1.41-6.43) and being female (OR = 2.46, 95% CI: 1.17-5.19). Reduced risk of STF was observed for never having smoked (OR = 0.48, 95% CI: 0.24-0.95), long service (OR = 0.53, 95% CI: 0.34-0.81) and persons working over 8h a day (OR = 0.42, 95% CI: 0.20-0.88).
Conclusions Risk factors for STF in a large US chemical company are similar to those reported from other workplaces, but we found that staying fit and healthy is important for reducing risk.

Source : Swaen G, Burns CJ, Collins JJ, Bodner KM, Dizor JF, Craun BA, Bonner EM. Occup. Med. 2014.

Review of standards for thermal protection PPE in the explosives industry

The suitability of PPE for use against different thermal challenges is often described by way of compliance with British, European or Internationally agreed standards. The review compared the range of test standards currently used for flame protective PPE for both general industrial use and specialist PPE for motor racing and fire fighting tasks with the thermal challenge expected from a range of explosive events.
Disparity has been found between the levels of challenge required to pass the test standards and the level displayed by the burning explosive materials – these practical challenges have been found to be significantly higher, causing levels of heating and burning which would produce significant injury to individuals wearing some types of PPE under certain circumstances.
The report recommends that harm models consider the effect of damage to the respiratory system; that further work is undertaken to better understand the performance of modern materials in an explosives environment; and that PPE should be tested against a representative explosive challenge as part of the process that dutyholders undertake in order to determine its suitability for use.

Source :

Preventing Falls through the Design of Roof Parapets

Workers are exposed to risks from falls during construction, operation, maintenance, and demolition of buildings. Parapets are the parts of the wall assembly that extend above the roof [Rajendran and Gambatese 2013] and can prevent falls from low-sloped (flat) roofs. Other design features that can prevent falls include using guardrail systems and permanent anchor points (for use with personal fall arrest systems and lifelines) [See NIOSH 2013 for more information].

Source :

Comparison of Three Respirator User Training Methods

Objective: This study addresses methods for training respirator users, particularly when occupational health professionals are not immediately available.
Methods: A randomized trial compared three training methods—printed brochure, video, and computer-based training—for two respirator types (filtering facepiece and a dual-cartridge half facemask). Quantitative fit testing (PortaCount) measured the effectiveness of training. The study included 226 subjects.
Results: For both respirator types, video was significantly superior to either print or computer-based training methods. Conclusions were consistent, whether determined by average fit factor (analysis of variance), log-transformed fit factors, or the number of users in the lowest quartile of achieved fit.
Conclusions: Video training for proper respirator use can be effective when direct training from an occupational health professional is unavailable. These methods are particularly relevant to “rapid rollout” situations, such as natural disasters, epidemics, or bioterrorism concerns.

Source : Harber, Philip MD, MPH; Boumis, Robert J. BS; Su, Jing MS; Barrett, Sarah BS; Alongi, Gabriela BS. Journal of Occupational & Environmental Medicine:
December 2013 - Volume 55 - Issue 12 - p 1484–1488.

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