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.

Work safety climate, personal protection use, and injuries among Latino residential roofers

BACKGROUND: This analysis describes work safety climate, personal protective equipment (PPE) use, and injuries among Latino residential roofers, and examines the associations of work safety climate with PPE use and injuries.
METHODS: Eighty-nine North Carolina residential roofers completed a baseline interview and daily logs about perceptions and use of PPE, occurrence of injuries in last 12 months, and work safety climate.
RESULTS: The mean work safety climate score was 26.5 (SD = 5.6). In the baseline interview, participants reported that the majority of employers provided PPE and that they used it most or all of the time; daily log data indicated that PPE was used for half or fewer of hours worked. 39.9% reported any injury in the last 12 months. Work safety climate was significantly correlated with the provision and use of most types of PPE, and was inversely associated with injury.
CONCLUSIONS: Supervisors promoting safety may increase the PPE use and decrease injuries.

Source: Arcury TA, Summers P, Rushing J, Grzywacz JG, Mora DC, Quandt SA, Lang W, Mills TH. Am. J. Ind. Med, 2014.

Facteurs de risque associés aux glissades chez les policiers et les brigadiers scolaires

Étude exploratoire
L’objectif principal de cette activité de recherche était d’identifier des facteurs de risque associés aux accidents de glissade en vue de proposer des avenues de recherche pour répondre aux besoins des travailleurs en collaboration avec les organismes de prévention et de santé au travail.
Cette activité a été réalisée en trois étapes : 1) Une revue de la littérature scientifique a permis de faire un bilan de connaissances sur la problématique des glissades afin d’identifier de manière générale les facteurs de risque, de comprendre la mécanique du mouvement humain sur surface glissante et plan incliné, et d’établir les liens entre les chaussures et les accidents; 2) Un examen des statistiques descriptives des accidents/incidents de glissade chez les policiers et chez les brigadiers scolaires pour les années 2007-2009 a été réalisée de façon à déterminer les circonstances dans lesquelles ces événements se produisent et ainsi qualifier l’importance des différents facteurs de risque pour les deux populations ciblées; 3) Des groupes de discussion ont été tenus avec des policiers, des brigadiers et des contrôleurs routiers pour comprendre les liens qui peuvent s’établir entre les divers facteurs de risque et pour aborder la question des chaussures portées par les travailleurs.


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).


Performance study of protective clothing against hot water splashes

From bench scale test to instrumented manikin test 
Hot liquid hazards existing in work environments are shown to be a considerable risk for industrial workers. In this study, the predicted protection from fabric was assessed by a modified hot liquid splash tester. In these tests, conditions with and without an air spacer were applied. The protective performance of a garment exposed to hot water spray was investigated by a spray manikin evaluation system. Three-dimensional body scanning technique was used to characterize the air gap size between the protective clothing and the manikin skin. The relationship between bench scale test and manikin test was discussed and the regression model was established to predict the overall percentage of skin burn while wearing protective clothing. The results demonstrated strong correlations between bench scale test and manikin test. Based on these studies, the overall performance of protective clothing against hot water spray can be estimated on the basis of the results of the bench scale hot water splashes test and the information of air gap size entrapped in clothing. The findings provide effective guides for the design and material selection while developing high performance protective clothing.

Source: Lu Y, Song G, Wang F. Ann. Occup. Hyg. 2014.

Ebola - Guidance on Personal Protective Equipment To Be Used by Healthcare Workers

The following procedures provide detailed guidance on the types of personal protective equipment (PPE) to be used and on the processes for donning and doffing (i.e., putting on and removing) PPE for all healthcare workers entering the room of a patient hospitalized with Ebola virus disease (Ebola). The guidance in this document reflects lessons learned from the recent experiences of U.S. hospitals caring for Ebola patients and emphasizes the importance of training, practice, competence, and observation of healthcare workers in correct donning and doffing of PPE selected by the facility.


Health Care Workers’ Reported Discomfort While Wearing Filtering Face-Piece Respirators

Filtering face-piece respirators (FFRs) are one method of protecting health care workers from airborne particles; however, research suggests adherence is poor, perhaps due to worker discomfort. Three separate focus groups were conducted at two Veterans Affairs health care facilities. Seventeen health care workers who reported using FFRs as part of their job duties were in the focus groups. Focus group transcripts were coded using qualitative descriptive coding techniques. Participants described experiences of discomfort and physical mask features they believed contributed to discomfort. Participants believed FFRs influenced patient care because some patients felt uneasy and changed health care workers' behaviors (e.g., doffing procedures, loss of concentration, rushed patient care, and avoidance of patients in isolation resulting from FFR discomfort). Assessment of comfort and tolerability should occur during fit-testing. These factors should also be taken into account by management when training employees on the proper use of FFRs, as well as in future research to improve comfort and tolerability.

Source: Sara M. Locatelli; Sherri L. LaVela; Megan Gosch, Workplace Health Saf, 2014; 62 (9) :362–368.

NIOSH Study Finds Lack of Adherence to Safe Handling Guidelines for Administration of Antineoplastic Drugs

A new article from the National Institute for Occupational Safety and Health (NIOSH) found that recommended safe handling practices for workers who administer antineoplastic drugs in healthcare settings are not always followed. This study will be published in the November issue of the Journal of Occupational and Environmental Hygiene and is currently available as an e-pub.
Results are derived from the 2011 Health and Safety Practices Survey of Healthcare Workers, the largest federally-sponsored survey of healthcare workers in the U.S. which addresses safety and health practices relative to use of hazardous chemicals. This paper presents findings on current administrative and engineering control practices, personal protective equipment (PPE), and barriers to using recommended PPE during administration of antineoplastic drugs by nearly 2,100 oncology nurses and other healthcare personnel who completed a module addressing antineoplastic drug administration.


Duration of slip-resistant shoe usage and the rate of slipping in limited-service restaurants

Results from a prospective and crossover study
Several studies have indicated that slip-resistant shoes may have a positive effect on reducing the risk of slips and falls, a leading cause of injury at work. Few studies, however, have examined how duration of shoe usage affects their slip-resistance properties. This study examined the association between the duration of slip-resistant shoes usage and the self-reported rate of slipping in limited-service restaurant workers. A total of 475 workers from 36 limited-service restaurants in the USA were recruited to participate in a 12-week prospective study of workplace slipping. Of the 475 participants, 83 reported changing to a new pair of shoes at least once during the 12-week follow-up. The results show that slip-resistant shoes worn for less than six months were moderately more effective than those worn for more than six months. Changing to a new pair of shoes among those wearing slip-resistant shoes at baseline was associated with a 55% reduction in the rate of slipping (RR = 0.45, 95% CI = 0.23-0.89). Further research is needed to develop criteria for the replacement of slip-resistant shoes. Practitioner Summary: The duration of usage impacts the slip-resistance properties of slip-resistant shoes. Slip-resistant shoes worn for less than six months were moderately more effective in reducing slips than slip-resistant shoes worn for more than six months. Shoe use policies should not only encourage or require their use but also include guidance on replacing slip-resistant shoes at regular intervals.

Source: Verma SK, Zhao Z, Courtney TK, Chang WR, Lombardi DA, Huang YH, Brennan MJ, Perry MJ. Ergonomics, 2014.

Norme CSA Z195 – Chaussures de protection

Nouvelle édition
Partout au Canada, les travailleurs sont tenus de protéger leurs pieds des dangers présents sur les lieux de travail en sélectionnant des chaussures de protection certifiées par Groupe CSA et en les utilisant adéquatement. La marque CSA indique aux consommateurs que leurs chaussures ont été certifiées en fonction des normes de performance en vigueur en matière de protection.
La nouvelle édition de la norme CSA Z195 énonce les exigences relatives aux chaussures antidérapantes, dotées ou non d'autres caractéristiques de sécurité. En outre, une nouvelle catégorie en matière de protection antistatique (« super SD ») a été ajoutée à l'intention des personnes qui travaillent avec des appareils électroniques et des instruments sensibles.


Exploratory breath analyses for assessing toxic dermal exposures of firefighters during suppression of structural burns

Firefighters wear fireproof clothing and self-contained breathing apparatus (SCBA) during rescue and fire suppression activities to protect against acute effects from heat and toxic chemicals. Fire services are also concerned about long-term health outcomes from chemical exposures over a working lifetime, in particular about low-level exposures that might serve as initiating events for adverse outcome pathways (AOP) leading to cancer. As part of a larger US National Institute for Occupational Safety and Health (NIOSH) study of dermal exposure protection from safety gear used by the City of Chicago firefighters, we collected pre- and post-fire fighting breath samples and analyzed for single-ring and polycyclic aromatic hydrocarbons as bioindicators of occupational exposure to gas-phase toxicants. Under the assumption that SCBA protects completely against inhalation exposures, any changes in the exhaled profile of combustion products were attributed to dermal exposures from gas and particle penetration through the protective clothing. Two separate rounds of firefighting activity were performed each with 15 firefighters per round. Exhaled breath samples were collected onto adsorbent tubes and analyzed with gas-chromatography-mass spectrometry (GC-MS) with a targeted approach using selective ion monitoring. We found that single ring aromatics and some PAHs were statistically elevated in post-firefighting samples of some individuals, suggesting that fire protective gear may allow for dermal exposures to airborne contaminants. However, in comparison to a previous occupational study of Air Force maintenance personnel where similar compounds were measured, these exposures are much lower suggesting that firefighters' gear is very effective. This study suggests that exhaled breath sampling and analysis for specific targeted compounds is a suitable method for assessing systemic dermal exposure in a simple and non-invasive manner.

Source: Pleil JD, Stiegel MA, Fent KW. J. Breath Res. 2014.

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