Viral diseases (other than aids) - 571 entries found
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Health and Safety Executive
The occupational zoonoses
Details are given of 17 zoonoses. Information provided includes: name of disease and responsible organism; animals carrying the organism; incidence; hazard to humans; means of transmission; occupations and activities at risk; means of control; clinical diagnosis; immunisation; legislation relating to notification of the disease. An introductory chapter outlines general regulatory requirements for hazard assessment, prevention and control, health surveillance and supply of information to employees. The diseases considered are: anthrax; bovine tuberculosis; brucellosis; cryptosporidiosis; hantavirus disease; hydatid disease (echinococcosis); leptospirosis (Weil's disease and cattle form); Lyme disease; Newcastle disease; orf; ovine chlamydiosis; psittacosis; Q fever; rabies; ringworm; Streptococcosis suis. A list of occupations with associated zoonosis hazards is appended.
HMSO Books, P.O. Box 276, London SW8 5DT, United Kingdom, 1993. viii, 32p. Bibl.ref. Price: GBP 5.00.
The health care industry
This article is concerned with technological change in industry over the last 20 years, its effect on the health of the worker, and the measures taken by the employer to control any risk arising therefrom. Technological change cannot be viewed in isolation. Although advances in technology and the introduction of new processes are the outward and most visible sign of change in work practices, in most cases it is managerial restructuring, political pressures, and changes in legislation which bring about far greater change and which in the long term may have a greater effect on the health of the worker. No industry illustrates this better that the National Health Service and more recently the rapidly expanding private health care sector.
Occupational Medicine, Feb. 1993, Vol.43, No.1, p.47-50. 10 ref.
Bloodborne pathogens final standard: Summary of key provisions
Fact sheet issued in connection with the issuing of the US Bloodborne Pathogens Final Standard (CIS 93-371). It explains in simple language the following: scope of the standard; preparation of exposure control plans; methods of compliance; special rules for HIV and HBV research laboratories and production facilities; provision of hepatitis B vaccination; post-exposure evaluations and follow-ups; hazard communication; information and training; recordkeeping.
OSHA Publications Office, U.S. Department of Labor, 200 Constitution Avenue, NW, Room N3101, Washington, DC 20210, USA, 1992 (also: INTERNET http://www.osha.gov/oshpubs/oshfacts/92-46.html). 1 doc.
What you should know about injuries from sharps
Training booklet on the prevention of injuries from sharp objects in health-care establishments. The dangers of exposure to hepatitis B and HIV are particularly stressed. Test for self assessment.
Scriptographic Publications Ltd., Channing House, Butts Road, Alton, Hants GU34 1ND, United Kingdom, 1992. 15p. Illus. Price: GBP 0.55-0.94 (depending on number of Scriptographic booklets ordered). ###
Society of Occupational Medicine and Ergonomics of the Provence-Côte d'Azur and Corsica regions - Meetings of 29 May, 26 June and 23 Oct. 1991
Société de médecine du travail et d'ergonomie de la région Provence-Côte d'Azur et de la région Corse - Séances du 29 mai, du 26 juin et du 23 octobre 1991 [in French]
Papers presented at the meetings of the Society of Occupational Medicine and Ergonomics of the Provence-Côte d'Azur and Corsica Regions (France, 29 May, 26 June and 23 Oct. 1991): caretakers in the Alpes-Maritimes; infectious hepatitis in specialized occupational environments; role of the industrial physician in the prophylaxis of tuberculosis; prospective survey of the employment status of construction workers declared as permanently disabled (France); vaccination against hepatitis B of non-medical personnel in a large French hospital; rehabilitation of workers with transplants and of cardiac patients after their operation; osteolysis of ungual phalanges in an automobile body-repair worker; hands of automobile body-repair workers in small and medium-size enterprises (48 cases); medical surveillance in the group-catering sector: complementary check-ups on an "as needed" basis; activity plan undertaken by several physicians (example: hygiene and ergonomics in the group-catering sector).
Archives des maladies professionnelles, 1992, Vol.53, No.4, p.296-310.
Poyen D., Martin F.
Prevention of hepatitis B in the workplace by vaccination
La prévention de l'hépatite B professionnelle par la pratique vaccinale en médecine du travail [in French]
Hepatitis B (HBV) remains a frequent and serious disease, sometimes still lethal. The best way to prevent it is vaccination. According to French legislation (CIS 91-1754), vaccination is compulsory for certain categories of workers. This responsibility is shared by workers, employers and physicians. All anti-HBV vaccines available today (whether plasma-based or manufactured by genetic engineering methods) are effective. This study reports on the very positive results of a vaccination campaign undertaken in France since 1981 among the workers of a large hospital.
Archives des maladies professionnelles, 1992, Vol.53, No.7, p.621-626. Illus. 15 ref.
Society of Occupational Medicine and Ergonomics of Bordeaux and region - Proceedings of the meetings of 24 May, 15 November and 13 December 1991
Société de médecine du travail et d'ergonomie de Bordeaux et de sa région - Séances du 24 mai, du 15 novembre et du 13 décembre 1991 [in French]
Topics of papers presented at the meetings of 24 May, 15 November and 13 December 1991 of the Society of Occupational Medicine and Ergonomics of Bordeaux and region (France): Health and safety in the use of composite materials in the aircraft industry; comments on the problems associated with the notification of occupational diseases under the French Scheme (example of Schedule 64 (intoxication due to carbon monoxide); repercussions of work on perinatal problems in rural settings (survey of 534 women); conditions of work; comparison of the results of objective and subjective analysis; work in tropical countries: update of specific preventive measures; medical problems due to laser check-out workstations in supermarkets; problem of aptitude to apprenticeship in the case of a subject suffering from tuberous sclerosis: a case study; survey of occupational deafness cases diagnosed in the unit of occupational diseases in Bordeaux; the concept of occupational risk (danger, risk, cyndinics); compulsory vaccination against hepatitis B (Law of 18 Jan. 1991; Order of 15 March 1991: CIS 91-1754).
Archives des maladies professionnelles, 1992, Vol.53, No.6, p.426-442.
Leprince A., Bouvet E., Abiteboul D.
Risk of workplace infection with the HIV virus
Risque professionnel d'infection par le virus de l'immunodéficience humaine [in French]
Survey of existing knowledge concerning the risk of infection with the AIDS virus (HIV) among hospital workers in France, based in part on a study. Data are presented on the actual cases of occupational HIV infection found in France. The occupational risk of contamination is discussed. Recommendations are made as to the basic and absolutely necessary preventive measures to be applied both in the wards and in laboratory work: wearing of safety gloves and masks; safe handling of sharp objects; contamination etc. Action to be taken after an accident possibly involving contamination is discussed: notification of the accident, tests, repairs. Case-story of a nurse who suffered an accident with potential transmission of the HIV virus.
Travail et sécurité, Oct. 1992, No.505, p.552-562. Illus. 9 ref.
Fukui T., Noda H., Hinami F., Tsuneoka T., Iwasaki M., Maeda T., Usuki S., Takata T., Tsujimoto G., Fukuhara M., Ohnishi K., Toyokawa K., Tanemoto K.
Blood contamination of medical staff and positive rate of HCV antibody in patients
Iryō jūjisha no ketsueki osen jiko to nyūin kanja no HCV kōtai yōsei ritsu [in Japanese]
Between 1 June 1990 and 5 May 1991, 25 cases of blood contamination occurred at Kobe Rosai Hospital. Ten staff members were contaminated by blood from patients with anti-hepatitis C virus (HCV) antibody. Nine were treated with alpha-interferon; none of the 10 contracted hepatitis. Screening of inpatients for this antibody (C100-3) revealed a prevalence of 11.3%, which is almost 10 times the rate in normal subjects in Japan. The rate in patients with liver disease was 15.4%, and 4.8% in the other departments. Thus, the risk of HCV infection of staff is high. Patients should be screened for HCV on admission.
Japanese Journal of Traumatology and Occupational Medicine, 9 Sep. 1992, Vol.40, No.9, p.603-607. Illus. 7 ref.
Li G.Y., Wang T., Huggins E.M., Shams N.K.B., Davis J.F., Calkins J.H., Hornung C.A., Altekruse J.M., Sigel M.M.
Cholylglycine measured in serum by RIA and interleukin-1β determined by ELISA in differentiating viral hepatitis from chemical liver injury
Serum bile acids have been shown to serve as useful indicators of liver disease. The study confirms these findings and adds an analysis of interleukin-1β (IL-1β) profiles to differentiate viral hepatitis from toxic liver damage associated with exposure to vinyl chloride (VC) or trinitrotoluene (TNT). The frequency of elevated cholylglycine (CG) was 100%, 75%, and 37.5% in viral hepatitis, VC- and TNT-linked liver-injury patients, respectively. The mean levels (µg/dL) were 578, 507, 142, and 65 in hepatitis B, hepatitis non-A non-B, VC and TNT liver-injury patients, respectively. The mean level of IL-1β in patients with hepatitis B was 424pg/mL and hepatitis non-A non-B was 384pg/mL compared with a mean of 33-40pg/mL in those with VC or TNT-linked liver disease. The IL-1β detection test proved further to be an important distinguishing parameter as it was 100% positive in patients with viral hepatitis but only 12.5% to 25% positive in patients with VC/TNT-induced liver damage.
Journal of Occupational Medicine, Sep. 1992, Vol.34, No.9, p.930-933. 15 ref.
Needlesticks: Preaching to the seroconverted?
This editorial on needlestick accidents discusses the potential for infectious disease transmission and the need for prevention strategies. The principal causes for concern are human immunodeficiency virus (HIV) and hepatitis B virus (HBV). Most of the work published on needlestick injuries concerns primary prevention (improved designs for the recapping and disposal of needles, staff training), while secondary prevention issues have been less publicised. It is argued that optimum management of injuries and peace of mind, particularly in less medically informed staff, demand a hospital policy for action and an expert contact for advice.
Lancet, 12 Sep. 1992, Vol.340, No.8820, p.640-642. 23 ref.
Viral Hepatitis Prevention Board
Five-step plan to prevent hepatitis B infection
Articles in this issue include consensus statements by the VHPB (Viral Hepatitis Prevention Board) on: no routine work restrictions on infected healthcare workers or non-responders; principles to prevent exposure to blood-borne infections (identification of risk, improved working practices, isolation of potentially infected material, individual protection, compliance monitoring); post-exposure prophylaxis. Other articles discuss the need for measuring compliance with protection guidelines and action recommended by the European Community.
Viral Hepatitis, 1992, No.4, 11p. Illus. Available from: Medical Imprint, 22 Lancaster Gate, London W2 3LY, United Kingdom.
Viral Hepatitis Prevention Board
VHPB acts to eliminate HEP B risk to workers by 1997
This issue contains a discussion of the need for hepatitis B risk assessment along with VHPB (Viral Hepatitis Prevention Board) consensus statements on reducing and assessing the risk of hepatitis B infection in employees, setting up policies and vaccination programmes for hepatitis B prevention and following up an initial course of vaccine. Other articles include studies on the cost-effectiveness of vaccination programmes and a comparison of vaccination policies in Australia and seven European countries.
Viral Hepatitis, 1992, No.3, 11p. Illus. Available from: Medical Imprint, 22 Lancaster Gate, London W2 3LY, United Kingdom.
Viral Hepatitis Prevention Board
Employers have key role in staff protection
This second issue of Viral Hepatitis contains some practical suggestions for improving protection of those occupationally exposed to viral hepatitis including VHPB (Viral Hepatitis Prevention Board) guidelines for the improvement of vaccination programmes. Other articles include a discussion on how to decide who is at occupational risk of hepatitis B, results of a survey into the knowledge and attitudes of unions towards occupational health and hepatitis B in Germany, Spain and the UK and the effects of a national campaign on improving rates of protection among medical students and doctors.
Viral Hepatitis, 1992, No.2, 11p. Illus. Available from: Medical Imprint, 22 Lancaster Gate, London W2 3LY, United Kingdom.
Viral Hepatitis Prevention Board
Improving protection against hepatitis B in the workplace
This special issue contains papers presented at a session of the International Congress on the Management of Infection (ICMI), held in Amsterdam in 1992. Topics covered: the risks for healthcare workers of hepatitis infection and techniques currently employed to reduce its spread; new US regulations for the control of blood-borne diseases in the workplace; reasons for different approaches to protective vaccination of healthcare workers across Europe; background to the formation of the Viral Hepatitis Prevention Board and its aims for European workers.
Viral Hepatitis, 1992, symposium special, 7p. Illus. Available from: Medical Imprint, 22 Lancaster Gate, London W2 3LY, United Kingdom.
Rivoalen C., Manouvrier C., Frenkiel J., Faure J.J., Caillard J.F., Czernichow P.
Behaviour of hospital staff regarding prevention. The case of hepatitis B.
Comportement du personnel hospitalier à l'égard de la prévention. Le cas de l'hépatite à virus B [in French]
A programme of immunisation against hepatitis B was introduced at the university hospital of Rouen (France) in the 1980s. The mean participation rate (55,8%) was compared to the corresponding sero-prevalence according to various criteria: age, sex, seniority, professional category, and hospital department. Staff were classified into four categories, depending on whether their seropositivity rates and their participation rates in the vaccination programme were higher or lower than the average in the hospital. The young and/or recently employed staff had a higher participation rate. Surgeons and personnel with few qualifications had a lower participation rate despite a higher risk. Voluntary prevention programmes must be particularly concentrated and adapted to the more exposed and less qualified categories of staff.
Archives des maladies professionnelles, 1992, Vol.53, No.5, p.363-368. Illus. 17 ref.
Davis W., Vainio H.
Special issue devoted to occupational cancer in Africa. It reproduces some of the papers presented at the International Course on Detection of Health Hazards in Human Populations Exposed to Chemical Mutagens and Carcinogens held in Harare (Zimbabwe), 9-20 Sep. 1991. The papers concern: public health in Africa - from infectious diseases to cancer prevention (Vainio H., Matos E.); limitations of the epidemiology of cancer in Africa (Jack A.D.); importance of cancer registries in Africa for cancer surveillance (Jack A.D.); occupational hazards and reproduction (Lindbohm M.L., Hemminki K.); causes, mechanisms and prevention of environmentally-induced cancers (Weinstein I.B., Groopman J.D.); hereditary factors in human cancers (Sylla B.S.); chromosomal aberrations, micronuclei and sister chromatid exchanges in cytogenic surveillance (Anwar W.A.); viruses and human cancer in Africa (Jack A.D.); mycotoxins (Nyathi C.B., Dube N., Hasler J.A.); molecular approaches to epidemiological studies of aflatoxin and hepatocellular carcinoma (Wild C.P.); interactions between schistosomiasis and carcinogenesis (Hasler J.A., Naik Y.S., Nyathi C.B.). In annex: list of faculty; list of participants.
African Newsletter on Occupational Health and Safety, 1992, Vol.2, Suppl.1, i, 75p. Bibl.ref.
Making hepatitis B prevention a priority in the workplace
First issue of a new quarterly publication. The articles provide a broad overview of the current problems of hepatitis B in the workplace and look at some of the steps already taken to improve protection for workers. The publication is also available in French, German and Spanish.
Viral Hepatitis, 1992, Vol.1, No.1, 11p. Illus. Available from: Medical Imprint, 22 Lancaster Gate, London W2 3LY, United Kingdom.
Grimsley L.F., Jacobs R.R., Perkins J.L.
Varicella-zoster virus susceptibility in day-care workers
The susceptibility of day-care workers to varicella-zoster virus (VZV) was evaluated by determining antibody to VZV in 545 day-care workers using an enzyme-linked immunosorbent assay (ELISA). The proportion of day-care workers susceptible to VZV was 4.8%, and the seronegativity among workers with a negative history of VZV infection was 13.6%. Susceptible workers identified by the serological screen should be sent home for 8-21 days after exposure if VZV infection occurs in the day care setting. All day-care workers of childbearing age should be given the option to be tested for immunity to VZV. Because reports indicate that adults from the tropics may have a higher susceptibility rate to VZV, it is recommended that all day-care workers from the tropics undergo serological screening.
Applied Occupational and Environmental Hygiene, Mar. 1992, Vol.7, No.3, p.191-194. 21 ref.
Lachapelle J.M., Frimat P., Tennstedt D., Ducombs G.
Occupational and environmental dermatology
Dermatologie professionnelle et de l'environnement [in French]
This review of dermatology is aimed at dermatologists and at occupational physicians. Contents: the biology of the skin, reactions of the skin to physical and chemical aggression; dermatoses due to physical and chemical agents; reactions of the skin to penetration by foreign matter; dermatoses due to airborne agents; skin cancer; dermatoses due to green plants; dermatoses due to living things other than green plants; changes in skin and hair; skin diseases, diabetes and venous diseases; self-inflicted skin conditions; dermatology and sports medicine; preventive measures; legislation; expert opinion and evaluation in dermatology. In appendices: test methods used in occupational dermatology; information on important allergens.
Masson, 120 Bd. Saint-Germain, 75280 Paris Cedex 06, France, 1992. 372p. Illus. Bibl.ref.
Oakley K., Gooch C., Cockcroft A.
Review of management of incidents involving exposure to blood in a London teaching hospital, 1989-91
The study reviews management of incidents involving exposure to blood involving 438 health care workers and students in a London teaching hospital from 1989 to mid-1991. A total of 447 incidents were reported: 337 sharps injuries and 110 other exposures. A total of 310 staff reporting incidents were already immune to hepatitis B virus. Of 345 source patients identified, 77 had already been tested for hepatitis B surface antigen (28 positive results) and 58 for HIV antibodies (18 positive results). Of those not previously tested, 145 of 266 were subsequently tested for hepatitis B surface antigen (two positive) and 149 of 287 for HIV antibodies (none positive). Specific hepatitis B immunoglobulin was given to 18 staff who were not immune and was avoided in 11 cases by a negative result for the patient. Management of exposure to blood is improved by widespread immunisation against hepatitis B virus and by knowledge of source patients' hepatitis B virus and HIV status.
British Medical Journal, 11 Apr. 1992, Vol.304, No.6832, p.949-951. 16 ref.
de Juanes J.R., Lago E., Arrazola P., Ortega P., Astasio P., Jaén F.
Nursing faced by hepatitis B and C as occupational diseases: their prevention
La enfermería frente a las hepatitis B y C, como causa de enfermedad profesional: su prevención [in Spanish]
The occupational risk of hepatitis B and C virus infection is considered to be a serious problem for nursing personnel. Statistics on the infected population with hepatitis B virus, in particular nursing staff, are given. Adequate information and barrier methods (gloves, masks, clothes) are indicated as preventive measures for this disease, as well as vaccination, which is discussed in more detail. With respect to hepatitis C virus infection, the situation seems to be more uncertain. However, in case of possibility of infection with this virus, the administration of standard gammaglobulin is recommended.
Medicina y seguridad del trabajo, Apr.-June 1992, Vol.39, No.156. p.3-10. 30 ref.
Ares Camerino A., Sainz Vera B., Soto Pino M.L., Fernández Campos P., Bocanegra Díaz-Crespo R., Suárez Collantes M.
Prevalence of hepatitis B markers among personnel of child assistance centres
Prevalencia de marcadores de la hepatitis B entre el personal laboral de centros de infancia [in Spanish]
The Department of Occupational Health of Cádiz (Spain) planned a programme for the prevention of hepatitis B in personnel of child assistance centres. This programme consisted of two subprogrammes: (1) information on the disease, its control, protection and prevention measures; and (2) vaccination. This article provides information on the first stage of the vaccination subprogramme aimed at examining the immunological condition of the population under study. The prevalence of hepatitis B markers in the study population was even higher than in general hospital personnel. For this reason, hepatitis B prevention and vaccination programmes are recommended in such institutions.
Medicina y seguridad del trabajo, Jan.-Mar. 1992, Vol.39, No.155, p.49-55. 21 ref.
Society of Occupational Medicine, Industrial Hygiene and Ergonomics of Western France - Meeting of 18-19 October, 1990
Société de médecine du travail, d'hygiène industrielle et d'ergonomie de l'Ouest - Séances des 18 et 19 octobre 1990 [in French]
Subjects treated: epilepsy and dangerous work; cardiovascular ageing; a typical immunological response after hepatitis B in a laboratory worker; study of atmospheric concentration of chemicals contained in a new disinfection process not relying on aldehydes; diabetes and occupational health; trends in the reliance on biological tests in occupational medicine; survey on work experience in banking; notification and analysis of occupational diseases in the Loire Valley; reliance on paramedical staff in inter-corporation OSH services; occupational medicine in the rubber industry; role of the occupational physician in noise measurement; workplace survey after an atypical case of silicosis.
Archives des maladies professionnelles, 1991, Vol.52, No.6, p.424-445. Illus.
Occupational risks in dentistry and stomatology
Riesgos profesionales en odonto-estomatología [in Spanish]
Occupational health hazards, occupational diseases recognised in Spain and preventive measures, including personal protection when relevant, for workers in dentistry and stomatology. Hazards are classified in terms of the aetiological agent, which can be physical, chemical or biological. Physical agents discussed are ionising radiation, halogen lighting, lasers, noise, work posture, dust and aerosols, intraocular foreign bodies, and microtrauma and vibration. Chemical agents reviewed are mercury, irritants (e.g. acids and alkalis, solvents) and sensitisers (e.g. anaesthetics). Disorders caused by biological agents are presented as follows: eye, skin and respiratory infections, viral hepatitis, and acquired immunodeficiency syndrome (AIDS). Legal aspects, such as compensation of occupational diseases, are also discussed.
Medicina y seguridad del trabajo, July-Sep. 1991, Vol.38, No.153, p.3-9; Oct.-Dec. 1991, Vol.38, No.154, p.3-14. 27 ref.
Department of Labor - Occupational Safety and Health Administration (OSHA)
Occupational Exposure to Bloodborne Pathogens: Final Rule [USA]
This standard (effective 6 Mar. 1992), aimed at eliminating or minimising occupational exposure to bloodborne pathogens (particularly Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV)), concerns: definitions; exposure controls; methods of compliance (engineering and work practice controls, personal protective equipment, housekeeping); HIV and HBV research laboratories and production facilities; Hepatitis B vaccination and post-exposure evaluation and follow-up; communication of hazards to employees (labels and signs, information and training); recordkeeping. The introduction to the standard includes a very detailed discussion of: events leading to the standard; health effects of exposure to bloodborne pathogens (epidemiology and symptoms of Hepatitis B and AIDS; other bloodborne pathogens: syphilis, malaria, babesiosis, brucellosis, leptospirosis, arboviral infections, relapsing fever, Creutzfeldt-Jacob disease, human T-lymphotropic virus type I, viral haemorrhagic fever); quantitative risk assessment (principally among health-care workers); significance of risk; regulatory impact/flexibility analysis; environmental impact.
Federal Register, 6 Dec. 1991, Vol.56, No.235, p.64003-64182. Illus.
Wada Y., Kamiyama S., Koizumi A.
Negligible risk of horizontal transmission of hepatitis B virus among mechanics and salespersons in the automobile industry
Transmission of hepatitis B virus (HBV) among hospital patients and medical staff has been well documented. The high prevalence of hepatitis B antigen (HBsAg) carriers in the Japanese population makes horizontal transmission in other occupational settings a real concern, but the actual risk of HBV infection has been unknown. The permanent work force of 44 automobile dealerships in Akita Prefecture (220 locations) was screened for HBsAg as part of routine medical examinations. Blood samples positive for HBsAg were tested for HBV core antigen to confirm the presence of persistent infection. The prevalence of HBV infection was much higher among subjects aged 35-44 than in other age groups. This reflects the hepatitis epidemics that followed the introduction of pertussis and polio vaccination programmes in 1948. The fact that infection did not spread into other age cohorts in these workplaces indicates that the risk of horizontal transmission is negligible when contact with biological fluids is unlikely.
Industrial Health, 1991, Vol.29, p.161-165. 12 ref.
Société de médecine du travail et d'ergonomie de Bordeaux et de sa région - Proceedings of the Meetings of 27 April and 19 October 1990
Société de médecine du travail et d'ergonomie de Bordeaux et de sa région - Séances du 27 avril et du 19 octobre 1990 [in French]
Papers presented at the meetings (Bordeaux, France, 27 April - 19 Oct. 1990): management of an accidental needle-prick injury contaminated with blood - role of industrial physician and general practitioner; occupational allergic dermatitis - a report on 437 cases observed in connection with occupational diseases; the actions and methodology of the occupational physician; contribution to the study of occupational warts - an epidemiological study conducted by the Mont-de Marsan (France) occupational health service in 1988.
Archives des maladies professionnelles, 1991, Vol.52, No.7, p.520-526.
Bandaranayake D.R., Salmond C.E., Tobias M.I.
Occupational risk of hepatitis B for police and customs personnel
A cross-sectional study was undertaken to establish whether New Zealand police and customs officers are at excess risk of hepatitis B virus infection as a consequence of occupational exposure to human blood and penetrating injury. The control group was comprised of civilians employed by both police and customs organisations. The prevalence of hepatitis B markers in the control group, when standardised for age, sex and ethnic distribution, was 13.4%, which agrees well with New Zealand blood donor figures. The prevalence ratios for police officers and customs officers compared with the civilians (adjusted for age, sex, and ethnic distribution) were 0.82 (95% confidence interval (CI) 0.63-1.06) and 0.49 (95% CI 0.34-0.70), respectively. Multivariate analysis failed to demonstrate any significant association between occupational variables and marker prevalence. There was an association between time spent living in high-risk areas of the country and marker prevalence.
American Journal of Epidemiology, 15 Dec. 1991, Vol.134, No.12, p.1447-1453. 11 ref.
Fernández Barboza R., Rivero D., Echeverría B., Machado I.
Cost-benefits of hepatitis B vaccination in Venezuelan hospital workers
Costo-beneficio de la vacunación contra la hepatitis B en trabajadores de hospitales de Venezuela [in Spanish]
A cost-benefit study of hepatitis B vaccination in Venezuelan hospital workers was performed through a decision tree analysis model, which includes the probabilities for the different outcomes of the hepatitis B virus infection (HBV). The current average cost of HBV infection to the Venezuelan Government was estimated at USD 1,759 per patient. Implementation of selective vaccination or a mass vaccination campaign for hospital workers would reduce the total cost of HBV infection by 49% and 72%, respectively, providing savings of USD 17 to 26 million. This type of economic analysis may influence the distribution of the resources to be allocated for the control of HBV infection in Venezuela. Summary in English.
Boletín de la Oficina Sanitaria Panamericana, July 1991, Vol.111, No.1, p.16-23. Illus. 20 ref.
Occupational health problems among nurses
Nurses are an integral component of the health care delivery system. In discharging their duties, nurses encounter a variety of occupational health problems which may be categorised into biological, chemical, physical and psychosocial hazards. A review of some examples of each of these four types of hazards is presented. Particular attention has been devoted to hepatitis B, acquired immunodeficiency syndrome, tuberculosis, cytotoxic drugs, anaesthetic agents, needlestick injury, back pain, and stress.
Scandinavian Journal of Work, Environment and Health, Aug. 1991, Vol.17, No.4, p.221-230. 102 ref.
Peyton R.X., Rubio T.C.
Construction safety practices and principles
This reference book surveys in detail construction safety principles and specific, effective how-to information for integrating safety into all aspects of jobsite operations. It demonstrates methods for incorporating safety management techniques into every phase of construction, from pre-job planning through project completion. It provides immediately applicable methods for effective jobsite safety, outlining employers' rights and responsibilities under OSHA guidelines, motivating employees to participate in the safety efforts and safety training. It also offers critical insights into current issues such as the worker component of accident causation, crisis management, hazard communication, substance abuse in the workplace, health hazards such as AIDS and hepatitis, and the sick building syndrome.
Chapman and Hall, Scientific Division of Associated Book Publishers Ltd., 11 New Fetter Lane, London EC4P 4EE, United Kingdom, 1991. vi, 266p. Illus. Index. Price: GBP 29.00.
Wang J.D., Lai M.Y., Chen J.S., Lin J.M., Chiang J.R., Shiau S.J., Chang W.S.
Dimethylformamide-induced liver damage among synthetic leather workers
The purpose of this study was to determine liver damage associated with dimethylformamide (DMF) exposure. Liver function tests, and creatinine phosphokinase (CPK) determinations were performed on 183 workers of a synthetic leather factory. Air concentrations of solvents were also measured. High exposure concentrations of DMF (25-60ppm) were significantly associated with elevated alanine aminotransferase (ALT) levels (ALT≥35IU/L), a result that did not change even after stratification by hepatitis B carrier status. The study demonstrates that exposure to high concentrations of DMF was associated with an elevated ALT (p=0.01), whereas hepatitis B surface antigen was slightly but independently associated with an elevated ALT (p=0.07). In those workers who had normal ALT values, there occurred still significantly higher mean ALT and aspartate aminotransferase activities, especially among those who were not hepatitis B surface antigen carriers. A significant association existed between elevated CPK levels and exposure to DMF. Liver damage among synthetic leather workers is ascribed to DMF but it is recommended that the occupational standard for DMF and its toxicity among hepatitis B surface antigen carriers be evaluated further.
Archives of Environmental Health, May-June 1991, Vol.46, No.3, p.161-166. 21 ref.
Vincent-Ballereau F., Lafaix C.
Prevention of blood transmitted infections in health care personnel: How to choose the containers for the disposal of sampling materials
Prévention des infections transmises par le sang chez les personnels de santé: comment choisir les conteneurs destinés à recueillir le matériel de prélèvement ou d'injection? [in French]
The study of different types of containers usable for the disposal of sampling and injection instruments has led to the establishment of 10 quality criteria. Those are described in detail in order to provide guidance to the user.
Travail et sécurité, Feb. 1991, No.2, p.146-151. Illus. 9 ref.
AIDS at the working place
SIDA et milieu de travail [in French]
Review of the workplace aspects of HIV/AIDS: contamination hazard for co-workers, dangers of continuing the employment of an HIV-infected worker at specific workplaces. The risk of being infected by HIV at the workplace is discussed, the occupational hazard being as of now demonstrated only in hospitals, health care facilities and laboratories. Guidance for safe working methods and reporting of incidents involving contact with the blood of the patient.
Travail et sécurité, Feb. 1991, No.2, p.132-145. Illus. 23 ref.
Employees at risk - Protecting the health of the health care worker
This book presents the current changes in the management of hospital employee health risks, and identifies infectious, chemical and physical hazards existing in to-day's health care workplace. It offers a coordinated approach to potential hazard assessment, biological monitoring, environmental surveillance, and health and safety education.
Chapman and Hall, Scientific Division of Associated Book Publishers Ltd., 11 New Fetter Lane, London EC4P 4EE, United Kingdom, 1991. xiii, 178p. Bibl.ref. Appendices. Index.
HIV infection. General rules for disinfection and risk prevention in the health professions
Infection à VIH. Règles générales de désinfection, prévention des risques dans les professions de santé [in French]
The prevention of HIV infection should take into account not only the risks of infection by HIV itself but also the risk of associated infections, often asymptomatic (such as hepatitis B), as well as immunodepressive complications. The principles of disinfection and of estimating the activity of disinfectants are explained, along with applications and methods of use of antiseptics and disinfectants. The problem of the prevention of risks of infection in hospitals is also approached by considering risks for AIDS patients, other sick people and personnel. For health service and laboratory personnel, sources of contamination according to biological site are outlined along with exposure to risks according to post or service, and the frequency of accidents and seroconversions. Preventive measures include recommendations concerning containers for disposable soiled objects so as to avoid all contact with blood. Finally, measures to take in case of accident involving exposure to blood or biological products are described.
Encyclopédie médico-chirurgicale, Toxicologie-pathologie professionnelle, 1991. 6p. 14 ref.
Ministère des affaires sociales et de l'intégration
Order of 23 August 1991 on vaccination: List of occupations concerned [France]
Arrêté du 23 août 1991 sur la vaccination: professions concernées [France] [in French]
Order of 23 Aug. 1991 (published in the Journal officiel of 3 Sep. 1991). This order, which completes Act 91-73 and orders of 6 Feb. 1991 and 15 Mar. 1991 (abstracted under CIS 91-1754), provides a list of medical and health care personnel to be immunised against hepatitis B, diptheria, tetanus and poliomyelitis.
Cahiers de notes documentaires - Sécurité et hygiène du travail, 4th Quarter 1991, No.145, Note No.1862-145-91, p.739.
Woolley A., Buttolph M.A.
Biological agents at work
Contents of this module usable for an OSH training course or for private study, accompanied by question-and-answer tests: basic information on health hazards due to biological agents (viruses, bacteria, protozoa and fungi; the process of infection); defence systems of the body (primary defences; the immune system); allergies; controls and legal requirements in the UK. In annex: fact sheets on common infectious diseases of concern in the workplace (hepatitis B, Legionnaires' disease, humidifier fever, leptospirosis, AIDS, aspergillosis, anthrax, brucellosis, glanders).
OHSOL Unit, Buckingham Building, Lion Terrace, Portsmouth PO1 3HE, United Kingdom, 1991. 41p. Illus.
Wong E.S., Stotka J.L., Chinchilli V.M., Williams D.S., Stuart C.G., Markowitz S.M.
Are universal precautions effective in reducing the number of occupational exposures among health care workers? - A prospective study of physicians on a medical service
In a questionnaire survey 277 physicians were queried concerning incidents of exposure to blood and body fluids and barrier use before and after the implementation of universal precautions. Implementation increased the frequency of barrier use during exposure incidents, decreased the number of exposure incidents that resulted in direct contact with blood and body fluids and increased averted exposures in which direct contact was prevented by barrier devices. Thus, universal precautions were effective in reducing the risk of occupational exposures among physicians.
Journal of the American Medical Association, 6 mar. 1991, Vol.265, No.9, p.1123-1128. 28 ref.
Murph J.R., Baron J.C., Brown C.K., Ebelhack C.L., Bale J.F.
The occupational risk of cytomegalovirus infection among day-care providers
Of the 252 day-care providers studied at 6 day-care centres, 96 (38%) were seropositive for cytomegalovirus at entry into the study. Among 82 seronegative providers available for follow-up, 7 seroconversions occurred. It was estimated that the overall risk of seroconversion ranged from 0% to 22% by 12 months and from 0% to 40% by 16 months. Risk of cytomegalovirus acquisition was independent of the presence of a child at home or caring for young children in the centre, although the risk of seroconversion appeared to be related to the risk of cytomegalovirus acquisition among the children at each centre.
Journal of the American Medical Association, 6 Feb. 1991, Vol 265, No.5, p.603-608. 20 ref.
Klein R.S., Freeman K., Taylor P.E., Stevens C.E.
Occupational risk for hepatitis C virus infection among New York City dentists
Demographic, occupational and behavioural data were recorded for dentists in the New York City area and sera were tested for antibodies to HCV (anti-HCV). Anti-HCV was found in 8 (1.75%) of 456 dentists compared with 1 (0.14%) of 723 controls and in 4 (9.3%) of 43 oral surgeons compared with 4 (0.97%) of 413 other dentists. Seropositive dentists claimed to have treated more intravenous drug users in the week or month before the study than did seronegative dentists. Findings show that dentists are at increased risk for hepatitis C infection. It is concluded that all health-care workers should regard patients as potentially infected with a communicable bloodborne agent.
Lancet, 21/28 Dec. 1991, Vol. 338, No.8782/83, p.1539-1542. 27 ref.
Kligman E.W., Peate W.F., Cordes D.H.
Occupational infections in farm workers
This paper deals with occupational infections which can cause disease and disability in agricultural workers. Prevention and control methods discussed include: personal protective equipment; educational efforts; workplace revisions and engineering controls; animal control measures, such as vaccines and antibiotics. To the physician treating a farmer with various symptoms the paper offers checklists of questions concerning work activities, exposures, and medical history. The symptoms, diagnostic tests, treatment, and prevention and control of the 11 most common agricultural infections are presented: anthrax; ascariasis; brucellosis; viral encephalitis; leptospirosis; Q fever; rabies; Rocky Mountain Spotted Fever; staphylococcal infections; tetanus; tularaemia.
Occupational Medicine: State of the Art Reviews, July-Sep. 1991, Vol.6, No.3, p.429-446. 18 ref.
Nagafuchi S., Kashiwagi S., Okada K., Anzai K., Nakamura M., Nishimura Y., Sasazuki T., Niho Y.
Reversal of non-responders and post-exposure prophylaxis by intradermal hepatitis B vaccination in Japanese medical personnel
Thirty-one Japanese non-responders to subcutaneous hepatitis B vaccination and 15 medical personnel who were accidentally exposed to specimens positive for hepatitis B e antigen and were given hepatitis B immunoglobin were intradermally immunised with hepatitis B vaccine every 2 weeks until delayed type hypersensitivity skin reaction to hepatitis B surface antigen (HBsAg) became positive. One year later, 74% of the non-responders still had sufficiently high levels of anti-HBsAg, while for the exposed personnel protection was 100%. Intradermal hepatitis B vaccination is therefore seen to be useful in reversing non-responsiveness to hepatitis B surface antigen and for prophylaxis after exposure.
Journal of the American Medical Association, 22/29 May 1991, Vol.265, No.20, p.2679-2683. Illus. 37 ref.
Beck-Sagué C.M., Jarvis W.R., Fruehling J.A., Ott C.E., Higgins M.T., Bates F.L.
Universal precautions and mortuary practitioners: Influence on practices and risk of occupationally acquired infection
Embalming, the most common funeral practice in North America, may expose the embalmer to infectious diseases and blood. 860 morticians in the US and Canada were surveyed in 1988 to estimate the incidence of self-reported occupational contact with blood and infectious disease, assess morticians' knowledge of acquired immunodeficiency syndrome (AIDS), determine their adherence to universal precautions, and identify predictors of practices designed to reduce risk of occupational exposure to infections. Of 539 (63%) respondents, 212 (39%) reported needle-stick injuries in the past 12 months, and 15 (3%) reported percutaneous exposures to HIV-contaminated blood. Those rating the risk of occupationally acquired human immunodeficiency virus infection as very high or high (194/539 [36%]) were more likely to decline funerals of bodies with antemortem diagnosis of AIDS (59/194 [30%]) and/or to charge more for such funerals (133/194 [69%]) than those who rated the risk as low to moderate (31/345 [9%], 174/345 [51%]).
Journal of Occupational Medicine, Aug. 1991, Vol.33, No.8, p.874-878. Illus. 22 ref.
Harris A.A., Daly-Gawenda D., Hudson E.K.
Vaccine choice and program participation rates when two hepatitis B vaccines are offered
Participation rates of health care workers in voluntary free hepatitis B virus immunisation programmes are 35% to 40%. University teaching hospital employees at risk for hepatitis B virus and presenting for immunisation were surveyed as to vaccine preference. Both plasma-derived and recombinant hepatitis B virus vaccines were available. During a 10-month period, 173 health care workers enrolled in the study. One hundred seventeen received recombinant vaccine, and 56 received plasma-derived vaccine; 66 were immunised post-exposure. Concern of a relationship of human immunodeficiency virus to hepatitis B virus plasma-derived vaccine was acknowledged by a small number of health care workers as important in vaccine selection. Recombinant hepatitis B virus vaccine rapidly and substantially supplanted plasma-derived vaccine but did not increase programme participation. It is suspected that mandatory immunisation or proof of immunity will be necessary if hepatitis B virus protection rates in health care workers are to improve.
Journal of Occupational Medicine, July 1991, Vol.33, No.7, p.804-807. 13 ref.
Ministère des affaires sociales et de la solidarité
Act of 18 January 1991 and Orders of 6 February and 15 March 1991: Vaccination. Compulsory vaccinations. Conditions of immunisation [France]
Loi n°91-73 du 18 janvier 1991 et arrêtés du 6 février et du 15 mars 1991: Vaccination - Obligations. Conditions d'immunisation [France] [in French]
All persons exposed as a result of their professional activity in a public or private health care or medical prevention establishment to the risk of contamination as well as all medical students must be immunised against hepatitis B, diphtheria, tetanus and poliomyelitis. Employees of biomedical analysis laboratories must also be vaccinated against typhoid fever. The cost of vaccination must be borne by the employer or the educational establishment concerned. The Order of 6 February 1991 lays down the conditions of immunisation of persons covered by article L.10 of the Public Health Code. The Order of 15 March 1991 provides a list of public or private health care or public health establishments in which exposed personnel must be vaccinated. Act No.91-73 was published in the Journal officiel of 20.01.1991. Decrees of 6 Feb. 1991 and 15 March 1991 were published in the Journal officiel of 21 Feb. 1991 and 3 April 1991, respectively.
Cahiers de notes documentaires - Sécurité et hygiène du travail, 1st Quarter 1991, No.143, Note No.1833-143-91, p.291 and 292.
AIDS and health care workers
Discussion of the risk of HIV infection through needlestick injury and of the risk faced by patients of being infected by HIV positive practitioners.
Occupational Health, Aug. 1991, Vol.43, No.8, p.243-245. 7 ref.
Mauskopf J.A., Bradley C.J., French M.T.
Benefit-cost analysis of hepatitis B vaccine programs for occupationally exposed workers
The Occupational Safety and Health Administration of the US proposed a vaccination programme for workers exposed to the hepatitis B virus 12 or more times per year. A benefit-cost analysis was performed of the proposed regulation and of an expanded rule that covers all at-risk workers, regardless of the number of exposures. The annualised cost of the proposed vaccination programme is estimated at USD 60.4 million. The financial benefit of the programme was estimated using two methods. The first estimates the avoided cost of medical care, prophylaxis, and lost productivity at USD 124 million annually. The second approach includes the value of avoided pain and suffering from hepatitis B, thus increasing the total dollar benefit to USD 679 million. Although both methods indicate that benefits are greater than programme costs, the valuation of avoided pain and suffering substantially increases net benefits. Furthermore, provision of the vaccine to all exposed workers is cost-effective if one or more cases of hepatitis B are avoided per 6500 workers annually.
Journal of Occupational Medicine, June 1991, Vol.33, No.6, p.691-698. 12 ref.
Gauch R.R., Feeney K.B., Brown J.W.
Attitudes and behaviors of medical technologists as a result of AIDS
To determine the influence of AIDS on the attitudes and behaviours of medical technologists, a survey was taken which shows that one quarter are considering leaving the profession. Individuals who plan to stay in the profession are less fearful of AIDS, more satisfied with the policies their organisations have established regarding the disease, and less willing to associate a declining employment situation with it. Improvement in safe laboratory practices is present in both groups, but the individuals considering a move out of the field exhibit the largest change. A surprising result is that fear of AIDS is not related to or only weakly associated with traditional demographic and occupational variables, suggesting that other more complex factors are influencing the views and work habits of medical technologists as a result of AIDS.
Journal of Occupational Medicine, Jan.1991, Vol.33, No.1, p.74-79. 18 ref.
Research in occupational health: the UK National Health Service
This article discusses the scope of research to be carried out in the UK National Health Service which, if allied to occupational health practice, might have important direct or indirect benefits for patient care. General research topics that await further study include: health inequalities amongst health care workers, job stress, back problems, pregnancy, and infection risks from blood. Topical specific hazards include gluteraldehyde, cytotoxic drugs, nuclear magnetic resonance imaging, and implications of new technology in surgery. The co-ordination of databases across different district health authorities would be very useful for epidemiological research, the delivery of OSH services and the development of vaccination strategies.
Journal of the Society of Occupational Medicine, Spring 1991, Vol.41, No.1, p.7-9. 11 ref.
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