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Health care services - 1,917 entries found

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CIS 04-377 Eckerman D.A., Abrahamson K., Ammerman T., Fercho H., Rohlman D.S., Anger W.K.
Computer-based training for food services workers at a hospital
Interactive computer-based safety instruction (CBI) was given to 73 workers in the food services department of a university hospital. Subjects were observed at their jobs prior to, during the instruction and after the instruction. The proportion of correct answers to a computer-based test on safety improved significantly after the training (95%) as opposed to before the training (74.5%). There was in particular an increased accuracy in answers to questions that required application of knowledge to the work setting (from 46% to 79%). Improvements in work practices were seen in 79% of workers. There were important improvements in knowledge and work practices, showing that the benefits of CBI extended effectively to the workplace floor.
Journal of Safety Research, 2004, Vol.35, No.3, p.317-327. Illus. 52 ref.

CIS 04-376 Luime J.J., Kuiper J.I., Koes B.W., Verhaar J.A.N., Miedema H.S., Burdorf A.
Work-related risk factors for the incidence and recurrence of shoulder and neck complaints among nursing-home and elderly-care workers
The objective of this study was to assess the relationship between the incidence and recurrence of shoulder and neck complaints and various work-related physical, psychosocial, and personal risk factors. A prospective cohort study was carried out among 769 workers of nursing homes and homes for the elderly. At baseline, a questionnaire was used to collect data on personal characteristics, physical workload, psychosocial workload, and the presence of shoulder and neck complaints. After one and two years, follow-up data were collected on shoulder and neck complaints. After adjustment for age and gender, shoulder complaints were found to relate strongly with obesity (odds ratio OR 2.12). Neck complaints were increased for obesity (OR 1.81), work in awkward postures (OR 1.76) and poor state of health (OR 1.53). The recurrence of both shoulder and neck complaints was associated with chronic complaints at baseline (shoulder: OR 1.91; neck: OR 1.71) but not with work-related risk factors.
Scandinavian Journal of Work, Environment and Health, Aug. 2004, Vol.30, No.4, p.279-286. Illus. 36 ref.

CIS 04-441 Accidental overexposure of radiotherapy patients in Białystok
An accidental overexposure occurred in the Białystok oncology centre, in Poland, which affected five patients undergoing radiotherapy. This report gives an account of the event, the subsequent dose assessment and the clinical consequences to the patients. It also discusses the lessons learned from this incident and provides recommendations for preventing similar events from occurring. The report is likely to be of use to the manufacturers and users of accelerators and to national regulatory bodies.
International Atomic Energy Agency (IAEA), Wagramerstrasse 5, P.O. Box 100, 1400 Wien, Austria, 2004. 103p. Illus. 36 ref. Price: EUR 24.00. Downloadable version (PDF format) free of charge. [in English]

CIS 04-109 Alanko K., Susitaival P., Jolanki R., Kanerva L.
Occupational skin diseases among dental nurses
In this study, 799 female dental nurses in the Helsinki district were surveyed using a computer-assisted telephone interview. A structured questionnaire was used to inquire about skin and respiratory symptoms, atopy, work history, work methods and occupational exposure. The 328 nurses who reported work-related dermatitis on their hands, forearms or face, were invited to an interview by an occupational physician; 245 nurses participated. 31 nurses had previously been diagnosed with an occupational skin disease (OSD). 133 nurses with a suspected OSD were selected for further clinical examinations with prick and patch testing. Among the 107 nurses who participated, 22 new cases of OSD were diagnosed. There were altogether 29 cases of allergic contact dermatitis, 15 of contact urticaria, 12 of irritant contact dermatitis, and one case of onychomycosis. Rubber chemicals and natural rubber latex in protective gloves, as well as dental-restorative plastic materials (methacrylates), were the most common agents responsible for the allergies.
Contact Dermatitis, Feb. 2004, Vol.50, No.2, p.77-82. 26 ref.

CIS 04-90 O'Hara R., Elms J., Pickvance S., Fishwick D., Hazell M., Frank T., Marlow P., Henson M., Harvey P., Evans G., Curran A.
Health and Safety Executive
The profile of patients' occupational health in primary care
This project was undertaken to help understand why the occupational health of patients has failed to gain a higher priority among primary care physicians, nurses, managers and planners, and what the HSE could do for occupational health to receive a higher priority in primary care diagnosis and subsequent treatment. Qualitative data was collected from three focus groups of primary care professionals, general practitioners, nurses and managers. Quantitative data was collected nationally from 295 general practitioners using a postal questionnaire. Recommendations are centred around the access of primary care staff to better information and advice on occupational health.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2004. x, 74p. Illus. 46 ref. Price: GBP 15.00. Downloadable version free of charge. [in English]

CIS 03-1922 Setbon M.
Hazards, public health and decision processes
Risques, sécurité sanitaire et processus de décision [in French]
The evaluation of major public health hazards is a central aspect of national health-care planning. Decision processes represent a key step determining whether these hazards and risks justify or not the launching of public intervention programmes. Resulting decisions are nationwide in scope. These hazards or risks can be relevant to three areas: the health care system, food and the environment. This publication presents the results of a retrospective research project aimed at making it easier to understand sanitary safety decisions taken in response to hazards or risks. Eight cases are studied, which then form the basis of a comparative overview.
Elsevier SAS, 23 rue Limois, 75725 Paris cedex 15, France, 2004. 170p. Bibl.ref. Price: EUR 30.00.

CIS 03-1947 Watanabe M., Akamatsu Y., Furui H., Tomita T., Watanabe T., Kobayashi F.
Effects of changing shift schedules from a full-day to a half-day shift before a night shift on physical activities and sleep patterns in single nurses and married nurses with children
Nurses (12 single, 18 married nurses with children) in a Japanese hospital were investigated. Subjects worked two different shift patterns consisting of a night shift after a half-day shift (HF-N) and a night shift after a day shift (D-N). Physical activity levels were recorded. The duration of sleep before a night shift was significantly shorter for married nurses than that of single nurses for both shift schedules. Changing shift from the D-N to the HF-N increased the duration of sleep before a night shift for both groups, and made wake-up time earlier for single nurses only. Detailed statistical analysis showed that the effects of a change in shift schedules seemed to have less effect on married nurses than single nurses. These differences might be due to the differences of their family and domestic responsibilities.
Industrial Health, Jan. 2004, Vol.42, No.1, p.34-40. Illus. 21 ref.

CIS 03-1650 Solé Gómez M.D.
Reproductive health protection and promotion: Role of health care personnel of occupational safety and health services
Protección y promoción de la salud reproductiva: funciones del personal sanitario del servicio de prevención [in Spanish]
This information note describes the role of the medical staff of occupational safety and health services with respect to the prevention of hazards to reproductive health or to the development of the unborn child. Topics addressed: identification of the population subject to the risk of reproductive function changes; organic changes in pregnant women, new mothers and breast-feeding women; training and information of male and female personnel on the risks to reproductive health; advice tailored to the individual; specific prevention measures (three months prior to conception, during pregnancy, during breast feeding). Risk factors that need to be taken into account for the evaluation of hazards among breast-feeding women or new mothers, as well as critical periods and possible mechanisms of risks to reproductive health in case of paternal exposure to chemical agents, are presented in tabular form.
Instituto Nacional de Seguridad e Higiene en el Trabajo, Ediciones y Publicaciones, c/Torrelaguna 73, 28027 Madrid, Spain, 2004. 6p. Illus. 12 ref. [in Spanish]


CIS 09-993 Wiskow C.
Guidelines on workplace violence in the health sector
As part of the Joint Programme of the International Labour Office (ILO), the International Council of Nurses (ICN), the World Health Organization (WHO) and Public Services International (PSI) to develop sound policies and practical approaches for the prevention and elimination of violence in the health sector launched in 2000, the major known national guidelines and strategies of the following countries were compared: United Kingdom; Australia; Sweden; USA (OSHA and California). Commonalities, differences, gaps and weaknesses are discussed. The study highlights promising examples and makes a number of recommendations.
World Health Organization, Distribution and Sales Service, 1211 Genève 27, Switzerland, 2003. 40p. 32 ref. [in English]

CIS 08-980 Ergonomics for the prevention of musculoskeletal disorders - Guidelines for nursing homes
A major component of OSHA's approach to ergonomics is the development of industry-specific and task-specific guidelines to reduce and prevent workplace musculoskeletal disorders (MSDs). These voluntary guidelines for nursing homes are tools to assist employers in recognizing and controlling ergonomics-related risk factors. It is recommended that the manual lifting of residents be minimized in all cases and eliminated when feasible, and that employers implement an effective ergonomics process that provides management support, involves employees, identifies problems, implements solutions, addresses reports of injuries, provides training and evaluates the programme.
Publications U.S. Department of Labor, Occupational Safety and Health Administration, 200 Constitution Avenue, Washington, D.C. 20210, USA, Mar. 2003. 37p. Illus. 10 ref. [in English]

CIS 07-891
Health and Safety Executive
Safe handling of cytotoxic drugs
This information sheet is aimed at persons who handle cytotoxic drugs, sometimes known as antineoplastic, anticancer or chemotherapy drugs. It provides useful information for pharmacists, medical and nursing staff, veterinary practitioners and others involved in handling these drugs, including people who clean up any spills. Topics addressed include the potential health hazards and health surveillance, legal framework and the duties of employers and employees. It also gives useful tips on ways of controlling and monitoring exposure and appropriate waste disposal.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, Sep. 2003. 7p. 25 ref. [in English]

CIS 07-671
Health and Safety Executive
Handling cytotoxic drugs in isolators in NHS pharmacies
This information note gives advice on factors to consider when selecting either negative or positive pressure isolators for handling cytotoxic drugs in NHS pharmacies. Topics covered: functions of an isolator; characteristics of negative and positive pressure isolators; routes of operator exposure; combined risk of operator exposure and product contamination; decision table for the selection of either a negative or a positive pressure isolator.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, Jan 2003. 6p. 5 ref.

CIS 06-452 Gensch R.W
Is AIDS still a topical issue in occupational medicine?
AIDS - immer noch ein Thema für Arbeitsmedizin? [in German]
Infection with HIV/AIDS is an important occupational health issue in health care establishments. According to estimations, there will be some 500,000 puncture injuries per year potentially leading to infection with HIV or hepatitis B or C. To reduce the number of these injuries, the following measures are necessary: provision of special containers for hazardous waste; use of fewer dangerous instruments; procedures for the declaration of accidents involving exposure to blood and the offer of post-exposure prophylaxis; reduction of work rates; and examination of workstation ergonomics. It is also necessary to make health service managers aware of the importance of workers' health requirements so that these workers will in turn adopt appropriate behaviours with respect to safety and health.
Paper presented at the 17th Freiburg Symposium, "Occupational Medicine in the Health Services", 10-12 September 2003.

CIS 06-451 von Schwarzkopf H.
Different forms of prophylaxis after exposure to HIV
Differenzierte Handlungsanweisungen bei der ostexpositionprophylaxe HIV [in German]
Guidelines concerning the management of health care personnel in contact with material potentially infected with HIV provide advice on whether it is necessary to administer post-exposure prophylaxis in order to reduce the risk of transmission. According to the type of exposure (puncture or cut, contact with skin, mucous membranes, lips or eyes, etc.), it is advisable to take immediate precautions within the following two hours, or the following 12 to 24 hours. In all cases, disinfection should be carried out and the occupational physician, or the emergency services or HIV specialist should be consulted to decide whether a post-exposure prophylaxis should be started. Such a prophylaxis is indicated when the patient is seropositive. When in doubt, a blood analysis and an ELISA (enzyme-linked immunosorbent assay) test should be carried out. Everything should be done to limit the use of post-exposure prophylaxis to obvious cases and to give as little medication as possible and in the most targeted manner.
Paper presented at the 17th Freiburg Symposium, "Occupational Medicine in the Health Services", 10-12 September 2003. Illus.

CIS 06-208 Hand hygiene during health care activities. Recommendations established in 2002 by the French Society of Hospital Hygiene
L'hygiène des mains dans l'exercice des soins. Recommandations établies en 2002 par la Société française d'hygiène hospitalière [in French]
This article presents the recommendations of the French Society of Hospital Hygiene with respect to hand hygiene during the provision of health care, a key aspect in the prevention of nosocomial infections. Various methods of hand washing and disinfection are described and recommendations are given for procedures, products and equipment to be used according to the level of risk.
Revue de médecine du travail, Mar.-Apr. 2003, Vol.XXX, No.2, p.44-51.

CIS 06-207 Denis M.A., Ecochard R., Bernadet A., Forissier M.F., Porst J.M., Robert O., Volckmann C., Bergeret A.
Risk of occupational blood exposure in a cohort of 24,000 hospital healthcare workers: Position and environment analysis over three years
Early and efficient prevention of occupational blood exposure at hospitals requires knowledge of exposures and risks according to staff characteristics, as well as calculation of annual exposure rates and relative rates. For this purpose, a three-year cohort study involving 24,000 healthcare workers was carried out in a group of 21 health centres in Lyon, France. The overall annual incidence of blood exposure was 3.5 per 100 workers per year, with a maximum for nurses and midwives (6.5) and a minimum for cleaners and paramedics (0.6). Exposures affected mainly nurses (57.81% of accidents, 12.12% of the cohort) and occurred mostly in the surgical and the medical departments (26.34% and 25.20% of accidents respectively). Emergency and intensive care staff had the highest relative rates (4.27 and 3.05 respectively) compared with maintenance staff. Nurses and laboratory staff were more exposed than physicians (relative rates of 3.76 and 2.30 respectively).
Journal of Occupational and Environmental Medicine, Mar. 2003, Vol.45, No.3, p.283-288. 13 ref.

CIS 06-190 X
Health and Safety Executive
Slips and trips in the health services
This information note provides practical advice on preventing slips and trips in the health services. Topics covered: importance of tackling the risks of slips and trips; main causes of slips and trips and how they can be controlled (adequate floor surface, managing the control of slips and trip risks); legal requirements. Two tables present the main causative factors of slips and trips and the corresponding risk control measures.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, Sep. 2003. 8p. 4 ref. [in English]

CIS 06-108 Henderson K.A., Matthews I.P., Adisesh A., Hutchings A.D.
Occupational exposure of midwives to nitrous oxide on delivery suites
Occupational exposure of midwives to nitrous oxide in delivery suites was investigated using environmental and biological monitoring. Environmental samples were taken in two hospitals over a period of four hours using passive diffusion tubes and urine measurements were taken at the start of the shift and after four hours. Environmental levels exceeded the legal occupational exposure standards for nitrous oxide (100 ppm over an 8h TWA) in 35 of 46 midwife shifts monitored. There was a high correlation between personal environmental concentrations and biological uptake of nitrous oxide for those midwives with no body burden of nitrous oxide at the start of a shift, but not for others. Greater engineering control measures are needed to reduce daily exposure to midwives to below the occupational exposure standard.
Occupational and Environmental Medicine, Dec. 2003, Vol.60, No.12, p.958-961. Illus. 20 ref.

CIS 06-152 Korniewicz D.M., Garzon L., Plitcha S.
Health care workers: Risk factors for nonlatex and latex gloves during surgery
This study examined glove failure factors in both non-latex and latex surgical gloves after routine use. Surgical gloves were collected from persons directly involved in surgical procedures. A total of 11,118 surgical gloves were examined in the laboratory for visual defects and barrier integrity. The overall defect rate was 7.8%; non-latex gloves were significantly more likely to fail (8.4%) than latex gloves (6.9%). Latex and non-latex gloves fail under different conditions. Latex gloves fail primarily due to length of use, whereas non-latex gloves are more sensitive to conditions of us (e.g. type of health care worker and type of surgery). Users can help guard against glove defects by double gloving and by changing gloves often, especially when using non-latex gloves in higher-risk surgeries.
AIHA Journal, Nov.-Dec. 2003, Vol.64, No.6, p.851-855. 43 ref.

CIS 05-734 Alexopoulos E.C., Burdorf A., Kalokerinou A.
Risk factors for musculoskeletal disorders among nursing personnel in Greek hospitals
The aim of this cross-sectional study was to investigate the relationships between physical, psychosocial, and individual characteristics of nursing personnel and musculoskeletal symptoms of the lower back, neck and shoulders. A questionnaire was addressed to 351 nurses of six hospitals in Athens, Greece. The response rate was 84%. Odds ratios (ORs) were estimated for all relevant risk factors by means of logistical regression analysis. It was found that physical load was associated with back pain (OR=1.85), neck pain (OR=1.88), and shoulder pain (OR=1.87). However, no consistent influence of psychosocial factors on complaints and their chronicity, or on sickness absence was observed. A perceived moderate general health was also a risk factor. The strongest associations were observed for sickness absence due to back pain (OR=2.03), neck pain (OR=8.31), and shoulder pain (OR=6.84).
International Archives of Occupational and Environmental Health, May 2003, Vol.76, No.4, p.289-294. 21 ref.

CIS 05-563 Dellve L., Lagerström M., Hagberg M.
Work-system risk factors for permanent work disability among home-care workers: A case-control study
The aim of this study was to explore and estimate the impact of the work system on permanent work disability among home-care workers. The 617 cases studied were all home-care workers in Sweden, whose disability pension had been approved in 1997 or 1998. The 771 controls were home-care workers still working. A questionnaire was used to gain information on working life and home life five and 15 years before disability pension entitlement. The most important risk factors in the work system were found to be poor ergonomic conditions, time pressure and lack of professional caring technique. Fifteen years prior to disability pension entitlement, insufficient management and relational problems at work were also risk factors. Five years before disability pension entitlement, organizational support, opportunities for co-working and working climate were also strongly related to persisting work ability. The magnitude of exposure to a number of risk factors had an increased effect. The strongest risk factor in home life was little opportunity to rest from work.
International Archives of Occupational and Environmental Health, Apr. 2003, Vol.76, No.3, p.216-224. Illus. 46 ref.

CIS 05-473 Gil Borrego D., Zabala Torrecilla E., Idoate García V.M., Pollán Rufo M.
Evaluation of the physical workload of operating theatre instrument nurses according to the OWAS method
Evaluación de la carga física de instrumentistas de quirófano mediante el método OWAS [in Spanish]
This study compares the workstations of nine operating theatre instrument nurses in different specializations of surgery including general surgery, traumatology, neurosurgery; cardiovascular surgery and ophthalmological surgery. Postural analyses of the trunk, arms and legs were carried out according to the OWAS method. Results show a high proportion of forced postures among cardiovascular surgery instrument nurses (OWAS action level 4). Practically all activities involve a physical workload corresponding to action levels 1 and 2. Physical workload is low in the case of eye surgery, since the work takes place in the sitting posture, and in arthroscopy, where the intervention is of short duration.
Medicina y seguridad del trabajo, Dec. 2003, Vol.L, No.193, p.33-36. 8 ref.

CIS 05-90 Gunnarsdottir H.K., Rafnsdottir G.L., Helgadottir B., Tomasson K.
Psychosocial risk factors for musculoskeletal symptoms among women working in geriatric care
The aim of this study was to explore the extent of the association between psychosocial work characteristics and musculoskeletal symptoms among women working in geriatric care. 1518 female employees of geriatric nursing homes and geriatric hospital wards in Iceland having a staff of 10 or more responded to a questionnaire. Odds ratios of over two for one or more musculoskeletal symptoms were found for the following risk factors: finding the job mentally difficult; mental exhaustion after one's shift; dissatisfaction regarding communications with supervisors or the flow of information; insufficient influence at work; dissatisfaction with the hierarchy; intense time pressures; lack of solidarity among colleagues; dissatisfaction with the job; harassment; violence or threats at work.
American Journal of Industrial Medicine, Dec. 2003, Vol.44, No.6, p.679-684. 34 ref.

CIS 05-85 Evanoff B., Wolf L., Aton E., Canos J., Collins J.
Reduction in injury rates in nursing personnel through introduction of mechanical lifts in the workplace
Health care workers incur frequent injuries resulting from patient transfer and handling tasks. In this study, injury and lost workday rates were examined before and after an ergonomic intervention which consisted of the introduction of mechanical lifts in acute care hospitals and long-term care (LTC) facilities. Workers were surveyed regarding lift use. The post-intervention period showed decreases in the rates of musculoskeletal injuries (relative risk RR=0.82), in lost workday injuries (RR=0.56), and in total lost days due to injury (RR=0.42). Larger reductions were seen in LTC facilities than in hospitals. Self-reported frequency of lift use by registered nurses and by nursing aides was higher in the LTC facilities than in hospitals. Observed reductions in injury and lost day injury rates were greater in nursing units that reported greater use of the lifts. Strategies to facilitate greater use of lifting devices should be explored, as further reductions in injuries may be possible with increased use.
American Journal of Industrial Medicine, Nov. 2003, Vol.44, No.5, p.451-457. 31 ref.

CIS 05-249 Hristov Z., Tomev L., Kircheva D., Daskalova N., Mihailova T., Ivanova V., Naidenova Z.
Work stress in the context of transition - A case study of three public sectors in Bulgaria
This publication examines work-related stress in three public sectors in Bulgaria (education, health care and public administration) in the context of political and economic transition. Explores work-related stress factors, symptoms and effects of stress and the strategy of trade unions in work stress prevention. It is a pilot effort of trade unions in Central and Eastern Europe to raise public awareness and to develop a trade union response to stress at the workplace. Stress at work has long been a neglected area of policy intervention in most transition countries. This study helps to broaden understanding on this important issue, and to stimulate governments and the social partners to look at the complex web of interaction between work-related stress and contributing factors stemming from the economic and political environment, and to find a coordinated policy response to it. The results presented are specific to Bulgaria and to the three sectors studied, but the methodology is applicable to other countries.
ILO Publications, International Labour Office, 1211 Genève 22, Switzerland, 2003. x, 106p. Illus. 20 ref. [in English]

CIS 05-100 Bonny J.S., Yéboué-Kouamé B.Y., Pillah M.A., Wognin S.B., Kouassi Y.M., Tchicaya A.F.
Intolerance to latex gloves among healthcare workers at teaching hospitals in Abidjan
L'intolérance aux gants de latex chez le personnel soignant des centres hospitaliers universitaires d'Abidjan [in French]
The objective of this cross-sectional study was to assess the degree of intolerance to latex gloves among healthcare workers at the three teaching hospitals in Côte d'Ivoire. Subjects included 609 healthcare workers. Data were collected by means of questionnaires, dermatological examinations and skin tests among workers reporting latex intolerance. Among the main findings: 9.8% of the workers reported signs of intolerance to latex gloves; clinical signs were found on 80% of the intolerant subjects, including eczema (39.5%), irritant contact dermatitis (33.3%) and urticaria (27.1%); the most frequent localization was the back of the hands (37.5%) and the most concerned services were paediatrics (16.2%), laboratory and radiology services (12.5%) and surgery (7.4%); concerned workers included nurses (15.8%), physicians (14%) and midwives (9.7%). Skin tests were carried out among 66.7% of workers with signs of latex intolerance, allowing an estimation of the rate of allergy as 2% of the healthcare workers.
Archives des maladies professionnelles et de médecine du travail, Sep. 2003, Vol.64, No.5, p.329-333. 16 ref.

CIS 05-230 Balty I.
Respirators and health care services
Appareils de protection respiratoire et métiers de la santé [in French]
In order to protect the respiratory tract of health care workers exposed to infectious agents, one needs to select appropriate personal protective equipment. However, there is often confusion as to whether surgical masks or respirators are best suited. The purpose of this information sheet is to clarify the issue. Written in the form of answers to frequently-asked questions, it explains the selection and use of respiratory protective equipment under the specific conditions that prevail in the health care environment.
Institut national de recherche et de sécurité, 30 rue Olivier-Noyer, 75680 Paris Cedex 14, France, 2003. 4p. Illus. 3 ref. Price: EUR 1.50. Downloadable version free of charge.$FILE/ed105.pdf [in French]

CIS 05-224 de Souza Ciorlia L.A., Zanetta D.M.T.
Hepatitis C in healthcare workers: Risks of exposure and infection
Hepatite C em profissionais da saúde: risco de exposição e infecção [in Portuguese]
This review article is devoted to the topic of hepatitis C and the risks of exposure and infection among health care personnel. Contents: general aspects concerning hepatitis C; epidemiology; diagnosis; preventive measures in the absence of vaccines or HCV-specific IgG immunoglobulins; notification of accidents; occupational accidents involving biological material; consequences of cut or needlestick accidents and microcutaneous exposures.
Revista brasileira de saúde ocupacional, 2003, Vol.28, No.107/108, p.91-100. 66 ref.

CIS 05-195 Berbare G.M., Fukusima S.S.
Hearing loss induced by high-speed motors among professional odontologists and odontology students: Audiometric analysis at frequencies ranging from 250Hz to 16kHz
Perda auditiva induzida por ruído de motores de alta rotação em odontólogos e alunos de odontologia: análise audiométrica em freqüências entre 250Hz e 16kHz [in Portuguese]
The objective of this study was to determine whether odontology students and dental surgeons were at risk of hearing loss related to the noise from high-speed motors used in this profession. The study involved 80 students and 40 dentists exposed to noise, together with a control group of 20 dentists unexposed to noise. All participants were subjected to audiometric examinations for frequencies ranging from 250Hz to 16kHz; those handing mercury were further subjected to a urinary mercury determination. Hearing loss was observed among 5% of the students and 70% of the dentists. Dentists exposed to noise showed a more pronounced hearing loss and higher levels of urinary mercury.
Revista brasileira de saúde ocupacional, 2003, Vol.28, No.107/108, p.29-38. Illus. 24 ref.

CIS 04-747 Benvenides Pereira A.M.T., das Neves Alves R.
Persons providing care are also in need of care: Understanding and preventing burnout
Quem cuida também merece cuidados: Conhecendo et prevenindo o burnout [in Portuguese]
This booklet on burnout and its prevention is aimed at persons caring for seropositive patients. It describes burnout symptoms, defines stress and burnout and provides guidance for avoiding burnout or mitigating its symptoms. It also includes relaxation and stretching exercises for relieving tension and emphasizes the importance of getting help from professionals when the person providing care can no longer cope with the symptoms alone.
Universidade Estadual de Máringá, Departamento de Psicologia, Av. Colombo, 5790, Bloco118, CEP 8702-900 Máringá, Brazil, 2003. 19p. Illus. 2 ref.

CIS 04-714 Fau-Prudhomot P., Fabin C., Montéléon P.Y.
Follow-up study organized by the Association of Medical and Social Centres of the Ile-de-France region on accidents involving exposure to blood (IEBs): Analysis of the initial results
Observatoire ACMS des accidents avec exposition au sang (AES): mise en place des premiers résultats [in French]
Accidents involving exposure to blood (AEBs) have been regularly recorded and analysed for several years in large public hospitals in France. However, this has not always been the case in private health care institutions and in other sectors of activity that present a potential hazard. The objective of this study was to record and describe AEBs occurring in small-to-medium-sized institutions as well as in non-health-care settings in the Ile-de-France region. Between July 2001 and January 2003, 196 cases of AEBs were recorded, of which 15 occurred outside health care settings during waste collection, cleaning or supervision of the premises. In health care settings, the victims were predominantly women (90.4%), persons with less than two years of tenure (60.3%) and persons vaccinated against hepatitis B (95.7%). More than half the cases of AEB occurred during the disposal of contaminated material (58%), in particular because containers were often not easily accessible (40%). Gloves were not worn in 40% of AEB cases.
Cahiers de médecine interprofessionnelle, 2003, Vol.43, No.2, p.125-140. 18 ref.

CIS 04-636 Frenette Y.
Surgical smoke: Are you aware of the risks?
Les fumées chirurgicales, connaissez-vous les risques? [in French]
The use of lasers in surgery is growing rapidly. However, when used on human tissues, these lasers vaporize cells and give rise to what is known as surgical smoke. The presence of viruses and bacteria in this smoke has been confirmed in several studies; furthermore, during the treatment of cancers using lasers, viable cancer cells were also detected. More than 80 chemicals have been found in surgical smoke, many of them harmful. Surgical smoke particles are respirable and can cause emphysema, bronchitis and pneumonia. The article describes a study on the decomposition products detected during laser treatment of pig skin, used for simulating human skin. Finally, the importance of proper ventilation and the use of masks are emphasised.
Travail et santé, Dec. 2003, Vol.19, No.4, p.34-39. Illus. 8 ref.

CIS 04-558 Kivimäki M., Virtanen M., Vartia M., Elovainio M., Vahtera J., Keltikangas-Järvinen L.
Workplace bullying and the risk of cardiovascular disease and depression
To examine exposure to workplace bullying as a risk factor for cardiovascular disease and depression in employees, logistic regression models were related to prospective data from two surveys in a cohort of 5432 hospital employees (601 men and 4831 women), aged 18-63 years. Outcomes were new reports of doctor-diagnosed cardiovascular disease and depression during the two-year follow-up among those who were free from these diseases at baseline. The prevalence of bullying was 5% in the first survey and 6% in the second survey. Two per cent reported bullying experiences in both surveys, an indication of prolonged bullying. After adjustment for sex, age, and income, the odds ratio of incident cardiovascular disease for victims of prolonged bullying compared to non-bullied employees was 2.3. A further adjustment for overweight at baseline attenuated the odds ratio to 1.6. The association between prolonged bullying and incident depression was significant, even after adjustment for overweight (odds ratio 4.2). This suggests that bullying is an aetiological factor for mental health problems. The victims of bullying also seem to be at greater risk of cardiovascular disease, but this risk may partly be attributable to overweight.
Occupational and Environmental Medicine, Oct. 2003, Vol.60, No.10, p.779-783. 24 ref.

CIS 04-360 Heikkonen J., Louhevaara V.
Empowerment in farmers' occupational health services
This study attempted to develop farmers' health and farmers' occupational health services (FOHS) by examining the feasibility of empowered farmers' teams on surveys of Finnish dairy farms. FOHS personnel of the health centre in three municipalities selected three farmer teams consisting of three or four couples for the intervention group. There were 31 farms in the intervention group and 33 similar farms in the comparison group. Site surveys in the intervention group involved FOHS personnel together with the farmer teams, while in the comparison group they involved the FOHS personnel alone. Before and after the surveys, each participating farmer couple responded to questionnaires. The initial survey was carried out in 1998-1999, and the follow-up took place in 2000-2001. During the follow-up, the FOHS personnel identified the changes made after the initial surveys on the farms. Altogether 217 changes were made, half of them to improve ergonomics. There were more changes in the work environment in the intervention group.
AAEM - Annals of Agricultural and Environmental Medicine, 2003, Vol.10, No.1, p.45-52. Illus. 28 ref. [in English]

CIS 04-74 Chan K., Tan K.L., Lee H.S., Eng P.
Malignant mesothelioma: Experience at the Singapore General Hospital
This article presents the clinical characteristics, management and outcomes in a case series of 16 patients (15 males, one female) diagnosed with malignant mesothelioma in a teaching hospital in Singapore between 1996 and 2001, with particular attention to the occupational history. The mean age of the patients was 61.5 (range, 46 to 78) years. Thirteen patients had malignant pleural mesothelioma (MPM) and three patients had mesothelioma of the peritoneum. Eleven of the patients with MPM (84.6%) presented with a pleural effusion and only two (15.4%) had chest pain. Initial pleural fluid cytology and closed pleural biopsies were negative in all patients who presented with a pleural effusion. The diagnosis was confirmed by thoracoscopy, which allowed a simultaneous diagnosis of talc pleurodesis in nine patients. All patients had documented asbestos exposure, of which 14 (87.5%) were confirmed to be occupationally related. The median time from first exposure to symptoms was 33.5 (range, 16 to 53) years. The median survival was six months.
Annals of the Academy of Medicine - Singapore, May 2003, Vol. 32, No. 3, p.388-391. Illus. 22 ref.

CIS 04-229
Hauptverband der gewerblichen Berufsgenossenschaften (HVBG)
Biological matter in the health and social care sector
Biologische Arbeitsstoffe im Gesundheitswesen und in der Wohlfahrtspflege [in German]
Contents of these guidelines of the German Mutual Occupational Accident Insurance concerning activities that imply contact with biological matter in the health and social care sector: scope; hazard evaluation; protective measures as a function of the degree of hazard of the activity; training of personnel; obligation to notify level 3 and 4 activities; additional protective measures that apply to specific activities (cleaning, disinfection, sterilization, handling of soiled linen, elimination of medical waste, endoscopy, protection against methicillin-resistant strains of Staphylococci aurei); preventive medical examinations and vaccinations. In appendices: useful addresses for persons in contact with highly-contagious or fatal diseases, protective plans against life-threatening imported diseases; classification of human and animal medical waste; examples of instructions for work falling under the provisions of the biological substances ordinance; constituents of a hygiene plan; related directives, rules and standards.
Carl Heymanns Verlag KG, Luxemburgerstrasse 449, 50939 Köln, Germany, Oct. 2003. 59p. Illus.

CIS 03-1988 Di Martino V.
Relationship between work stress and workplace violence in the health sector
Based on an extensive literature analysis, this study tackles the issues of stress and violence at work in the health sector, highlighting the magnitude of the problem, the key factors and the way they interrelate. Contents: definition of stress and violence; stress as a source of workplace violence; workplace violence as a source of stress; cumulative effects of stress and violence; specific implications for the health sector (sector-specific environment as cause of stress and violence, impact on working conditions and employment, impact on costs); approaches to coping.
ILO Publications, International Labour Office, 1211 Genève 22, Switzerland, 2003. viii, 33p. Illus. 50 ref. [in English]

CIS 03-1917 Charbotel B., Forissier M.F., Hours M., Bergeret A.
Review of occupational hazards from waste disposal in the health care sector
Revue sur les risques professionnels liés à l'élimination des déchets d'activité de soins [in French]
This literature survey reports on the current situation with respect to occupational hazards among workers involved in waste disposal in the health care sector. Biological hazards are the most important. In the early stages of waste disposal, blood exposure accidents are associated with the risk of infection with hepatitis or human immunodeficiency viruses. Other infectious diseases such as tuberculosis have been reported among workers involved in medical laboratory waste disposal. In health care establishments, chemical and radioactive wastes need to be managed by specialized and well-identified waste disposal systems. However, it appears that these systems are not always operational. Risks related to handling are important and are not always well controlled. Road transport risks have received little attention, but should not be overlooked given their potential seriousness.
Archives des maladies professionnelles et de médecine du travail, Apr. 2003, Vol.64, No.2, p.100-105. 32 ref.

CIS 03-1786 Schach V., Jahanbakht S., Livardjani F., Flesch F., Jaeger A., Haïkel Y.
Risks from mercury in dental practices: Past history or near future?
Le risque mercuriel dans les cabinets dentaires: histoire ancienne ou futur proche? [in French]
Mercury is the cause of mercurialism, an occupational disease recognized as such in the schedule of occupational diseases. Furthermore, it has been established that this metal is an important pollutant, both for the atmospheric and marine environments. This literature review examines occupational hazards caused by the inhalation of mercury in the dental profession. Contents: evaluation of the exposure to mercury among dentists; epidemiological studies among dentists; causes of pollution by mercury in dental practices; prevention (substitution, local exhaust, housekeeping, personal hygiene); medical supervision; compensation; French regulations.
Documents pour le médecin du travail, 1st Quarter 2003, No.93, p.7-23. Illus. 52 ref.

CIS 03-1916 Abiteboul D., Lolom I., Lamontagne F., Pellissier G., Tarantola A., Descamps J.M., Bouvet E.
Risk of blood exposure among hospital workers - Trends 1990-2000
Risque d'exposition au sang parmi le personnel hospitalier - Evolution 1990-2000 [in French]
A survey had been conducted among health care workers in 1990 to quantify the frequency and risk factors of blood exposure accidents (BEAs). 502 nurses from 17 hospitals had volunteered to participate. It was the first study that yielded data not only on the frequencies by nurse, but also by risk-involving task (injection, sample collection, installing and removing intravenous perfusions, work involving pacemakers). The most hazardous tasks were identified and ranked. The objective of the present study was to analyse the trends in BEA risks ten years later. Participants included 1506 volunteers among nurses in 36 hospitals. There were significant improvements from 1990 to 2000, the frequency of BEAs having decreased from approximately 0.35 to 0.12 per nurse per year, and needlestick injuries, which are the leading cause, from 0.26 to 0.07 respectively, per nurse per year.
Documents pour le médecin du travail, 4th Quarter 2003, No.96, p.447-457. Illus. 25 ref.

CIS 03-1875 Singleton M., Griffiths C., Morrison G., Soanes T.
Health and Safety Executive
Dose constraints for comforters and carers
This report was prepared to enable guidance to be developed for employers, to assist them in meeting relevant legislative requirements for the exposure of persons who offer support and care to patients undergoing procedures involving ionizing radiation where this would not be considered directly part of their occupation. The report identifies relevant legislation and guidance, discusses its interpretation, identifies circumstances in which these persons are exposed and presents information relating to the extent of these exposures, including results of dose measurements. Significant use of published information has been made, that has been supplemented wherever possible, with contributions from healthcare professionals.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2003. iv, 62p. 44 ref. Price: GBP 15.00. [in English]

CIS 03-1645 Genz H.O
Health promotion through learning organizations
Gesundheitsförderung durch Organisationsentwicklung [in German]
Published by the German mutual occupational insurance fund for health care and social services, this booklet explains in broad terms how to implement a programme for improving work organization in hospitals for the purpose of improving workers' health. Contents: concept of "learning organization"; typical structure of a health promotion project; workgroups (health circles and project groups); project steps; problems that may be encountered during the project and their solutions. Check lists for the various project phases are provided in an appendix.
Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege (BGW), Pappelallee 35-37, 22089 Hamburg, Germany, [c2003]. 40p. Illus. 7 ref.

CIS 03-1975 Sluiter J.K., van der Beek A.J., Frings-Dresen M.H.W.
Medical staff in emergency situations: Severity of patient status predicts stress hormone reactivity and recovery
Although repetitive exposure to stressful situations is thought to habituate the physical stress responses, work stress is experienced by medical personnel in emergency and intensive care units. The purpose of this study was to investigate neuroendocrine reactions (reactivity during and recovery after work) among experienced emergency caregivers during emergency situations. Participants included 20 male ambulance paramedics. A stress protocol was developed in which cortisol was measured in saliva at baseline, during the emergency period and during recovery. Four scenarios were tested between subjects in which the severity of the emergency situation and the time of day were taken into account. It was found that the endocrine reactions were higher during and after the handling of patients in direct life-threatening situations and during morning hours.
Occupational and Environmental Medicine, May 2003, Vol.60, No.5, p.373-375. Illus. 2 ref.

CIS 03-1432 Wallace R., Schluter P., Webb P.
Helicobacter pylori and hepatitis A and B infections in carers of adults with intellectual disability
Helicobacter pylori, hepatitis A and hepatitis B are common transmissible diseases among adults with intellectual disability. This pilot study was designed to assess the possibility that H. pylori infection might pose an occupational risk, and the extent of hepatitis A and B immunization rates among carers of adults with intellectual disability. The overall rate of H. pylori infection was comparable to that in the general population. However, carers working with currently and previously institutionalized adults with intellectual disability had a higher prevalence of H. pylori infection than carers of never institutionalized clients. Hepatitis immunization rates were better among carers working with clients with a history of institutionalization, but could be improved in all carer groups.
Journal of Occupational Health and Safety - Australia and New Zealand, Feb. 2003, Vol.19, No.1, p.99-108. Illus. 24 ref.

CIS 03-1396 Passfield J., Marshall E., Adams R.
"No lift" patient handling policy implementation and staff injury rates in a public hospital
Patient handling has been recognized as a major cause of back injuries to nursing personnel. However, a variety of patient lifting techniques have failed to reduce injury rates. Accordingly, a "no lift" patient handling policy was implemented in a general hospital in Australia. As hypothesized, the number of workers compensation claims for back injuries in the post-training period showed a reduction compared with those in the pre-training period. In the pre-training period, back injury claims were significantly associated with the manual handling of patients, but not post-training. The multi-factorial approach to injury prevention implemented in this study could be applied to the control of injuries in other sectors.
Journal of Occupational Health and Safety - Australia and New Zealand, Feb. 2003, Vol.19, No.1, p.73-85. Illus. 41 ref.

CIS 03-1478 Mayhew C., Chappell D.
"Internal" occupational violence (or bullying) in the health care industry
This article focuses on "internal" occupational violence (or bullying) in the health care industry. Analysis of the findings of a range of international research studies indicate at least 8% of health care workers experience bullying of one sort or another from their colleagues each year. A further proportion are the recipients of more overt violence from colleagues. The article argues that these internal violent events are manifest on an escalating continuum of abuse, imposition of unreasonable work practices, threats and physical violence. Thus, the incidents differ in severity. Victims subjected to repeated humiliations and threats suffer diminished well-being and reduced productivity. It is concluded that holistic organization-wide prevention strategies are required for effectively reducing the risks of bullying in health care settings.
Journal of Occupational Health and Safety - Australia and New Zealand, Feb. 2003, Vol.19, No.1, p.59-71. 125 ref.

CIS 03-1431 Coward P.
Occupational infectious disease risks in the health care industry
Health care workers are at risk of exposure to infectious diseases; in addition, pregnant health care workers may be exposed to infectious diseases that are reproductive hazards. This article provides an overview of some of the major infectious risks to which health care workers may be exposed, and discusses appropriate risk management strategies. The following hazards are discussed: blood-borne viruses (hepatitis B and C, HIV); risks to pregnancy (rubella, cytomegalovirus, varicella-zoster, parovirus B19); hepatitis A; tuberculosis; meningococcal disease; pertussis.
Journal of Occupational Health and Safety - Australia and New Zealand, Feb. 2003, Vol.19, No.1, p.35-44. 40 ref.

CIS 03-1491 Williams C.
Aboriginal health workers, emotional labour, obligatory community labour and OHS
This article discusses the concepts of "emotional labour" and "obligatory community labour", to examine the occupational safety and health hazards and outcomes for Aboriginal primary health care workers in South Australia. Aboriginal health workers use their own emotions as cultural brokers to improve health outcomes for Aboriginal patients. Working in this community involves extra duties associated with Aboriginal identity, which are essential parts of the job. Interviews of 29 Aboriginal health care workers revealed that they exhibited very high levels of emotional exhaustion, levels which give cause for concern. The workers frequently came to these jobs with a profile of impaired physical health from previous hazardous occupations. Their current health-care jobs are made more stressful because of racism, low standards of cultural sensitivity among their non-Aboriginal colleagues and abuse from patients.
Journal of Occupational Health and Safety - Australia and New Zealand, Feb. 2003, Vol.19, No.1, p.21-34. 43 ref.

CIS 03-1246 David H., Cloutier E., La Tour S.
Resorting to private home care and nursing care agencies by home care support services of local community service centres
Le recours aux agences privées d'aide à domicile et de soins infirmiers par les services de soutien à domicile des CLSC [in French]
This report describes the current situation with respect to the practice of outsourcing home care by the home care services of local community service centres to private agencies in a region of Quebec, Canada. This study was carried out in response to a request from the scientific committee of the Occupational Safety And Health Research Institute of the Province of Quebec (Institut de recherche en santé et en sécurité du travail - IRSST) to report on the situation of private home care agencies, in view of their increasing role in the provision of home care. The prime objective of this study was to descriptively document this current situation as it exists in a large urban region. It involved interviews with key staff at four local community service centres and at five private home care agencies under contract.
Institut de recherche en santé et en sécurité du travail du Québec (IRSST), 505 boul. de Maisonneuve Ouest, Montreal (Quebec) H3A 3C2, Canada, 2003. x, 130p. Illus. 18 ref. Price: CAD 10.00. [in French]

CIS 03-1428 Cristóbal Cañadas D., Parrón Carreño T., Carreño Alonso F.J.
Analysis of biological exposure hazards in health care institutions
Análisis de los riegos de exposición biológica en centros de salud [in Spanish]
In Spain, there are 12 percutaneous exposure accidents per 100,000 hours worked in hospitals. Biological hazards are the most frequent hazards in health care institutions, and the workers that are at greatest risk of exposure are those in contact with patients or who handle contaminated samples. A questionnaire survey on working conditions and biological exposure hazards was carried out among 48 nurses in a health care institution. Needlestick injuries were the most frequent. 41.7% of the respondents were of the opinion that the institutions where they worked showed deficiencies with respect to the protection of workers against biological hazards.
Prevención, trabajo y salud, 2003, No.24, p.18-24. Illus. 7 ref.

CIS 03-1451 Vilela J.A., Díaz T., Sanfeliz A.
Ergonomic analysis of the job of operating theatre nurse: Descriptive study
Análisis ergonómico en enfermería instrumentista: un enfoque descriptivo [in Spanish]
This article describes an ergonomics study of the job of operating theatre nurse based on video observations of nine surgery operations. The head, leg, arm and torso movements, as well as the amplitude of the movements of operating theatre nurses during the operations were analysed. Depending on the workplace layout, two types of problems were observed: raising of the arms above shoulder level in cases where the workbench was too high or a leaning of the torso in cases where it was too low, and numerous examples of lateral bending or torsion of the torso in cases where it was situated beyond the maximum manoeuvring zone.
Prevención, trabajo y salud, 2003, No.24, p.5-10. Illus. 15 ref.

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