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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.

CIS 03-1114 Jost M., Francioli P., Iten A., Jost J., Colombo C., Cartier B., Rüegger M., Gutzwiller A.
Prevention of blood-borne infections during patient care
Prévention des infections transmises par voie sanguine lors de soins aux patients [in French]
Verhütung blutübertragbarer Infektionen beim Umgang mit Patienten [in German]
Prevenzione delle infezioni trasmese par la via ematica nel contatto con i pazienti [in Italian]
Aimed at health care workers in contact with patients, this booklet addresses the issue of infection hazards from HIV, hepatitis B and hepatitis C in the event of accidental exposure to blood or other biological fluids. Contents: infection hazards; purpose of prevention; main preventive measures (avoiding pricks and injuries, avoiding contact with blood and biological fluids, ensuring cleanliness and hygiene during work, hepatitis B vaccination); measures to be taken in the event of accidental exposure. Updated version of CIS 90-2070.
Suva, Abteilung Arbeitsmedizin, Postfach, 6002 Luzern, Switzerland, 5th rev.ed., May 2003. 7p. 1 ref. [in German] [in French] [in Italian]

CIS 03-1230 Susitaival P., Kirk J.H., Schenker M.B.
Atopic symptoms among California veterinarians
To study the prevalence of allergic symptoms among veterinarians in California, a questionnaire was sent to 2,000 of them; the return rate was 71%. It was found that a history of either asthma, allergic rhinitis (AR) or atopic dermatitis (AD) was reported by 66% of respondents. AR was reported by 62%, asthma by 16% and AD by 11%. 40% of the veterinarians reported animal-related respiratory and/or skin symptoms. The most commonly-reported sources of symptoms were allergies to cats and dogs. In multivariate logistic analysis, the significant risk factors for having adult asthma were the history of AR with the history of AD (odds ratio (OR) 13.9), AR alone (OR 6.3) and asthma in childhood (OR 6.4).
American Journal of Industrial Medicine, Aug. 2003, Vol.44, No.2, p.166-171. Illus. 43 ref.

CIS 03-1229 Telksniene R., Januskevicius V.
Occupational skin diseases in nurses
The aim of this work was to evaluate the incidence of occupational skin diseases in nurses, their morbidity rate, symptoms, possible causes and relation with occupational environment. The study group consisted of 706 nurses from different departments of a university hospital in Kaunas (Lithuania). A questionnaire and collection of information concerning the use of disinfectants were the main investigation methods. It was found that 47.3% nurses were suffering from occupational skin diseases. Allergic contact dermatitis was found to be the most frequent (28.5%) disease. Irritant contact dermatitis of non-allergic origin was diagnosed in 8.4% of nurses. The main symptoms of occupational skin diseases were itching and reddening. The risk of developing occupational dermatitis was increased by working with aldehydes and hydrogen peroxide as well as by using latex gloves and long working hours.
International Journal of Occupational Medicine and Environmental Health, 2003, Vol.16, No.3, p.241-247. Illus. 7 ref.

CIS 03-1305 Pałczyński C., Walusiak J., Krakowiak A., Szymczak W., Wittczak T., Ruta U., Górski P.
Nasal lavage fluid examination in diagnostics of occupational allergy to chloramine
Chloramine T is a known sensitizing agent in the occupational environment of health care workers. The aim of this study was to evaluate the usefulness of the nasal challenge test in diagnostics of respiratory allergy to chloramine T. The study was conducted in six subjects with chloramine T asthma and rhinitis. Two control groups comprised seven atopic subjects with asthma and rhinitis and six healthy persons. All controls had negative results of prick tests with chloramine T and none displayed any respiratory symptoms under exposure to the agent. A "nasal pool" technique was used to evaluate morphological and biochemical parameters in nasal washings before and 30min, 4h and 24h after the provocation with chloramine T and placebo. A significant increase was found in the total count and percentage of eosinophils and basophils, albumin, tryptase and eosinophil cationic proteins in the nasal lavage fluid from patients with chloramine T respiratory allergy when compared to both control groups. The results indicate the applicability of the "nasal pool" technique as a diagnostic procedure in chloramine T-induced airway allergy.
International Journal of Occupational Medicine and Environmental Health, 2003, Vol.16, No.3, p.231-240. Illus. 26 ref.

CIS 03-1480 Wager N., Fieldman G., Hussey T.
The effect on ambulatory blood pressure of working under favourably and unfavourably perceived supervisors
To investigate the role played by employees' perceptions of their supervisors' interactional styles in causing workplace stress, a field study was carried out among female healthcare workers. Allocation to the experimental and control groups was based on participants' responses to a questionnaire on their supervisors' interactional style. The 13 subjects reported working under two very divergently perceived supervisors on different days while the 15 controls worked either under one supervisor, or two similarly-perceived supervisors. Blood pressure was recorded every 30min over a 12-hour period during three days. The control group showed a 3mm Hg difference in systolic pressure (SBP) and a non-significant difference in diastolic pressure (DBP) between the two supervisor conditions. The experimental group showed significantly higher SBP (15mm Hg) and DBP (7mm Hg) when working under a less favoured compared to a favoured supervisor. In conclusion, an unfavourably perceived supervisor is a potent workplace stressor, which might have a significant impact on supervisees' cardiovascular functioning.
Occupational and Environmental Medicine, July 2003, Vol.60, No.7, p.468-474. Illus. 61 ref.

CIS 03-601 Winkler C., Irwin J.N.
Health and Safety Executive
Contractorisation - Aspects of health and safety in the supply chain
This report investigates the reality behind the perceptions within the Health and Safety Executive that subcontracting is increasing health and safety risks, particularly in small enterprises. An investigation was undertaken with selected companies from the events, food processing and health service sectors. Two supply chains were selected in each of these sectors, consisting of a combination of customer and/or second tier suppliers. Questionnaires were used in face-to-face meetings with two or three individuals in each company, complemented by discussion to elicit wider views and opinions. The report provides information and recommendations that may be used as the basis for developing future guidance and action.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2003. x, 36p. Price: GBP 10.00. [in English]

CIS 03-994 Vartia M.
Workplace bullying - A study on the work environment, well-being and health
This study (published as a thesis in the Department of Psychology, University of Helsinki), examines the prevalence of bullying, the risks of bullying in the work environment, bullying strategies, as well as differences between men and women in facing workplace bullying in various organizational settings, with an emphasis on the situation in Finland. Cross-sectional questionnaire surveys were carried out among 949 municipal employees and 1870 prison workers as well as longitudinal surveys over two years on 5432 hospital employees. Bullying was most common in prisons (prevalence 20.1%), followed by municipal institutions (10.1%) and hospitals (5.0%). Bullying correlates with a poor social and managerial climate and with violence among prison inmates. Prolonged bullying was associated with increased incidence of depression (OR 4.81) and cardiovascular disease (OR 2.31). Differences between the sexes were small, with men and women perceiving bullying equally often. Female victims were usually bullied by their co-workers, whereas male victims reported being equally often bullied by supervisors or managers and co-workers.
Finnish Institute of Occupational Health, Publication Office, Topeliuksenkatu 41 a A, 00250 Helsinki, Finland, 2003. 68p. Illus. 120 ref. Price: EUR 18.00. [in English]

CIS 03-940 Petzäll K., Petzäll J.
Transportation with hospital beds
Transporting patients in hospital beds is a common task in hospitals wards. The aim of the study was to explore the influence of different bed wheel arrangements on the effort and difficulties experienced by personnel when transporting patients. Four test beds were used and tested in four common transport situations. Nineteen nurses (two male, seventeen female) participated in the tests. The perception of effort was rated on Borg's category ratio scale, and the perceived level of difficulty on the visual analogue scale. Multiple comparisons were conducted to determine which pairs of beds differed significantly. The results show that the wheel arrangements have a major influence on the effort and difficulties perceived by the personnel. Standard small diameter castor wheels made the bed easier to manoeuvre in limited spaces, while larger wheels on fixed axles made the beds more comfortable to handle during long distance transportation.
Applied Ergonomics, July 2003, Vol.34, No.4, p.383-392. Illus. 14 ref.

CIS 03-677 Roussel C., Barret G.
Working conditions and occupational hazards in veterinary clinics
Conditions de travail et risques professionnels dans les cliniques vétérinaires [in French]
This article presents the results of a survey on the occupational hazards faced by persons working in urban veterinary clinics, together with the findings from a survey of published literature summarizing the main pathologies encountered in this sector of activity. The survey involved 43 persons employed in veterinary services in the French department of Val d'Oise. The main hazards highlighted included exposure to ionizing radiation and chemicals (in particular anaesthetic gases and vapours), zoonoses, skin and respiratory allergies, and scratch and bite injuries.
Documents pour le médecin du travail, 2nd Quarter 2003, No.94, p.161-167. 24 ref. [in French]

CIS 03-676 Flodin U., Landtblom A.M., Axelson O.
Multiple sclerosis in nurse anaesthetists
Volatile anaesthetics are chemically related to organic solvents used in industry. Earlier studies have shown that exposure to industrial solvents may increase the incidence of multiple sclerosis (MS). This study was conducted for the purpose of establishing whether exposure to anaesthetics poses a similar risk. 90 nurses with MS were identified. They were given a questionnaire, which was filled in by 85 subjects; 13 of these were nurse anaesthetists. Incidence data for women in the region of Gothenburg in Sweden and in Denmark were used as references to estimate the risk by calculation of the standardized incidence ratio (SIR). Eleven of the 13 nurse anaesthetists were exposed to anaesthetic gases before onset of MS. Mean duration of exposure before diagnosis was 14.4 years. 10 cases were diagnosed in the study period 1980-99, resulting in significantly high SIRs of 2.9 and 2.8 with the Gothenburg and the Danish reference data, respectively.
Occupational and Environmental Medicine, Jan. 2003, Vol.60, No.1, p.66-68. 17 ref.

CIS 03-244 Reijula K., Räsänen K., Hämäläinen M., Juntunen K., Lindbohm M.L., Taskinen H., Bergbom B., Rinta-Jouppi M.
Work environment and occupational health of Finnish veterinarians
The health and work environment of Finnish veterinarians was evaluated in a questionnaire survey. The questionnaire was mailed to the 1169 veterinarians under 65 years of age and working in Finland; 785 responded. Results indicated that veterinarian's work was physically demanding, and often involved an increased risk of accident. The risks were considered moderately or considerably high by over half of the respondents, and the highest risks occurred among veterinarians working in equine, mixed (both small and large animals) and livestock-rearing practice. The veterinarians were committed to their work, although they also experienced work-related stress and fatigue. Veterinarians working in towns, or those involved in education and research, reported the most stress. Serious work-related exhaustion was experienced most often by women in the youngest and by men in the oldest age groups. On average, the veterinarians spent over 100hr a month on call. The work of a Finnish veterinarian, the work environment and the risks of the work varied greatly depending on the tasks assigned to the veterinarian.
American Journal of Industrial Medicine, July 2003, Vol.44, No.1, p.46-57. Illus. 19 ref.

CIS 03-480 Salminen S., Kivimäki M., Elovainio M., Vahtera J.
Stress factors predicting injuries of hospital personnel
Stress at work has long been recognized as a factor in increasing risk for mental and physical health problems. The extent to which work stressors and stress predicted injuries occur was studied in a population of 5,111 workers (624 men, 4,487 women) of 10 Finnish hospitals. Their psychological distress was measured by the General Health Questionnaire, and overload and job control by the Harris scale and the Job Content Questionnaire, respectively. Injuries certified by a physician were followed up for three years: the 213 injuries in 1997 were used as a measure of baseline and the 443 injuries in 1998-1999 were the dependent variables. Psychological distress was not significantly related to injuries. However, low decision latitude (risk ratio = 1.27), low skill discretion only for men (risk ratio = 2.76), and highly monotonous work (risk ratio = 1.26) were stressors predicting injuries. In addition, workers with numerous interpersonal problems or many conflicts in collaboration at work were more often involved in injuries. This study showed that stressors related to autonomy of work and interpersonal relationships at the workplace are predictors of injuries in hospital settings. These factors are potentially amenable to organizational interventions.
American Journal of Industrial Medicine, July 2003, Vol.44, No.1, p.32-36. 32 ref.

CIS 03-322 Crippa M., Belleri L., Mistrello G., Carsana T., Neri G., Alessio L.
Prevention of latex allergy among health care workers: Evaluation of the extractable latex protein content in different types of medical gloves
Since the 1980s, there has been increased use of latex gloves by health care workers and a concomitant increase of irritant and allergic reactions. The total protein content and the latex allergenic protein content of 29 different types of medical gloves commonly used in a hospital were evaluated with the Lowry modified method and the RAST inhibition assay in glove samples and extracts to acquire information useful for preventing latex allergy in hospital personnel. The highest concentrations of total proteins and allergenic latex proteins were found in examination powdered latex gloves and in surgical powdered latex gloves; a significant amount of latex proteins was found in some brands of nitrile gloves. The clear association between the total protein levels and the allergenic latex protein levels suggests that the gloves with highest total protein content have the greatest allergenic potential. Therefore, it is recommended that manufacturing companies provide package inserts including the total protein contents and possibly allergenic latex protein levels They should declare whether they have added latex to their nitrile glove formulation. RAST-inhibition assays directly on glove samples instead of glove extract seems to be a highly reliable and faster alternative for the evaluation of the allergenic potential of latex gloves.
American Journal of Industrial Medicine, July 2003, Vol.44, No.1, p.24-31. Illus. 20 ref.

CIS 02-1463
World Health Organization (WHO)
Hospital Infection Control Guidance for Severe Acute Respiratory Syndrome (SARS)
Conseils en matière de lutte contre l'infection nosocomiale [in French]
Guidance document designed to prevent the spreading of SARS infection to health care workers involved in the treatment of patients with the disease, whether in an outpatient/triage or an inpatient setting. Measures include the wearing of protective clothing and personal protective equipment, disinfection and attention to sharps.
Internet document, 2003. 2p. [in English] [in French]

CIS 02-1461 Severe Acute Respiratory Syndrome (SARS) - Isolation and infection control
A set of interim guidelines published with the aim of reducing the risk if infection by SARS for people occupationally exposed to the disease, in particular in a health care and air travel setting. Individual fact sheets are devoted to the protection of workers in the following areas: health care workers in close contact with SARS patients; cleaners of commercial aircraft following a flight with a passenger with suspected SARS; workers exposed to SARS patients in healthcare and other institutional settings; workers exposed to human remains (bodies) of SARS patients; specific guidelines devoted to aerosol-generating procedures on patients with suspected SARS; laboratory biosafety guidelines for handling and processing specimens associated with SARS.
Internet document, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd., Atlanta, GA 30333, USA, 2003. 16p. [in English]

CIS 02-1460
Health Canada
Infection control guidance for health care workers in health care facilities and other institutional settings - Severe Acute Respiratory Syndrome (SARS)
Guide de prévention des infections pour les travailleurs de la santé dans les établissements de soins et autres établissements: Syndrome respiratoire aigu sévère (SRAS) [in French]
This fact sheet was developed to assist health care workers in the prevention of the transmission of SARS in institutions where patients suspected of having or diagnosed with the disease are being cared for. Contents: patient triage; hand washing; wearing of masks for eye and face protection; wearing of gloves and gowns; guidelines for patient accommodation; patient transport within the facility and between institutions; disinfection of patient care equipment; environmental control; avoidance of aerosol-generating procedures; post-mortem care.
Internet document, 2003. 6p. [in English] [in French]


CIS 09-992 Cooper C.L., Swanson N.
Workplace violence in the health sector - State of the art
Key findings of the review on workplace violence in the health sector: violence has become an issue of increasing concern in the workplace over the past 15 years, particularly in Europe, Australia and North America. In the United States, 85% of all non-fatal assaults occur in the retail and service sectors. Within the service sector, health care workers face a 16-fold higher risk of violence than workers of other services sectors. A recent United Kingdom study indicates that abusive actions from fellow workers such as harassment and bullying may also be pervasive in health care.
World Health Organization, Distribution and Sales Service, 1211 Genève 27, Switzerland, 2002. ix, 76p. Illus. Bibl.ref. [in English]

CIS 09-991 di Martino V.
Workplace violence in the health sector - Country case studies
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, a number of country studies were realized to fill major information gaps and provide evidence for the drafting of guidelines to address workplace violence in the health sector (see CIS 09-000; ISN7). This report contains summaries of the following country studies: Australia, Brazil, Bulgaria, Lebanon, Portugal, South Africa and Thailand.
World Health Organization, Distribution and Sales Service, 1211 Genève 27, Switzerland, 2002. xi, 42p. Illus. 12 ref. [in English]

CIS 09-1000 Framework guidelines for addressing workplace violence in the health sector
Directives générales sur la violence au travail dans le secteur de la santé [in French]
La violencia laboral en el sector de la salud [in Spanish]
The International Labour Office (ILO), the International Council of Nurses (ICN), the World Health Organization (WHO) and Public Services International (PSI) launched in 2000 a Joint Programme to develop sound policies and practical approaches for the prevention and elimination of violence in the health sector. These guidelines are intended to support all those responsible for safety in the workplace, be it governments, employers, workers, trade unions, professional bodies or members of the public. They were based on a number of country studies as well as cross-cutting theme studies carried out to fill major information gaps. They offer guidance through the complexity of issues to be considered when developing anti-violence policies and strategies for all work-settings in the health sector, and can be adapted to meet local and national needs and constraints.
World Health Organization, Distribution and Sales Service, 1211 Genève 27, Switzerland, 2002. 31p. 17 ref. [in English] [in Russian] [in Spanish] [in French]

CIS 08-1469 OSHA Fact Sheet - Bloodborne pathogens
Bloodborne pathogens are infectious materials in blood that can cause disease in humans, including hepatitis B and C and human immunodeficiency virus (HIV). Workers exposed to these pathogens risk serious illness or death. This information sheet explains the protection against bloodborne pathogens provided by the OSHA standard specifying the legal obligations of employers to prevent exposure among workers at risk. These obligations include hazard evaluation, exposure evaluation, implementing engineering controls, providing personal protective equipment, information and training of personnel, medical supervision and maintaining records.
U.S. Department of Labor, Occupational Safety and Health Administration, 200 Constitution Avenue, Washington, D.C. 20210, USA, 2002. 2p. 4 ref. [in English]

CIS 06-1207 Radiological protection for medical exposure to ionizing radiation
Protection radiologique relative à l'exposition médicale aux rayonnements ionisants [in French]
Dian li fu she yi liao zhao she de fu she fang hu [in Chinese]
Radiologičeskaja zaš@6cita pri medicinskom oblučenii ionizirujuščim izlučeniem [in Russian]
This safety guide prepared jointly by the IAEA, the WHO and the Pan American Health Organization (PAHO) provides recommendations on how safety requirements may be fulfilled for the protection of patients and visitors against exposure to ionizing radiation in medical practice. Recommendations cover the establishment of guidance levels for diagnostic medical exposures, acceptance-testing processes for radiation equipment, calibration of radiotherapy units and reporting of accidental exposures.
International Atomic Energy Agency (IAEA), Wagramerstrasse 5, P.O. Box 100, 1400 Wien, Austria, 2002. 86p. 68 ref. Price: EUR 14.50. Downloadable version free of charge, [in Chinese] [in English] [in French] [in Russian]

CIS 06-454 Jarke J, Marcus U.
HIV infection of occupational origin among medical personnel - An assessment
Berufsbedingte HIV-Infektionen bei medizinischem Personal - eine aktuelle Übersicht [in German]
In Germany, the risk of workplace infection by HIV is lower than that for hepatitis B or C. The possibilities for preventing a chronic infection by one of these viruses by a post-exposure intervention are comparable. Prophylactic procedures following a known or possible exposure to HIV are described in detail in German-Austrian recommendations concerning post-exposure prophylaxis for HIV. In 44 declared cases of HIV infection of occupational origin among health care workers in Germany, only eight were identified as being clearly linked to work. In 16 cases, the link with occupational exposure was judged to be insufficient and in 20 cases, other risk factors were evident. To detect HIV infections contracted at work following an undeclared exposure and to facilitate the evaluation of the risk of transmission at work, all health care personnel in all sectors at risk should be offered HIV tests at regular intervals.
Arbeitsmedizin - Sozialmedizin - Umweltmedizin, 2002, No.5, p. 218-220, 222-231. 73 ref.

CIS 06-453 Hoffman F, Kralj N., Beie M.
Needle-stick injuries in health care - Frequency, causes and preventive measures
Kanülenstichverletzungen im Gesundheitsdienst - Häufigkeit, Ursachen und Präventionsstrategien [in German]
Health service personnel are at risk of infection by blood-borne pathogens, notably the hepatitis B and C virus and the human immunodeficiency virus (HBV, HCV, HIV) which may be contracted during injuries or punctures with sharp or pointed instruments or needles. An epidemiological study conducted in two German health care establishments showed that some 500,000 needle-stick injuries occur each year in Germany, most of them during the disposal or recapping of used syringes. The administration of post-exposure prophylaxis is recommended for all health service workers immediately after the declaration of exposure. Programmes for the prevention of needle-stick injuries (avoidance of recapping, waste disposal in specially adapted containers, wearing surgical gloves) would limit the cost of post-exposure prophylaxis and avoid the development of chronic hepatitis, cirrhosis or liver cancer.
Gesundheitswesen, 2002, No.5, p. 259-266. Illus. 112 ref.

CIS 03-1915 Moens G.
Needlestick injury accidents and their prevention
Piqûres et prévention [in French]
A programme aimed at reducing the frequency of needlestick injury accidents was implemented in a large Belgian hospital between 1990 and 1997. A study was subsequently carried out among all workers at risk to assess the effectiveness of the prevention programme. It compares data for the years 1990-1995 with those for 1996-1997. For health care personnel, a significant reduction in the number of needlestick injury accidents was observed, from 17.2 per 100 full-time equivalent (FTE) workers in 1990-1996 to 12.7/100 FTEs in 1996-1997. Among catering, laundry and housekeeping staff, no significant differences were observed; for these workers, most accidents were caused by needles or sharp objects inappropriately discarded in plastic bags or cardboard boxes. Overall, the average annual incidence of needlestick injury accidents declined from 33.4/100 occupied beds in 1990-1995 to 30.1 in 1996-1997. It transpires from this study that despite preventive efforts, the reduction in overall incidence of needlestick injury accidents appears only belatedly.
Travail et bien-être, Dec. 2002, Vol.5, No.5, p.21-25. Illus.

CIS 03-1358 Folkerts K.H., Franz A., Kiefer A., Hennersdorf G.
Investigations of the radiation exposure of staff and patients in cardiac catheterization laboratories and during vascular brachytherapy
Untersuchungen zur Strahlexposition von Beschäftigten und Patienten im Herzkatheterlabor und bei der vaskulären Brachytherapie [in German]
Interventional radiological measures can lead to high radiation exposures for medical staff. In order to determine radiation exposure to staff and patients, 52 measurements were made at a cardiac catheterization laboratory with a new dosimetry system. Besides the measurement of body dose behind the lead apron, measures of radiation were performed in front of the lead apron and at the physician's wrist. The patient's dose was also estimated. From the mean doses, the radiation dose per year for a physician performing 1000 interventions was determined to be 1.9mSv/year which is below the new limit of 20mSv/year. The results for vascular brachytherapy did not show significantly higher exposures.
Zeitschrift für Kardiologie, 2002, Vol.91, No.6, p.493-502. Illus. 11 ref.

CIS 03-990 Büssing A., Glaser J., Höge T.
Bundesanstalt für Arbeitsschutz und Arbeitsmedizin
Screening for neuropsychic strain in stationary health care (screening of loads TAA-KH-S) - Manual for the identification and evaluation of neurospychic load among hospital staff
Screening psychischer Belastungen in der stationären Krankheitspflege (Belastungsscreening TAA-KH-S) - Handbuch zur Erfassung und Bewertung bei Beschäftigen im stationärem Pflegebereich [in German]
This document presents a tool for screening for neuropsychic strain among hospital health care workers (entitled "Screening of loads TAA-KH-S") in the form of a 79-item questionnaire (see also CIS 03-989). It enables hospital practitioners to analyze reliably and at low cost the neuropsychic load of hospital staff and to implement appropriate organizational measures. It presents the theoretical and methodological principles, the results of a study carried out in two hospitals to verify the basis, the objectivity, the validity and the reliability of this tool.
Wirtschaftsverlag NW, Postfach 10 11 10, 27511 Bremerhaven, Germany, 2002. 107p. Illus. 100 ref. Price: EUR 11.50.

CIS 03-989 Büssing A., Glaser J., Höge T.
Bundesanstalt für Arbeitsschutz und Arbeitsmedizin
Screening for neuropsychic strain in stationary health care (screening of loads TAA-KH-S) - Guide and documentation
Screening psychischer Belastungen in der stationären Krankheitspflege (Belastungsscreening TAA-KH-S) - Manual und Materialien [in German]
This document presents a tool for screening for neuropsychic strain among hospital health care workers (entitled "Screening of strain TAA-KH-S") in the form of a 79-item questionnaire. It describes the method and its characteristics, and includes full instructions for its implementation. The questionnaire is included in an appendix. This guide is a companion to the manual analysed under CIS 03-990.
Wirtschaftsverlag NW, Postfach 10 11 10, 27511 Bremerhaven, Germany, 2002. 47p. Illus. 18 ref. Price: EUR 8.00.

CIS 03-970 Winstanley S., Whittington R.
Anxiety, burnout and coping styles in general hospital staff exposed to workplace aggression: A cyclic model of burnout and vulnerability to aggression
This study compared anxiety, coping styles and burnout among hospital staff according to the frequency of aggressive experiences. A sub-sample was also examined to determine any immediate after-effects from aggressive encounters. 375 healthcare workers across professions completed questionnaires which were analysed according to the type and frequency of aggression experienced within the preceding year. There were no significant differences in levels of anxiety or in coping styles. However, significant differences were determined in levels of burnout. Emotional exhaustion and depersonalization were significantly higher among staff more frequently victimized. A cyclical model is proposed according to which burnout from all sources might increase vulnerability to victimization. Increases in emotional exhaustion lead directly to an increase in depersonalization as a coping mechanism, which subsequently manifests as a negative behavioural change toward patients, thus rendering staff more vulnerable to further aggression.
Work and Stress, Oct.-Dec. 2002, Vol.16, No.4, p.302-315. Illus. 34 ref.

CIS 03-942 Russo A., Murphy C., Lessoway V., Berkowitz J.
The prevalence of musculoskeletal symptoms among British Columbia sonographers
A questionnaire survey was carried out to determine baseline prevalence of musculoskeletal symptoms and identify related biomechanical, psychosocial, organizational and demographic risk factors among the population of 211 sonographers in British Columbia, Canada. 91% of respondents reported musculoskeletal pain or discomfort that they associated with the work tasks of scanning. Almost half reported frequent and severe symptoms. The neck, shoulder and upper back were the main symptomatic sites. A very small minority had taken leave from work due to the symptoms, with more than two thirds of respondents reporting working in pain. Bivariate analyses found significant associations between scanning time, static postures, psychosocial factors, and degree of musculoskeletal symptoms.
Applied Ergonomics, Sep. 2002, Vol.33, No.5, p.385-393. Illus. 31 ref.

CIS 03-654 Gontcharov I.B., Kovachevich I.V., Pool S.L., Navinkov A.L., Barratt M.R.
Medical care system for NASA-Mir spaceflights
A fundamental goal of space medicine is to maintain the health and fitness of space crews. Meeting this goal requires reliable, effective, up-to-date medical support systems for use in microgravity. This article describes some of the factors considered in the design and assembly of Russian and U.S. in-flight medical care systems. The successful mutual use of U.S. and Russian medications and medical equipment under the NASA-Mir program conclusively demonstrated the importance and advantages of cooperation among participating space agencies. Continued progress toward the integration of U.S. and Russian flight medical systems will further increase the effectiveness of the medical support of joint missions aboard the International Space Station.
Aviation, Space, and Environmental Medicine, Dec. 2002, Vol.73, No.12, p.1219-1223. Illus. 9 ref.

CIS 03-930 Miller A.K., Tepper A., Sieber K.
Historical risks of tuberculin skin test conversion among non-physician staff at a large urban hospital
Following cases of nosocomial transmission of Mycobacterium tuberculosis among workers at a 1000-bed urban hospital, an extensive evaluation was carried out of this risk among workers with potential exposure to tuberculosis patients or to contaminated biological samples. A retrospective cohort study was conducted to determine the incidence and risk of tuberculin skin test (TST) conversions among workers employed between 1 January 1990 and 30 September 1992. Personal, social and occupational risk factors were evaluated in 2,362 workers with potential exposure and 886 workers with no known exposure. The 33-month cumulative rate of TST conversion was 5.8% for potentially exposed workers and 2.0% for controls. Among workers with potential tuberculosis exposure, statistically significantly elevated risks were found for nurses, laboratory technicians, pharmacy workers, phlebotomists, housekeepers, clerks, emergency room workers and emergency responders.
American Journal of Industrial Medicine, Sep. 2002, Vol.42, No.3, p.228-235. 33 ref.

CIS 03-740 Jung D., Böttiger A.
Mutagenicity and teratogenicity studies during the handling of cytostatic drugs
Studien zur Mutagenität und Teragenität beim Umgang mit Zytostatika [in German]
Three studies involving hospital pharmacists were carried out in order to establish mutagenic and teratogenic hazards during the handling of cytostatic drugs. Sister chromatid exchanges, breaks in DNA strands, alkyl guanidine transferase levels and mitosis levels were evaluated. Under working conditions that include the most recent technologies (work in laminar flow safety cabinets), no significant differences were observed between exposed and non-exposed groups.
Ergo-Med, Nov.-Dec. 2002, Vol.26, No.6, p.162-166. Illus. 3 ref.

CIS 03-988 Cox T., Randall R., Griffiths A.
Health and Safety Executive
Interventions to control stress at work in hospital staff
This report provides examples of how sources of work stress were identified and managed in a number of hospital settings. Over the course of two years, five case groups, containing staff involved in a variety of jobs (both direct care and non-direct care) were followed. An account of the stress management process using these case study examples is provided, including information about how a number of problems are being tackled in hospital settings, highlighting the benefits that good management practices can have in terms of working conditions and staff well-being. The evidence from these case studies demonstrates that that risk management can be a powerful tool for dealing with sources of work stress.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2002. viii, 160p. Illus. 24 ref. Price: GBP 20.00. [in English]

CIS 03-712 Safety and health good practice on-line for the healthcare sector
God arbejdsmiljøpraksis online for sundhedssektoren [in Danish]
Gute praktische Lösungen online - Arbeits- und Gesundheitsschutz im Gesundheitssektor [in German]
Ámesē diasúndesē me tēn kalḗ praktikḗ asfáleias kai ugeías ston toméa ugeionomikḗs períthalpsēs [in Greek]
Buenas prácticas en seguridad y salud online para el sector de la atención sanitaria [in Spanish]
God arbetsmiljöpraxis för hälsovårssektorn via direktanslutning [in Swedish]
Les bonnes pratiques en matière de santé et de sécurité dans le secteur des soins de santé, en ligne [in French]
Buona prassi on-line in materia di sicurezza e salute per il settore sanitario [in Italian]
Goede praktijken voor veiligheid en gezondheid in de gezondheidssector, online [in Dutch]
Em linha: Boas práticas em matéria de segurança e saúde para o Sector da Saúde [in Portuguese]
Internet-sivusto terveydenhuollon hyvistä työturvallisuus- ja terveyskäytännöistä [in Finnish]
Data sheet on the main risks of work in the healthcare sector, and on the means of preventing them. Contents: main risk factors; risk assessment and safety management; particular issues (needle injuries; work shifts and nightwork; latex allergy; manual handling and stressful working postures; psychosocial issues).
European Agency for Safety and Health at Work, Gran Via 33, 48009 Bilbao, Spain, 2002. 2p. Illus. [in Danish] [in German] [in Greek] [in English] [in Spanish] [in Swedish] [in French] [in Italian] [in Dutch] [in Portuguese] [in Finnish]

CIS 03-562 Violence - Occupational hazards in hospitals
Recent data indicate that hospital workers are at increased risk for experiencing violence in the workplace. This booklet aimed at increasing worker and employer awareness of the risk factors for violence in hospitals and at providing strategies for reducing exposure to these factors. Topics covered: types of workplace violence; workers at risk; areas where violence may occur; effects of violence (injury, disability, psychological trauma, death); risk factors; prevention strategies for employers; dealing with the consequences of violence; safety tips for hospital workers; case reports of effective strategies.
Publications Dissemination, National Institute for Occupational Safety and Health (NIOSH), 4676 Columbia Parkway, Cincinnati, OH 45226-1998, USA, Apr. 2002. iv, 10p. 9 ref. [in English]

CIS 03-319 Edelstam G., Arvanius L., Karlsson G.
Glove powder in the hospital environment - Consequences for healthcare workers
Exposure to starch powder from natural rubber latex medical gloves can cause allergy symptoms due to the absorption of latex protein antigens onto the starch powder. A questionnaire was distributed to all employees working within the medical centre of a hospital. The procedure was repeated after the centre had been changed to a powder-free working environment. The focus of the questions was to determine the extent of symptoms that could be associated with glove powder or latex proteins. Responses were compared before and eight months after a new powder-free glove policy was fully implemented. The study pointed out that a relatively high percentage of the hospital workers were suffering from glove-related symptoms. A significant reduction of itching on the hands, hand eczema and upper respiratory-tract disorders was found after the change to a powder-free environment.
International Archives of Occupational and Environmental Health, Apr. 2002, Vol.75, No.4, p.267-271. Illus. 18 ref.

CIS 03-242 Laraqui C.H,, Laraqui O., Douma A., Mounassif M., Rahhali A.
Perception of occupational hazards among health care workers in prisons in Morocco
Perception des risques professionnels chez le personnel de soins en milieu carcéral au Maroc [in French]
The aim of this study was to identify the perception of occupational hazards among health care workers in prison, to evaluate their satisfaction at work and to propose preventive measures. This survey was carried out in 2000 in several prisons. Among the 140 distributed questionnaires, 58% were recovered. 72.8% of the staff declared that night guard had a negative influence on their work and health and 90.1% on their social life. 35% found the working atmosphere confined, 80.2% complained of physical constraints including 50.6% from draught, 35% from excessive heat and 74% from humidity. Poor lighting of the premises was underlined by 55.5%. The most feared infectious diseases were tuberculosis (98.8%), scabies (93.8%), syphilis (91.4%), viral hepatitis (41.9%) and HIV (41.9%). Risky objects most frequently mentioned were hollow needles (80.2%), solid needles (76.5%), blades and scalpels (75.2%). Incidents involving exposure to blood were reported by 87.7% of the staff 80.2% had been threatened by prisoners. Only 2.5% had benefited from training in hygiene and prevention.
Archives des maladies professionnelles et de médecine du travail, Sep. 2002, Vol.63, No.5, p.374-381. 15 ref.

CIS 03-241 Boufares F., Njah M., Amamou H.
Evaluation of occupational accidents in the hospital sector: Case of the Farhat Hached Hospital in Sousse
Evaluation des accidents du travail dans le secteur hospitalier: cas de l'hôpital Farhat Hached de Sousse [in French]
This prospective study of occupational accidents in a university hospital in Tunisia was carried out from 1 January 1998 to 31 December 1999. All occupational accidents were taken into account. In all cases, the victim and the witnesses (if any) were interviewed by means of a questionnaire concerning the details of the accident, the professional status of the victim and the proposed prevention measures. Tables present the results by age, tenure, sex, occupational category, department, timing of the accident and cause.
SST - Santé et Sécurité au Travail, Apr. 2002, No.21, p.14-24. Illus. 5 ref.

CIS 03-451 Estryn-Béhar M., Milanini G., Blanco E., Bonnet S.
Ergonomic study preceding the change in the layout of the medical secretariat of a clinic
Etude ergonomique préalable au réaménagement du secrétariat médical d'une clinique [in French]
The quality of reception is an important aspect of the functioning of a private surgical and medical clinic. Several ergonomic studies involving health care personnel have been carried out in hospital settings. However, little attention has been paid to the administration services that receive the patients, despite the fact that their conditions of work have a direct bearing on the relationship between the patients and the institution. This article describes an ergonomic study carried out in the medical secretariat of a private clinic. Work involved job studies and data collection, followed by the analysis of the data and of proposals submitted by the staff. It resulted in a new design involving a total change in the layout of the work premises.
Documents pour le médecin du travail, 4th Quarter 2002, No.92, p.369-376. Illus. 3 ref.

CIS 03-82 Manual of occupational health in primary care
This manual is aimed at occupational health advisors working in primary health care facilities in the United Kingdom. Individual sections address the following issues: working with patients; advice; stress; musculoskeletal diseases; cancer; lung disease; skin protection; noise and deafness; working mothers. Each section includes case histories, statistics, proposed actions and sources of information.
Sheffield Occupational Health Advisory Service, 3rd Floor Queen's Building, 55 Queen Street, Sheffield S1 2DX, United Kingdom, 2002. Loose-leaf binder containing approx. 450p. Illus. Approx.150 ref. Index. Price: GBP 70.00 (plus packaging and postage).

CIS 03-408 Spinelli Gomes R.
Ministério do Trabalho e Emprego
Ambient working conditions and risks of X-ray exposure in the radiology department of a public hospital
Condições do meio ambiente de trabalho e riscos da exposição aos raios X no serviço de radiodiagnóstico de um hospital público [in Portuguese]
The objective of this study of the conditions of work in the radiology departments of public hospitals of São Paulo (Brazil) was to examine the conditions of use of X-ray equipment and the measures taken to limit exposures to radiation. A questionnaire survey was carried out on a sample of radiology departments in São Paulo state. In a second phase, an evaluation of workers' risks of exposure and control measures was carried out in the radiology department of a large public hospital. This allowed to highlight the gaps that exist in radiology departments, both in terms of the equipment itself (absence of periodical maintenance, unsuitable use) and of the technical measures aimed at limiting workers' exposure. This work is illustrated by photographs of the equipment and radiological department premises.
Fundacentro, Rua Capote Valente 710, São Paulo, SP 05409-002, Brazil, 2002. 139p. Illus. 44 ref. Price: BRL 15.00.

CIS 02-1711 Green-McKenzie J., Rainer S., Behrman A., Emmett E.
The effect of a health care management initiative on reducing workers' compensation costs
The effects of a cost control and a health care management initiative on workers' compensation costs were assessed in seven cohorts of workers at a university hospital. Cost control measures started in 1993 included early return to work and injury prevention programs, internal administration of legal cases, and utilization of modified duty assignments. The health care management initiative fully in place in 1997 included aggressive case management and the setting up of an occupational medicine panel. Workers' Compensation costs and lost workdays incurred by each cohort were compared. A reduction of 41-59% in indemnity payments and a reduction of 46-67% in lost time cases were realized after the health care management initiative was fully in place. Accepted claims were reduced by 10-15%.
Journal of Occupational and Environmental Medicine, Dec. 2002, Vol.44, No.12, p.1100-1105.17 ref.

CIS 02-1692 Nettis E., Colanardi M.C., Soccio A.L., Ferrannini A., Tursi A.
Occupational irritant and allergic contact dermatitis among healthcare workers
Occupational irritant contact dermatitis among health-care workers is due to exposure to a wide range of irritants such as soap, solvents, cleaning agents and protective gloves which remove the surface lipid layer and produce cellular damage. Data on 360 patients working in health-care environments and experiencing contact dermatitis at their hands, wrists and forearms were selected from the database of an allergy department of a university hospital. Allergic contact dermatitis and irritant contact dermatitis were considered to be work-related in 16.5% and 44.4% of diagnoses, respectively. The major aetiological agents were nickel sulfate, components of disinfectants and rubber chemicals. The best treatment is to avoid these allergens or to reduce their contact by using properly-selected protective gloves. Subjects with atopic dermatitis should avoid wet work and contact with irritants, since atopic dermatitis is significantly associated with irritant contact dermatitis.
Contact Dermatitis, Feb. 2002, Vol.46, No.2, p.101-107. Illus. 32 ref.

CIS 02-1943 Lot F., Migueres B., Yazdanpanah Y., Tarantola A., Abiteboul M., Domart M., Bouvet E.
Occupational HIV and HCV seroconversions among health care workers in France - Situation as of 30 June 2001
Séroconversions professionnelles par le VIH et le VHC chez le personnel de la santé en France - Le point au 30 juin 2001 [in French]
This article presents the results of an ongoing study on contaminations by the human immunodeficiency syndrome (HIV) and the hepatitis C virus (HCV) among health care workers in France as of 30 June 2001. No new cases of HIV seroconversion were reported since 1997, the total number of cases since the start of the study remaining at 13. With respect to HCV, 43 seroconversions were reported, of which 32 were the result of contacts with patients known to be infected at the time of accidental exposure. The breakdown in the number of cases is given by occupation, by health care department and by geographical region, together with data concerning the circumstances of the accidental infection, clinical surveillance and biological monitoring, medical follow-up evolution. The study protocol and the questionnaires are included as appendices.
Documents pour le médecin du travail, 2nd Quarter 2002, No.90, p.157-166. Illus. 5 ref.

CIS 02-1720 Eriksen W., Bruusgaard D.
Physical leisure-time activities and long-term sick leave: A 15-month prospective study of nurses' aides
The objective of the study was to determine the relationship between physical leisure-time activities and the occurrence of long-term sick leave among nurses' aides. Of 5563 Norwegian nurses' aides who were not on sick leave when they completed a questionnaire in 1999, 4744 (85.3%) completed a second questionnaire 15 months later. Brisk walks (odds ratio (OR), 0.78), aerobics or gymnastics (OR, 0.71), and other physical leisure activities (OR, 0.81) for 20 minutes or more at least once a week predicted fewer cases of long-term sick leave (>14 days), after adjustments for baseline health complaints, demographic and family characteristics, former and current smoking status and work factors. In conclusion, regular physical leisure-time activity may be associated with a reduced risk of long-term sickness absence in nurses' aides.
Journal of Occupational and Environmental Medicine, June 2002, Vol.44, No.6, p.530-538. 33 ref.

CIS 02-1940 Clarke S.P., Sloane D.M., Aiken L.H.
Effects of hospital staffing and organizational climate on needlestick injuries to nurses
This study determined the effects of staffing and organization on the likelihood of needlestick injuries in hospital nurses. Staffing levels and survey data about working climate and risk factors for needlestick injuries were collected in 40 units in 20 hospitals. It was found that units with low staffing and poor organizational climates were generally twice as likely as well-staffed and better-organized units to report risk factors, needlestick injuries and near misses. Remedying problems with understaffing, inadequate administrative support and poor working climate could reduce needlestick injuries.
American Journal of Public Health, July 2002, Vol.92, No.7. p.1115-1119. 18 ref.

CIS 02-1946 Rydock J.P.
A simple method for tracer containment testing in hospital isolation rooms
This article describes a simple method for tracer containment testing of hospital isolation rooms using a portable gas chromatograph system. Results from tracer testing of two isolation rooms in two different hospitals are presented. One isolation room had a significant negative pressure differential between room and corridor, and the other isolation room was not at negative pressure. A small quantity of sulfur hexafluoride gas was injected manually in an isolation room. Tracer concentrations were thereafter measured in the corridor adjacent to the room at 5-minute intervals for 20 minutes after the injection, yielding a quantitative measure of leakage of the tracer from the isolation room. Finally, measuring the tracer concentration in the isolation room 30 minutes after injection yielded an indication of how effectively the ventilation system removed a contaminant released at the position of the bed. The results show that the method is well-suited for studying containment in hospital isolation rooms.
Applied Occupational and Environmental Hygiene, July 2002, Vol.17, No.7, p.486-490. Illus. 19 ref.

CIS 02-1350 Caillaud V., Benegas-Bernard M., Creppy E., Sanchez D., Teulières A.M.
Exposure of health-care personnel to cytostatic substances - Experience of hospitals in Dax and Bayonne
Exposition du personnel de soins aux cytostatiques - L'expérience des centres hospitaliers de Dax et de Bayonne [in French]
The cell toxicity of cytostatic substances affect both cancerous and healthy cells. Most of these products also exhibit mutagenic, carcinogenic and teratogenic activity. There are very few published studies concerning the risks from handling cytostatic substances and the preventive measures to be implemented for limiting exposure to them. The objective of this study was to determine the levels of exposure of health care workers to cytostatic substances. It involved 60 workers in the oncology departments of two hospitals in southwestern France. Urinary metabolites were determined and health data were collected by means of questionnaires. No pathologies that could be linked to exposure to cytostatic substances were found. The principles of precaution and prevention applicable to work in the presence of cytostatic substances are outlined.
Documents pour le médecin du travail, 1st Quarter 2002, No.89, p.51-64. 19 ref.

CIS 02-757 Robert E., Saillenfait A.M.
Occupational hazards for pregnant women
Risques professionnels chez la femme enceinte [in French]
There currently exist very few occupational exposure factors clearly identified as presenting a risk for human reproduction, the most important being solvents and lead for women working in the chemical industry and certain infectious agents (rubella, toxoplasmosis and human immunodeficiency virus) for health care personnel. It is necessary at the same time to evaluate the intensity of exposure through regular measurements, to carry out biological monitoring of exposed workers and to be alert to the general clinical symptoms which include migraine, nausea or perceived ill odours. The importance of applying the basic preventive measures should be emphasized and additional collective or individual protective measures should be provided if necessary. Pregnant women need to inform their occupational physician of their state as soon as possible so as to enable the provision of less constraining working conditions before possibly considering the interruption of work.
Encyclopédie médico-chirurgicale, Toxicologie-Pathologie professionnelle, 1st Quarter 2002, No.134, 6p. 39 ref.

CIS 02-944 Garb J.R.
One-year study of occupational human immunodeficiency virus postexposure prophylaxis
A 12-month experience with human immunodeficiency virus (HIV) post-exposure prophylaxis (PEP) in a specialized medical care centre in the United States was evaluated for timeliness of treatment and adherence to treatment recommendations. 46 health care workers were started on HIV PEP. Risk status of the source patient, rather than type of exposure, was a significant determinant for both initiating and completing treatment. Of those exposed to HIV-positive sources, 79% completed the full 28 days of therapy. Only 22% of all health care workers who started PEP discontinued treatment because of adverse effects. The mean time from exposure to first dose of PEP was one hour and 46 minutes. The use of a defined treatment protocol, with supporting educational material and immediately-available PEP medication is an effective way of managing HIV exposures.
Journal of Occupational and Environmental Medicine, Mar. 2002, Vol.44, No.3, p.265-270. 14 ref.

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