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Health care services - 1,917 entries found

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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.

CIS 02-604 Carrivick P.J.W., Lee A.H., Yau K.K.W.
Effectiveness of a workplace risk assessment team in reducing the rate, cost, and duration of occupational injury
This study evaluated the effectiveness of a consultative workplace risk assessment team in reducing the rate and severity of injury among cleaners in a 600-bed hospital. Cohorts of cleaning services and orderly services staff ever employed within both a 4 year pre-intervention and a three-year post-intervention period were assigned to the intervention and comparison groups, respectively. The date, compensation claims cost, and hours lost from work were obtained for each injury during the study period. Age, sex, work experience and hours worked were ascertained for every subject whether injured or not. Reductions of two thirds in injury rate, 73% in cost, and 43% in duration were evident in the intervention group. The success of the workplace risk assessment team intervention supports the adoption of a participatory approach to reducing the rate and consequence of workplace injury.
Journal of Occupational and Environmental Medicine, Feb. 2002, Vol.44, No.2, p.155-159. 15 ref.

CIS 02-943 Chodick G., Lerman Y., Wood F., Aloni H., Peled T., Ashkenazi S.
Cost-utility analysis of hepatitis A prevention among health-care workers in Israel
This study was conducted to evaluate the cost-effectiveness of different strategies of preventing hepatitis A (HA) among physicians, nurses and paramedical staff. The strategies compared were passive immunization during a hepatitis A outbreak, systematic mass vaccination of all workers, and screening for antibodies to HA virus followed by vaccination of non-immune employees. An epidemiological model was used to predict the prevented number of HA cases. The lowest cost per prevented HA case (USD 6240) was achieved by screening prior to vaccination among 18- to 39-year-old physicians and paramedical workers, and the highest (USD 61,858) by mass vaccination of nurses over 39 years of age. Taking USD 60,000 as a limit cost per saved quality-adjusted life year, selective vaccination for physicians and for paramedical workers is proposed. Mass vaccination of all health care workers, aside from nurses over 40 years of age, becomes cost-effective once the active HA vaccine price is reduced to USD 23.
Journal of Occupational and Environmental Medicine, Feb. 2002, Vol.44, No.2, p.109-115. 30 ref.

CIS 02-961 Alcouffe J., Fabin C., Fau-Prudhomot P., Manillier P., Montéléon P.Y., Pignerol S., Vedrenne F.
Why does low back pain continue to be so frequent among women health care workers in private institutions in Ile-de-France?
Pourquoi les lombalgies sont-elles toujours aussi fréquentes chez les femmes travaillant en milieu de soins dans les établissements privés de l'Ile-de-France? [in French]
This epidemiological survey was carried out in order to study the frequency of low back pain among women working in the health care sector in the region of Paris (France). Two sets of data were collected in consecutive years. A standardized questionnaire was sent in 1999 and 2000 to a random sample of workers. Of the 1964 usable responses, similar levels of backache occurrences in the previous twelve months were found (68.8% and 67.2%). Six factors were found to correlate with backaches: believing having strenuous postures (odds ratio (OR) 2.45); feeling stressed (OR 1.92); not having the possibility to do quality work (OR 1.60); having more than 20 years of seniority (OR 1.59); not regularly practicing a sport activity (OR 1.37); not putting into practice the training received with respect to work movements and postures (OR 1.36). Among the 320 women having participated in both surveys, the incidence rate of low back pain was 22.9%, with causal factors being strenuous postures and not having the possibility to do quality work.
Cahiers de médecine interprofessionnelle, 2002, Vol.42, No.1, p.17-28. 27 ref.


CIS 08-273
Health and Safety Executive
Glutaraldehyde and you
This leaflet describes health problems that can arise when working with glutaraldehyde and outlines employers' responsibilities. It also explains what workers should do to protect their health when working with glutaraldehyde.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, Dec. 2001. 8p. [in English]

CIS 08-413 Glutaraldehyde - Occupational hazards in hospitals
Contents of this booklet on health hazards from exposure to glutaraldehyde in hospitals: health effects due to exposure to glutaraldehyde; hospital workers at risk of exposure; type of work which may expose workers to glutaraldehyde; protection against glutaraldehyde exposure; safety tips; case report of nurses exposed to glutaraldehyde and measures taken to reduce exposure.
Publications Dissemination, National Institute for Occupational Safety and Health (NIOSH), 4676 Columbia Parkway, Cincinnati, OH 45226-2001, USA, Sep. 2001. iii, 8p. 14 ref. [in English] [in English]

CIS 06-55 Quality management applied to health promotion and occupational safety and health - Principles, methods and requirements
Qualitätsmanagement in Gesundheitsförderung und Prävention - Grundsätze, Methoden und Anforderungen [in German]
This publication reports on the current situation with respect to the application of the concept of quality management in health promotion and occupational safety and health and presents practical examples. Articles are grouped under the following headings: quality management as a task in health promotion and in occupational safety and health; aspects, approaches and trends in quality management; practical examples of quality management implementation; recommendations and guidance for the implementation of quality management in health promotion and occupational safety and health.
Bundeszentrale für gesundheitliche Aufklärung (BZgA), Osterheiner Str. 220, 51109 Köln, Germany, 2001. 343p. Illus. Bibl.réf.. [in German]

CIS 03-1728 Ursunáriz Sala P., Santos Jiménez I., Vallejo San Juan A., García Feijoo J., Castillo Gómez A.
Ergonomic conditions and VDU eye syndrome in relation to the use of computer screens
Condiciones ergonómicas y síndrome ocular de las pantallas de visualización de datos [in Spanish]
With the increasing use of computers, a condition called VDU eye syndrome is becoming more frequent. In this study, a survey was conducted among 150 employees working in the administration department of a hospital without prior ocular pathologies. Ocular symptoms were evaluated by means of a questionnaire. An ergonomic study of the workstations of employees with ocular symptoms was then carried out. 91.1% were women. A large majority worked at screens placed at a distance of over 60cm. The ergonomics of workstations are consequently of key importance for avoiding ocular problems. A series of organizational and technical measures are proposed for improving workstation ergonomics.
Medicina y seguridad del trabajo, 2001, Vol.XLVIII, No.190, p.61-70. Illus. 4 ref.

CIS 03-1782 Sanz-Gallardo M.I., De Juanes J.R., Jaén F., Sevilla E.
Cytotoxic substances: Basic rules for their handling in hospital environments
Citotóxicos: normas básicas par su manipulación en el ámbito sanitario [in Spanish]
The handling of cytotoxic substances is potentially hazardous for health service workers. Furthermore, threshold limit values that would allow risk-free handling are not known and analytical and biological methods of exposure evaluation are not sufficiently reliable. Consequently, the handling of cytotoxic products requires precautionary measures that take into account the exposure routes and the modes of action of these substances (alkylating agents, antimetabolites, antibiotics, antimitotics and others). General protection measures are described as well as precautions for avoiding skin contact, inhalation or ingestion and precaution to be taken during preparation, administration, waste disposal, transfer or contamination. Workers in contact with cytotoxic agents need regular medical supervision.
Medicina y seguridad del trabajo, 2001, Vol.XLVIII, No.190, p.49-58. 21 ref.

CIS 03-1781 Uribe Llopis P.
Formaldehyde. Use in a hospital. Hazards and preventive measures
Formaldehído. Uso en un centro hospitalario. Riesgos y medidas de prevención [in Spanish]
Formaldehyde (or formol) is a widely-used chemical agent in hospitals. Its hazards are reviewed, together with the appropriate prevention measures. Contents: formaldehyde metabolism; production; main uses; health effects due to exposure to formaldehyde; threshold limit values; sterilization through the use of formaldehyde; use of formaldehyde in pathological anatomy; working methods; preventive measures (at the source, determination in work atmospheres, protection of workers, exposure evaluation).
Medicina y seguridad del trabajo, 2001, Vol.XLVIII, No.188-189, p.43-59. Illus. 14 ref.

CIS 03-1452 Břggild H., Jeppesen H.J.
Intervention in shift scheduling and changes in biomarkers of heart disease in hospital wards
The effect of introducing regularity, few consecutive night shifts, more weekends off, and only 2 different types of shifts (day-evening or day-night) into shift scheduling on biomarkers of heart disease was studied. Ergonomic shift criteria were introduced in a quasi-experimental controlled intervention in four hospital wards. Six wards participated as controls. Altogether 101 nurses and nurses' aides were followed for 6 months with measurements of cholesterol and triglycerides. After 6 months, the HDL-cholesterol level had increased in the intervention group, and the total cholesterol and LDL-cholesterol levels and the total : HDL cholesterol ratio had decreased. Lipids and lipoproteins changed as predicted, both when the changes were assessed in respect to the changes in schedules that resulted from the intervention and the changes that occurred regardless of the intervention. The study suggests that scheduling based on ergonomic criteria is a possible means for reducing the risk of heart disease among shift workers.
Scandinavian Journal of Work, Environment and Health, Apr. 2001, Vol.27, No.2, p.87-96. Illus. 23 ref.

CIS 03-1453 Jansen J.P., Burdorf A., Steyerberg E.
A novel approach for evaluating level, frequency and duration of lumbar posture simultaneously during work
In this study, statistical models are proposed for determining the essential characteristics of postural loads. A direct registration of lumbar posture was made over a workday with an inclinometer for 64 nurses, 16 housekeepers and 27 office workers. An exposure variation analysis was used to summarize information on the angle of trunk flexion, the time period of maintained postures, and the percentage of work time. A hierarchical regression analysis was used to compare these characteristics. The occupational groups did not differ in either frequency or duration of trunk flexion >30°. Nurses were exposed to longer work times than the office workers with trunk flexions of 30-70° maintained for less than five seconds, whereas office workers experienced longer work times at angles of <30° for longer periods. Comparable differences were found between housekeepers and office workers. This method offers an alternative to conventional ergonomic analysis in which the dynamics of exposure are often ignored.
Scandinavian Journal of Work, Environment and Health, Dec. 2001, Vol.27, No.6, p.373-380. Illus. 17 ref.

CIS 03-931 Kamińska W.
Protective gloves for medical staff
Rękawice ochronne dla personelu medycznego [in Polish]
Contents of this booklet on protective gloves for medical staff: regulations in Poland applicable to the protection of medical staff; requirements with respect to physical properties and testing of protective gloves; types of protective gloves; means of prevention of diseases related to the use of latex gloves.
Centralny Instytut Ochrony Pracy, ul. Czerniakowska 16, 00-701 Warszawa, Poland, 2001. 24p. 17 ref.

CIS 03-689 Meyer V.P., Brehler.R., Castro W.H.M., Nentwig C.G.
Work-related stress and strain among dentists in private practice
Arbeitsbelastungen bei Zahnärzten in niedergelassener Praxis [in German]
The aim of this questionnaire study was to identify specific occupational stress and strain among dentists in private practice and to examine the prevalence of occupational dermatoses, spinal complaints and mental stressors. The questionnaire was designed to allow comparison with a previous study on stress conducted in 1984. Between 1984 and 1999, exhaustion had risen from 25% to 57%, the subjectively perceived demands on concentration from 61% to 81% and stress due to professional responsibility from 6% to 14%. Approx. 87% dentists reported having experienced neck and back pain in the past and 45% reported suffering from atopic diseases with eczema being most common, followed by atopic dermatitis and allergic rhinoconjunctivitis.
Institut der Deutschen Zahnärzte, Universitätsstrasse 73, 50931 Köln, Germany, 2001. 167p. Illus. 95 ref. Price: EUR 29.95.

CIS 03-678 Scorneau A.M., Van de Leemput C., Gilbert P.
Evaluation of handling-related prevention measures in a hospital
The purpose of this study was to evaluate prevention measures relative to manual handling in the specific context of health care in hospitals, a sector where numerous studies have confirmed the prevalence of back problems. The survey was carried out among hospital nursing personnel who had followed a training course on patient handling. Analysis of the results shows that the perception of the training by the participants corresponds to the objective of primary prevention, namely increasing risk awareness. Further analysis of the difficulties experienced highlights their diversity as well as the interconnection between handling and other professional constraints. It is concluded that in order to be effective, handling training must be part of a global ergonomic approach.
Médecine du travail & Ergonomie / Arbeidsgezondheitszorg & Ergonomie, 2001, Vol.XXXVIII, No.1, p.67-73. 23 ref.

CIS 03-974 Savikko A., Alexanderson K., Hensing G.
Do mental health problems increase sickness absence due to other diseases?
The aim of this study was to analyse the association of mental health problems with sickness absence in general. A total of 1407 women employed as metal workers, medical secretaries and nurses, were included. Sick-leave data were collected through social insurance and employment registers. Data on mental health were collected by means of questionnaires, and enabled the classification of subjects into five broad indicators of mental health. For all indicators, it was found that women with mental health problems had higher levels of sickness absence than women without mental health problems. The association was found for frequency, incidence, length and duration of sickness absence. In all diagnoses, the influence of mental health problems need to be taken into account for sickness absenteeism and rehabilitation.
Social Psychiatry and Psychiatric Epidemiology, 2001, Vol.36, p.310-316. 28 ref.

CIS 03-440 Kralj N.
Technical and immunological methods of preventing hepatitis B viral infections
Sicherheitstechnische und immunologische Prävention berufsbedingter Hepatitis-B-Virus-Infektionen [in German]
In this thesis, a critical review of occupational hazards and epidemiology relating to hepatitis B infection was carried out, together with incidents that give rise to infections in occupational settings. The frequency with which the piercing of gloves occurred in hospital environments was also evaluated for the purpose of defining the conditions giving rise to such incidents. Results were compared to those of published studies. Despite the adoption of purely technical prevention measures such as wearing double-layer protective gloves or incision-resistant gloves, and protecting the skin to avoid skin diseases, protective vaccination remains an indispensable prevention measure.
FFAS, Postfach 5171, Freiburg, Germany, 2001. 124p. Illus. 152 ref.

CIS 03-239 Hollmann S., Schmidt K.H., Trenckmann U.
Quality assurance through comprehensive self-evaluation: Application of the participatory productivity management (PPM) approach in a psychiatric hospital
Qualitätssicherung durch umfassende Selbstevaluation: Anwendung des partizipativen Produktivitätsmanagement (PPM) in einer psychiatrischen Klinik [in German]
Efforts to introduce quality assurance systems in public health in general and in psychiatric practice in particular are confronted with a number of problems relating to the measurement and evaluation of performance. Participative Productivity Management (PPM) is a new method aimed at resolving some of these issues. PPM guides teams to develop their own performance evaluation systems as a basis for creating feedback information. Each group develops its own system with the help of an external moderator in three steps: firstly the work tasks that the group has to perform are defined; next, indicators that measure the quality of the performance for each work task are identified; finally the contribution of each indicator to the overall quality of the work group is described with the help of performance-evaluation- functions. This article describes the implementation of PPM in two wards of a psychiatric hospital, showing that it is possible to measure and influence the quality of psychiatric services.
Zeitschrift für Arbeitswissenschaft, Dec. 2001, Vol.55, No.4, p.260-267. Illus. 8 ref.

CIS 02-1738 Hui L., Ng G.Y.F., Yeung S.S.M., Hui-Chan C.W.Y.
Evaluation of physiological work demands and low back neuromuscular fatigue on nurses working in geriatric wards
This study evaluated the physiological demands and low back neuromuscular fatigue patterns following a daytime work shift of 21 female nurses working in geriatric wards. Subjects' heart rate at work was monitored for 8h and surface electromyogram (EMG) of their back muscle was recorded during a one-minute horizontal trunk holding test before and after work. Results showed that the nurses had heart rates exceeding 90 beats/min in 57% and 110 beats/min in 19% of their working hours. Muscular fatigue after work was highlighted by EMG data. The nurses rated the lifting, transfer and turning of patients as most physically demanding, and these corresponded to the highest heart rates recorded. The physiological and neuromuscular strain on the nurses indicated that extreme care should be exercised at work, particularly towards the end of a work shift when the muscles have become fatigued.
Applied Ergonomics, Oct. 2001, Vol.32, No.5, p.479-483. Illus. 32 ref.

CIS 02-1794 Imbriani M., Zadra P., Negri S., Alessio A., Maestri L., Ghittori S.
Biological monitoring of occupational exposure to sevoflurane
Monitoraggio biologico dell'esposizione professionale a sevoflurane [in Italian]
In 18 operating theatres of Italian hospitals a workplace monitoring programme was undertaken of the inhalation anaesthetic sevoflurane and the determination of its urinary metabolite hexafluoroisopropanol (HFIP) in 145 members of the staff. Tentatively, biological limit values of 160µg/L and 488µg/L of HFIP in urine correspond to the recommended exposure limits (NIOSH) for sevoflurane of 2ppm (when it is the only anaesthetic used) and 0.5ppm (when nitrous oxide is also used), respectively. Urinary concentration of HFIP could probably be used therefore as an adequate biological exposure index for sevoflurane.
Medicina del lavoro, May-June 2001, Vol.92, No.3, p.173-180. Illus. 16 ref.

CIS 02-1793 Summary of recommendations for a rational implementation of the Ministry of Health guidelines for the prevention of occupational risks in the handling of antineoplastic drugs
Sintesi delle indicazioni per una razionale applicazione delle Linee Guida Ministeriali sulla prevenzione dei rischi occupazionali nella manipolazione dei chemioterapici antiblastici [in Italian]
With reference to the guidelines published by the Italian Ministry of Health for the safe handling of antineoplastic drugs, a working group of the Italian Society of Preventive Medicine for Health-Care Workers made recommendations for risk assessment, environmental and biological monitoring, and workplace and individual protection measures aimed at the reduction of exposure. In addition, there are proposals for education and training of health-care and technical personnel.
Medicina del lavoro, Mar.-Apr. 2001, Vol.92, No.2, p.137-148. 23 ref.

CIS 02-1792 Previdi M., Marraccini P.
Latex protein allergy and preventive measures
Allergia alle proteine del lattice e percorsi di prevenzione [in Italian]
A clinical and epidemiological outline of latex allergy and its management is presented. A feasibility analysis and a literature survey were made in a hospital of a latex-free stream. There is equipment available now, in particular non-powdered gloves with low levels of protein residue, which can minimize the occurrence of latex sensitization, especially in operating theatres.
Medicina del lavoro, Mar.-Apr. 2001, Vol.92, No.2, p.108-119. 60 ref.

CIS 02-1802 Muzi G., Dell'Omo M., Crespi E., Madeo G., Monaco A., Curradi F., Diodati R., Abbritti G.
Smoking in the workplace: Study at a hospital in central Italy
L'abitudine al fumo di tabacco nei luoghi di lavoro. Studio in un'Azienda Ospedaliera dell'Italia centrale [in Italian]
Report of a survey in a general hospital in Central Italy on the smoking habits of 2743 employees. The prevalence of smokers was quite high in both men (36.0%) and women (36.7%). The highest prevalence was found among ward orderlies (45.2%) and nurses (38.9%), the lowest among doctors (26.3%). The role of industrial physicians in combating smoking is emphasized.
Medicina del lavoro, Jan.-Feb. 2001, Vol.92, No.1, p.54-60. Illus. 19 ref.

CIS 02-1808 Ngowi A.V.F., Maeda D.N., Partanen T.J.
Assessment of the ability of health care providers to treat and prevent adverse health effects of pesticides in agricultural areas of Tanzania
A survey of Tanzanian health care providers in agricultural areas was undertaken in 1991-1994 to assess their knowledge of toxic effects of pesticides in order to develop effective strategies for reducing pesticide poisoning. Interviews were conducted with 104 physicians, clinical officers and nurses at health care facilities in the coffee and cotton growing areas. 80% of respondents reported to have seen one and 9% two or more cases of pesticide poisoning in the preceding three months. The respiratory tract was the major route for pesticide to enter the human body; this was followed by gastrointestinal tract, skin, and eyes. Only one of the respondents could identify the groups of pesticides mostly used in the study areas. The survey indicated that training of hospital staff in toxicity of pesticide exposure is an important task and a prerequisite for efficient recognition, diagnosis and treatment of pesticide poisoning cases in Tanzania.
International Journal of Occupational Medicine and Environmental Health, 2001, Vol.14, No.4, p.349-356. 21 ref.

CIS 02-1975
Health and Safety Executive
Handling home care - Achieving safe, efficient and positive outcomes for care workers and clients
Workers in the social and health care sectors are at a high risk of musculoskeletal disorders as a result of manual handling tasks, in particular assisting patients having restricted mobility. With a better approach to work organization and ergonomic job design, most of these risks can be eliminated or reduced. Aimed primarily at social and health care workers and their managers and employers, this guidance includes practical advice on assisting patients in their mobility while minimizing musculoskeletal risks to workers. Contents: general advice (activities covered by this guidance, who this guidance is aimed at, legal position, the "no lifting" policy adopted by certain home care service providers as opposed to a policy of risk control, cooperative approach); case studies on improved mobility and risk control; legal aspects; glossary.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2001. iv, 80p. Illus. 16 ref. Price: GBP 9.50.

CIS 02-1254 Strauss R.M., Gawkrodger D.J.
Occupational contact dermatitis in nurses with hand eczema
Occupation-related dermatitis is a common problem in nurses, who are exposed to a wide variety of allergenic and irritant substances. In a group of 44 nurses with hand dermatitis (40 female), 18 were thought to have an allergic contact dermatitis, 15 an irritant dermatitis, 7 other form of eczema, 3 atopic dermatitis and one pompholyx. 10 of the 15 irritant cases were diagnosed as occupational. Of the 18 patients with allergic contact dermatitis, the allergens were thought to be occupationally relevant in 8 cases. In 6 of these cases, the dermatitis was due to natural rubber latex (3) or other rubber chemicals (3). Two had additional evidence of immediate-type hypersensitivity to natural rubber latex (one was patch test allergic to latex, the other to thiuram mix). Natural rubber latex allergy, both delayed and immediate, is a significant problem, and nurses at risk should be tested for both types of hypersensitivity, as well as being patch tested to standard, rubber and medicaments series.
Contact Dermatitis, May 2001, Vol.44, No.5, p.293-296. Illus. 19 ref.

CIS 02-1473 Břggild H., Jeppesen H.J.
Intervention in shift scheduling and changes in biomarkers of heart disease in hospital wards
In a controlled monitoring of 101 nurses in 4 hospital wards in Denmark, measurements of cholesterol and triglycerides were taken over a period of 6 month. Shift scheduling criteria were introduced (few consecutive night shifts, more weekends off and only 2 different types of shifts day-evening or day-night). After 6 months the high-density lipoprotein (HDL) cholesterol level had increased and the total cholesterol and low-density lipoprotein (LDL) cholesterol levels had decreased. Scheduling based on ergonomic criteria is thus a possible means for reducing the risk of heart disease among shift workers.
Scandinavian Journal of Work, Environment and Health, Apr. 2001, Vol.27, No.2, p.87-96. Illus. 23 ref.

CIS 02-1280 Leggat P., Kedjarune U.
Occupational risks of modern dentistry: A review
Occupational health risks in modern dentistry include exposure to infectious diseases (such as hepatitis B and C (HBV and HCV) and human immunodeficiency virus (HIV)), musculoskeletal and other injuries, contact dermatitis, radiation, noise, mercury, dental materials and stress. Percutaneous injuries are of particular concern to those dentists who may be exposed to serious infectious agents (such as HIV, HBV and HCV), and education on how to avoid such injuries would be beneficial. Dentists should receive HBV immunization and use personal protective measures and appropriate sterilization or high-level disinfection techniques. Dentists should be kept up to date with current OHS practices (particularly in areas such as exposure to mercury, radiation and some of the newer dental materials) through continuing education programmes.
Journal of Occupational Health and Safety - Australia and New Zealand, June 2001, Vol.17, No.3, p.279-286. 48 ref.

CIS 02-1279 Fenga C., Aragona P., Cacciola A., Ferreri F., Spatari G., Stilo A., Spinella R., Germanň D.
Ocular discomfort and conjunctival alterations in operating room workers: A single-institution pilot study
A questionnaire study was carried in an Italian hospital among 213 subjects working in operating theatres and 40 other hospital workers, aimed at investigating the prevalence of ocular discomfort symptoms. A randomized comparative study of the ocular surface and conjunctival cytology was also carried out, comparing two groups of age- and sex-matched subjects among operating-theatre workers reporting ocular discomfort symptoms and randomly-enrolled subjects among other hospital staff. Ophthalmological examination of the ocular surface was performed on each subject. A high prevalence (72.3%) of ocular discomfort symptoms was reported by operating- theatre workers, while in other personnel the prevalence was 55%. The ocular tests showed that the conjunctival features and break-up time were statistically significantly altered in operating-theatre workers reporting ocular discomfort symptoms. Also, the conjunctival impression cytology study showed statistically significant alterations of all the investigated parameters. This seems to indicate that the operating-theatre environment could play a role in the onset of eye disturbances.
International Archives of Occupational and Environmental Health, Mar. 2001, Vol.74, No.2, p.123-128. Illus. 24 ref.

CIS 02-1467 Carrivick PJ.W., Lee A.H., Yau K.K.W.
Consultative team to assess manual handling and reduce the risk of occupational injury
The objective of the study was to describe the formation of a consultative team to assess the risk of manual handling within the cleaning services department of a hospital in Western Australia, and to evaluate the effectiveness of its recommendations in reducing the rate and severity of workers' compensation injury. Statistical analysis showed that implementation of the recommendations significantly reduced numbers and rates of injury, but not the severity of injury, in the cleaning services study group. There was no difference in numbers or severity of injuries for the comparison groups before and after implementation of the recommendations. The recommendation of the consultative team can produce a meaningful and sustained reduction in rates of injury within a risk population. The results support a consultative approach to reducing workplace injuries from manual handling. The team process has potential for application to occupational groups at risk of exposure to other types of hazards.
Occupational and Environmental Medicine, May 2001, Vol.58, No.5, p.339-344. 19 ref.

CIS 02-823 Liss G.M., Tarlo S.M.
Natural rubber latex-related occupational asthma: Association with interventions and glove changes over time
Until 1999, there were 60 compensated claims for occupational asthma following exposure to latex in the Canadian province of Ontario. Of these, 49 were among health care workers (HCWs). The number of claims among HCWs varied between zero and two per year up to 1990, increased to between seven and eleven per year from 1991 to 1994 and declined to three per year in 1995-1996 and to between one and two per year in 1997-1999. In eight of the ten institutions having two or more occupational asthma latex claims, all claims occurred in 1996 or earlier. At the largest hospital, there were five accepted claims between 1993 and 1995. These findings suggest that despite the effect of increasing recognition of latex-related occupational asthma, the introduction of gloves with reduced powder or protein, and other interventions have resulted in actual declines the number of cases.
American Journal of Industrial Medicine, Oct. 2001, Vol.40, No.4, p.347-353. Illus. 24 ref.

CIS 02-821 Dibo M., Brasch J.
Occupational allergic contact dermatitis from N,N-bis(3-aminopropyl)dodecylamine and dimethyldidecylammonium chloride in 2 hospital staff
A case study of 2 nurses developing eczema on their hands and arms after contact with a new disinfectant containing quaternary ammonium compounds. After changing their workplace, the nurses recovered.
Contact Dermatitis, July 2001, Vol.45, No.1, p.40. 3 ref.

CIS 02-684 Laatar A., Dziri-Belellahom M., Chekili S., Zakraoui L.
Stress fracture - Case of an occupational accident in a hospital
Fracture de fatigue - A propos d'un accident du travail survenu en milieu hospitalier [in French]
Stress fracture is considered to be a multi-factorial disorder, consequent to a local mechanical overload of the bone following hyper-solicitation. Usually described in the military and in athletes, this injury remains rare in the occupational field. This article describes a case of stress fracture of the third metatarsal in a male nurse attached to a surgery department for 17 years, following a particularly strenuous night shift. Several cases of stress fracture related to work were identified through a literature survey, enabling a discussion on the context in which these lesions occurred, as well as their pathophysiological mechanisms. Finally, the difficulties of having these lesions recognized as occupational diseases are discussed.
Archives des maladies professionnelles et de médecine du travail, Dec. 2001, Vol.62, No.8, p.626-628. Illus. 16 ref.

CIS 02-850 Gielen K., Goossens A.
Occupational allergic contact dermatitis from drugs in healthcare workers
Contact sensitivity to pharmaceutical drugs occurs mainly among healthcare workers, pharmaceutical industry operators and veterinary surgeons. Of the 14,689 patients suspected of contact allergy examined in the dermatology department of a university hospital between 1978 and 2001, occupational allergic contact dermatitis from drugs was diagnosed in 33 cases. The most common sensitizers were antibiotics including penicillins, cephalosporins, and aminoglycosides. They accounted altogether for 35 positive patch tests, followed by propacetamol hydrochloride, and ranitidine hydrochloride, which elicited 10 and 7 positive reactions, respectively. The highest number of the sensitized patients were nurses (26), followed by veterinarians (4), pharmacists (2) and medical doctors (1).
Contact Dermatitis, Nov. 2001, Vol.45, No.5, p.273-279. Illus. 41 ref.

CIS 02-745 Wheat J.R., Donham K.J., Simpson W.M.
Medical education for agricultural health and safety
Family physicians who respond to agricultural hazards can maintain their rural practices while establishing the credibility necessary for acceptance as partners in programmes for agricultural community health. Family physicians with expertise in rural community health and occupational and environmental medicine (OEM) can be the front line of agricultural medicine. They need to be trained in rural medicine, rural public health, family medicine and OEM (including agricultural medicine). Few educational institutions are prepared currently to merge and coordinate these programmes into a coherent rural and agricultural medicine programme. It is recommended that a medical school in each distinctive agricultural region construct a model for developing physicians specialized in agricultural medicine and seek partners and resources to implement the model. Examples include the Iowa, South Carolina and Alabama models. A vocal rural and agricultural constituency may be required for success.
Journal of Agromedicine, 2001, Vol.8, No.1, p.77-92. Illus. 20 ref.

CIS 02-734 Kivimäki M., Sutinen R., Elovainio M., Vahtera J., Räsänen K., Töyry S., Ferrie J.E., Firth-Cozens J.
Sickness absence in hospital physicians: 2 year follow up study on determinants
Short (1 to 3 days) and long (more than 3 days) recorded spells of sickness absence during a 2 year follow up period for 447 (251 male and 196 female) hospital physicians in Finland and 466 controls (female head nurses and ward sisters) were analysed. It was found that physicians took one third to a half the sick leave of controls. All the health outcomes were strongly associated with sickness absence in both groups. Of work-related factors, teamwork had the greatest effect on sickness absence in physicians. Physicians working in poorly functioning teams were at 1.8 times greater risk of taking long spells than physicians working in well functioning teams. Risks related to overload, heavy on-call responsibility, poor job control, social circumstances outside the workplace, and health behaviours were smaller. In this occupational group, sickness absence is strongly associated with health problems, and the threshold for taking sick leave is high.
Occupational and Environmental Medicine, June 2001, Vol.58, No.6, p.361-366. Illus. 34 ref.

CIS 02-727 Hannerz H., Tüchsen F.
Hospital admissions among male drivers in Denmark
To analyse the disease pattern among professional drivers in Denmark, cohorts of all 20-59-year-old Danish male professional drivers in the years 1981, 1986, 1991, and 1994 were formed. Standardized hospital admission ratios SHRs were higher among professional drivers than in the male working population at large. Also, drivers of passenger transport, compared with drivers of goods vehicles, had significantly high SHRs due to infectious and parasitic diseases, diseases of the circulatory system, and diseases of the respiratory system, and significantly lower rates of injury. For both driver groups, the SHRs for acute myocardial infarction increased with time whereas the SHR for acute gastritis decreased. For drivers of passenger transport an increasing SHR for chronic obstructive pulmonary disease, was found over time. In conclusion, drivers of passenger transport and drivers of goods vehicles differ in their disease patterns. Preventive efforts are needed in both groups, but requiring different strategies.
Occupational and Environmental Medicine, Apr. 2001, Vol.58, No.4, p.253-260. Illus. 52 ref.

CIS 02-970 Trinkoff A.M., Storr C.L., Lipscomb J.A.
Physically demanding work and inadequate sleep, pain medication use, and absenteeism in registered nurses
Pain and fatigue are early indicators of musculoskeletal strain. This study examined associations among eight physical demands and inadequate sleep, pain medication use, and absenteeism in 3727 working registered nurses. Among the demands, awkward head and arm postures were associated with each outcome (inadequate sleep: odds ratio (OR) 1.96; pain medication OR, 1.65; absenteeism OR, 1.60). A dose-response relationship was present; as the number of demands increased, the likelihood of each outcome increased. Odds ratios for eight demands versus no demands were as follows: inadequate sleep (OR 5.88), pain medication (OR 3.30), and absenteeism (OR 2.13). Adjustment using multiple logistic regression for lifestyle, demographics, and work schedule did little to alter the findings. Interventions to promote nurses' health should limit the physical demands of the work.
Journal of Occupational and Environmental Medicine, Apr. 2001, Vol.43, No.4, p.355-363. 33 ref.

CIS 02-799 Wrangsjö K., Swartling C., Meding B.
Occupational dermatitis in dental personnel: Contact dermatitis with special reference to (meth)acrylates in 174 patients
Between 1995 and 1998, 174 dental personnel were referred as patients to the Department of Occupational and Environmental Dermatology, Stockholm. Hand eczema was diagnosed in 109 patients. 77 had positive reactions to substances in the standard series and 44 to substances exclusive to the dental series. 24 patients had positive reactions to (meth)acrylates, the majority with reactions to several test preparations. The most frequent allergens besides (meth)acrylates were nickel, cobalt, palladium, fragrance mix, colophonium and thiuram mix. Allergy to natural rubber latex was diagnosed in 14 patients. In conclusion, irritant hand dermatitis was the dominant diagnosis. Contact allergy to (meth)acrylate was seen in 22% of the patch tested patients, with reactions to 3 predominant test substances.
Contact Dermatitis, Sep. 2001, Vol.45, No.3, p.158-163. 21 ref.

CIS 02-463 Lönnroth E.C., Shahnavaz H.
Users' demands regarding dental safety glasses. Combining a quantitative approach and grounded theory for the data analysis
Despite the frequency of eye infections among dentists, few use proper eye protection. To understand users' demands behind the low use of safety glasses, a questionnaire was mailed to all dentists and dentists' assistants in Sweden on the factors they found most important when choosing protective glasses; they were also asked to rate the importance of 31 statements regarding ergonomic aspects of dental safety glasses. Results showed that dentists ranked the visual aspects as most important, while for the assistants, the protective aspects were given a higher priority. Protective glasses which satisfy the highly visual demanding work performed by dentists are not yet available on the market, which may explain the low use level.
International Journal of Occupational Safety and Ergonomics, 2001, Vol.7, No.1, p.49-59. Illus. 10 ref.

CIS 02-461 Brophy M.O., Achimore L., Moore-Dawson J.
Reducing incidence of low-back injuries reduces cost
Report on an ergonomics programme employing mechanical lifting devices in order to reduce musculoskeletal injuries in nursing personnel in a nursing home. Comparisons in health and financial outcomes were made between the pre-intervention period (two years) and the intervention period (four years). There was a significant reduction in the number of low-back injuries and the total number of lost workdays was reduced from 1,476 before to 625 per year after the intervention. There was a significant reduction in the average yearly cost associated with low-back injuries.
AIHA Journal, July-Aug. 2001, Vol.62, No.4, p.508-511. Illus. 17 ref.

CIS 02-394 Rytkönen E., Sorainen E.
Vibration of dental handpieces
The vibration of new and used dental hand pieces was tested in three directions during idling. Work was simulated by drilling on plastic plate. An analysis was performed of the weighted vibration and the total acceleration of high-frequency vibration ("ultra vibration"). Neither the water and air injection nor the grip force of fingers had any significant effect on the vibration level. The weighted accelerations were well below hazardous levels. The vibration spectra of the hand pieces contained powerful vibration at high frequencies, but the effects of this ultra vibration and exposure during work are not well known.
AIHA Journal, July-Aug. 2001, Vol.62, No.4, p.477-481. Illus. 10 ref.

CIS 02-450 Engkvist I.L., Kjellberg A., Wigaeus H.E., Hagberg M., Menckel E., Ekenvall L.
Back injuries among nursing personnel - Identification of work conditions with cluster analysis
The aim of this study was to identify working conditions that are typical for nursing personnel and relevant for the risk of back injuries, and to analyse how individual characteristics contribute to the risk of injuries in these situations. Six well-defined clusters were identified by cluster analysis. Two clusters had an over-representation of injuries and they were characterised by a combination of full-time work, work on a rolling schedule, regular patient transfers and a high proportion of assistant nurses. In the three clusters with a lower proportion of injuries, the nurses worked part-time. In the cluster with the lowest rate of injuries, there were no regular patient transfers. The decreased risk of injury may thus be a joint effect of fewer working hours, fixed working schedule and less patient handling.
Safety Science, Feb. 2001, Vol.37, No.1, p.1-18. 36 ref.

CIS 02-449 Nussbaum M.A., Torres N.
Effects of training in modifying working methods during common patient-handling activities
It is generally recommended that workers who perform strenuous physical exertions be given training in proper techniques to minimize musculoskeletal risks. In the present study, the effects of training were examined at a behavioral level, and it was assumed that any long-term reduction in injuries must be preceded by measurable changes in how exertions are performed. Because of high injury incidence rates among nurses, common patient-handling tasks were the basis of the study. Participants performed several such tasks and sub-groups received training that consisted of either a commercial video or combined lecture and practice sessions. Compared to a control group, postural, and biomechanical measures were significantly altered following training. Specifically, training was associated with the adoption of a more upright lifting posture. The results suggest that training can modify behavior in an intended direction.
International Journal of Industrial Ergonomics, Jan. 2001, Vol.27, No.1, p.33-41. Illus. 26 ref.

CIS 02-329 Larese Filon F., Bosco A., Fiorito A., Negro C., Barbina P.
Latex symptoms and sensitization in health care workers
This study evaluated the prevalence of latex-related symptoms and sensitisation among 1,165 health care workers in Trieste hospitals by means of a questionnaire, a medical examination, skin prick tests and IgE-specific evaluation. Glove-related symptoms were noticed on 17.2% of the nurses, the majority of symptoms being mild dermatitis with itching and erythema. Symptoms suggestive of IgE-mediated latex allergy were found in 51 subjects; 35 complained of contact urticaria and 16 of asthma and/or rhinitis. The resulting symptoms were significantly related to skin prick tests that were positive to latex (odds ratio (OR) = 11.89), to personal atopy (OR = 2.15), to familiar atopy (OR = 2.12), to skin prick test positivity to related fruit (OR = 2.01) but not to prick test positivity to common inhalant allergens (OR = 1.00). Symptoms increased as a direct function of the time-usage of latex gloves and were more prevalent in operating room staff.
International Archives of Occupational and Environmental Health, Apr. 2001, Vol.74, No.3, p.219-223. Illus. 38 ref.

CIS 02-298 Geukens S., Goosens A.
Occupational contact allergy to (meth)acrylates
Among 13,833 patients suspected of contact dermatitis examined during the years 1978-1999, occupational contact allergy to acrylates and methacrylates was diagnosed in 31 patients. The three most common sensitizers were ethylene glycol dimethacrylate (17 positive patch tests), 2-hydroxyethyl methacrylate (14 positive tests) and triethyleneglycol dimethacrylate (6 positive tests). The aim of this report was to identify the occupations and industries responsible for occupational sensitization to acrylates and methacrylates. 14 of the 31 patients worked in the dental sector, where acrylate- or methacrylate-containing dental prostheses and dental composites would appear to be mainly responsible for allergy to acrylates and methacrylates. An increase in skin problems related to the growing use of acrylates or methacrylates is clearly shown by the data.
Contact Dermatitis, Mar. 2001, Vol.44, No.3, p.153-159. Illus. 27 ref.

CIS 02-275 Porru S., Carta A., Placidi D.
Job fitness definition of workers exposed to biological risks in a health care environment: Considerations in light of a case report
Il giudizio di idoneitŕ lavorativa di lavoratori esposti a rischio biologico in ambiente sanitario: considerazioni alla luce di un caso clinico [in Italian]
Report of the case of a young female nurse in the haematology department of an Italian hospital, who was in charge of preparing and administering antineoplastic drugs. She was suffering from membranous glomerulonephritis and was being treated with immunosuppressant agents. The risk assessment showed that the preparation and administration of the antineoplastic drugs was not safely performed and she showed moderate leucopenia. This worker was judged unfit for work involving high risk of exposure to potentially harmful pharmaceutical agents. The case provided the opportunity for underlining the role of the occupational physician in detecting potentially harmful cases of exposure.
Medicina del lavoro, Sep.-Oct. 2001, Vol.92, No.5, p.345-352. 20 ref.

CIS 02-469 Granier M., Bourchenin P., Perrin P., Beuchot J., Labourayre J.L., Samuel A., Meyer J.P., Baranski R.M., Jandrot P.
Method for analysing manual handling tasks aimed at health care institutions and employees
Méthode d'analyse des manutentions manuelles destinée aux établissements et personnels de soins [in French]
Recent studies show that health care workers are the most exposed to manual handling, and rank immediately behind building industry workers for strenuous postures. Aimed at health care institutions as well as health care workers, this manual describes a method for analysing the working conditions of health care workers with respect to manual handling. Phases of the approach include job study, analysis, interpretation of results, search for solutions and evaluation of actions. An example showing the application of the method in a 40-bed rehabilitation ward is presented.
Institut national de recherche et de sécurité, 30 rue Olivier-Noyer, 75680 Paris Cedex 14, France, 1st ed., Aug. 2001. 72p.+27p. (annexes). Illus. 33 ref.

CIS 01-1734
Health and Safety Executive
Health and safety in care homes
This booklet is aimed at owners, managers and employees of care institutions such as hospitals, nursing homes, specialized institutions for handicapped persons or persons undergoing rehabilitation programmes and residential care homes owned by local authorities. Its purpose is to help them understand and meet their duties under current safety and health legislation. Contents: legal framework; managing health and safety; reporting of incidents; first aid; hazardous substances; control of infection; patient handling; aggression and violence to staff; work-related stress; legionellosis; utilities (gas and electricity); asbestos; general working environment; health and safety in the kitchen, the laundry and outdoors.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2001. iv, 60p. Illus. 66 ref. Price: GBP 8.50.

CIS 01-1836
Health and Safety Executive
Blood-borne viruses in the workplace - Guidance for employers and employees
Blood-borne viruses (BBVs) include hepatitis B, hepatitis C and hepatitis D, which affect the liver, and human immunodeficiency virus (HIV), which causes acquired immune deficiency syndrome (AIDS). This guidance note is aimed at all persons involved in work where exposure to blood or other body fluids may occur. Contents include: description of BBVs; types of work where exposure to BBVs may occur; legal responsibilities of employers and employees; actions to be taken after possible infection with a BBV; special considerations for first-aid attendants.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, July 2001. 8p. 11 ref.

CIS 01-1816
Health and Safety Executive
The regulatory requirements for medical exposure to ionising radiation - An employer's overview
This guidance note is aimed at senior managers and clinicians of public and private hospitals, as well as at practicing physicians, chiropractors and dentists who use ionizing radiation. It provides an overview of their responsibilities under the Ionising Radiation Regulations 1999 (IRR99, see CIS 00-617) and the Ionising Radiation (Medical Exposure) Regulations 2000 (IR(ME)R2000). The main provisions of these regulations involve the need for risk assessment, use of appropriate equipment, quality assurance programmes, training of employees and procedures for dealing with incidents.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, Nov. 2001. iv, 16p. Illus. 11 ref. Price: GBP 6.50.

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