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Health care services - 1,917 entries found

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CIS 00-468 Kanerva L., Miettinen P., Alanko K., Estlander T., Jolanki R.
Occupational allergic contact dermatitis from glyoxal, glutaraldehyde and neomycin sulfate in a dental nurse
Case report of a non-atopic dental nurse with work-related hand dermatitis. Two patch test sessions gave positive reactions to glyoxal, glutaraldehyde and neomycin sulfate. The latter had been frequently used to treat her dermatitis. The sensitizations to glyoxal and glutaraldehyde were considered occupational. As the nurse had been exposed to both products, it is not clear if she developed cross-reactivity or concomitant sensitization.
Contact Dermatitis, Feb. 2000, Vol.42, No.2, p.116-117. 10 ref.

CIS 00-467 Berndt U., Wigger-Alberti W., Gabard B., Elsner P.
Efficacy of a barrier cream and its vehicle as protective measures against occupational irritant contact dermatitis
In a randomized, double-blind study, a new barrier cream and its moisturizing vehicle were compared regarding their skin compatibility, efficacy and resulting acceptance. Two panels of 25 hospital nurses each with mild signs of skin irritation were asked to use one of the test products (barrier-cream or vehicle) over a period of four weeks. Effects of both types of preparations were studied weekly. No significant differences were found between the barrier cream and its vehicle. In both groups, clinical skin status improved and stratum corneum hydration increased significantly during the study period. Both preparations were well tolerated and accepted, thus showing both skin protection and skin care. These results contribute to the debate as to whether a strict distinction between "skin care" and "skin protection" products is justified.
Contact Dermatitis, Feb. 2000, Vol.42, No.2, p.77-80. Illus. 14 ref.

CIS 00-557 Elford W., Straker L., Strauss G.
Patient handling with and without slings: An analysis of the risk of injury to the lumbar spine
In this study, kinematic variables and subjective ratings of body part stress and lifter preference were used as measures of the relative risk for three two-person techniques for carrying a patient from one chair to another chair (using no sling, one and two slings). 22 nurses participated in the study conducted in Australia. Kinematic measures of angular displacement, velocity and acceleration were obtained using the lumbar motion monitor and visual analogue scales were used to obtain measures of body part stress for seven body parts. There was no significant difference between one and two sling techniques. Mean total body stress rating was higher for the no-sling technique and all subjects indicated that their preference was for slings. Although all measures of risk rated the no-sling technique as carrying a higher level of risk than the techniques using slings, the elimination of manual patient handling seems the best option for the reduction of work-related back injuries.
Applied Ergonomics, Apr. 2000, Vol.31, No.2, p.185-200. Illus. 63 ref.

CIS 00-556 Kjellberg K., Johnsson C., Proper K., Olsson E., Hagberg M.
An observation instrument for assessment of work technique in patient transfer tasks
The aim of the study was to design and evaluate an observation instrument for the description and ergonomic assessment of the techniques of nursing personnel for moving patients. The instrument consists of 24 items arranged in three phases of a transfer: the preparation phase, the starting position and the actual performance. Observations can be made from video recordings by trained observers. The validity and reliability of the instrument were evaluated on 35 video-recorded patient transfers from hospital wards, and were mostly satisfactory.
Applied Ergonomics, Apr. 2000, Vol.31, No.2, p.139-150. 55 ref.


CIS 02-759
Hauptverband der gewerblichen Berufsgenossenschaften (HVBG)
BG rules - Disinfection procedures in health care establishments
BG-Regeln - Desinfektionsarbeiten im Gesundheitsdienst [in German]
This document reproduces the full text of guideline BGR 206 of the Mutual Occupational Accident Insurance Association (HVBG) concerning disinfection procedures in health care establishments. Contents: scope; definitions; general provisions; responsibilities of employers (hazard evaluation, use of substitute products, employee qualifications, list of dangerous chemicals, environmental surveillance of premises, technical and organizational safety measures, information of personnel); rules applicable to specific disinfection tasks (washing and wiping; sterilization of instruments, beds; elimination of waste and excretions; sterilization of the hands and the skin; disinfection in veterinary medicine). Appendices include examples of a hygiene plan and a disinfection plan, check lists for evaluating the hazards of disinfection work, literature references to the properties of disinfection products and lists of related guidelines, rules and standards.
Carl Heymanns Verlag KG, Luxemburgerstrasse 449, 50939 Köln, Germany, July 1999. 98p. Illus.

CIS 02-377 Rosell Farrás M.G., Guardino Solà X.
Prevention of glutaraldehyde exposure in hospitals
Prevención de la exposición a glutaraldehído en hospitales [in Spanish]
Following an introduction defining the physical and chemical characteristics of glutaraldehyde, listing its applications in a hospital environment (in the sterilization of endoscopy instruments, for the cleaning of zones having a high risk of infection, as a fixation agent in histopathology, as a radiographic developer and in the treatment of warts) and describing its effects on health, this information note presents various methods for measuring the concentrations of this substance in ambient air. The procedures to be followed for limiting exposure, as well as the personal protective equipment required (gloves, aprons, safety spectacles, face masks and half-mask respirators) are described. The classifications of various concentrations of glutaraldehyde solutions used in hospitals, as well as the corresponding risk phrases are also mentioned. In Spain, the short-term exposure limit is 0.05ppm for 15 minutes.
Instituto Nacional de Seguridad e Higiene en el Trabajo, Ediciones y Publicaciones, c/Torrelaguna 73, 28027 Madrid, Spain, 1999. 6p. 11 ref.

CIS 02-414 Kilgariff C., Best M.
An investigation of manual handling in Victorian health education programs
The incidence of manual handling injuries in nurses and other carers is high. Therefore, consideration needs to be given to the quality and quantity of manual handling training occurring at teaching institutions to ensure maximum protection of these employees as they enter the workforce. This study used a questionnaire to investigate the amount and type of manual handling and occupational safety and health (OSH) training which is being taught in health care courses in Victoria. The results indicated that there were inadequate practical and theoretical hours allocated to manual handling and patient handling skills, and inadequate OSH education. Recommendations from the study include: an increase in both the practical and theoretical hours of manual handling education in nursing courses; assessment of the manual handling and transfer skills components of the curriculum; and inclusion of OSH and risk assessment in all undergraduate health care courses.
Journal of Occupational Health and Safety - Australia and New Zealand, Oct. 1999, Vol.15, No.5, p.475-481. Illus. 10 ref.

CIS 02-494 Colquhoun R.
Burnout in mental health professionals: A personal construct approach
Burnout is characterized by depersonalization, a decreased sense of personal accomplishment and physical, mental and emotional exhaustion. This research project used quantitative and qualitative methods to assess the influence of affect states (anger, depression and good feelings), differences in work-related construct systems and socio-demographic variables on burnout. The study group consisted of 60 health care professionals, who were questioned on their working environment and personal life; the replies were transcribed and rated on a number of scales. A personal construct model of burnout was developed, according to which affect states were associated with levels of burnout and differences in content of work-related construct systems were predictive of levels of burnout. However, there were no significant differences in socio-demographical factors among professionals who showed burnout. Implications of the present research are discussed and ideas for future research are suggested.
Journal of Occupational Health and Safety - Australia and New Zealand, Feb. 1999, Vol.15, No.1, p.67-78. 45 ref.

CIS 01-1802 Ündeğer Ü., Zorlu A.F., Başaran N.
Use of the alkaline comet assay to monitor DNA damage in technicians exposed to low-dose radiation
The exposure of human beings to ionizing radiation is still of great concern in occupational and environmental medicine, and the widespread use of radiotherapy in the treatment of cancer has led to anxiety about the possible hazards to staff who are at risk of such occupational exposure. In this study, DNA damage in the peripheral lymphocytes of 30 technicians employed in radiation oncology departments for at least one year was examined by the alkaline electrophoresis "comet" technique. The results were compared with those of 30 controls with comparable age, sex, and smoking habits who were not working in radiation oncology or chemotherapy services. The DNA damage observed in the lymphocytes of the technicians was significantly higher than that in the controls (P < 0.001). Cigarette smoking was also related to increases in DNA damage, and a significant association was found between the duration of occupational exposure to low-dose ionizing radiation and the DNA damage.
Journal of Occupational and Environmental Medicine, Aug. 1999, Vol.41, No.8, p.693-698. 36 ref.

CIS 01-1697 Valanis B., Vollmer W.M., Steele P.
Occupational exposure to antineoplastic agents: Self-reported miscarriages and stillbirths among nurses and pharmacists
Antineoplastic agents are mutagenic and teratogenic, with potential effects on reproduction among workers exposed to these agents. This study investigates pregnancy loss associated with occupational exposures to antineoplastic drugs by comparing rates of spontaneous abortion and stillbirths for pregnancies with and without antineoplastic exposure for either parent, before or during pregnancy. A total of 7,094 pregnancies of 2,976 pharmacy and nursing staff were examined. Exposure of the mother to antineoplastic agents during the pregnancy was associated with a significantly increased risk of spontaneous abortion (odds ratio = 1.5) and combined risk of spontaneous abortion and stillbirth (odds ratio = 1.4). Among the wives of exposed men, too few stillbirths occurred to allow analysis. However, for spontaneous abortion and any loss, the patterns of increased risk were similar to those seen for women, although the odds ratios were not statistically significant.
Journal of Occupational and Environmental Medicine, Aug. 1999, Vol.41, No.8, p.632-638. 24 ref.

CIS 01-1832 Marin M.G., Van Lieu J., Yee A., Bonner E., Glied S.
Cost-effectiveness of a post-exposure HIV chemoprophylaxis program for blood exposures in health care workers
A cost-effectiveness analysis of a post-exposure chemoprophylaxis programme for health care workers who sustained exposures to blood was performed. A programme of treatment with zidovudine (AZT) alone versus no treatment and a treatment with three-drug therapy versus no treatment was analysed. Assuming that 35% of exposures were to HIV positive sources, the ATZ regimen prevented 53 HIV seroconversions per 100,000 exposures, at a societal cost of USD 2.0 million per case of HIV prevented. The cost per quality-adjusted life year saved was USD 175,222. A three-drug chemoprophylactic therapy programme (postulating 100% effectiveness and 35 % source HIV positivity), prevented 66 seroconversions per 100,000 exposures, at a cost of USD 2.1 million per case of HIV prevented and USD 190,392 per quality-adjusted life year saved. Treating only workers exposed to sources known to be HIV-positive would be the most cost-effective strategy.
Journal of Occupational and Environmental Medicine, Sep. 1999, Vol.41, No.9, p.754-760. Illus. 17 ref.

CIS 01-1843 Meyer J.P., Gary Y., Lafaurie S., Leprince A.
Lumbar diseases in health care occupations
Pathologies lombaires dans les professions de soins [in French]
This article consists of the highlights of papers presented at a conference on lumbar diseases in health care occupations held in Hamburg, Germany, on 10-11 September 1998. Topics covered include: epidemiological studies; physiopathology; evaluating the degree of strain (biomechanical analyses, observation, measuring the energetic cost); prevention principles (general principles, posture training, manual handling aids); ergonomic approach.
Documents pour le médecin du travail, 1st Quarter 1999, No.77, p.35-41.

CIS 01-1387 Rescalvo Santiago F.
Manual on the prevention of occupational hazards during the handling of patients
Manual de prevención de riesgos laborales en la movilización de enfermos [in Spanish]
Manual on the prevention of hazards related to the handling of patients by health care personnel. It presents the basic principles of anatomy, biomechanics and postural ergonomics, and describes the body movements and postures to be adopted for the proper handling and displacing of patients in various situations. It also includes practical exercises for avoiding or attenuating backaches.
IBERMUTUAMUR, Ramírez de Arellano 27, 28403 Madrid, Spain, 1999. 63p. Illus. 4 ref.

CIS 01-1568 Hoffmann C.
Job satisfaction of German Red Cross nurses - A longitudinal study
Arbeitszufriedenheit bei Schwestern vom Deutschen Roten Kreuz: eine Längsschnittuntersuchung [in German]
Contents of this thesis analysing the results of a longitudinal study of job satisfaction among German Red Cross nurses: historical overview of job satisfaction; description of the workplace of Red Cross nurses; significance and features of job satisfaction; job satisfaction as a function of hierarchical position, various aspect of the job, and work-time schedules; analysis of the causes of job resignations; suggestions for improving job satisfaction. Results are summarized for individual hierarchical groups. Interview guides and detailed questionnaires are included as appendices.
Shaker Verlag, Postfach 1290, 52013 Aachen, Germany, 1999. vi, 337p. Illus. 142 ref.

CIS 01-1556 van Vuuren W.
Organisational failure: Lessons from industry applied in the medical domain
Medical risk management and medical accidents are receiving growing interest from researchers in the fields of industrial engineering and human factors. Many methods have been developed to analyse safety and risks in industrial settings, particularly in high-risk industries such as chemical processing, nuclear power and aviation. To cope with the increasing demand for risk management methods and tools in the medical field, the possibility of transferring methods and tools initially developed for industrial settings is investigated. For this purpose, a taxonomy for classifying organizational root causes of safety-related incidents, developed for the steel industry, is used to classify organizational root causes of both industrial and medical incidents. The article concludes by evaluating the applicability of the method in two differfent medical settings, the emergency and anaesthesia departments of a large hospital.
Safety Science, Oct.-Nov. 1999, Vol.33, No.1-2, p.13-29. Illus. 28 ref.

CIS 01-1561 Camerino D., Fattorini E., Molteni G., De Vito G.
The relationship between psycho-social factors, workload and epidemiological pathologies
Relazione tra fattori psicosociali, carico lavorativo e patologie di rilievo epidemiologico [in Italian]
In order to evaluate the effect of psychosocial factors and related stress responses on the onset of musculoskeletal disorders, a study was conducted on 1182 nurses (949 women and 233 men) in three large Milan hospitals. The main task investigated was the transfer of patients. Psychosocial aspects were researched by using four different questionnaires and rating scales. Ailments were quantified by using a questionnaire developed and validated in Italy for the collection of data on back pain. Research results confirmed that objective evaluations of the physical load and subjective evaluations are consistent, that physical load is the main risk for back ailments and that there is a significant relationship between psychosocial factors, stress and fatigue. Based on this research, it is recommended that information and training for nurses consider the potential for change in the relationship between the individual and the organization in the management of workloads.
Prevenzione oggi, Jan.-Mar. 1999, Vol.XI, No.1, p.43-69. Illus. 54 ref.

CIS 01-841 Lönnroth E.C., Dahl J.E., Shahnavaz H.
Evaluating the potential occupational hazard of handling dental polymer products using the HET-CAM technique
The irritation potencies of eight dental polymer products, used as dental restorative materials, adhesives or temporary constructions, were tested using the HET-CAM (hen's egg test-chorioallantoic membrane) technique. Results showed that the liquid component of all products had a strong irritation capacity but powder suspensions and extracts from cured and freshly mixed non-cured materials had no effect on the CAM. Thus, dental personnel who manually handle liquid and powder are exposed to components with a high irritation potential, in contrast to patients who are exposed to the cured and mixed non-cured materials with low irritation potential. This illustrates the importance of safe handling procedures and practices for dental personnel who handle non-cured polymers manually.
International Journal of Occupational Safety and Ergonomics, 1999, Vol.5, No.1, p.43-57. 43 ref.

CIS 01-581 Murlidhar V.
Bloodborne occupational diseases of health care workers (HCW)
This manual on the risks of exposure to bloodborne diseases of health care personnel focuses on hepatitis B and C, HIV and AIDS transmission risks. Transmission mechanisms, risk factors for seroconversion following percutaneous injury, post-exposure prophylaxis, hygiene practices, decontamination and sterilization, personal protective equipment and vaccination are presented along with safety recommendations for dealing with sharp instruments and body fluids.
Society for Participatory Research in Asia (PRIA), 42 Tughlakabad Institutional Area, New Delhi 110062, India, 1999. i, 27p. 52 ref.

CIS 01-579
Health and Safety Commission
Safe disposal of clinical waste
This booklet provides guidance for managing the safe segregation, handling, transport and disposal of clinical waste. Categories of clinical waste are defined and preventive actions such as training, personal hygiene, immunization, information on accidents and waste treatment, and monitoring of procedures are discussed. The duty of care along the chain dealing with the waste is explained. The essential points of applicable regulations are presented. Replaces CIS 93-624.
HSE Books, P.O.Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2nd ed., 1999. iv, 68p. Illus. 59 ref. Price: GBP 10.50.

CIS 01-379 Using anaesthetic gases: Assessing the risks
Utilisation de gaz d'anesthésie: évaluation des risques [in French]
Risico-evaluatie bij gebruik van anesthesiegassen [in Dutch]
Nitrous oxide and chlorinated hydrocarbons frequently used as anaesthetic gases are mutagenic and teratogenic upon prolonged exposure, and have possible effects on the central nervous system and the liver. Measurements made in hospital operating theatres reveal that high concentrations can persist for long times. Particularly high loads can occur in cases of inadequate ventilation during inhalation anaesthetics with halogenated products. This booklet provides exposure limit values applicable in Belgium for anaesthetic gases, describes the potential risk factors associated with working with these substances in hospitals, and provides check-lists for ensuring the limitation of exposure.
Ministère fédéral de l'Emploi et du Travail, 51 rue Belliard, 1040 Bruxelles, Belgium, June 1999. 15p.

CIS 01-469 Caring for elderly people
Le travail d'aide aux personnes âgées [in French]
This report is based on a questionnaire survey aimed at investigating how employees of retirement homes and home care assistants for elderly people perceive their own working conditions, mental and physical workload, and state of health. Results indicate that women predominate in this activity. Heath problems are generally due to physical strains and organizational factors. The need for appropriate training, especially of those who care for the dying, is emphasized.
Centre Interservices de Santé et de Médecine du travail en Entreprise (CISME), 31 rue Médéric, 75832 Paris Cedex 17, France, Apr. 1999. xvii, 140p. Illus. 31 ref.

CIS 01-595 De Gucht V., Fischler B., Demanet C.
Immune dysfunction associated with chronic professional stress in nurses
The relationship between chronic professional stress and immunity as well as the possible psychopathology of this relationship were examined. Sixty nurses were selected on the basis of high or low scores of professional stress and psychopathology by means of questionnaires. Chronic professional stress appears to be associated with immune dysfunction including signs of immune activation and possibly immune suppression. The increase in activation markers, CD3+CD16CD56+ cells and serum neopterin was associated with high stress/low psychopathology whereas the decrease of CD8+CD11b+ cells was more pronounced in the high stress/high psychopathology group. In the presence of chronic stress, distinct psychological mechanisms may be associated with specific immune dysfunctions.
Psychiatry Research, 1999, Vol.85, No.1, p.105-111. 20 ref.

CIS 01-442 Waits J.B., Wheat J.R.
Preventive agricultural medicine: A medical student's perspective on an important component of rural community health
Farming and keeping livestock are the most dangerous profession in terms of mortality. Despite progress in other areas of occupational medicine, occupational health issues in agriculture have been subordinate to those of manufacturing industry until only very recently. This report tells of a visit to a cotton farm in western Alabama as part of a Rural Medicine rotation by a medical student and includes a focussed literature review on various issues in agricultural health. Pressing health issues for farmers include exposure to toxic chemicals, trauma and injury, respiratory disease, infections, stress and psychiatric illnesses. There are additional issues involving family members. The rural family physician is in a unique position to prevent morbidity and mortality by social action and early diagnosis.
Journal of Agromedicine, 1999, Vol.6, No.3, p.11-25. Illus. 16 ref.

CIS 01-262
Health and Safety Executive
Safe use of pneumatic air tube transport systems for pathology specimens
Pathology specimens may present infectious, chemical or radiation hazards. This information sheet provides advice to persons using pneumatic air tube transport systems to deliver pathology specimens within various sections of a hospital, for example between operating theatres and pathology laboratories. Contents include: general description of pneumatic air tube transport systems; employers' legal responsibilities with respect to risk assessment and preventive action in the United Kingdom; assessing risks; spillage containment and clean-up procedures; employee information and training.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, Sep. 1999. 3p. 1 ref.

CIS 01-162 Nayebzadeh A., Dufresne A.
Evaluation of exposure to methyl methacrylate among dental laboratory technicians
Following the diagnosis of two cases of occupational asthma among dental technicians, an industrial hygiene survey was conducted in two dental laboratories to determine time-weighted average and peak concentrations of methyl methacrylate vapour and time-weighted average concentration of acrylic dust. The time-weighted average concentrations of methyl methacrylate vapour were 0.7ppm and 1.6ppm and average peak concentrations were 9.3ppm and 9.7ppm for the first and second laboratory, respectively. The use of a local exhaust ventilation system was significant in reducing the peak concentration of methyl methacrylate vapour in the breathing zone of dental technicians. However, the local exhaust ventilation was not efficient in reducing the concentration of airborne acrylic dusts. Occupational exposure of dental technicians to dental materials, in particular to methyl methacrylate, requires further investigation. Local exhaust ventilation systems can reduce the concentration of methyl methacrylate in the dental laboratories to a significant extent if installed and used properly.
American Industrial Hygiene Association Journal, Sep.-Oct. 1999, Vol.60, No.5, p.625-628. 15 ref.

CIS 01-152 Smedley J., Jury A., Bendall H., Frew A., Coggon D.
Prevalence and risk factors for latex allergy: A cross-sectional study in a United Kingdom hospital
To determine the prevalence and risk factors for symptoms related to gloves, and the relation between symptoms and immunological evidence of type I hypersensitivity to latex, a cross-sectional survey was carried out among the hospital's 773 employees. A self-administered questionnaire was used to collect information on symptoms related to gloves and associated risk factors among staff likely to use gloves at work. All who reported symptoms suggestive of type I hypersensitivity were invited for skin prick testing and measurement of specific IgE to latex (RAST). Among the 372 responders, symptoms related to gloves were common, 49% reported redness or itching of the hands, 14% reported urticaria, and 6% reported chest tightness. However, the frequency of positive skin prick tests and RASTs was surprisingly low (only two subjects tested positive). These findings indicate the need for caution in the interpretation of symptoms related to gloves even when they seem to suggest type I hypersensitivity.
Occupational and Environmental Medicine, Dec. 1999, Vol.56, No.12, p.833-836. 19 ref.

CIS 00-1580 Ramos Carrillo C.
Ministerio de trabajo y asuntos sociales
Biological hazards among health care personnel - Prevention programmes
Riesgos biológicos en personal sanitario - Programas de prevención [in Spanish]
Topics: antibodies; bacterial diseases; biological hazards; chickenpox; health care personnel; health programmes; immunodeficiency syndrome; infectious hepatitis; influenza; legionellosis; manuals; medical supervision; risk factors; rubella; Spain; training material; tuberculosis; typhoid fever; vaccination; virus diseases.
Instituto Nacional de Seguridad e Higiene en el Trabajo, c/Torrelaguna 73, 28027 Madrid, Spain, 1999. 51p. 21 ref.

CIS 00-1636 Hasselhorn H.M., Toomingas A., Lagerström M.
Occupational health for health care workers - A practical guide
Topics: chemical hazards; cytotoxic effects; dental services; disinfectants; disposal of harmful waste; health care personnel; heavy work; hospitals; immunodeficiency syndrome; infectious diseases; infectious hepatitis; inhalation anaesthetics; manual lifting; manuals; mental illness; musculoskeletal diseases; needle-stick injuries; night work; noise; occupational hygiene; radiological services; risk factors; shift work; skin diseases; violence.
Elsevier Science B.V., Sara Burgerhartstraat 25, P.O. Box 211, 1000 AE Amsterdam, Netherlands, 1999. xiii, 231p. Bibl.ref. Index.

CIS 00-1763 NIOSH respiratory protection program in health care facilities: Administrator's guide
Guide to the implementation of a respiratory protection programme in health care facilities used for the prevention of tuberculosis infection.
Publications Dissemination, National Institute for Occupational Safety and Health (NIOSH), 4676 Columbia Parkway, Cincinnati, OH 45226, USA, 1999. x, 112p. Illus.

CIS 00-1794 Ng V., Koh D., Chan G., Ong H.Y., Chia S.E., Ong C.N.
Are salivary immunoglobulin A and lysozyme biomarkers of stress among nurses?
Salivary immunoglobulin A (IgA) and lysozyme have been studied as possible biomarkers of stress. The study examined the stress levels among female nurses in various units of a hospital and the relationship between these stress levels and salivary IgA and lysozyme secretion. Stress levels were assessed with a ten-point Stress Assessment Score (SAS) and a direct question on perceived life stress. Enzyme-linked immunosorbent assay and lyso-plate methods were used to determine salivary IgA and lysozyme levels. Nurses working in various units under different conditions experienced dissimilar levels of stress. Salivaly IgA, but not lysozyme, correlated inversely with self-reported levels of stress. It may thus be a potential biomarker in future studies on stress.
Journal of Occupational and Environmental Medicine, Oct. 1999, Vol.41, No.10, p.920-927. Illus. 27 ref.

CIS 00-1683 Kanerva L., Estlander T.
Occupational allergic contact dermatitis from colophony in 2 dental nurses
This article reports the cases of two dental nurses, one with fingertip dermatitis, the other with irritant contact dermatitis. They both had a previous episode of hand dermatitis. Patch testing showed a positive reaction to colophony, a substance present in dental varnishes, pastes and disinfectants.
Contact Dermatitis, Dec. 1999, Vol.41, No.6, p.342-343. 14 ref.

CIS 00-1388 Wesołowski W., Sitarek K.
Occupational exposure to ethylene oxide of hospital staff
Occupational exposure to ethylene oxide was assessed among the workers in direct contact with ethylene oxide or with ethylene oxide-sterilized instruments in 13 hospitals located in the city of Łodź (Poland) and its suburbs. Individual dosimetry and stationary sampling methods were employed. The samples collected from the occupational environment were analysed by gas chromatography with mass detection. The analytical method enabled determination of low ethylene oxide concentrations in the presence of accompanying chemicals, such as ethyl alcohol, isopropyl alcohol, ethyl ether and isoflurene. In total, 227 determinations were made, and ethylene oxide at concentrations above 0.01mg/m3 (which was the detection limit of the method) was found to be present in 164 samples. The ethylene oxide levels were found to vary widely, from lower than 0.01 of the TLV (STEL: 3mg/m3) to several hundred times.
International Journal of Occupational Medicine and Environmental Health, Jan.-Mar. 1999, Vol.12, No.1, p.59-65. Illus. 9 ref.

CIS 00-1038 Latocca R., Manzi E., Arduca A., Bolognesi L., Cesana G.
Chief medical officers in hospitals and their awareness concerning the application of Italian decree 626/94
Dirigenza medica apicale e livelli di consapevolezza circa l'applicazione del D.L.G.S. 626/94 [in Italian]
The implementation in Italian legislation of European Union directives on the improvement of safety and health at work places new responsibilities and duties toward hospital staff on chief medical officers in hospitals. In an Italian hospital, the awareness of these physicians concerning occupational infections, exposure to chemical agents, use of antineoplastic and antiviral drugs, use of protective garments and devices, exposure to ionizing and nonionizing radiation, use of electric devices, lifting, and fire prevention, as well as staff formation was found to be insufficient. A serious lack of preparedness for an accidental release of biological fluids was noticed. Training for these tasks and periodic controls using check lists were recommended.
Medicina del lavoro, May-June 1999, Vol.90, No.3, p.484-496. 14 ref.

CIS 00-1054 Chen Z., Baur X.
Concentration of natural rubber latex allergens in rubber products and in indoor air of hospitals and physicians' practices
Naturlatexallergengehalt in Gummiartikeln und in der Raumluft von Krankenhäusern und Arztpraxen [in German]
Today, 75% of all latex gloves are powdered with corn starch, which has a respirable particle fraction of 20 to 30%. Thus latex allergens are released in indoor air. In dust samples taken from rooms in 2 hospitals and 2 doctors' practices in which powdered latex gloves were used, levels of allergenic latex protein of up to 714ng/m3 air were found. Samples taken in rooms in which no latex gloves were used contained no allergenic latex protein. An examination of 145 employees yielded a close relationship between the concentration of allergenic latex protein in indoor air and allergic respiratory disorders. At aeroallergen levels of 0.6ng/m3 and higher, conjunctivitis, rhinitis and symptoms of asthma were reported by 19 of 122 exposed employees while no such problems were found among the 23 non-exposed controls. Latex-specific IgE antibodies were found only in exposed persons. A switch of powdered latex gloves to non-powdered latex or synthetic gloves quickly reduced the airborne concentration below the detection limit.
Allergologie, Oct. 1999, Vol.22, No.10, p.598-605. 21 ref.

CIS 00-1165 Hignett S.
Hands-on approach
An ergonomic approach to manual lifting has had encouraging results in a hospital in Nottingham (England), as reported incidents and staff absenteeism due to musculoskeletal injuries have been reduced dramatically in the past four years.
Occupational Health, Apr. 1999, Vol.51, No.4, p.23-25. Illus. 8 ref.

CIS 00-1022 Åkesson I., Johnsson B., Rylander L., Moritz U., Skerfving S.
Musculoskeletal disorders among female dental personnel - Clinical examination and a 5-year follow-up study of symptoms
The objectives were to explore musculoskeletal disorders among dental personnel, to survey findings and diagnoses according to a standardized protocol, and to compare and evaluate different methods for the detection of musculoskeletal disorders in a population. In a 5-year follow-up study, 90 dental personnel and 30 controls were studied. The Nordic questionnaire, the present pain-rating according to the Borg category ratio scale, and physical examination were used. Findings were that dental personnel had an increased risk of musculoskeletal disorders as verified by symptoms and diagnoses and more painful or persistent conditions. This led to a selection out of work. The questionnaire and the present pain rating gave a relatively good picture of musculoskeletal disorders arising from the neck, shoulders and hips and would be useful as screening tools. Their sensitivity in detecting disorders was higher for diagnoses than for findings. However, these methods were not as sensitive for disorders involving the elbows/wrists/hands. Physical examinations gave more detailed information.
International Archives of Occupational and Environmental Health, Sep. 1999, Vol.72, No.6, p.395-403. 36 ref.

CIS 00-1035 Ritchie K.A., Macdonald E.B., Gilmour W.H., Murray K.J.
Analysis of sickness absence among employees of four NHS trusts
To determine the value of using routinely collected sickness absence data as part of a health needs assessment of healthcare workers, sickness absence records of 12,900 National Health Service (NHS) staff for one calendar year were analysed. Almost 60% of the study population had no spells of sickness absence in the year of study and almost 20% had only one spell of sickness absence. Female staff were more likely to have experienced sickness absence than male staff. Although absence due to conditions related to pregnancy were included in the analysis, the incidence of these was not sufficient to account for the higher rates of absence among female staff. In general, full-time staff had greater rates of sickness absence than part-time staff. 71% of all absences were of <1 week duration. The main known causes of sickness absence were respiratory, digestive and musculoskeletal disorders.
Occupational and Environmental Medicine, Oct. 1999, Vol.56, No.10, p.702-708. Illus. 24 ref.

CIS 00-1064 Jolanki R., Estlander T., Alanko K., Savela A., Kanerva L.
Incidence rates of occupational contact urticaria caused by natural rubber latex
Topics: allergens; domestic and related helpers, cleaners; Finland; frequency rates; health care personnel; laboratory work; latex; morbidity; natural rubber; skin allergies; statistical evaluation; statistics; urticaria.
Contact Dermatitis, June 1999, Vol.40, No.6, p.329-331. Illus. 24 ref.

CIS 00-1060 Hoerauf K., Lierz M., Wiesner G., Schroegendorfer K., Lierz P., Spacek A., Brunnberg L., Nüsse M.
Genetic damage in operating room personnel exposed to isoflurane and nitrous oxide
To evaluate possible genetic damage in lymphocytes, exposure of operating room personnel to waste anaesthetic gases was measured. Venous blood samples were drawn and lymphocytes were cultured. The operating room personnel at the hospital were exposed to an 8-hour time weighted average of 12.8ppm nitrous oxide and 5.3ppm isoflurane. The mean sister chromatid exchange frequency was significantly higher in exposed workers than controls; the proportion of micronuclei was also higher but not significant. Exposure even to trace concentrations of waste anaesthetic gases may cause dose-dependent genetic damage. Concerning the micronuclei test, no clastogenic potential could be detected after average chronic exposure to waste anaesthetic gas. However, an increased frequency of sister chromatid exchanges in human lymphocytes could be detected.
Occupational and Environmental Medicine, July 1999, Vol.56, No.7, p.433-437. Illus. 28 ref.

CIS 00-779 Krishnan U., Janicak C.A.
Compliance with OSHA's respiratory protection standard in hospitals
Data from the US Occupational Safety and Health Administration (OSHA) inspections that occurred in hospitals and resulted in violations of the respiratory protection standards were examined. From July 1, 1990, to June 30, 1995, the complaint rates for hazards in the workplace significantly increased. During 1990-1991, tuberculosis hazard complaint inspections rates were approximately 5 complaints per 1,000 complaint inspections conducted. During 1994-1995, tuberculosis hazard complaint inspections rates were approximately 76 complaints per 1,000 complaint inspections conducted, representing an increase of over 15 times. During this same period, the percentage of respiratory protection violations in relation to all violations doubled. Increased employee awareness of the hazards and current safety laws could have contributed to the increased frequency of employee complaints, leading to increases in inspections, violations and fines. Employers must adhere to the current safety and health requirements specifically as they pertain to respiratory hazards and tuberculosis.
American Industrial Hygiene Association Journal, Mar.-Apr. 1999, Vol.60, No.2, p.228-234. Illus. 11 ref.

CIS 00-878 Knibbe J.J., Friele R.D.
The use of logs to assess exposure to manual handling of patients, illustrated in an intervention study in home care nursing
Logs registering the frequency of manual handling could be an option in nursing. The development of a log is accounted for and its use during an intervention, introducing 40 patient hoists in home care, is described. The exposure to manual handling was reduced significantly in the intervention group (average number of patient transfers per nurse/week 35-21). The control group remained stable (24-24). The reduction of exposure was only partly due to the hoists substituting manual transfers, suggesting the presence of an elimination effect. Possible explanations indicating that the hoists were partly responsible for this are: (1) the patients' relatives could now perform the transfers with the hoist; (2) hoists combine several manual transfers into one mechanical transfer; (3) hoists require only one operator for manual transfers that require two nurses. The log pointed to unpredicted elimination effects in addition to the substitution effects, and provided detailed information for evaluating the intervention.
International Journal of Industrial Ergonomics, Aug. 1999, Vol.24, No.4, p.445-454. 35 ref.

CIS 00-762 Check prevention - Social workers at institutions with residential facilities
Check prévention - Travail social en institution avec hébergement [in French]
Check preventie - Sociaal werk met inslapen [in Dutch]
This booklet is aimed at managers of institutions with residential facilities to help them conduct the occupational risk assessment required by Belgian legislation within their organization, and to enable them to keep track of areas that need improvement. A first section to be filled in consists of the names of workers and their occupations. This is followed by check lists concerning electrical safety, fire hazards, workers' health, equipment, residents, workplaces and buildings, emergency organization and first aid, and company policies and organization.
PREVENT, rue Gachard 88, Bte 4, 1050 Bruxelles, Belgium, 1999. 20p.

CIS 00-744 Niven K.
Accident costs in the NHS
Evaluation of accident costs in the British National Health Service (NHS) Topics: analysis of accident causes; cost of accidents; hospitals; notification of occupational accidents; plant safety organization; statistical aspects; survey; United Kingdom.
Safety and Health Practitioner, Sep. 1999, Vol.17, No.9, .34-38. Illus. 12 ref.

CIS 00-890 Böhle F.
Not only improved quality but also higher efficiency - Subjectifying work action in the care of the elderly
Nicht nur mehr Qualität, sondern auch höhere Effizienz - Subjektivierendes Arbeitshandeln in der Altenpflege [in German]
The usual mode of calculated, rational action is held to be inapplicable when caring for elderly persons, where current trends in rationalization and economy are shown to yield counterproductive, costly secondary effects. In this paper, specific work structure based on a "subjectifying" approach and the empirical evaluation of different situations are described. Consequences for the organization of care for the elderly focussing on quality and efficiency are discussed. The bases for the concept of "subjectifying" is a complex use of sensory perception, subjective feelings and empathy, as well as mental processes that are linked to actions and behaviours.
Zeitschrift für Arbeitswissenschaft, Aug. 1999, Vol.53, No.3, p.174-181. 23 ref.

CIS 00-371 Manual for paramedics on HIV/AIDS
This booklet aimed at paramedicals, patients and people dealing with HIV/AIDS patients provides practical information about safe behaviour and protective measures. Main topics covered: basic facts; how to protect oneself from AIDS; misconceptions about AIDS; precautions to be taken by health care workers (personal protective equipment, hygiene of the hands, management of body fluids, waste disposal).
Society for Participatory Research in Asia, 42 Tughlakabad Institutional Area, New Delhi, India, 1999. 30p. Illus.

CIS 00-535 Frostick S., Davies J., Kemp G., Manning D.
Health and Safety Executive
Manual handling injuries to workers attending the Royal Liverpool University Hospital
This report describes work conducted in three phases aimed at analysing the components of accidents in manual handling injuries (MHI) and comparing them to other injuries. 55% of MHIs occurred in 15 out of 130 occupational groups. Most frequently represented occupations were labourers, sales and shop assistants and drivers. In some occupations, such as scaffolders, stagers and steeplejacks, all injuries were MHIs. Moving and transporting stock or materials, construction and tidying were the most frequently mentioned activities associated with MHIs. Lifting, lowering, carrying, trying to jump clear, holding with both hands and moving backwards were body movements involved in more than 70% of the MHIs.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 1999. x, 71p. 17 ref. Price: GBP 25.00.

CIS 00-548 Preventing needlestick injuries in health care settings
This booklet is addressed to employers and workers in health care establishments. Health care workers exposed to needles are at an increased risk of needlestick injuries. Such injuries can lead to serious (even fatal) infections with bloodborne pathogens, such as hepatitis B and C viruses and human immunodeficiency virus (HIV). Case studies of needlestick injuries are presented. The brochure advises avoiding the unnecessary use of needles, using needleless and safer needle devices, and promoting education and safe work practices. It also presents intervention strategies for reducing the risks.
Publications Dissemination, National Institute for Occupational Safety and Health (NIOSH), 4676 Columbia Parkway, Cincinnati, OH 45226-1998, USA, Nov. 1999. 23p. Illus. 77 ref.

CIS 00-501
Health and Safety Executive
Asbestos: Medical guidance note
Guidance note aimed at doctors and other health professionals with responsibility for medical surveillance of employees exposed to asbestos, including information on action levels and exposure limits, health effects, medical surveillance, notification of asbestos-related diseases, and Social Security benefits. Asbestos properties, legislation and past uses are briefly described.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 6FS, United Kingdom, 3rd ed., 1999. 4p. 8 ref. Price: GBP 4.50.

CIS 00-546 Guastello S.J., Gershon R.R.M., Murphy L.R.
Catastrophe model for the exposure to blood-borne pathogens and other accidents in health care settings
Workers at three hospitals were surveyed on HIV-relevant exposures (needlesticks, cuts, splashes, contact with open wounds), the accident rate for broadly-defined injuries, and several occupationally relevant themes. A cusp (cubic polynomial) model predicting HIV-relevant exposures was more accurate than a linear model containing the same variables. Some of the variables predisposed workers to greater differences in HIV-relevant and general accident exposures: shiftwork, climate, depressive symptoms and workpace. Other variables governed how close an individual was to a critical threshold where a harmful incident would take place: verbal abuse, professional group membership. Similarly, a cusp model for accident incidents predicted from HIV-relevant exposures and occupational variables was also more accurate than comparison models. Two variables predisposed the worker to a greater accident risk: depression symptoms and shift work. Four other variables predisposed the worker to lesser accident risk: job satisfaction, safety climate, environment stressors and workpace.
Accident Analysis and Prevention, Nov. 1999, Vol.31, No.6, p.739-749. Illus. 15 ref.

CIS 00-555 Lawson S., Skevington J., O'Connell B., Ryan M., Sprigg V.
Evaluation of the clinical utility of mobility charts
This article reports the findings of a project that evaluated the utility of pre-designed mobility charts and stickers used to communicate a patient's mobility status and provide instructions on patient transferring techniques. A six-month trial of the mobility charts and stickers was undertaken on a combined orthopedic-rheumatology ward at a major hospital in Western Australia. A second ward with a comparable patient population (orthopedics) served as a comparison ward. The extent to which the stickers communicated clear, unambiguous instructions was also investigated. The trial revealed strong hospital staff support for the use of mobility charts. Nurses appraised the chart as being a useful, user-friendly communication tool that provided patient-specific information on transferring techniques. The findings also revealed that some stickers needed modification to enhance clarity of the instructions.
Journal of Occupational Health and Safety - Australia and New Zealand, Aug. 1999, Vol.15, No.4, p.365-371. Illus. 2 ref.

CIS 00-558 Bernacki E.J., Guidera J.A., Schaefer J.A., Lavin R.A., Tsai S.P.
An ergonomics program designed to reduce the incidence of upper extremity work related musculoskeletal disorders
In 1992, the Johns Hopkins Hospital and University in Baltimore (MD, USA) initiated a programme aimed at the early diagnosis and treatment of potential upper extremity work-related musculoskeletal disorders (UEWMSDs) among employees. The programme consisted of an ergonomic assessment of workplaces of employees with UEWSMSD, as well as the identification and correction of areas throughout the hospital and university where UEWMSDs could possibly occur. The programme resulted in an initial increase in the number and cost for the treatment of UEWMSDs. Subsequently, there was a significant decrease in the number of UEWMSDs reported and virtual elimination of the need to use surgical procedures to correct these conditions.
Journal of Occupational and Environmental Medicine, Dec. 1999, Vol.41, No.12, p.1032-1041. Illus. 59 ref.

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