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Health care services - 1,917 entries found

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CIS 05-617 Pechter E., Davis L.K., Tumpowsky C., Flattery J., Harrison R., Reinisch F., Reilly M.J., Rosenman K.D., Schill D.P., Valiante D., Filios M.
Work-related asthma among health care workers: Surveillance data from California, Massachusetts, Michigan, and New Jersey, 1993-1997
In this study on work-related asthma (WRA), cases were identified using physician reports and hospital discharge data in four states. Structured interviews were used to confirm cases and collect data on occupations and exposures associated with WRA. It was found that health care workers accounted for 16% of the 1879 confirmed WRA cases, but only 8% of the states' workforce. Cases were primarily nurses employed in hospitals. The most commonly reported exposures were to cleaning products, latex, and poor air quality. It is concluded that health care providers need to recognize the risk of WRA, since early diagnosis decreases the morbidity associated with the disease. Careful product purchasing and facility maintenance would decrease the risk.
American Journal of Industrial Medicine, Mar. 2005, Vol.47, No.3, p.265-275. 89 ref.

CIS 05-452 Hignett S.
Health and Safety Executive
Measuring the effectiveness of competency-based education and training programmes in changing the manual handling behaviour of healthcare staff
This study aimed to measure the impact of competency-based training on the manual handling behaviour of health care staff. Sixteen health care organizations representing both acute and primary care participated in the study. A questionnaire was developed to measure the level of compliance with the training recommendations at each participating organization. Four members of staff were also recruited at each organization and asked to perform the following patient handling tasks: sitting-to-standing transfer; repositioning in sitting; lying-to-lying transfer. Postural data were recorded and participants were interviewed. Results showed that there was a wide variation in the level of compliance. In general, a high level of compliance was found in organizations where staff had better problem-solving abilities, possibly due to higher levels of supervision and support in the workplace.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2005. x, 70p. Illus. 49 ref. Price: GBP 15.00. Downloadable version free of charge. [in English]

CIS 05-482 Ferreira J., Stanley L.
Health and Safety Executive
Evaluation of manual handling tasks involving the use of carry chairs by UK ambulance personnel
The emergency carry chair is an important manual handling aid, used by ambulance services as the primary method for transporting patients up and down stairs and into the ambulance. In this ergonomic study, eight ambulance personnel performed four simulated handling tasks that commonly involved the use of the carry chairs: transporting a patient up and down stairs, lifting a patient into the back of an ambulance, wheeling a patient up a 10° ramp, and negotiating a kerb. Force, posture and anthropometric data were combined into a biomechanical model to predict the risk of injury to the low back and the physical demands imposed on operators. The risk of musculoskeletal injury related to each of the tasks is discussed.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2005. viii, 73p. Illus. 31 ref. Price: GBP 25.00. Downloadable version free of charge. [in English]

CIS 04-560 Benavides F.G., Castejón J., Gimeno D., Porta M., Mestres J., Simonet P.
Certification of occupational diseases as common diseases in a primary health care setting
It is often difficult to discern whether a disease is an occupational or common disease, especially in a primary care setting. From a random sample of 322 workers attending a primary health care centre in Spain, 207 workers agreed to participate in this study aimed at determining the proportion of probable occupational diseases misclassified as common diseases by general practitioners. An occupational questionnaire was administered, and medical records of each participant were examined. The data were independently reviewed by two occupational physicians and a general practitioner. It was found that 33 of the 207 cases (15.9%) were probably related to occupational factors according to expert opinion, while in the workers' assessment, occupational factors accounted for 74 (35.7%) cases of disease. The consequences of these findings are discussed.
American Journal of Industrial Medicine, Feb. 2005, Vol.47, No.2, p.176-180. 24 ref.

CIS 04-590 Bourbonnais R., Brisson C., Malenfant R., Vézina M.
Health care restructuring, work environment and health of nurses
The objective of this cross-sectional study was to examine the psychosocial work environment and health of nurses in Quebec which has undergone significant restructuring in the past 15 years. It involved 2006 nurses from 16 health centers and a reference population of 2636 women employed in other occupations. They were given a questionnaire on work characteristics, psychological demands, decision latitude and social support at work from Karasek's Job Content Questionnaire, as well as on organizational changes and their state of health. Prevalence ratios and binomial regression were used to examine the associations between current work characteristics, changes and psychological distress. A considerable increase in the prevalence of psychological distress and adverse psychosocial work factors was found in comparison to the prevalence reported by a comparable group of nurses in 1994. These adverse factors were also more prevalent among nurses than among other Quebec working women.
American Journal of Industrial Medicine, Jan. 2005, Vol.47, No.1, p.54-64. 58 ref.


CIS 10-0027 Social dialogue in the health services: A tool for practical guidance
This guidance has been developed based on the findings of the Joint Meeting on Social Dialogue in Health Services, held from 21 to 25 October 2002 at the International Labour Office in Geneva, Switzerland. It is intended to provide a framework to manage and facilitate processes of social dialogue in health services. As a complement to the guidance, a companion handbook for practitioners provides practical direction, advice and exercises for the facilitators and organizers of the ILO constituents and other stakeholders in health services, to assist them in conducting training courses or to implement processes.
ILO Publications, International Labour Office, 1211 Genève 22, Switzerland, 2004. vii, 45p. Illus. 15 ref. (vol.1); vii, 79p. 15 ref. (vol.2). [in English] [in English]

CIS 08-1249 Guidelines for preventing workplace violence for health care and social service workers
Health care and social service workers are at high risk of violent assault at work. In 2000 in the United States, health service workers overall had an incidence rate of 9.3 for injuries resulting from assaults and violent acts. The rate for social service workers was 15, and for nursing workers, 25. This compares to an overall private sector injury rate of two. Aimed at employers in the health care and social services sector, these guidelines explain how to implement a violence prevention programme. Topics addressed: importance of management commitment and employee involvement; worksite analysis; hazard prevention and control; safety and health training; recordkeeping and programme evaluation.
Publications U.S. Department of Labor, Occupational Safety and Health Administration, 200 Constitution Avenue, Washington, D.C. 20210, USA, 2004. 44p. Illus. 40 ref. [in English]

CIS 08-500 Guidelines for preventing workplace violence for health care and social service workers
For many years, health care and social service workers have faced a significant risk of job-related violence. Assaults represent a serious safety and health hazard within these sectors of activity. The OSHA's violence prevention guidelines provide recommendations for controlling workplace violence, developed following a careful review of workplace violence studies, public and private violence prevention programs and input from stakeholders. This booklet provides an overview of the OSHA guidelines and presents the key elements of a violence prevention programme (management commitment and employee involvement, worksite analysis, hazard prevention and control, safety and health training, recordkeeping and programme evaluation), together with programmes and services proposed by OSHA.
Occupational Safety and Health Administration, 200 Constitution Avenue NW, Washington, DC 20210, USA, 2004. 44p. Illus. 40 ref. [in English]

CIS 07-981 Hodgson M.J., Reed R., Craig T., Murphy F., Lehmann L., Belton L., Warren N.
Violence in healthcare facilities: Lessons from the Veterans Health Administration
This cross-sectional study examined assault frequency and risk factors in health care. A questionnaire survey was carried out in 142 hospitals. Thirteen percent of employees described at least one assault in the previous year, with the proportion assaulted per facility ranging from 1% to 26%. Patients were the most common assaulters. Working in geriatrics, psychiatry and rehabilitation represented a high risk for assault. Hours of work and work patterns represented major risk factors for assault, as were high measures of organizational stress. Training in dispute resolution strategies was associated with lower rates of assaults. Possible strategies to reduce violence are discussed.
Journal of Occupational and Environmental Medicine, Nov. 2004, Vol.46, No.11, p.1158-1165. Illus. 22 ref.

CIS 07-980 Escribà-Agüir V., Tenías-Burillo J.M.
Psychological well-being among hospital personnel: The role of family demands and psychosocial work environment
This cross-sectional study was carried out to investigate the effect of gender role and the psychosocial work environment on the psychological well-being of staff at two hospitals in Spain. A total of 313 workers were surveyed on their psychological well-being by means of a self- administered questionnaire. Findings are discussed. Subjects with a very good marital relationship had less risk of presenting bad mental health (odds ratio (OR) 0.43), and limitation in the social function (OR 0.43) and emotional role (OR 0.35). Those who dedicated more than 30h per week to domestic chores had a higher risk of limitation of social function (OR 2.48). Those exposed to high psychological demands presented a higher probability of poor mental health (OR 1.77). Finally, workers exposed to low job social support had a higher risk of poor mental health (OR 1.86), low vitality (OR 2.21) and limitation in the social function (OR 1.88).
International Archives of Occupational and Environmental Health, Aug. 2004, Vol.77, No.6, p.401-408. 35 ref. [in English]

CIS 07-238 Employment relations and union services: Health and safety - Workplace stress
This guide is aimed at safety representatives of health service unions in the United Kingdom. Topics addressed: definition and causes of stress at work; effects of stress on workers; effects of stress on the organization; stress among health services workers and physiotherapists; role of the Health and Safety Executive; stress research; responsibilities of employers; United Kingdom laws and regulations; jurisprudence; role of safety representatives.
The Chartered Society of Physiotherapy, 14 Bedford Row, London WC1R 4ED, United Kingdom, May 2004. 36p. 42 ref. [in English]

CIS 07-208 Bleyer T., Hold U., Macheleidt M., Müller-Arnecke H.W., Rademacher U., Windel A.
Bundesanstalt für Arbeitsschutz und Arbeitsmedizin
Lifting and carrying aids in emergency services - Compilation and examination of major interfaces
Hebe- und Tragehilfen im Rettungsdienst - Zusammenstellung und Betrachtung wesentlicher Schnittstellen [in German]
Factors such as patient weight, the narrowness of stairways and landings and the use of lifting aids have an impact on the physical load of the bearer's body during patient transport or emergency operations. This study evaluates various transport aids from the standpoint of their ease of handling and flexibility of use. By means of an ergonomic evaluation, it examines the interfaces between aids and bearers. An analysis of patient transport operations also provides information on postures and movements, particularly with respect to the hand-arm system. Recommendations are proposed for optimizing the use of various aids on the basis of the overall information gathered, taking ergonomic and anthropometric aspects into account.
Wirtschaftsverlag NW, Postfach 10 11 10, 27511 Bremerhaven, Germany, 2004. 140p. Illus. 54 ref. Price: EUR 14.00.,xv=vt.pdf [in German]

CIS 06-1053 Violence - Occupational hazards in hospitals
Violencia - Peligros ocupacionales en los hospitales [in Spanish]
Spanish translation of the document indexed under CIS 03-562. This booklet aims to increase worker and employer awareness of the risk factors for violence in hospitals and to provide strategies for reducing exposure to these factors. Topics covered: types of workplace violence; workers at risk; areas where violence may occur; effects of violence (injury, disability, psychological trauma, death); risk factors; prevention strategies for employers; dealing with the consequences of violence; safety tips for hospital workers; case reports of effective strategies.
Publications Dissemination, National Institute for Occupational Safety and Health (NIOSH), 4676 Columbia Parkway, Cincinnati, OH 45226-1998, USA, 2004. iii, 11p. 9 ref. [in Spanish] [in Spanish] [in English]

CIS 06-967 Wilburn S.Q., Eijkemans G.
Preventing needlestick injuries among healthcare workers: A WHO-ICN collaboration
Effective measures to prevent infections from occupational exposure of healthcare workers to infected blood include immunization against hepatitis B virus, eliminating unnecessary injections, implementing universal precautions, eliminating needle recapping, disposing of the sharp into a sharps container immediately after use, use of safer devices such as needles that sheath or retract after use, provision and use of personal protective equipment and training workers in the risks and prevention of transmission. Post-exposure prophylaxis with antiretroviral medications can reduce the risk of HIV transmission by 80%. In 2003, the World Health Organization (WHO) and the International Council of Nurses (ICN) launched a pilot project in South Africa, Tanzania and Vietnam to protect healthcare workers from needlestick injuries. The results of the pilot will be disseminated worldwide, along with best policies and practices for prevention.
International Journal of Occupational and Environmental Health, Oct.-Dec. 2004, Vol.10, No.4, p.451-456. Illus. 35 ref.

CIS 06-848 Felknor S.A., Sequeira L.F., Weinger M., Burau K.D., De Mezerville L., Delclos G.
Worker safety training in public hospitals in Costa Rica
The development and implementation of a worker safety training programme for the public hospital system in Costa Rica is described. The programme was developed under a collaborative agreement between the Costa Rican Social Security System and the University of Texas School of Public Health. A national survey to assess safety in public hospitals revealed high rates of injury, under-reporting of injuries and a lack of worker safety training. A programme based on the results of the survey was implemented using a training-of-trainers model. It created opportunities for human resources development in occupational health in the hospital system, allowed for the sustainability of the training effort and reduced the dependency on external funding. Over 3,700 workers and 57 trainers were trained in the first three years of the programme.
International Journal of Occupational and Environmental Health, Oct.-Dec. 2004, Vol.10, No.4, p.445-450. Illus. 13 ref.

CIS 06-966 De Schryver A.A., Van Hooste W.L., Van Winckel M.A., Ven Sprundel M.P.
Heliobacter pylori infection: A global occupational risk for healthcare workers?
This literature review on the occupational risks from Helicobacter pylori, a major cause of gastroduodenal diseases, was carried out to identify the risks to specific groups of healthcare workers. The risks were found to be highest for gastroenterologists, certain categories of nurses and workers caring for persons with mental disability. Results for other groups are not conclusive.
International Journal of Occupational and Environmental Health, Oct.-Dec. 2004, Vol.10, No.4, p.428-432. 72 ref.

CIS 06-965 Chen-Yeung M.
Severe acute respiratory syndrome (SARS) and healthcare workers
Severe acute respiratory syndrome (SARS) is caused by a novel coronavirus, transmitted from human to human by aerosols or by direct contact. This article reviews how health care workers (HCWs) became infected during the outbreak of the disease in Hong Kong and describes the infection-control measures put in place. Risk factors for infection in HCWs included lack of awareness and preparedness when the disease first struck, poor institutional infection control measures, lack of training in infection control procedures, poor compliance with the use of personal protection equipment (PPE), exposure to high-risk procedures such as intubation and nebulization, and exposure to unsuspected SARS patients. Measures to prevent nosocomial infection include: establishing isolation wards for triage, SARS patients and convalescence; training and monitoring hospital staff in infection-control procedures; active and passive screening of HCWs; enforcement of droplet and contact precautions; and compliance with the use of PPE.
International Journal of Occupational and Environmental Health, Oct.-Dec. 2004, Vol.10, No.4, p.421-427. Illus. 32 ref.

CIS 06-480 Johnsson C., Kjellberg K., Kjellberg A., Lagerström M.
A direct observation instrument for the assessment of nurses' patient transfer technique (DINO)
The aim of this project was to develop and test a direct observation instrument to assess the work technique of nursing personnel during patient transfers. The instrument consists of 16 items divided into the three phases of a transfer: the preparation, performance and result phases. To quantify the assessments, a scoring system was developed, giving an overall score for each transfer, depending on the level of risk to musculoskeletal health and safety. Four observers assessed 45 patient transfers at hospital wards using this instrument. Results showed that the inter-observer reliability and criterion-related validity of the instrument were satisfactory.
Applied Ergonomics, Nov. 2004, Vol.35, No.6, p.591-601. Illus. 37 ref.

CIS 06-450 Jarke J.
Health service personnel with chronic HBV, HCV and HIV infections - Guidelines for work versus exclusion from the profession
Chronisch HBV-, HCV-, HIV-infiziertes Personal im Gesundheitsdienst - Regelungen zur Berufsausübung versus Berufsverbote [in German]
Patients at health care centres should be effectively protected against viral infections (hepatitis, HIV) transmitted by infected health care personnel. While the occupational physician is responsible for health and safety at work rather than for protecting the patient, they must act with regard to the well-being of the patient. In Germany, no guidelines have been issued for the protection of patients which could serve as a guide to occupational physicians, infected health care workers and employers. Nevertheless, recommendations published by scientific institutions provide sufficient guidance for rational measures to be drawn up to allow infected workers to continue in their occupation and to enable employers to carry out their duties in accordance with labour laws. Unfortunately, those in charge often make decisions on an irrational or emotional basis, leading to discrimination and injustice for health care workers. It is argued that a legal directive is urgently needed.
Arbeitsmedizin - Sozialmedizin - Umweltmedizin, 2004, No.8, p. 428-434. 12 ref.

CIS 06-476 Newell T.M., Kumar S.
Prevalence of musculoskeletal disorders among orthodontists in Alberta
In a survey of musculoskeletal disorders (MSDs) among dental professionals, a standardized Nordic questionnaire was mailed out to all registered orthodontists in Alberta, Canada. There was a 52.4% response rate from a sample of 61. Results showed low back trouble to be the most prevalent MSD (59%), followed by neck (56%) and shoulder trouble (47%). There were no significant differences in MSD prevalence between men and women and no correlations existed between age, years of work and number of hours of practice per week. It is suggested that further attention should be directed towards risk factors and ergonomic intervention.
International Journal of Industrial Ergonomics, Feb. 2004, Vol.33, No.2, p.99-107. Illus. 16 ref.

CIS 06-425 Nevala N., Tamminen-Peter L.
Ergonomics and usability of an electrically adjustable shower trolley
The aim of this study was to investigate the musculoskeletal, cardio-respiratory and perceived work strain for nurses performing bathing tasks using two types of shower trolley: one with electrically-adjustable height and a turning mechanism and a traditional trolley with hydraulically-adjustable height but without a turning mechanism. The subjects were 12 healthy female nurses. Measurements of muscular activity, heart rate, perceived strain and perceptions of the shower trolleys were carried out during a normal workday. The muscular activity of the back muscles and the perceived musculoskeletal strain after work were lower with the electrically-adjustable trolley than with the traditional trolley. The usability features were perceived to be better for the electrically-adjustable trolley. There were no significant differences in the muscular activity of the trapezius muscles or the cardio-respiratory strain between the two types of trolleys.
International Journal of Industrial Ergonomics, 2004, Vol.34, No.2, p.131-138. Illus. 40 ref.

CIS 06-246 Fujiwara K., Tsukishima E., Kasai S., Masuchi A., Tsutsumi A., Kawakami N., Miyake H., Kishi R.
Urinary catecholamines and salivary cortisol on workdays and days off in relation to job strain among female health care providers
This study examined the effects of psychosocial job strain on the excretion of neuroendocrine stress hormones (adrenaline, noradrenaline, and cortisol) on workdays and days off. 16 Japanese female health care providers filled out Karasek's job content questionnaire and had their neuroendocrine excretions (ie, urinary catecholamines and salivary cortisol) measured on a day off and on two workdays (one day shift and one night shift). Noradrenaline excretion was significantly greater over time in the high-strain group than in the low-strain group, and that of the high-demand group was significantly greater over time than that of the low-demand group. Adrenaline excretion did not significantly differ as a function of strain or demand, but was significantly higher in the group with high supervisory support than the group with low supervisory support. The concentration of salivary cortisol on a dayshift was significantly lower in the high-strain group than in the low-strain group. The implications of these findings are discussed.
Scandinavian Journal of Work, Environment and Health, Apr. 2004, Vol.30, No.2, p.129-138. Illus. 45 ref.

CIS 06-230 Borges A., Maizlish N., Loreto V.
Low back pain among female infirmary workers in Venezuela
Lumbalgia ocupacional en enfermeras venezolanas [in Spanish]
A questionnaire survey of 302 female workers was carried out in two hospitals in Venezuela. Subjective assessments of low-back pain were examined in relation to observed occupational risk factors. The prevalence of current low-back pain was 28% and prevalence of frequent pain during the previous year was 48%. Significant associations were found between low-back pain and tasks involving uncomfortable positions of the trunk and the lifting of loads and with the intensity of work. Menstruation and smoking were significant non-occupational risk factors.
Salud de los Trabajadores, Jan. 2004, Vol.12, No.1, p.19-32. 28 ref.

CIS 05-733 Kumar S., Moro L., Narayan Y.
Morbidity among X-ray technologists
A questionnaire survey of occupational and non-occupational health factors was carried out among a random sample of 20 volunteer X-ray technologists from two University hospitals. Participants were from 20 to 53 years of age and 89% were physically active. Despite their relatively young age and active lifestyle, they suffered from significant and diverse musculoskeletal problems. Eighty three percent had backache, 39% of female respondents had neck pain and 28% has shoulder pain. The pain was aggravated by work activities and relieved by rest, massage, the application of heat or ice and exercise. Most suffered multiple episodes of pain and half of the female sample suffered from upper extremity pain.
International Journal of Industrial Ergonomics, Jan. 2004, Vol.33, No.1, p.29-40. 21 ref.

CIS 05-647 Jungbauer F.H.W., Van der Harst J.J., Groothoff J.W., Coenraads P.J.
Skin protection in nursing work: Promoting the use of gloves and hand alcohol
Exposure to skin irritants is a cause of occupational skin disease in nurses. In this study, the effectiveness of soap and water, alcohol-based hand rubs and gloves in prevention programmes was investigated. In particular, two recommended procedures were evaluated: use of alcohol-based hand rubs instead of soap and water in disinfection procedures when the hands are not visibly dirty, and use of gloves in wet activities such as patient washing. The effectiveness of these recommendations was investigated in healthy volunteers over a period of three weeks, five days a week. An increase in transepidermal water loss (TEWL) occurred with the regular prevention method, while mean TEWL decreased among subjects using the recommended method. Skin irritation from occlusion by gloves appeared to be more pronounced in the regular method compared to the recommended method. The results of this study justify the conclusion that in nursing work, alcohol-based hand rubs are the preferred disinfectants.
Contact Dermatitis, Sep. 2004, Vol.51, No.3, p.135-140. Illus. 23 ref.

CIS 05-747 Lakowo S., Soares J.J.F., Nolan P.
Violence towards psychiatric staff: A comparison of gender, job and environmental characteristics in England and Sweden
This study compares violence encountered by staff at mental institutions in Sweden and the United Kingdom. Psychiatric personnel from the United Kindgom (301 nurses and 74 psychiatrists) and Sweden (745 nurses and 306 psychiatrists) were assessed by means of a questionnaire covering working conditions and exposure to violence. Analysis showed an association between being abused and being male, of young age, British and a nurse. Multivariate logistic regression confirmed that British female and male nurses were the main risk group for exposure to violence. Interventions thus need to be sensitive to gender differences, societal context, professional roles and interactions between them. Furthermore, clinical supervision and team functioning, together with organizational and environmentally friendly settings, may help reduce violence in mental institutions.
Work and Stress, Jan.-Mar. 2004, Vol.18, No.1, p.39-55. 70 ref.

CIS 05-466 Leszczyszyn-Pynka M., Kłys-Rachwalska M., Sacharczuk B., Boroń-Kaczmarska A.
Occupational exposure to human immunodeficiency virus (HIV) - How can we reduce the risk?
The aim of this study was to analyse occupational exposure to potentially infectious body fluids among health care workers (HCWs) in a region of Poland. Nurses were the most commonly exposed category of HCWs. Needle-sticks were responsible for 73.6% of the incidents, while recapping a needle was the cause of exposure in 6.9% of the incidents. Prophylaxis with antiretroviral drugs was necessary in 22.8% of the cases. Among 189 registered nurses, 66 performed invasive procedures without any personal protective equipment. As many as 60.3% of exposures to potentially infectious material result from non-compliance with the relevant recommendations. Continuous education and training is critically needed to prevent occupational exposure to blood-borne infections among HCWs.
International Journal of Occupational Safety and Ergonomics, 2004, Vol.10, No.4, p.425-429. 15 ref.

CIS 05-464 Andersen C.I., Von Essen S.G., Smith L.M., Spencer J., Jolie R., Donham K.J.
Respiratory symptoms and airway obstruction in swine veterinarians: A persistent problem
This cross-sectional study was conducted during the American Association of Swine Veterinarians annual meeting. The 122 subjects (median age 42.5 years) completed a respiratory symptom and work history questionnaire and performed spirometry. Work-related symptoms included rhinitis (69%), cough and chest tightness (53%) and wheezing (31%). Airway obstruction was seen in 24% of participants. Veterinarians with airway obstruction reported working more hours per week in hog barns than did practitioners with normal pulmonary function.
American Journal of Industrial Medicine, Oct. 2004, Vol.46, No.4, p.386-392. 49 ref.

CIS 05-300 Jansen J.P., Morgenstern H., Burdorf A.
Dose-response relations between occupational exposures to physical and psychosocial factors and the risk of low back pain
To assess dose-response relations between occupational exposures to physical and psychosocial factors and the risk of low back pain, a cohort of 523 subjects, working in nursing homes and homes for the elderly, was followed for one year. Physical load for different occupations was assessed by quantitative observations at the workplace. Information on low back pain and other factors was gathered with questionnaires administered at baseline and at one year. Two outcome measures of low back pain incidence were used: any new episode of pain lasting for at least a few hours during follow up (LBP); and any new episode of disabling pain that interfered with daily activities during follow up (LBP/D). Results indicate that the risk of LBP was not associated with physical factors, but this outcome was inversely associated with age and weakly, though imprecisely, associated with two psychosocial factors (low decision authority and high work demands). In contrast, the risk of LBP/D was positively associated with age and not associated with the psychosocial factors. Occupational exposure to trunk flexion over 45 degrees appears to be a risk factor for low back pain with disability.
Occupational and Environmental Medicine, Dec. 2004, Vol.61, No.12, p.972-979. 33 ref.

CIS 05-467 Dement J.M., Epling C., Østbye T., Pompeii L.A., Hunt D.L.
Blood and body fluid exposure risks among health care workers: Results of the Duke health and safety surveillance system
The objective of this research was to better define the blood and body fluids (BBF) exposure risk and risk factors among a cohort of health care workers. 24,425 health care workers were followed for BBF exposure events from 1998 to 2002. 2,730 BBF exposures were reported during the study period, corresponding to a total annual rate of 5.5 events per 100 full-time equivalents and a percutaneous exposure rate of 3.9. Higher rates were observed for males, persons employed less than four years, Hispanic employees, and persons less than 45 years of age. Even higher rates were observed for house staff, nurse anaesthetists, inpatient nurses, phlebotomists and operating room technicians. Rates of percutaneous exposures from hollow needles were found to decrease over the study period; however, exposure rates from suture needles appear to be increasing.
American Journal of Industrial Medicine, Dec. 2004, Vol.46, No.6, p.637-648. Illus. 38 ref.

CIS 05-428 Gauron C.
Medical practice and ionizing radiation: Information sheets to help analyse the hazards
Médecine et rayonnements ionisants: des fiches d'aide à l'analyse des risques [in French]
Following a survey on radiation protection conducted in the Ile-de-France region, a pluridisciplinary working group comprising several institutions and various experts published a series of information sheets aimed at helping analyse the hazards of conventional and interventional radiology. These sheets summarize information on radiation protection by type of activity and cover the following aspects: relevant legislation; fixed equipment in medical settings; mobile equipment in medical settings; scanography in medical settings; interventional radiology in medical settings (for short and long-tem treatment).
Documents pour le médecin du travail, 4nd Quarter 2004, No.100, p.469-497. Illus.$FILE/tc100.pdf [in French]

CIS 05-233 Debbabi F., Chatti S., Magroun I., Maalel O., Mahjoub H., Mrizak N.
Night work: Its consequences on the health of hospital staff
Le travail de nuit: ses répercussions sur la santé du personnel hospitalier [in French]
Night work and its consequences on health and social life were studied in 118 health care workers at the two university hospitals in Sousse, Tunisia. A case-control study nested in a cross-sectional study was conducted from January to April 1999, based on a standardized questionnaire. It was found that sleep disturbances consisting of difficulties in falling asleep and restless sleep were significantly higher in night workers than in day workers. Gastro-intestinal complaints were found in 38.2% of the night workers and 23.8% of the day workers respectively. Weight gains were noted in 32.7% of night workers and in 7.9% of day workers. The neuropsychic disturbances found in 76.3% of night workers and 31.7% of day workers were mainly memory disorders, anxiety, stress during work and mental fatigue.
Archives des maladies professionnelles et de médecine du travail, Oct. 2004, Vol.65, No.6, p.489-492. 23 ref.

CIS 05-124 Preventing occupational exposures to antineoplastic and other hazardous drugs in health care settings
The purpose of this booklet is to increase awareness among health care workers and their employers about the health risks posed by working with antineoplastic and other hazardous drugs. Contents: background; potential for worker exposure; conditions for exposure; exposure routes; evidence for worker exposure; evidence for health effects in workers; current standards and recommendations; case reports; conclusions and recommendations (recommended procedures, receiving and storage, drug preparation and administration, ventilated cabinets, cleaning, housekeeping, waste disposal). A list of drugs that should be handled as hazardous drugs is included in an appendix.
Publications Dissemination, National Institute for Occupational Safety and Health (NIOSH), 4676 Columbia Parkway, Cincinnati, OH 45226-2002, USA, Sep. 2004. viii, 50p. 155 ref. [in English]

CIS 05-231 David C.
Infectious wastes - Disposal of health care sector and similar wastes involving infection hazards
Déchets infectieux - Elimination des DASRI et assimilés [in French]
Many occupational groups are involved with the management of infectious wastes. This guide presents the various regulations concerning the disposal of infectious health care waste and body parts. It describes the sectors of activity that are involved, measures concerning the packing, storage, transport, pre-treatment, incineration or cremation and traceability of the waste, as well as the training and information of persons at risk of exposure.
Institut national de recherche et de sécurité, 30 rue Olivier-Noyer, 75680 Paris Cedex 14, France, June 2004. 50p. Illus. 24 ref. Price: EUR 7.30. Downloadable version free.$FILE/ed918.pdf [in French]

CIS 05-228 Salico de Sosa S.H.
Biological safety in blood banks
Bioseguridad en bancos de sangre [in Spanish]
Blood banks are responsible for collecting and preparing blood formulations for transfusion. These operations need to be carried out with care to avoid the exposure of personnel, donors and patients. This article describes the hazards that are inherent in the activities of blood banks (chemical, physical, psychological and social hazards, but primarily biological hazards related to blood exposure), the biological safety measures to be adopted, prophylaxis (vaccination against HBV, possibly with injection of IgG) and the procedure to adopt in the event of an accident, in particular when involving exposure to contaminated blood. Current Argentinean biological safety standards and regulations are also cited.
Salud Ocupacional, Jan.-Mar. 2004, Vol.XXII, No.88, p.7-14. Illus. 13 ref.

CIS 05-227 Insausti Macarrón D., Caso Pita C., Rodríguez de la Pinta M.D., Gómez Parra I.R., Lucas J.C., Cruzet Fernández F.R.
Hepatitis C virus infection among health care personnel following accidents involving biological material
Infección por virus de hepatitis C en profesionales sanitarios tras accidente con material biológico [in Spanish]
The objective of this study was to analyse cases of hepatitis C virus (HCV) infections that occurred following accidents involving biological material reported between 1991 and 2002 among the health care personnel of a Spanish hospital. Data were collected by means of a questionnaire. 554 needlestick injuries with potential HCV contamination were reported during the study period. Five workers were infected, corresponding to an overall risk of 0.9%. Unexpected situations being difficult to avoid, it is advised that health care personnel be provided with safe equipment and that accident cases be followed so as to allow the early detection and efficient treatment of cases.
Medicina y seguridad del trabajo, June 2004, Vol.L, No.195, p.31-38. 25 ref.

CIS 05-196 Uribe Llopis P., Barbero del Palacio P., Bernat Jiménez A., Rodríguez de la Pinta M.L., Cruzet Fernández F.
Preventive action aimed at limiting noise in a hospital laundry
Acción preventiva correctora del ruido en una lavandería hospitalaria [in Spanish]
This article describes the preventive actions that were undertaken in a hospital laundry to lower the noise level below the intervention level 1 specified in Royal Decree 1316/1989 (CIS 91-287). The intervention involved insulating the two industrial dryers that generated high noise levels in all work zones. Noise level measurements were carried out before and after the fitting of the insulating enclosure. Results indicate that an important decrease in noise level was achieved, down to values that do not represent a risk to workers.
Medicina y seguridad del trabajo, Mar. 2004, Vol.L, No.194, p.37-42. Illus. 9 ref.

CIS 05-226 Caso Pita C., Insausti Macarrón D., Rodríguez de la Pinta M.L., Lucas J.C., Alonso Cobo M.T., Cruzet Fernández F.
Viral hepatitis among health care workers: Time trends
Hepatitis víricas en personal sanitario: Evolución temporal [in Spanish]
The objective of this study was to examine the trends in the incidence of viral hepatitis cases among workers of a Spanish hospital between 1979 and 2003. 253 cases of occupational disease caused by a biological agent were recorded during this period, including 89 cases of hepatitis (35.2%). The distribution of hepatitis cases by category of staff shows that qualified nurses and physicians are the most affected. The incidences of all types of hepatitis and hepatitis B show a decreasing trend during the study period, with very low rates since 1985 when hepatitis B vaccination was first introduced. A significant decrease was also observed for hepatitis C or non-A, non-B (NANB) hepatitis.
Medicina y seguridad del trabajo, Mar. 2004, Vol.L, No.194, p.11-21. Illus. 47 ref.

CIS 04-678 Jost M., Rüegger M., Liechti B., Gutzwiller A.
Safe handling of cytostatic substances
Sicherer Umgang mit Zytostatika [in German]
Sécurité dans l'emploi des cytostatiques [in French]
Contents of this booklet on the prevention of hazards during the handling of cytostatic substances in health care settings: hazards during the handling of cytostatic substances; workplace hazard evaluation; principles to be adopted for the safe handling of cytostatic substances; protective measures during the production and preparation of cytostatic substances; protective measures during transport, administration to patients and disposal of cytostatic substances; protective measures in cases of accidental release; personal hygiene measures; legal aspects.
Suva, Abteilung Arbeitsmedizin, Postfach, 6002 Luzern, Switzerland, 2004. 66p. Illus. 82 ref. [in German] [in French]

CIS 04-628 Gilles L., Favier B., Lombard I., Ardiet C., Boufercha R., Catros F., Eppling I., Fourmaintraux D., Gondran C., Merle J.L., Pelletier A., Roussel A., Latour J.F.
Cytotoxic drugs: Evaluation of the impact of purging intravenous lines on the exposure of nursing staff
Médicaments cytotoxiques: évaluation de l'impact de la purge des lignes de perfusion sur l'exposition du personnel infirmier [in French]
Occupational exposure to cytotoxic agents is recognized as a potential hazard to health care workers. However, the level of contamination of nurses during the administration of drugs remains unknown. The objective of this study was to assess exposure of nurses to 5-fluoro-uracil (5FU) after connecting intravenous infusion bags containing this drug to the patients. Eight regional cancer treatment centres participated in the study and were distributed into two groups according to the way of purging intravenous lines: with the solvent (group A) or with the antineoplastic agent (group B). Samples were taken on nurses' gloves during drug administration. 127 samples were collected and analysed. Gloves appeared to be more often contaminated with 5FU in group B than in group A (65.6% and 34.9% respectively). Similarly, the mean amounts detected were lower in group A (1350ng) than in group B (10,800ng). These results suggest that the use of infusion sets purged with the solvent makes it possible to reduce nurses' exposure. Nevertheless, as the levels of 5FU still remain important, this study confirms the obligation to wear protective gloves during administration and to implement a quality assurance system that includes training and regular evaluation of the staff.
Archives des maladies professionnelles et de médecine du travail, Mar. 2004, Vol.65, No.1, p.9-17. Illus. 23 ref.

CIS 04-713 Ravallec C.
Health care wastes that present infectious hazards - Waste disposal system
Déchets d'activités de soins à risque infectieux - La filière d'élimination [in French]
Health care wastes that present infectious hazards are an important public health issue. These potentially contaminated wastes are generated during medical or veterinary activities, and may expose persons handling or otherwise coming into contact with them to biological hazards such as HIV, HBV or HCV. Approximately 155,000 tons of these wastes are generated each year in France. Their disposal requires the involvement of specialized waste disposal enterprises, which apply strict traceability controls at each step. Precautions need to be taken starting from the time the wastes are generated. They need to be placed in suitable packaging according to the type of waste and the hazard it involves. Separation should be carried out at the source. Intermediate storage of these packages should be in containers placed in a suitable area that satisfies precise criteria. Waste collection should be carried out by persons specially trained with respect to biological hazards. Important precautionary measures should be taken during the incineration of these wastes. Empty containers should be washed and disinfected before being re-introduced into the collection cycle.
Travail et sécurité, July-Aug. 2004, No.642, p.28-39. Illus.$File/TS642page29.pdf?OpenElement [in French]

CIS 04-601 Balty I.
Proctective gloves in the health care sector
Gants de protection pour les métiers de santé [in French]
In health care settings, using gloves that are suited to the task contributes to the safety of both health care staff and their patients. Consequently, one needs to understand the advantages and limitations of the various types of gloves and their constituent materials. This practical safety information sheet presents the regulations and standards that apply to protective gloves, together with good practices for their use. Contents: types of gloves; efficiency of gloves with respect to protecting against biological hazards; good practices in the use of gloves. In boxes: materials used in glove manufacture; prevention of allergies; regulations and standards.
Travail et sécurité, May 2004, No.640, insert 4p. Illus. 5 ref.$FILE/visu.html?OpenElement [in French]

CIS 04-655 Goyer N., Beaudry C., Bégin D., Bouchard M., Carrier G., Gely O., Gérin M., Lefebvre P., Noisel N., Perrault G.
Impacts of the lowering of the permissible exposure value for formaldehyde - Group 3: Other sectors
Impacts d'un abaissement de la valeur d'exposition admissible au formaldéhyde - Groupe 3: Autres secteurs [in French]
The objective of this study was to assess the number of workers in a variety of industries and sectors in Quebec that would be exposed to excessive formaldehyde concentration levels and the cost of compliance per worker as a function of the various possible threshold limit values under consideration. This specific study was carried out within the framework of a large research programme aimed at evaluating the health and socio-economic impacts of lowering the current maximum permissible exposure value for formaldehyde of 2ppm to one of the values of 1.0, 0.75 or 0.3ppm, either as maximum or 8-hr time-weighted average values. (See also CIS 04-642 to 04-651, CIS 04-653 and CIS 04-654).
Institut de recherche en santé et en sécurité du travail du Québec (IRSST), 505 boul. de Maisonneuve Ouest, Montreal (Quebec) H3A 3C2, Canada, 2004. 97p. 94 ref. Price: CAD 8.56. Downloadable version (PDF format) free of charge. [in French]

CIS 04-716 Denis M.A., Ecochard R., Bernadet A., Forissier M.F., Porst J.M., Robert O., Volckmann C., Bergeret A.
Blood exposure incidents: Importance of an early warning system
Accidents d'exposition au sang: intérêt d'un "système sentinelle" [in French]
This study highlights the importance of an early warning system for blood exposure incidents for determining case-by-case preventive actions when it is observed that a specific health care action presents a higher-than-expected frequency of incident occurrence (warning threshold). It presents the results of a database compilation of incidents having occurred in public hospitals in Lyon, France, between 1996 and 2003, together with their analysis. This analysis led to the evaluation and selection of safety equipment and enabled the introduction of specific and sustainable preventive and collaborative measures.
Documents pour le médecin du travail, 3rd Quarter 2004, No.99, p.383-387. 8 ref.

CIS 04-432 Antineoplastic agents - Occupational hazards in hospitals
The purpose of this booklet is to create awareness among health care workers of the adverse health effects of antineoplastic agents, to explain how one can be exposed to these agents, and to propose control methods and work practices to prevent or reduce exposure to these agents. Contents: health effects caused by antineoplastic agents; persons at risk of exposure to antineoplastic agents; when workers are at greatest risk of exposure; how to protect oneself from exposure; safety tips; case reports.
Publications Dissemination, National Institute for Occupational Safety and Health (NIOSH), 4676 Columbia Parkway, Cincinnati, OH 45226-2002, USA, Sep. 2004. iii, 13p. 29 ref. [in English]

CIS 04-381 Yamauchi H.
Effects of night work on urinary excretion rates of 6-sulfatoxymelatonin, norepinephrine and estriol in pregnant women
The objective of this study was to assess the effects of night work on the biological functions of pregnant women. Three pregnant and six non-pregnant nurses working in shifts cooperated for the study. Urine samples were collected during the day shift, the night shift and the days off. Urinary concentrations of 6-sulfatoxymelatonin and norepinephrine were measured by enzyme-linked immunosorbent assay and estriol by radioimmunoassay. Excretion profiles of urinary 6-sulfatoxymelatonin in the pregnant and the non-pregnant women were altered on the night shift, which could be caused by the disturbance in the circadian rhythms of melatonin secretion. Among the pregnant women, urinary norepinephrine levels during the night work were considerably higher, while the effect of night work on urinary estriol level of the pregnant women remained uncertain.
Industrial Health, Apr. 2004, Vol.42, No.2, p.268-276. Illus. 39 ref.

CIS 04-408 Leggat P.A., Kedjarune U., Smith D.R.
Toxicity of cyanoacrylate adhesives and their occupational impacts for dental staff
Cyanoacrylate (CA) and its homologues have a variety of medical, dental and industrial applications as adhesives. The increasing use of CA in dentistry, particularly as an adhesive and sealing glue, has raised concerns regarding its potential toxicity in humans. Although the reported toxicity of CA is uncommon in the dental workplace, possible effects include urticaria, contact dermatitis and other dermatoses. Dental staff using CA adhesives should avoid direct contact with CA and use appropriate personal protective measures. Furthermore, maintaining higher levels of humidity, optimizing room ventilation and using special air conditioning filters in the working environment may be useful in minimizing the toxicity of volatile CA adhesives.
Industrial Health, Apr. 2004, Vol.42, No.2, p.207-211. 32 ref.

CIS 04-378 Álvarez González A., Yuste Grijalba J., Sánchez-Arcillas Conejo I.
Evaluation of occupational hazards in hospitals based on homogenous functional groups and on the Gescesan method
La evaluación de los riesgos laborales en los centros hospitalarios basada en los grupos funcionales homogéneos y en el método Gescesan [in Spanish]
An analysis of the advantages and drawbacks of the Gescesan hospital hazard evaluation method was carried out. This method consists of a computer-based application supplied by the Spanish National Institute for Occupational Hygiene and Safety (INHST). An example of an evaluation based on homogenous functional groups, which enables the definition of various activities within each service, is also presented.
Medicina y seguridad del trabajo, Dec. 2004, Vol.L, No.197, p.37-53. 18 ref.

CIS 04-484 Imai H., Nakao H., Tsuchiya M., Kuroda Y., Katoh T.
Burnout and work environments of public health nurses involved in mental health care
In this case-control study of burnout among psychiatric nurses, cases comprised 525 public health nurses engaged in mental health services at public health centres, while the control group comprised 525 public health nurses engaged in other health services. Pines' Burnout Scale was used to measure burnout. A questionnaire was also prepared to investigate systems for supporting nurses working at public health centres and to define emergency mental health service factors contributing to burnout. Prevalence of burnout was significantly higher in the psychiatric group (59.2%) than in the control group (51.5%). Lack of job control and frequent overtime in emergency services were significantly correlated with prevalence of burnout in the psychiatric group, but not in the control group.
Occupational and Environmental Medicine, Sep. 2004, Vol.61, No.9, p.764-768. 36 ref.

CIS 04-393 Niven K.J.M.
Health and Safety Executive
Real time evaluation of health and safety management in the National Health Service
A high priority for the National Health Service (NHS) is ensuring patient safety by minimizing staff absence due to incidents and work-related illness. The aim of this project was to evaluate whether it was possible to reliably measure changes in safety and health performance after a safety and health intervention. The work involved three phases: designing a safety and health performance measurement methodology; evaluating the use of a safety and health management system workbook; designing and implementing a field study to measure changes in safety and health performance. Work involved literature reviews, questionnaire surveys and an analysis of safety and health management system records. It was concluded that the methodology could highlight changes in safety and health performance.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2004. xviii, 224p. Illus. 147 ref. Price: GBP 25.00. Downloadable version free of charge. [in English]

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

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