SciCombinator

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Concept: Personal protective equipment

169

OBJECTIVES: To investigate the association between occupational contamination and exposure levels to antineoplastic drugs and the application of control measures in a hospital work environment. Methods : Wipe samples of equipments were collected at a hospital in Osaka Prefecture, Japan, from 2007 to 2011. These samples were subjected to measurements of cyclophosphamide (CP), gemcitabine (GEM), platinum-containing drugs (Pt), and fluorouracil (5FU). Additionally, 24-h urine samples were collected from pharmacists who handled antineoplastic drugs, which were analyzed for CP and alpha-fluoro-beta-alanine (AFBA). The application of control measures was scored according to a checklist, which consisted of the following five items: safety equipment and maintenance, training and documentation, devices for safe handling, personal protective equipment, and emergency care. The aim was to obtain a score of 80%. Results : The median CP, GEM, and 5FU concentrations of all wipe samples were significantly lower during the period when the mean score was >80% (attainment period) versus when the mean score was ≤80% (nonattainment period; all P < 0.001, Mann-Whitney's U-test). Additionally, the median urinary CP and AFBA concentrations of pharmacists during the attainment period tended to be lower than that of those during the nonattainment period (P = 0.061 and 0.061, respectively, using Mann-Whitney's U-test). Conclusions : Contamination and levels of exposure to antineoplastic drugs decreased with a score higher than 80%. The scores of the items on the checklist appeared to adequately reflect the condition of the control measures, as increases in all five items were associated with reductions in the contamination by and levels of exposure to all drugs.

Concepts: Arithmetic mean, Scores, Personal protective equipment, Protection, Pharmacy, Occupational safety and health, Prefectures of Japan, Osaka Prefecture

167

Proper adherence to infection control precautions, including appropriate selection and use of personal protective equipment (PPE), is of significant importance to the health and well-being of perioperative personnel. Surgical masks are intended for use as a barrier to protect the wearer’s face from large droplets and splashes of blood and other body fluids; however, surgical and high-filtration surgical laser masks do not provide enough protection to be considered respiratory PPE. Potential exposure to airborne contaminants and infectious agents, including those present in surgical smoke, necessitates the use of respiratory PPE, such as a surgical N95 particulate filtering facepiece respirator. Filtering facepiece respirators greatly reduce a wide size range of particles from entering the wearer’s breathing zone and are designed to protect the user from both droplet and airborne particles. Every health care worker who must use a respirator to control hazardous exposures in the workplace must be trained to properly use the respirator and pass a fit test before using it in the workplace.

Concepts: Health care, Medicine, Infectious disease, Personal protective equipment, Protection, Protective gear, Respirator, Masks

156

Chemical pesticides, regardless of their inherent hazard, are used intensively in the fast changing agricultural sector of Ethiopia. We conducted a cross-sectional pesticide Knowledge Attitude and Practice (KAP) survey among 601 farmers and farm workers (applicators and re-entry workers) in three farming systems [large-scale closed greenhouses (LSGH), large-scale open farms (LSOF), and small-scale irrigated farms (SSIF)]. Main observations were that 85% of workers did not attain any pesticide-related training, 81% were not aware of modern alternatives for chemical pesticides, 10% used a full set of personal protective equipment, and 62% did not usually bath or shower after work. Among applicators pesticide training attendance was highest in LSGH (35%) and was lowest in SSIF (4%). None of the female re-entry farm workers had received pesticide-related training. Personal protective equipment use was twice as high among pesticide applicators as among re-entry workers (13 versus 7%), while none of the small-scale farm workers used personal protection equipment. Stockpiling and burial of empty pesticide containers and discarding empty pesticide containers in farming fields were reported in both LSOF and by 75% of the farm workers in SSIF. Considerable increment in chemical pesticide usage intensity, illegitimate usages of DDT and Endosulfan on food crops and direct import of pesticides without the formal Ethiopian registration process were also indicated. These results point out a general lack of training and knowledge regarding the safe use of pesticides in all farming systems but especially among small-scale farmers. This in combination with the increase in chemical pesticide usage in the past decade likely results in occupational and environmental health risks. Improved KAP that account for institutional difference among various farming systems and enforcement of regulatory measures including the available occupational and environmental proclamations in Ethiopia are urgently needed.

Concepts: Agriculture, Pesticide, Personal protective equipment, Protection, Irrigation, Farm, Tractor, DDT

120

In the President’s Malaria Initiative (PMI)-funded Africa Indoor Residual Spraying Project (AIRS), end-of-day clean-up operations require the safe disposal of wash water resulting from washing the exterior of spray tanks and spray operators' personal protective equipment. Indoor residual spraying (IRS) programs typically use soak pits - large, in-ground filters - to adsorb, filter and then safely degrade the traces of insecticide found in the wash water. Usually these soak pits are permanent installations serving 30 or more operators, located in a central area that is accessible to multiple spray teams at the end of their workday. However, in remote areas, it is often impractical for teams to return to a central soak pit location for cleanup. To increase operational efficiency and improve environmental compliance, the PMI AIRS Project developed and tested mobile soak pits (MSP) in the laboratory and in field applications in Madagascar, Mali, Senegal, and Ethiopia where the distance between villages can be substantial and the road conditions poor. Laboratory testing confirmed the ability of the easily-assembled MSP to reduce effluent concentrations of two insecticides (Actellic 300-CS and Ficam VC) used by the PMI AIRS Project, and to generate the minimal practicable environmental “footprint” in these remote areas. Field testing in the Mali 2014 IRS campaign demonstrated ease of installation and use, resulted in improved and more consistent standards of clean-up, decreased transportation requirements, improved spray team working conditions, and reduced potential for operator exposure to insecticide.

Concepts: Malaria, Africa, Personal protective equipment, Protection, Occupational safety and health, Pesticide application, DDT, Spray

28

Incorrect use of personal protective equipment (PPE) may lead to the spread of infectious agents among health care workers and patients. Although novel education programs show promise, there is no standard evaluation for the competencies developed during training.

Concepts: Health care, Health care provider, Psychology, Healthcare, Illness, Personal protective equipment, Protection, Occupational safety and health

28

Objective: The present study measured arm and other body injuries to classroom staff that were caused by a student who had developmental disabilities and treatment-resistant aggression. Methods: Following a baseline (no equipment) phase, staff wore protective equipment on their arms but not on other areas of their body. Results: The frequency of self-reported arm injuries increased with protective equipment, but injury severity decreased. Wearing the protective equipment was also associated with more injuries to other areas of the body. Conclusions: Staff-worn protective equipment may reduce the severity but not the frequency of staff injuries from aggression; as well, the presence of protective equipment may set the occasion for increased injuries to non-protected areas of the body.

Concepts: Present, Injury, Aggression, Personal protective equipment, Protection, Disability, Physical trauma, Accident

28

SUMMARY Ornithosis outbreaks in poultry processing plants are well-described, but evidence for preventive measures is currently lacking. This study describes a case-control study into an outbreak of ornithosis at a poultry processing plant in the East of England, identified following three employees being admitted to hospital. Workers at the affected plant were recruited via their employer, with exposures assessed using a self-completed questionnaire. Cases were ascertained using serological methods or direct antigen detection in sputum. 63/225 (28%) staff participated, with 10% of participants showing evidence of recent infection. Exposure to the killing/defeathering and automated evisceration areas, and contact with viscera or blood were the main risk factors for infection. Personal protective equipment (goggles and FFP3 masks) reduced the effect of exposure to risk areas and to self-contamination with potentially infectious material. Our study provides some evidence of effectiveness for respiratory protective equipment in poultry processing plants where there is a known and current risk of ornithosis. Further studies are required to confirm this tentative finding, but in the meantime respiratory protective equipment is recommended as a precautionary measure in plants where outbreaks of ornithosis occur.

Concepts: Photosynthesis, Epidemiology, Effect, Personal protective equipment, Protection, Protective gear, Livestock, Goggles

28

BACKGROUND:: Pesticide poisoning rates remain high among farmworkers despite programs aimed at reducing pesticide exposure. METHODS:: A cross-sectional study was conducted among 187 Hispanic farmworkers in North Carolina. Farmworkers were interviewed to determine the association between pesticide safety training and knowledge about pesticides and use of personal protective equipment (PPE). RESULTS:: Use of PPE was higher among farmworkers who reported wearing gloves reduced the harmful effects of pesticides (adjusted odds ratio, 5.73; 95% confidence interval, 2.20-14.92) and those who received pesticide safety training at the extension office or growers association (adjusted odds ratio, 44.62; 95% confidence interval, 3.96-503.33). CONCLUSION:: Some farmworkers are still not using PPE. Evaluation of Environmental Protection Agency Worker Protection Standards pesticide safety training and requirements for providing PPE are crucial to encourage farm workers to use PPE.

Concepts: Odds ratio, Interval finite element, Pesticide, Personal protective equipment, United States Environmental Protection Agency, Protection, Poison, Protective gear

26

Cancer incidence appears to be higher amongst firefighters compared to the general population. Given that many cancers have an environmental component, their occupational exposure to products of carbon combustion such as polycyclic aromatic hydrocarbons (PAHs) is of concern. This is the first UK study identifying firefighters exposure to PAH carcinogens. Wipe samples were collected from skin (jaw, neck, hands), personal protective equipment of firefighters, and work environment (offices, fire stations and engines) in two UK Fire and Rescue Service Stations. Levels of 16 US Environmental Protection Agency (EPA) PAHs were quantified together with more potent carcinogens: 7,12-dimethylbenzo[a]anthracene, and 3-methylcholanthrene (3-MCA) (12 months post-initial testing). Cancer slope factors, used to estimate cancer risk, indicate a markedly elevated risk. PAH carcinogens including benzo[a]pyrene (B[a]P), 3-MCA, and 7,12-dimethylbenz[a]anthracene PAHs were determined on body surfaces (e.g., hands, throat), on PPE including helmets and clothing, and on work surfaces. The main exposure route would appear to be via skin absorption. These results suggest an urgent need to monitor exposures to firefighters in their occupational setting and conduct long-term follow-up regarding their health status.

Concepts: Polycyclic aromatic hydrocarbon, Benzene, Personal protective equipment, United States Environmental Protection Agency, Protection, Environmentalism, Occupational safety and health, Naphthalene

26

Contamination of the skin and clothing of health care personnel during removal of personal protective equipment (PPE) contributes to dissemination of pathogens and places personnel at risk for infection.

Concepts: Health care, Health, Skin, Personal protective equipment, Protection, Occupational safety and health, High-visibility clothing