Long-term ethylene oxide exposure trends in US hospitals: relationship with OSHA regulatory and enforcement actions.
(1/4)
OBJECTIVES: We assessed long-term trends in ethylene oxide (EtO) worker exposures for the purposes of exposure surveillance and evaluation of the impacts of the Occupational Safety and Health Administration (OSHA) 1984 and 1988 EtO standards. METHODS: We obtained exposure data from a large commercial vendor and processor of EtO passive dosimeters. Personal samples (87,582 workshift [8-hr] and 46,097 short-term [15-min] samples) from 2265 US hospitals were analyzed for time trends from 1984 through 2001 and compared with OSHA enforcement data. RESULTS: Exposures declined steadily for the first several years after the OSHA standards were set. Workshift exposures continued to taper off and have remained low and constant through 2001. However, since 1996, the probability of exceeding the short-term excursion limit has increased. This trend coincides with a decline in enforcement of the EtO standard. CONCLUSIONS: Results indicate the need for renewed intervention efforts to preserve gains made following the passage and implementation of the 1984 and 1988 EtO standards. (+info)
The effect of work practices on personal exposure to glutaraldehyde among health care workers.
(2/4)
Glutaraldehyde is a potential sensitizer and has been implicated in the literature as a cause of respiratory irritation and asthma among health care workers. In order to evaluate the effect of work practices and general ventilation system on employees' peak exposure to glutaraldehyde, 42 breathing zone personal air samples were taken in five hospitals. In addition, work practices were observed and recorded during the course of sampling and were classified into three categories. Presence of local or general ventilation system, air change per hour, and quantity of glutaraldehyde used were also recorded. Geometric mean concentration of all samples was 0.025 ppm (GSD=3.05). Statistical analysis indicated that work practice was the most important factor affecting the level of exposure to glutaraldehyde. In locations where "poor" or "unsafe" work practices were employed, the geometric mean concentrations were much higher (GM=0.05, GSD=2.11 and GM 0.08, GSD=1.52, respectively). The result has indicated higher prevalence of headache and itchy eyes among employees who worked where unsafe work practices were observed. Employing proper work practices can significantly reduce exposure to glutaraldehyde among health care workers. It has been recently proposed that the current occupational exposure limit of 0.2 ppm shall be reduced to either 0.1 or 0.05 ppm in the province of Quebec (Canada). In this case, it is likely that concentration levels higher than these levels be experienced in some workplaces. Therefore, it is imperative that employers initiate necessary corrective action immediately. (+info)
Contamination of medical gas and water pipelines in a new hospital building.
(3/4)
Medical gases and water were sampled and tested for purity prior to the opening of a 176-bed addition to a 450-bed general hospital. Contamination was found. In delivered oxygen, compressed air, and nitrous oxide, this consisted of a volatile hydrocarbon at an initial concentration of 10 parts per million and a dust of fine gray particulate matter. In water from new taps bacterial contamination with as many 400,000 organisms per 100 ml was present. All these contaminants were considered potential hazards to patient safety. Studies were done to help delineate the nature and origin of these contaminants. Each contaminant was eventually largely eliminated by purging the respective pipeline systems with continuous flows. Planners, builders, and responsible medical personnel must be aware of the potential for such hazards in a new hospital building. (+info)
Evaluating OSHA's ethylene oxide standard: employer exposure-monitoring activities in Massachusetts hospitals from 1985 through 1993.
(4/4)
OBJECTIVES: This study characterized exposure-monitoring activities and findings under the Occupational Safety and Health Administration's (OSHA's) 1984 ethylene oxide (EtO) standard. METHODS: In-depth mail and telephone surveys were followed by on-site interviews at all EtO-using hospitals in Massachusetts (n = 92, 96% participation rate). RESULTS: By 1993, most hospitals had performed personal exposure monitoring for OSHA's 8-hour action level (95%) and the excursion limit (87%), although most did not meet the 1985 implementation deadline. In 1993, 66% of hospitals reported the installation of EtO alarms to fulfill the standard's "alert" requirement. Alarm installation also lagged behind the 1985 deadline and peaked following a series of EtO citations by OSHA. From 1990 through 1992, 23% of hospitals reported having exceeded the action level once or more; 24% reported having exceeded the excursion limit; and 33% reported that workers were accidentally exposed to EtO in the absence of personal monitoring. CONCLUSIONS: Almost a decade after passage of the EtO standard, exposure-monitoring requirements were widely, but not completely, implemented. Work-shift exposures had markedly decreased since the mid-1980s, but overexposures continued to occur widely. OSHA enforcement appears to have stimulated implementation. (+info)