Seroepidemiology of Toxocara canis infection among mountain aboriginal schoolchildren living in contaminated districts in eastern Taiwan.
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We conducted a seroepidemiological study of Toxocara canis infection among mountain aboriginal schoolchildren aged 7-12 years living in contaminated districts in eastern Taiwan. To detect sera IgG (> or =1:64) we used a T. canis larval excretory-secretory antigen-based enzyme-linked immunosorbent assay. A short questionnaire elicited information on the practices of raising dogs, playing with soil, eating raw vegetables, or whether the child normally washed his/her hands before eating. The overall seroprevalence was quite high, reaching 76.6% (252/329). Neither age nor gender seemed to be important factors related to a positive serology. Aboriginal schoolchildren who raised dogs (OR=1.83, 95% CI: 1.04-3.19, P=0.03), or played with soil (OR=2.52, 95% CI: 1.49-4.25, P <0.001) seemed to be more susceptible to T. canis infection than those who did not. Children who habitually washed their hands before eating (OR=0.57, 95% CI: 0.33-0.97, P=0.04) had a lower chance of acquiring T. canis infection than those who did not. (+info)
Hand hygiene: simple and complex.
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This review gives an overview of hand hygiene in healthcare and in the community, including some aspects which have attracted little attention, such as hand drying and cultural issues determining hand hygiene behaviour. Hand hygiene is the most effective measure for interrupting the transmission of microorganisms which cause infection both in the community and in the healthcare setting. Using hand hygiene as a sole measure to reduce infection is unlikely to be successful when other factors in infection control, such as environmental hygiene, crowding, staffing levels and education are inadequate. Hand hygiene must be part of an integrated approach to infection control. Compliance with hand hygiene recommendations is poor worldwide. While the techniques involved in hand hygiene are simple, the complex interdependence of factors which determine hand hygiene behaviour makes the study of hand hygiene complex. It is now recognised that improving compliance with hand hygiene recommendations depends on altering human behaviour. Input from behavioural and social sciences is essential when designing studies to investigate compliance. Interventions to increase compliance with hand hygiene practices must be appropriate for different cultural and social needs. New strategies to promote hand hygiene worldwide include the formation of public-private partnerships. (+info)
Nicotine exposure and decontamination on tobacco harvesters' hands.
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Green tobacco sickness is an illness associated with nicotine exposures among tobacco harvesters. Agricultural workers manually harvest tobacco and thus have the potential for skin exposure to nicotine, particularly on the hands. Often gloves are not worn as it hinders the harvesters' ability to harvest the tobacco leaves. The purposes of this study were to measure the concentration of nicotine residue on the hands of tobacco harvesters and the effectiveness of hand washing at removing the residue. Wipe samples from the hands of 12 tobacco harvesters were collected at the end of morning and afternoon work periods over two consecutive days. Each harvester had one hand wiped before washing his hands, and the other hand wiped after washing his hands with soap and water. Eight samples per worker were collected over the two days for a total of 96 samples collected. In addition to the hand-wipe samples, leaf-wipe samples were collected from 15 tobacco plants to estimate the amount of nicotine residue on the plants. The average nicotine level in leaf-wipe samples was 1.0 microg cm(-2). The geometric mean pre-wash and post-wash nicotine levels on the hands were 10 and 0.38 microg cm(-2), respectively. Nicotine leaf-wipe level, right or left hand and time of sampling did not significantly influence exposure. Job position-working on the bottom versus the top of the tobacco harvesting machine-was associated with nicotine levels. Pre-wash nicotine levels were higher for workers on the bottom of the harvester but not significantly higher (P = 0.17). Post-wash nicotine levels were significantly higher for workers on the bottom of the harvester (P = 0.012). A substantial amount of nicotine was transferred to the hands, but washing with soap and water in the field significantly reduced nicotine levels by an average of 96% (P < 0.0001). (+info)
Dermal exposure to polycyclic aromatic hydrocarbons among road pavers.
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OBJECTIVES: Dermal exposure to polycyclic aromatic hydrocarbons (PAHs) and the role of an industrial by-product, coal fly ash, on workers' PAH exposure were investigated during stone mastic asphalt (SMA) paving and remixing. METHODS: PAH exposure was measured at eight sites during the laying of SMA containing coal fly ash or limestone (conventional SMA) as the filler. Six of the surveys were carried out during SMA paving and two during remixing of SMA (hot recycling at the paving site). Dermal PAH exposure was measured by hand washing (using sunflower oil and wiping with Kleenex tissues) before and after the work shift, and by placing exposure pads on the workers' wrists during the work shift. The analyses included 15 native PAHs from the hand-washing samples determined using high-performance liquid chromatography equipped with a two-channel fluorescence detector and 16 native PAHs and four methylated PAHs from the exposure pads using gas chromatography with mass-selective detection. RESULTS: The PAH results obtained using the pad and hand-washing methods (concentrations after the work shift) were equivalent and showed a strong correlation (r = 0.757, P < 0.001, N = 23 for total PAHs). There was a statistically significant difference between pre- and post-shift samples as measured by hand washing. The skin contamination by PAHs was significantly higher (P < 0.01) during remixing than during SMA paving. The variation in PAH contamination on the skin explained more of the variation in the excretion of urinary 1-hydroxypyrene and phenanthrols than the variation in the respiratory PAH concentrations. CONCLUSIONS: The industrial by-product investigated in asphalt, coal fly ash, had no statistically significant effect on the workers' dermal PAH exposure. The dermal exposure of paving workers to PAHs was higher during remixing than during SMA paving. (+info)
A multicentric survey of the practice of hand hygiene in haemodialysis units: factors affecting compliance.
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BACKGROUND: This study intended to investigate the degree of compliance with hand hygiene and use of gloves by health workers in haemodialysis (HD) units, and the factors that influenced adherence to hand hygiene protocols. METHODS: During the month of November 2003, one person observed the health care staff in each of nine different dialysis units, during 495 randomly distributed 30 min observation periods that covered all steps of a haemodialysis session (connection, dialysis and disconnection). The observers noted the number of potential opportunities to implement standard precautions and the number of occasions on which the precautions were actually taken. Adherence to standard precautions was evaluated, analysing the influence of the following variables: the patient-to-nurse ratio, the number of HD shifts scheduled per day, acute HD units vs chronic, whether or not infectious patients were isolated and in-house vs contract cleaning personnel. RESULTS: There were a total of 977 opportunities to wear gloves for, and to wash the hands following, a patient-oriented activity, and 1902 opportunities to wash hands before such an activity. Gloves were actually used on 92.9% of these occasions. Hands were washed only 35.6% of the time after patient contact, and only 13.8% of the time before patient contact. Poor adherence to hand washing was associated with the number of shifts per HD unit per day and with higher patient-to-nurse ratios. In the acute HD units, there was greater adherence to standard precautions than in the chronic units, although there too it was substandard. The personnel's knowledge of patients' infectious status did not modify their adherence to hand hygiene practices. A higher patient-to-nurse ratio independently influenced hand washing both before and after patient contact. CONCLUSIONS: The overall adherence of health care workers to recommended hand washing practices is low. Whether or not programmes promoting higher hand hygiene standards and the potential use of alcohol-based hand cleansers will improve hand hygiene practices in HD units requires further investigation. (+info)
Efficacy of two distinct ethanol-based hand rubs for surgical hand disinfection -- a controlled trial according to prEN 12791.
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BACKGROUND: Aim of the study was to determine the efficacy of two distinct ethanol-based hand rubs for surgical hand disinfection in a controlled cross-over trial according to prEN 12791. METHODS: 20 subjects were included. Hands were washed for 1 min with soap. The bacterial prevalue was obtained by rubbing finger tips in TSB for 1 min. Then, each subject treated the hands with the reference procedure (n-propanol, 60% v/v) or the product (Sterillium Rub, based on 80% ethanol; Avagard, based on 61% ethanol and 1% chlorhexidine gluconate) which were all applied in 3 to 4 portions each of 3 ml for a total of 3 min. Bacterial postvalues (immediate effect) were taken from one hand, the other hand was gloved for 3 h. After gloves were taken off the second postvalue was taken for the assessment of a sustained effect. RESULTS: Bacterial pre-values were between 4.38 +/- 0.66 and 4.46 +/- 0.71. Sterillium Rub achieved the required immediate (mean log10-reduction of 2.59 +/- 1.19) and sustained effect (1.73 +/- 1.08) compared with the reference treatment (immediate effect: 2.58 +/- 1.16; sustained effect: 1.67 +/- 0.96). Avagard, however, did not achieve the required immediate (1.82 +/- 1.40) and sustained effect (1.41 +/- 1.08) in comparison to the reference disinfection (immediate effect: 2.98 +/- 0.90; sustained effect: 2.56 +/- 1.17; p < 0.01; Wilcoxon test). CONCLUSION: Based on our data, Sterillium Rub can be regarded to be effective for surgical hand disinfection, but Avagard can not. The addition of 1% chlorhexidine gluconate to 61% ethanol (w/w) did not outweigh an ethanol concentration of 80% (w/w). (+info)
Medicare and Medicaid programs; fire safety requirements for certain health care facilities; amendment. Interim final rule with comment period.
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This interim final rule with comment period adopts the substance of the April 15, 2004 temporary interim amendment (TIA) 00-1 (101), Alcohol Based Hand Rub Solutions, an amendment to the 2000 edition of the Life Safety Code, published by the National Fire Protection Association (NFPA). This amendment will allow certain health care facilities to place alcohol-based hand rub dispensers in egress corridors under specified conditions. This interim final rule with comment period also requires that nursing facilities install smoke detectors in resident rooms and public areas if they do not have a sprinkler system installed throughout the facility or a hard-wired smoke detection system in those areas. (+info)
Potential of the polyvalent anti-Staphylococcus bacteriophage K for control of antibiotic-resistant staphylococci from hospitals.
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The increasing prevalence of antibiotic-resistant staphylococci has prompted the need for antibacterial controls other than antibiotics. In this study, a lytic bacteriophage (phage K) was assessed in vitro for its ability to inhibit emerging drug-resistant Staphylococcus aureus strains from hospitals and other species of Staphylococcus isolated from bovine infections. In in vitro inhibitory assays, phage K lysed a range of clinically isolated methicillin-resistant S. aureus (MRSA) strains, S. aureus with heterogeneous vancomycin resistance and vancomycin resistance, and teicoplanin-resistant strains. In these assays, 14 of the MRSA strains were initially only weakly sensitive to this phage. However, propagation of phage K on these less-sensitive strains resulted in all 14 being sensitive to the modified phages. The results enforce the principle that, while certain target bacteria may be relatively insensitive to lytic phage, this can be overcome by obtaining modified phage variants from passage of the phage through the insensitive strains. Model in situ hand wash studies using a phage-enriched wash solution resulted in a 100-fold reduction in staphylococcal numbers on human skin by comparison with numbers remaining after washing in phage-free solution. Infusion of the phage into a nonimmunogenic bismuth-based cream resulted in strong anti-Staphylococcus activity from the cream on plates and in broth. (+info)