Practice of universal precautions among healthcare workers.
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INTRODUCTION: Healthcare workers (HCWs) are exposed to bloodborne infections by pathogens, such as HIV, and hepatitis B and C viruses, as they perform their clinical activities in the hospital. Compliance with universal precautions has been shown to reduce the risk of exposure to blood and body fluids. This study was aimed at assessing the observance of universal precautions by HCWs in Abeokuta, Ogun State, Nigeria. SUBJECTS AND METHODS: The study was conducted in September 2003 in Abeokuta metropolis, Ogun State, Nigeria. The respondents were doctors, trained and auxiliary nurses, laboratory scientists and domestic staff. They were selected through a multistage sampling technique from public and private healthcare facilities within the metropolis. The instrument was an interviewer-administered, semistructured questionnaire that assessed the practice of recapping and disposal of used needles, use of barrier equipment, handwashing and screening of transfused blood. RESULTS: There were 433 respondents, 211 (48.7%) of which were trained nurses. About a third of all respondents always recapped used needles. Compliance with nonrecapping of used needles was highest among trained nurses and worst with doctors. Less than two-thirds of respondents (63.8%) always used personal protective equipment, and more than half of all respondents (56.5%) had never worn goggles during deliveries and at surgeries. The provision of sharps containers and screening of transfused blood by the institutions studied was uniformly high. A high percentage (94.6%) of HCWs observed handwashing after handling patients. The use of barrier equipment was variable in the institutions studied. CONCLUSION: Recapping of used needles is prevalent in the health facilities studied. Noncompliance with universal precautions place Nigerian HCWs at significant health risks. Training programs and other relevant measures should be put in place to promote the appropriate use of protective barrier equipment by HCWs at all times. (+info)
Occupational skin exposure and hand eczema among dental technicians-need for improved prevention.
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OBJECTIVES: The aims of this study were to estimate occupational skin exposure, the use of skin protection, and the incidence of hand eczema among dental technicians. METHODS: In a retrospective cohort study, dental technicians (N=2139) and randomly selected population controls (N=2288) received a postal questionnaire on occupational skin exposure, protective glove use, and hand eczema, including the year of onset. The response rate was 57% for the dental technicians and 58% for the controls. RESULTS: Altogether 80% of the dental technicians reported skin exposure to uncured (meth)acrylates (MA), and 87% had skin contact with grinding dust from MA. Thirty-nine percent used protective gloves when handling uncured MA. Twenty-two percent of the currently employed technicians reported participation in obligatory training concerning the handling of thermosetting plastics, and 58% did not know how long normally used gloves protected the skin against uncured MA. Altogether 48% of the dental technicians and 30% of the controls reported more than 10 hand washings a day (P<0.001). For the dental technicians, the incidence of hand eczema was 8.5 cases/1000 person-years during MA-exposed time. For the controls, the incidence was 3.3. The incidence rate ratio for the men was 3.6 (95% CI 2.3-5.6), and for the women it was 2.4 (95% CI 1.7-3.3). CONCLUSIONS: The work of dental technicians involves frequent and unprotected exposure to MA and frequent hand washings. Dental technicians have twice the risk of hand eczema than the general population. Efforts to improve skin protection and increase participation in obligatory training about handling thermosetting plastics are important. (+info)
Exposure pathway assessment at a copper-beryllium alloy facility.
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Controlling beryllium inhalation exposures to comply with regulatory levels (2 micro g m(-3) of air) does not appear to prevent beryllium sensitization and chronic beryllium disease (CBD). Additionally, it has proven difficult to establish a clear inhalation exposure-response relationship for beryllium sensitization and CBD. Thus, skin may be an important route of exposure that leads to beryllium sensitization. A 2000 survey had identified prevalence of sensitization (7%) and CBD (4%) in a beryllium alloy facility. An improved particulate migration control program, including dermal protection in production areas, was completed in 2002 at the facility. The purpose of this study was to evaluate levels of beryllium in workplace air, on work surfaces, on cotton gloves worn by employees over nitrile gloves, and on necks and faces of employees subsequent to implementation of the program. Over a 6 day period, we collected general area air samples (n = 10), wipes from routinely handled work surfaces (n = 252), thin cotton glove samples (n = 113) worn by employees, and neck wipes (n = 109) and face wipes (n = 109) from the same employees. In production, production support and office areas geometric mean (GM) levels of beryllium were 0.95, 0.59 and 0.05 micro g per 100 cm(2) on work surfaces; 42.8, 73.8 and 0.07 micro g per sample on cotton gloves; 0.07, 0.09 and 0.003 micro g on necks; and 0.07, 0.12 and 0.003 micro g on faces, respectively. Correlations were strong between beryllium in air and on work surfaces (r = 0.79), and between beryllium on cotton gloves and on work surfaces (0.86), necks (0.87) and faces (0.86). This study demonstrates that, even with the implementation of control measures to reduce skin contact with beryllium as part of a comprehensive workplace protection program, measurable levels of beryllium continue to reach the skin of workers in production and production support areas. Based on our current understanding of the multiple exposure pathways that may lead to sensitization, we support prudent control practices such as use of protective gloves to minimize skin exposure to beryllium salts and fine particles. (+info)
Follow-up study of latex-allergic health care workers in Japan.
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BACKGROUND: While many cases of latex allergy have been reported in Japanese health care workers (HCWs) since 1992, there have been no follow-up studies after removing latex from the workplace. We had previously replaced all working environment latex gloves and latex products with low-allergen or non-latex products. The purpose of the investigation was to evaluate the benefits of the latex allergy countermeasures that were taken in our hospital, and the effects of life guidance education. METHODS: We investigated 16 latex-allergic HCWs in our hospital. We gave them a detailed questionnaire and tested them by a skin prick test (SPT) with latex extract and specific IgE antibodies against latex using the Pharmacia CAP RAST system, RAST FEIA. We compared these results with earlier results from the time of diagnosis. RESULTS: According to the questionnaire, none of the HCWs had changed their work habits, though all were avoiding the use of latex products as much as possible. Of the 16 patients, 81.2% were eating foods for which cross reactivity with latex has been reported. However, the foods had not induced severe allergic symptoms. In the SPT, 62.5% of scores decreased and 81.2% of patients had decreases in specific IgE antibody levels. CONCLUSIONS: After avoiding latex products and following our educational suggestions, the patients' allergy symptoms had generally improved. This indicates that our countermeasures against latex allergy were largely successful. (+info)
Prevalence and determinants of asthma in adult male leather tannery workers in Karachi, Pakistan: a cross sectional study.
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BACKGROUND: This study aimed to estimate the prevalence and to identify some risk factors of adult asthma in male leather tannery workers in Karachi, Pakistan. METHODS: A cross sectional study was conducted from August 2003 to March 2004 on leather tannery workers of Karachi, Pakistan. Data were collected from 641 workers engaged in 95 different tanneries in Korangi industrial area selected as sample of convenience. Face to face interviews were performed using a structured pre-tested questionnaire by trained data collectors. RESULTS: Prevalence of adult asthma was 10.8% (69/641) in this study population. The prevalence of perceived work-related asthma was 5.3% (34/641). Multivariable logistic regression model showed that after taking into account the age effect, the leather tannery worker were more likely to be asthmatic, if they were illiterate (adjusted OR = 2.13, 95% CI: 1.17-3.88), of Pathan ethnicity (adjusted OR = 2.69; 95% CI: 1.35-5.36), ever-smoked (adjusted OR = 2.22, 95% CI: 1.16-4.26), reportedly never used gloves during different tanning tasks (OR = 3.28; 95% CI : 1.72-6.26). Also, the final model showed a significant interaction between perceived allergy and duration of work. Those who perceived to have allergy were more likely to have asthma if their duration of work was 8 years (adjusted OR = 2.26; 95% CI: 1.19 - 4.29) and this relationship was even stronger if duration was 13 years (adjusted OR = 3.67; 95% CI: 1.98-6.79). CONCLUSION: Prevalence of asthma in leather tannery workers appears to be high and is associated with educational status, ethnicity, smoking, glove use, perceived to have allergy and duration of work. (+info)
CT fluoroscopy shielding: decreases in scattered radiation for the patient and operator.
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PURPOSE: High-radiation exposure occurs during computed tomographic (CT) fluoroscopy. Patient and operator doses during thoracic and abdominal interventional procedures were studied in the present experiment, and a novel shielding device to reduce exposure to the patient and operator was evaluated. MATERIALS AND METHODS: With a 16-slice CT scanner in CT fluoroscopy mode (120 kVp, 30 mA), surface dosimetry was performed on adult and pediatric phantoms. The shielding was composed of tungsten antimony in the form of a lightweight polymer sheet. Doses to the patient were measured with and without shielding for thoracic and abdominal procedures. Doses to the operator were recorded with and without phantom, gantry, and table shielding in place. Double-layer lead-free gloves were used by the operator during the procedures. RESULTS: Tungsten antimony shielding adjacent to the scan plane resulted in a maximum dose reduction of 92.3% to the patient. Maximum 85.6%, 93.3%, and 85.1% dose reductions were observed for the operator's torso, gonads, and hands, respectively. The use of double-layer lead-free gloves resulted in a maximum radiation dose reduction of 97%. CONCLUSIONS: Methods to reduce exposure during CT fluoroscopy are effective and should be searched for. Significant reduction in radiation doses to the patient and operator can be accomplished with tungsten antimony shielding. (+info)
Latex allergen sensitization and risk factors due to glove use by health care workers at public health units in Florianopolis, Brazil.
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BACKGROUND: Natural rubber latex allergy is a "new" illness whose prevalence has reached epidemic proportions in highly exposed populations such as health care professionals. OBJECTIVE: The aim of the study was to evaluate the frequency of reactions to latex and risk factors due to glove use in health care workers (HCW) in Florianopolis, Santa Catarina, Brazil. METHODS: We evaluated latex-related allergy in 260 HCW by means of a questionnaire, skin prick tests (SPT) and serum latex specific IgE antibody levels. The subjects were divided into two groups depending on level of exposure to latex gloves. Comparisons were made between the different variables and a risk score was calculated using logistic regression analysis. RESULTS: Glove-related symptoms were observed in 57% of 140 HCW. Significant differences between HCW and control groups were found for the following symptoms: contact dermatitis (P < .0001), cutaneous rash (P < .0001), asthma or allergic rhinitis (P < .0001), symptoms associated with toy balloons (P < .0001), airborne glove powder causing latex allergen reaction (P < .0001), food allergy (P < .0001), fruit allergy (P < .0001) and multiple surgical interventions (P = .0052). Contact dermatitis and anaphylaxis were the main problems, with a high risk factor for the development of latex allergy. Logistic regression analysis showed a significant positive association between the risk of latex allergy and those subjects who reported more than 4 positive answers on the questionnaire (including SPT) (odds ratio 6.8; 95% confidence interval 0.7-60.3). No latex-related allergy symptoms were reported by the control group. Serological latex specific immunoglobulin (Ig) E antibody levels were negative for both groups. CONCLUSION: It is essential to recognize which professionals are sensitized to latex in order to provide appropriate treatment and to establish adequate prevention. (+info)
Occupational risk factors for asthma among nurses and related healthcare professionals in an international study.
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OBJECTIVE: The authors examined the relations between self-reported work tasks, use of cleaning products and latex glove use with new-onset asthma among nurses and other healthcare workers in the European Community Respiratory Health Survey (ECRHS II). METHODS: In a random population sample of adults from 22 European sites, 332 participants reported working in nursing and other related healthcare jobs during the nine-year ECRHS II follow-up period and responded to a supplemental questionnaire about their principal work settings, occupational tasks, products used at work and respiratory symptoms. Poisson regression models with robust error variances were used to compare the risk of new-onset asthma among healthcare workers with each exposure to that of respondents who reported professional or administrative occupations during the entire follow-up period (n = 2481). RESULTS: Twenty (6%) healthcare workers and 131 (5%) members of the referent population reported new-onset asthma. Compared to the referent group, the authors observed increased risks among hospital technicians (RR 4.63; 95% CI 1.87 to 11.5) and among those using ammonia and/or bleach at work (RR 2.16; 95% CI 1.03 to 4.53). CONCLUSIONS: In the ECRHS II cohort, hospital technicians and other healthcare workers experience increased risks of new-onset current asthma, possibly due to specific products used at work. (+info)