Factors associated with environmental service worker cleaning practices in health care settings: A systematic review of the literature.

INTRODUCTION: Health care-associated infections can be reduced through better environmental disinfection practices. Central to effective disinfection is the environmental service worker (ESW). The aim of this systematic literature review was to identify factors associated with the disinfection practices of ESWs in health care settings. METHODS: A systematic literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses principles. Ten online databases and search engines were selected for the review of English-language studies published between 2000 and 2019. RESULTS: Thirty-one (31) eligible studies were identified. Environmental disinfection was associated with many factors (eg, knowledge, perceptions) as well as ESW exposure to education/training sessions. When education/training was combined with performance evaluation/feedback, significant improvement in ESW disinfection practices was reported. CONCLUSIONS: To sustain improvements in disinfection practices, education/training sessions need to be continuous. The long-term commitment of an organization is also essential for continuous improvement in disinfection outcomes. While knowledge transfer is critical for behavior change, education/training also needs to focus on the skills and perceptions of ESWs. Future studies need to use a randomized controlled design with larger sample sizes to determine a true effect.

Relationship of Arsenic and Lead in Soil with Fruit and Leaves of Apple Trees at Selected Orchards in Michigan.

ABSTRACT: Historically, lead arsenate pesticides were commonly used in fruit orchards. Residues of metals from this historical use can persist in soil for decades, which can result in potential risk for humans if they consume fruits grown on contaminated soil. This research was conducted to assess lead and arsenic levels in apples, leaves, and orchard soil where the apples were grown to determine the relationship between metal levels in fruits and fruit products with those in orchard soil. Soil and tree tissue samples were collected from several Michigan farms, and metal concentrations were quantified by using microwave extraction and inductively coupled plasma mass spectrometry. Soil samples were collected at depths of 0 to 20 cm and 20 to 40 cm at a distance of 1 m from the tree trunk. Fruit samples also were processed into juice and pomace fractions to assess the partitioning of arsenic and lead during juice processing. The lead concentration was significantly higher in topsoil (9.4 µg/kg) compared with subsoil (6.9 µg/kg), but the arsenic content did not differ between the two soil layers (P > 0.05). Lead concentrations in apple leaves were correlated with lead in topsoil (0 to 20 cm; P = 0.03). Concentrations of total arsenic in all juice samples were less than 1 µg/kg and showed less potential than lead for uptake and translocation to fruits. There was no significant relationship between soil arsenic content and total arsenic concentrations in juice, pomace, and leaf samples (P > 0.05). Results of this research indicate that lead and total arsenic concentrations in apples and apple products from these selected orchards in Michigan are unlikely to be impacted by the contamination of these metals in orchard soil.