Differences in Hospital Managers', Unit Managers', and Health Care Workers' Perceptions of the Safety Climate for Respiratory Protection.

This article compares hospital managers' (HM), unit managers' (UM), and health care workers' (HCW) perceptions of respiratory protection safety climate in acute care hospitals. The article is based on survey responses from 215 HMs, 245 UMs, and 1,105 HCWs employed by 98 acute care hospitals in six states. Ten survey questions assessed five of the key dimensions of safety climate commonly identified in the literature: managerial commitment to safety, management feedback on safety procedures, coworkers' safety norms, worker involvement, and worker safety training. Clinically and statistically significant differences were found across the three respondent types. HCWs had less positive perceptions of management commitment, worker involvement, and safety training aspects of safety climate than HMs and UMs. UMs had more positive perceptions of management's supervision of HCWs' respiratory protection practices. Implications for practice improvements indicate the need for frontline HCWs' inclusion in efforts to reduce safety climate barriers and better support effective respiratory protection programs and daily health protection practices.

Mortality during a Large-Scale Heat Wave by Place, Demographic Group, Internal and External Causes of Death, and Building Climate Zone.

Mortality increases during periods of elevated heat. Identification of vulnerable subgroups by demographics, causes of death, and geographic regions, including deaths occurring at home, is needed to inform public health prevention efforts. We calculated mortality relative risks (RRs) and excess deaths associated with a large-scale California heat wave in 2006, comparing deaths during the heat wave with reference days. For total (all-place) and at-home mortality, we examined risks by demographic factors, internal and external causes of death, and building climate zones. During the heat wave, 582 excess deaths occurred, a 5% increase over expected (RR = 1.05, 95% confidence interval (CI) 1.03-1.08). Sixty-six percent of excess deaths were at home (RR = 1.12, CI 1.07-1.16). Total mortality risk was higher among those aged 35-44 years than ≥ 65, and among Hispanics than whites. Deaths from external causes increased more sharply (RR = 1.18, CI 1.10-1.27) than from internal causes (RR = 1.04, CI 1.02-1.07). Geographically, risk varied by building climate zone; the highest risks of at-home death occurred in the northernmost coastal zone (RR = 1.58, CI 1.01-2.48) and the southernmost zone of California's Central Valley (RR = 1.43, CI 1.21-1.68). Heat wave mortality risk varied across subpopulations, and some patterns of vulnerability differed from those previously identified. Public health efforts should also address at-home mortality, non-elderly adults, external causes, and at-risk geographic regions.

Using multiple data sets for public health tracking of work-related injuries and illnesses in California.

BACKGROUND: Research suggests the U.S. Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses underestimates the magnitude of workplace injuries and illnesses. Enumerating workplace injuries and illnesses may be improved by utilizing multiple state-based data sources. METHODS: Using California-based datasets (workers' compensation claims, health care facility data, and physician reports), we enumerated unique cases of amputations and carpal tunnel syndrome (2007-2008), and evaluated the datasets for usefulness in occupational health tracking by performing record linkage across all datasets and calculating match rates between them. RESULTS: 6,862 amputation and 39,589 carpal tunnel syndrome (CTS) cases were identified. Match rates between the datasets ranged from 34.0% to 45.6% (amputations) and 3.0% to 43.5% (CTS). Enumerated amputation and CTS cases from state-based sources were about five and ten times greater than the BLS SOII estimates (1,390 and 3,720). CONCLUSIONS: Successful demonstration of this state level approach has broad implications for improving federal and state efforts to track and prevent work-related injuries and illnesses.