"Caminando Con Riesgo": perceptions of occupational injury, workplace safety and workers rights among Spanish-speaking hospitalized patients.

Introduction: Occupational health disparities are well documented among immigrant populations and occupational injury remains a high cause of morbidity and mortality among immigrant populations. There are several factors that contribute to the high prevalence of work-related injury among this population and those without legal status are more likely to experience abusive labor practices that can lead to injury. While the work-related injuries and experiences of Spanish-speaking workers have been explored previously, there is a paucity of literature documenting injury among hospitalized patients. Additionally, there are few documented hospital-based occupational injury prevention programs and no programs that implement workers rights information. The purpose of this study was to further explore the context of work related injuries primarily experienced by Spanish speaking patients and knowledge of their rights in the workplace. Methods: This was a semi-structured qualitative interview study with Spanish speaking patients admitted to the hospital for work related injuries. The study team member conducting interviews was bilingual and trained in qualitative methodology. An interview guide was utilized for all interviews and was developed with an immigrant workers rights organization and study team expertise, and factors documented in the literature. Participants were asked about the type and context of the injury sustained, access and perceptions of workplace safety, and knowledge of participants rights as workers. All interviews were conducted in Spanish, recorded, transcribed in Spanish and then translated into English. A codebook was developed and refined iteratively and two independent coders coded all English transcripts using Dedoose. Interviews were conducted until thematic saturation was reached and data was analyzed using a thematic analysis approach. Results: A total of eight interviews were completed. All participants reported working in hazardous conditions that resulted in an injury. Participants expressed a relative acceptance that their workplace environment was dangerous and acknowledged that injuries were common, essentially normalizing the risk of injury. There were varying reports of access to and utilization of safety information and equipment and employer engagement in safety was perceived as a facilitator to safety. Most participants did have some familiarity with Occupational Safety and Health Administration (OSHA) inspections but were not as familiar with OSHA procedures and their rights as workers. Discussion: We identified several themes related to workplace injury among Spanish speaking patients, many of which raise concerns about access to workplace safety, re-injury and long-term recovery. The context around immigration is particularly important to consider and may lead to unique risk factors for injury, recovery, and re-injury both in the workplace and beyond the workplace, suggesting that perhaps immigration status alone may serve as a predisposition to injury. Thus, it is critical to understand the context around work related injuries in this population considering the tremendous impact of employment on one's health and financial stability. Further research on this topic is warranted, specifically the exploration of multiple intersecting layers of exposure to injury among immigrant populations. Future work should focus on hospital-based strategies for injury prevention and know your rights education tailored to Spanish speaking populations.

Transient decrease in sound tolerance levels following hearing deprivation in normal-hearing subjects.

Objective: To determine the circadian influence on sound sensitivity produced by temporal hearing deprivation in healthy normal human subjects. Design: Participants underwent bilateral earplugging before completion of anthropometry, the author's developed questionnaire, the Hamilton Anxiety and Depression Inventory, pure tone audiometry (PTA), stapedial reflex thresholds (SRT), distortion products otoacoustic emissions input/output (DPOAE-I/O), and uncomfortable loudness levels (ULLs). Afterward, the participants were randomly divided into group A, starting at 8:00 a.m. and finishing at 8:00 p.m., and group B, starting at 4:00 p.m. and ending at 4:00 a.m. Serum cortisol levels and audiological test results were obtained at the beginning and end of the session and 24-h free urinary cortisol levels were measured. Study sample: Thirty healthy volunteers. Results: PTA was 2.68 and 3.33 dB HL in groups A and B, respectively, with no statistical difference between them. ULLs were significantly lower in group A compared to group B, with an average of 8.1 dB SPL in group A and 3.3 dB SPL in group B (p < 0.0001). A SRT shift was observed in group A, with no difference in group B, and a night shift in DPOAE-I/O in group B. Conclusions: Reduced loudness tolerance is demonstrated during daytime hearing deprivation in contrast to nighttime; this may be due to increased central gain in the awake cortex.

Pediatric lower respiratory tract infection: Considerations for the anesthesiologist.

Neonatal and childhood infectious diseases continue to be a global health problem. Acute respiratory tract infections are typically classified as upper respiratory tract infection and lower respiratory tract infections. The most common lower respiratory infections in childhood are pneumonia and bronchiolitis. Vaccination against measles, diphtheria, pertussis, Haemophilus influenzae, pneumococcus, and influenza resulted in a significant reduction in the incidence of acute respiratory tract infection globally. Though the global burden of the disease has decreased, the mortality rates still are higher in developing countries. Patients with severe lower respiratory tract infections and their complications are often evaluated for elective or emergency procedures. In this review article, the authors aim to discuss the etiology, pathogenesis, preoperative evaluation of lower respiratory tract infections, and the anesthesia implications pertinent to the practice of anesthesia.

Addressing process safety challenges in downstream industries in Brunei Darussalam.

International oil and gas corporations operating in Brunei may apply process safety management (PSM) and analysis techniques, resulting in varying approaches and measures to address process safety issues. Global corporations may have developed their own process safety standards while smaller firms employ established ones. This research compares the local PSM systems and standards with international ones to determine which employers face the most difficulties in implementing or increasing process safety inside their organizations. This study found that Occupational Safety and Health Administration (OSHA) regulations are used by 30% of local users in downstream operations. Common challenges encountered by local users are management/leadership commitment to process safety (11.9%), mechanical integrity and management of safety critical devices (5.3%), management review and intervention for continuous improvement (4.9%), communication amongst workers (3.8%), management of change (3.8%), operational control, permit to work and risk management (3.8%) and incident reporting (3.8%).

OSHA and NIOSH Turn 50.

OSHA and NIOSH turn 50 in 2021. Practice resources are described as well as links for following the respective 50-year anniversary reflections.

Descriptive epidemiology of clinically significant occupational poisonings, United States, 2008-2018.

INTRODUCTION: References listing common occupational poisons often include agents that were observed decades prior to the introduction of worker protective laws and regulations. Current causes of work-related acute poisonings have not been characterized. This study's primary objective was to describe the most common poisons and routes of exposure responsible for clinically significant occupational poisonings. A secondary objective was to determine the crude rate of clinically significant occupational poisonings and occupational poisoning-related deaths over the study period. METHODS: This was a retrospective cohort study using electronic data from the American Association of Poison Control Centers' (AAPCC) National Poison Data System (NPDS), and open source data from the United States Bureau of Labor Statistics (BLS). The NPDS was queried for all cases with exposure reason coded as "Unintentional-Occupational" for the period 1 January 2008 to 31 December 2018. A case of clinically significant occupational poisoning (CSOP) was defined as a case with moderate or severe clinical effects reported, to include fatal cases. A descriptive analysis was conducted using unadjusted odds ratios to assess the strength of association between main variables of interest and CSOP. RESULTS: 329,437 exposure cases were available for analysis. Of these, 54,254 were considered CSOP and included 196 deaths. The top five poisons responsible for occupational fatalities were hydrogen sulfide, ammonia, carbon monoxide, simple asphyxiants, and chlorines. Fatalities were 3.7 times (OR: 3.7; 95% CI: 2.2-6.4) more likely to be men and 5.7 times (OR: 5.7; 95% CI: 4.0-8.1) more likely to have had an inhalational exposure, compared to those workers with CSOP without fatality. The crude rate of occupational fatal poisoning reported to US poison centers was 11.3 deaths per 100,000,000 worker-years during the study period. The crude rate of clinically significant occupational poisoning was 3.1 per 100,000 worker-years. These rates remained generally stable over the study period. CONCLUSION: Occupational poisonings continue to be a significant cause of morbidity and mortality in the workplace despite significant improvements in workplace chemical safety over the last four decades. Workplace education and proper preventive measures devoted to inhalational toxicants and respiratory protection are opportunities for improvement.

Honoring Eula Bingham: A Memorial Gathering During the Covid-19 Pandemic.

Eula Bingham, a toxicologist who invigorated the Occupational Safety and Health Administration as its director and set stringent standards to protect workers from hazardous materials, died on 13 June 2020 in Cincinnati. Throughout Dr. Bingham's long career, she insisted tirelessly that workers had the absolute right to be safe on the job. Her thoughtful and generous wisdom shaped the entire field of occupational safety and health. Her bold and courageous actions prevented countless illnesses and injuries in workers around the world. This article presents the edited transcript from a Virtual Memorial Remembrance of Eula Bingham.

A scoping review of surgical masks and N95 filtering facepiece respirators: Learning from the past to guide the future of dentistry.

With the 2019 emergence of coronavirus disease 19 (colloquially called COVID-19) came renewed public concern about airborne and aerosolized virus transmission. Accompanying this concern were many conflicting dialogues about which forms of personal protective equipment best protect dental health care practitioners and their patients from viral exposure. In this comprehensive review we provide a thorough and critical assessment of face masks and face shields, some of the most frequently recommended personal safeguards against viral infection. We begin by describing the function and practicality of the most common mask types used in dentistry: procedural masks, surgical masks, and filtering respirator facemasks (also called N95s). This is followed by a critical assessment of mask use based on a review of published evidence in three key domains: the degree to which each mask type is shown to protect against airborne and aerosolized disease, the reported likelihood for non-compliance among mask users, and risk factors associated with both proper and improper mask use. We use this information to conclude our review with several practical, evidence-based recommendations for mask use in dental and dental educational clinics.

Analysis of Occupational Safety and Health Administration (OSHA) noise standard violations over 50 years: 1972 to 2019.

INTRODUCTION: Noise exposure has long been an occupational health concern and has been an important area of focus of the Occupational Safety and Health Administration (OSHA) since its founding. Nevertheless, it remains unclear what effects OSHA's noise standards have had on employer efforts to reduce risks. Consequently, a review of OSHA noise standard violations was performed to clarify the violation trends between 1972 and 2019. METHODS: Using the OSHA Information System, researchers identified 119 305 violations involving four noise standards between 1972 and 2019: 29 CFR 1910.95, occupational noise exposure in general industry; 1926.52, occupational noise exposure in construction; 1926.101, hearing protection in construction, and 1904.10, recording criteria for cases involving occupational hearing loss. Violation frequencies of noise standard subparagraphs and relationships to factors such as industry differences were analyzed using descriptive statistics and t tests. RESULTS: The most commonly violated noise standard was 1910.95 in manufacturing. Such violations rose between 1972 and 1985 and then declined steadily. Whether in general industry or construction, four noise standards were most-frequently cited: lack of feasible administrative or engineering controls (1910.95[b] and 1926.52[d]) and inadequate hearing conservation program (1910.95[c] and 1926.52[b]). These violations were more highly penalized (mean = $1036.50) than other subparagraph violations (mean = $915.80). Programmed and unprogrammed inspections generated similar violation quantities except between 1980 and 1985, when programmed inspections exhibited a sharp spike in violations. CONCLUSION: The study identified trends in OSHA noise standard violations and possible explanations for those trends. The study findings can support development of more practical noise-exposure protection policy.

Effects of continuous exposure to low concentration of ClO2 gas on the growth, viability, and maintenance of undifferentiated MSCs in long-term cultures.

INTRODUCTION: Hygienic management is more important in the manufacturing of cell products than in the production of chemical agents, because cell material and final product cannot be decontaminated. On the other hand, especially in the selection of hygienic agent, the adverse effects on the cells must be considered as well as the decontamination effect. ClO2 is a potent disinfectant, which is now expected as a safe and effective hygienic agent in the field of cell production. In this study, we investigated the effects of low dose ClO2 gas in the atmosphere of CO2 incubator on the characteristics of MSCs cultured in it. METHODS: First, we installed a ClO2 generator to a CO2 incubator for cell culture in which a constant level of ClO2 can be maintained. After culturing human cord derived MSCs in the CO2 incubator, the characteristics of cells were analyzed. RESULTS: Continuous exposure to 0.05 ppmv of ClO2 gas did not affect cell proliferation until at least 8th passage. In the FACS analysis, antigens usually expressed on MSCs, CD105, CD90, CD44, CD73 and CD29, were positively observed, but differentiation markers, CD11b and CD34, were little expressed on the MSCs exposed to 0.05 ppmv or 0.1 ppmv of ClO2 gas just as on the control cells. Also in the investigation for cell death, 0.05 ppmv and 0.1 ppmv of ClO2 gas little affected the viability, apoptosis or necrosis of MSCs. Furthermore, we assessed senescence using SA-ß-gal staining. Although the frequency of stained cells cultured in 0.1 ppmv of ClO2 gas was significantly increased than that of not exposed cells, the stained cells in 0.05 ppmv were rare and their frequency was almost the same as that in control. CONCLUSIONS: All these results indicate that, although excessive concentration of ClO2 gas induces senescence but neither apoptosis nor cell differentiation, exposure to 0.05 ppmv of ClO2 gas little affected the characteristics of MSCs. In this study we demonstrate that continuous exposure to appropriate dose of ClO2 gas can be safely used as decontamination agent in cell processing facilities.

Infection Prevention: 2020 Review and Update for Neurodiagnostic Technologists.

Since 1995, ASET has published recommendations for infection prevention. With the aim of keeping our readers current with updates in infection prevention initiatives, this article reviews ASET's past publications by Altman 1995, Altman 2000, Scott 2013, and Sullivan & Altman 2008, and incorporates new information from published scientific literature, online resources, print publications, national and international guidelines, OSHA and other regulatory agencies. Knowledge of current infection control practices and recommendations is essential for every Neurodiagnostic technologist, whether working in a hospital, an ambulatory setting, intensive care unit or in the operating room. All technologists who have direct patient contact are responsible for ensuring use of best practices to prevent the spread of infection.

Shedding light on a potential hazard: Dental light-curing units.

BACKGROUND: Dental light-curing units (LCUs) are powerful sources of blue light that can cause soft-tissue burns and ocular damage. Although most ophthalmic research on the hazards of blue light pertains to low levels from personal electronic devices, computer monitors, and light-emitting diode light sources, the amount of blue light emitted from dental LCUs is much greater and may pose a "blue light hazard." METHODS: The authors explain the potential risks of using dental LCUs, identify the agencies that provide guidelines designed to protect all workers from excessive exposure to blue light, discuss the selection of appropriate eye protection, and provide clinical tips to ensure eye safety when using LCUs. RESULTS: While current literature and regulatory standards regarding the safety of blue light is primarily based on animal studies, sufficient evidence exists to suggest that appropriate precautions should be taken when using dental curing lights. The authors found it difficult to find on the U.S. Food and Drug Administration database which curing lights had been cleared for use in the United States or Europe and could find no database that listed which brands of eyewear designed to protect against the blue light has been cleared for use. The authors conclude that more research is needed on the cumulative exposure to blue light in humans. Manufacturers of curing lights, government and regulatory agencies, employers, and dental personnel should collaborate to determine ocular risks from blue light exist in the dental setting, and recommend appropriate eye protection. Guidance on selection and proper use of eye protection should be readily accessible. CONCLUSIONS AND PRACTICAL IMPLICATIONS: The Centers for Disease Control and Prevention Guidelines for Infection Control in the Dental Health-Care Setting-2003 and the Occupational Safety and Health Administration Bloodborne Pathogen Standard do not include safety recommendations or regulations that are directly related to blue light exposure. However, there are additional Occupational Safety and Health Administration regulations that require employers to protect their employees from potentially injurious light radiation. Unfortunately, it is not readily evident that these regulations apply to the excessive exposure to blue light. Consequently employers and dental personnel may be unaware that these Occupational Safety and Health Administration regulations exist.

Assessment of personal protective equipment use and occupational exposures in small industries in Jeddah: Health implications for workers.

Small-scale industries account for a large proportion of jobs and play a vital role in most countries' economic growth and prosperity. Due to the very low use of personal protective equipment (PPEs), employees are exposed to numerous physical, chemical, and accidental hazards in small-scale industries. PPEs are very effective in minimizing occupational injuries, accidents, and other hazards which otherwise result in substantial manpower and financial losses. The study objective was to assess the availability and use of PPEs as well as self-reported occupational exposures among workers in surveyed small industries in Jeddah. The study involved 102 workers from 28 small-scale industries (vehicle repair, welding, and paint). A survey was conducted to gather data of socio-demographic characteristics, self-reported occupational exposures, and frequency of PPEs used by workers. The occupational exposures (never exposed, sometimes exposed and always exposed) were reported in percentages including; noise exposure (19.6, 73.5 and 6.9%); dust/smoke exposure (9.8, 69.6 and 20.6%); vapors/fumes exposure (11.8, 60.8 and 27.5%); and direct sunlight (43.1, 56.9 and 0%), respectively. The reported use of different PPEs in descending order was; knee joints mats (50%), welding shields (50%), safety glasses (33.3%), gloves (27.5%), face masks (26.5%), safety shoes (10.8%) and earplugs/ muffs (8.8%). On the basis of this study findings, hand hygiene and general OSH awareness like interventions can be developed which will help in minimizing workplace exposures among small-scale industry workers.

Beryllium Standard Update.

The updated Occupational Safety and Health Administration's (OSHA) beryllium standard for general industry, construction, and shipyards reduced exposure limits for this known human carcinogen and became effective in 2018. Occupational and environmental health nurses need to monitor updates recently proposed for general industry to clarify implementation of the standard.

Carbon Monoxide Poisoning.

Carbon monoxide poisoning is a serious and life-threatening event. Educating workers and communities on exposure sources, symptoms, and prevention is an important role for occupational health nurses.

Prevalence and Risk Factors of Work-Related Musculoskeletal Disorders Among Intensive Care Unit Nurses in China.

This cross-sectional study investigated the prevalence and risk factors of work-related musculoskeletal disorders among intensive care nurses in the Hunan Province of China. Nurses working in mixed intensive care units of 20 tertiary hospitals in this province participated in an online survey regarding work-related musculoskeletal injuries. The seven-part questionnaire included basic demographics; job and workplace characteristics; risk perception; physical, psychosocial, and workplace organizational factors; and musculoskeletal symptoms. The response rate was 70.7% (702 of 993 nurses). Approximately 97% of the respondents reported experiencing at least one work-related musculoskeletal disorder within the previous year. Low back pain was the most commonly reported musculoskeletal disorder (80.1%), followed by neck (78.6%) and shoulder pain (70.4%). The multivariate logistic regression analysis indicated that work-related musculoskeletal disorders were significantly associated with female gender (odds ratio [OR] = 0.115), unmarried status (OR = 0.136), a greater perception of risk (OR = 2.352), and lack of a safe work environment (OR = 1.056). These findings underscore the need for nurses and managers to reinforce risk awareness, improve physical and psychosocial working conditions, and promote a safer work environment.

A Descriptive Study of Musculoskeletal Injuries in Long-Haul Truck Drivers: A NIOSH National Survey.

Long-haul truck drivers are significantly affected by musculoskeletal injuries with incidence rates 3.5 times higher than the national average. Yet, little is known about injuries that affect long-haul trucks drivers. In 2010, interviewers collected data from 1,265 long-haul truck drivers at 32 truck stops across the United States. These surveys were analyzed to describe all self-reported musculoskeletal injuries. Injuries to the arm (26.3%) and back (21.1%) were the two areas most reported in the survey. Musculoskeletal injuries were most often caused by falls (38.9%) and contact with an object or equipment (33.7%) resulting most commonly in sprains/strains (60%). This large scale survey highlights the significance of musculoskeletal injuries in long-haul truck drivers and suggests the need to develop interventions to prevent injuries and improve recovery once injuries occur.