Tuberculosis in the Workplace: OSHA's Compliance Experience

1996 ◽  
Vol 17 (3) ◽  
pp. 159-164
Author(s):  
Melissa McDiarmid ◽  
Melissa J. Gamponia ◽  
Margaret A.K. Ryan ◽  
Jon Mark Hirshon ◽  
N.A. Gillen ◽  
...  
Keyword(s):  
Occupational Safety ◽  
Integrated Management ◽  
Skin Testing ◽  
Control Program ◽  
The Elderly ◽  
Homeless Shelters ◽  
Respiratory Protection ◽  
Health Administration ◽  
Term Care ◽  
Healthcare Facilities

AbstractObjective:Inspections of 272 facilities were performed between May 1992 and October 1994 to determine compliance with applicable Occupational Safety and Health Administration (OSHA) requirements for prevention of tuberculosis (TB) transmission.Design:Retrospective record review of two data sources: (1) OSHA's Computerized Integrated Management Information System and (2) an inspector-completed questionnaire on inspection results.Setting/Participants:Inspections of five types of facilities: healthcare institutions, correctional facilities, homeless shelters, long-term–care facilities for the elderly, and others, including drug treatment centers that the Centers for Disease Control and Prevention (CDC) identified as having a higher than expected rate of TB.Methods:The OSHA Compliance Memorandum, based on the 1990 CDC Guidelines, which outlined elements of a TB prevention program, was used in performing 272 inspections of facilities between May 1992 and October 1994. Elements of compliance were recorded and reviewed from the IMIS database and inspectors' questionnaires.Results:Regulated facilities were not fully compliant with OSHA guidance. Generally, healthcare facilities performed better than other facilities. Most facilities (79%) were compliant with administrative elements of a comprehensive TB control program, such as early identification of known or suspected infectious TB patients and skin testing of workers. Only 29% of inspected facilities were found to have acceptable respiratory protection programs for the prevention of occupational TB.Conclusion:Facilities have not been fully compliant with the OSHA memorandum describing protection of workers from TB. Facility compliance was better with some traditionally recognized TB infection control elements, but was weaker in the area of respiratory protection programs. This may reflect a lack of familiarity with the latter type of hazard protection.

Tuberculosis Surveillance Practices in Long-Term Care Institutions

1995 ◽  
Vol 16 (3) ◽  
pp. 148-151
Author(s):  
Gary Naglie ◽  
Margaret McArthur ◽  
Andrew Simor ◽  
Monika Naus ◽  
Angela Cheung ◽  
...  
Keyword(s):  
Skin Test ◽  
Long Term Care ◽  
Skin Testing ◽  
The Elderly ◽  
Positive Tuberculin Skin Test ◽  
Tuberculin Skin Testing ◽  
Term Care ◽  
Policies And Procedures ◽  
Testing Practices

AbstractObjecitves:To identify the tuberculosis (TB) skin-testing practices of long-term care facilities for the elderly in Toronto, Ontario.Design:A telephone survey using a 25-item questionnaire.Setting:Twenty-nine nursing homes (NHs) and 26 Homes for the Aged (HFAs) in metropolitan Toronto.Results:Thirty-one percent of facilities (17 of 55) had no formal tuberculin skin-testing program, including 52% of NHs (15 of 29) versus 8% of HFAs (2 of 26; P= 0.001). Ninety-two percent of HFAs (24 of 26) compared with 45% of NHs (13 of 29), obtained preadmission or admission skin-test status of residents (P= 0.0005). Annual testing was performed at 46% of HFAs (12 of 26) and 27% of NHs (8 of 29; P= 0.28). Of facilities that carried out any skin testing, 64% of HFAs (16 of 25) versus 32% of NHs (6 of 19) measured induration to establish test positivity (P=0.068). Fifty-two percent of HFAs (13 of 25), compared with 21% of NHs (4 of 19), recorded the actual size of induration in the patient record (P=0.085). Only 28% of HFAs (7 of 25) and 21% of NHs (4 of 19) correctly defined a positive tuberculin skin test.Conclusions:TB surveillance practices in long-term care institutions in Toronto are inadequate and often yield results that do not predict the risk of infection and cannot be used to investigate outbreaks. Tuberculin skin-testing practices were better at HFAs, which are subject to provincial legislation regarding TB surveillance, than at NHs, which are not subject to this legislation. Staff at HFAs and NHs require education regarding tuberculin skin-testing policies and procedures.

scholarly journals Respiratory Performance Offered by N95 Respirators and Surgical Masks: Human Subject Evaluation with NaCl Aerosol Representing Bacterial and Viral Particle Size Range

2008 ◽  
Vol 52 (3) ◽  
pp. 177-185 ◽  
Author(s):  
Shu-An Lee ◽  
Sergey A. Grinshpun ◽  
Tiina Reponen
Keyword(s):  
Occupational Safety ◽  
Size Range ◽  
Test Chamber ◽  
Respiratory Protection ◽  
Health Administration ◽  
Particle Size Range ◽  
Surgical Masks ◽  
Significant Difference ◽  
Exhalation Valve ◽  
N95 Respirators

Abstract Objectives: This study aimed at determining the protection factors (PFs) provided by N95 filtering facepiece respirators and surgical masks against particles representing bacterial and viral size ranges (aerodynamic size: 0.04–1.3 μm). Methods: The protection levels of N95 filtering facepiece respirators (four models) and surgical masks (three models) were investigated while they were donned by 12 subjects performing the OSHA (US Occupational Safety and Health Administration) fit-testing exercises in a test chamber. Results: About 29% of N95 respirators and ∼100% of surgical masks had PFs <10, which is the assigned PF designated for this type of respirator by the OSHA. On average, the PFs of N95 respirators were 8–12 times greater than those of surgical masks. The minimum PFs were observed in the size range of 0.04–0.2 μm. No significant difference in PF results was found between N95 respirators with and without an exhalation valve. Conclusions: The study indicates that N95 filtering facepiece respirators may not achieve the expected protection level against bacteria and viruses. An exhalation valve on the N95 respirator does not affect the respiratory protection; it appears to be an appropriate alternative to reduce the breathing resistance.

Patterns and trends in OSHA occupational noise exposure measurements from 1979 to 2013

2018 ◽  
Vol 76 (2) ◽  
pp. 118-124 ◽  
Author(s):  
Stephanie K Sayler ◽  
Benjamin J Roberts ◽  
Michael A Manning ◽  
Kan Sun ◽  
Richard L Neitzel
Keyword(s):  
Manufacturing Industry ◽  
Occupational Safety ◽  
Noise Exposure ◽  
Oil And Gas ◽  
Integrated Management ◽  
Occupational Noise ◽  
Health Administration ◽  
Noise Levels ◽  
Noise Measurements ◽  
Over Time

ObjectivesNoise is one of the most common exposures, and occupational noise-induced hearing loss (NIHL) is highly prevalent. In addition to NIHL, noise is linked to numerous non-auditory health effects. The Occupational Safety and Health Administration (OSHA) maintains the Integrated Management Information System (IMIS) database of compliance-related measurements performed in various industries across the USA. The goal of the current study was to describe and analyse personal noise measurements available through the OSHA IMIS, identifying industries with elevated personal noise levels or increasing trends in worker exposure over time.MethodsThrough a Freedom of Information Act request, we obtained OSHA’s noise measurements collected and stored in IMIS between 1979 and 2013 and analysed permissible exposure limit (PEL) and action level (AL) criteria measurements by two-digit industry code.ResultsThe manufacturing industry represented 87.8% of the 93 920 PEL measurements and 84.6% of the 58 073 AL measurements. The highest mean noise levels were found among the agriculture, forestry, fishing and hunting industry for PEL (93.1 dBA) and the mining, quarrying and oil and gas extraction group for AL (93.3 dBA). Overall, measurements generally showed a decreasing trend in noise levels and exceedances of AL and PEL by year, although this was not true for all industries.ConclusionsOur results suggest that, despite reductions in noise over time, further noise control interventions are warranted both inside and outside of the manufacturing industry. Further reductions in occupational noise exposures across many industries are necessary to continue to reduce the risk of occupational NIHL.

scholarly journals Strategies for managing N95 mask shortages at water resource recovery facilities during pandemics: a review

2020 ◽  
Vol 82 (12) ◽  
pp. 2798-2812
Author(s):  
Rasha Maal-Bared ◽  
Jennifer Loudon
Keyword(s):  
Health Care ◽  
Water Resource ◽  
Health Care Professionals ◽  
Occupational Safety ◽  
Health And Safety ◽  
Resource Recovery ◽  
Respiratory Protection ◽  
Health Administration ◽  
Dry Heat ◽  
Job Safety

Abstract As the numbers of COVID-19 cases grew globally, the severe shortages of health care respiratory protective equipment impacted the ability of water resource recovery facilities (WRRFs) to acquire N95 masks for worker protection. While the Occupational Safety and Health Administration (OSHA) encourages WRRFs to conduct job safety assessments to mitigate risks from bioaerosols, it does not provide clear guidance on respiratory protection requirements, leaving the use of N95 masks across the industry non-standardized and difficult to justify. Strategies need to be developed to cope with shortages during pandemics, and these should take into consideration a WRRF's size and disinfection equipment available. Our objective is to provide an overview of respiratory protection-related practices recommended for health care professionals that apply to WRRFs (e.g., elimination, substitution, extended use, reuse, disinfection). Reviewed N95 mask disinfection strategies included using hydrogen peroxide, autoclaving, moist heat, dry heat, ultraviolet germicidal irradiation (UVGI), ethylene oxide, chlorine and ethanol. Of these, dry heat, autoclaving and UVGI present the most promise for WRRFs, with UVGI being limited to larger utilities. We recommend that WRRFs work closely with disinfection technology manufacturers, mask providers, health and safety staff and inspectors to develop suitable programs to cope with N95 mask shortages during pandemics.

scholarly journals A Hazard Identification Approach of Integrating 4D BIM and Accident Case Analysis of Spatial–Temporal Exposure

2021 ◽  
Vol 13 (4) ◽  
pp. 2211
Author(s):  
Si Van-Tien Tran ◽  
Numan Khan ◽  
Doyeop Lee ◽  
Chansik Park
Keyword(s):  
Information Integration ◽  
Occupational Safety ◽  
Integrated Management ◽  
Safety Information ◽  
Hazard Identification ◽  
Information Modeling ◽  
Health Administration ◽  
Construction Stage ◽  
Building Information ◽  
Identification Approach

Construction sites are considered as complicated work environments. Various concurrent activities may overlap apropos to time and workspace, predisposing them to spatial–temporal exposure and repetitive accidents. Detecting the characteristics of repetitive accidents before the construction stage contributes to prevent injuries and fatalities caused by spatial—temporal conditions at construction job sites. To resolve this problem, this study proposes a novel hazard identification approach through spatial–temporal exposure analysis called HISTEA, which integrated scenario analysis of accident cases into 4D building information modeling (BIM). The proposed approach consists of three modules: (1) spatial–temporal hazard investigation (SHI) to analyze the accident cases and develop the hazard database of the spatial–temporal overlap condition of pair-wise activities; (2) spatial–temporal condition identification (SCI) to determine the conflict among different activities, considering the workspace and time overlap from the 4D BIM model; and (3) safety information integration (SII) to deliver safety knowledge to the project team through a web-based application. To illustrate and validate this approach, a HISTEA prototype for foundation work has been developed to be used at the pre-construction stage. The developed prototype is based on the analysis of 496 accident reports extracted from the integrated management information system (IMIS) of the Occupational Safety and Health Administration for the SHI module database. The proposed approach is expected to proactively aid project teams in detecting hazards that ultimately reduce repetitive accidents caused by overlapping activities.

Occupational Co-exposures to Multiple Chemical Agents from Workplace Measurements by the US Occupational Safety and Health Administration

2020 ◽  
Vol 64 (4) ◽  
pp. 402-415
Author(s):  
Delphine Bosson-Rieutort ◽  
Philippe Sarazin ◽  
Dominique J Bicout ◽  
Vikki Ho ◽  
Jérôme Lavoué
Keyword(s):  
Occupational Exposure ◽  
Web Application ◽  
Occupational Safety ◽  
Metal Cluster ◽  
Integrated Management ◽  
Measurement Data ◽  
The United States ◽  
Occupational Safety And Health ◽  
Health Administration ◽  
Safety And Health

Abstract Objectives The occupational environment represents an important source of exposures to multiplehazards for workers’ health. Although it is recognized that mixtures of agents may have differenteffects on health compared to their individual effects, studies generally focus on the assessment ofindividual exposures. Our objective was to identify occupational co-exposures occurring in the United States using the multi-industry occupational exposure databank of the Occupational Safety and Health Administration (OSHA). Methods Using OSHA’s Integrated Management Information System (IMIS), measurement data from workplace inspections occurring from 1979 to 2015 were examined. We defined a workplace situation (WS) by grouping measurements that occurred within a company, within the same occupation (i.e. job title) within 1 year. All agents present in each WS were listed and the resulting databank was analyzed with the Spectrosome approach, a methodology inspired by network science, to determine global patterns of co-exposures. The presence of an agent in a WS was defined either as detected, or measured above 20% of a relevant occupational exposure limit (OEL). Results Among the 334 648 detected exposure measurements of 105 distinct agents collected from 14 513 US companies, we identified 125 551 WSs, with 31% involving co-exposure. Fifty-eight agents were detected with others in >50% of WSs, 29 with a proportion >80%. Two clusters were highlighted, one for solvents and one for metals. Toluene, xylene, acetone, hexone, 2-butanone, and N-butyl acetate formed the basis of the solvent cluster. The main agents of the metal cluster were zinc, iron, lead, copper, manganese, nickel, cadmium, and chromium. 68 556 WS were included in the analyses based on levels of exposure above 20% of their OEL, with 12.4% of co-exposure. In this analysis, while the metal cluster remained, only the combinations of toluene with xylene or 2-butanone were frequently observed among solvents. An online web application allows the examination of industry specific patterns. Conclusions We identified frequent co-exposure situations in the IMIS databank. Using the spectrome approach, we revealed global combination patterns and the agents most often implicated. Future work should endeavor to explore the toxicological effects of prevalent combinations of exposures on workers’ health to prioritize research and prevention efforts.

scholarly journals Analysis of Various Lockout Tagout (LOTO) Devices used in Industrial Safety

2018 ◽  
Vol 7 (3.12) ◽  
pp. 1329
Author(s):  
Sameer Kumar ◽  
S M.Tauseef
Keyword(s):  
Occupational Safety ◽  
Control Program ◽  
Occupational Safety And Health ◽  
Cnc Machining ◽  
Industrial Safety ◽  
Health Administration ◽  
Energy Control ◽  
Safety And Health ◽  
And Control ◽  
Safety Enhancement

Industries have equipment and processes which use hazardous energies like electrical, chemical, gravity, thermal, hydraulics etc. These hazardous energies are handled with utmost precaution and control of these hazardous energies ensures and enhances Safety. Factories Act-India, Occupational Safety and Health Administration, USA(OSHA) and others have defined a very detailed Hazardous Energy Control Program known as Lockout Tagout(LOTO) where these hazardous energies are controlledThese detailed LOTO procedures requires various LOTO devices to control the hazardous energies. These LOTO devices have many varieties (design, sizes, shapes etc.) based on the application.This paper aims to study various LOTO devices used for controlling various hazardous energies like electrical, mechanical, gravity, chemical, hydraulic, thermal, their specifications, application and limitations on a CNC Machining Centre.This will help in identification and use of most appropriate LOTO device for controlling specific hazardous energies. This can be very efficient in safety enhancement and reduction in safety related incidents.  

Pharmacology Issues Related to Dementia Syndrome of Depression in Elderly Residents of Long-Term Care Settings

2015 ◽  
Vol 25 (2) ◽  
pp. 61-69
Author(s):  
Angel L. Ball ◽  
Adina S. Gray
Keyword(s):  
Depressive Symptoms ◽  
The Elderly ◽  
Environmental Communication ◽  
Pharmacological Intervention ◽  
Team Approach ◽  
Discussion Paper ◽  
Term Care ◽  
Anticholinergic Medications ◽  
Inappropriate Treatment ◽  
Dementia Syndrome

Pharmacological intervention for depressive symptoms in institutionalized elderly is higher than the population average. Among the patients on such medications are those with a puzzling mix of symptoms, diagnosed as “dementia syndrome of depression,” formerly termed “pseudodementia”. Cognitive-communicative changes, potentially due to medications, complicate the diagnosis even further. This discussion paper reviews the history of the terminology of “pseudodementia,” and examines the pharmacology given as treatment for depressive symptoms in the elderly population that can affect cognition and communication. Clinicians can reduce the risk of misdiagnosis or inappropriate treatment by having an awareness of potential side effects, including decreased attention, memory, and reasoning capacities, particularly due to some anticholinergic medications. A team approach to care should include a cohesive effort directed at caution against over-medication, informed management of polypharmacology, enhancement of environmental/communication supports and quality of life, and recognizing the typical nature of some depressive signs in elderly institutionalized individuals.

The Unusual Cruelty of Nursing Homes Behind Bars

2020 ◽  
Vol 32 (5) ◽  
pp. 264-271
Author(s):  
Rachel E. López
Keyword(s):  
Nursing Homes ◽  
Human Dignity ◽  
Prison Population ◽  
Financial Burden ◽  
The Elderly ◽  
The United States ◽  
Term Care ◽  
Trained Staff ◽  
State Prisons ◽  
The Cost

The elderly prison population continues to rise along with higher rates of dementia behind bars. To maintain the detention of this elderly population, federal and state prisons are creating long-term care units, which in turn carry a heavy financial burden. Prisons are thus gearing up to become nursing homes, but without the proper trained staff and adequate financial support. The costs both to taxpayers and to human dignity are only now becoming clear. This article squarely addresses the second dimension of this carceral practice, that is the cost to human dignity. Namely, it sets out why indefinitely incarcerating someone with dementia or other neurocognitive disorders violates the Eighth Amendment of the United States Constitution’s prohibition on cruel and unusual punishment. This conclusion derives from the confluence of two lines of U.S. Supreme Court precedent. First, in Madison v. Alabama, the Court recently held that executing someone (in Madison’s case someone with dementia) who cannot rationally understand their sentence amounts to cruel and unusual punishment. Second, in line with Miller v. Alabama, which puts life without parole (LWOP) sentences in the same class as death sentences due to their irrevocability, this holding should be extended to LWOP sentences. Put another way, this article explains why being condemned to life is equivalent to death for someone whose neurodegenerative disease is so severe that they cannot rationally understand their punishment.

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