scholarly journals Physical integrity of medical exam gloves with repeated applications of disinfecting agents: evidence for extended use

2021 ◽  
Author(s):  
Jared S Shless ◽  
Yoshika S Crider ◽  
Helen O Pitchik ◽  
Alliya S Qazi ◽  
Ashley Styczynski ◽  
...  
Keyword(s):  
The United States ◽  
Leak Test ◽  
Water Leak ◽  
Failure Risk ◽  
Percentage Points ◽  
Leak Testing ◽  
Control And Prevention ◽  
Repeated Applications ◽  
Crisis Conditions ◽  
And Control

Background: The COVID-19 pandemic has created global shortages of personal protective equipment (PPE) such as medical exam gloves, forcing healthcare workers to either forgo or reuse PPE to keep themselves and patients safe from infection. In severely resource-constrained situations, limited cycles of disinfection and extended use of gloves is recommended by the U.S. Centers for Disease Control and Prevention (CDC) to conserve supplies. However, these guidelines are based on limited evidence. Methods: Serial cycles of hand hygiene were performed on gloved hands using alcohol-based hand rub (ABHR) (six and ten cycles), 0.1% sodium hypochlorite (bleach) solution (ten cycles), or soap and water (ten cycles) on three types of latex and three types of nitrile medical exam gloves, purchased in the United States and India. A modified FDA-approved water-leak test was performed to evaluate glove integrity after repeated applications of these disinfecting agents. 80 gloves per disinfectant-glove type combination were tested. Within each glove type the proportion of gloves that failed the water-leak test for each disinfectant was compared to that of the control using a non-inferiority design with a non-inferiority margin of five percentage points. Results were also aggregated by glove material, and combined for overall results. Findings: When aggregated by glove material, the dilute bleach exposure demonstrated the lowest difference in proportion failed between treatment and control arms: -2.5 percentage points (95% CI: -5.3 to 0.3) for nitrile, 0.6 percentage points (95% CI: -2.6 to 3.8) for non-powdered latex. For US-purchased gloves tested with six and ten applications of ABHR, the mean difference in failure risk between treatment and control gloves was within the prespecified non-inferiority margin of five percentage points or less, though some findings were inconclusive because confidence intervals extended beyond the non-inferiority margin. The aggregated difference in failure risk between treatment and control gloves was 3.5 percentage points (0.6 to 6.4) for soap and water, and 2.3 percentage points (-0.5 to 5.0) and 5.0 percentage points (1.8 to 8.2) for 10 and 6 applications of ABHR, respectively. The majority of leaks occurred in the interdigital webs (35%) and on the fingers (34%). Conclusion: Current guidelines do not recommend extended use of a single-use PPE under normal supply conditions. However, our findings indicate that some combinations of glove types and disinfection methods may allow for extended use under crisis conditions. We found that ten applications of dilute bleach solution have the least impact on glove integrity, compared to repeated applications of ABHR and soap and water. However, the majority of glove and exposure combinations were inconclusive with respect to non-inferiority with a 5 percentage point non-inferiority margin. Testing specific glove and disinfectant combinations may be worthwhile for settings facing glove shortages during which extended use is necessary. The modified water-leak testing method used here is a low-resource method that could easily be reproduced in different contexts.  

scholarly journals Spatio-temporal analysis of influenza-like illness and prediction of incidence in high-risk regions, in the United States from 2011 to 2020

2021 ◽  
Author(s):  
Zhijuan Song ◽  
Xiaocan Jia ◽  
Junzhe Bao ◽  
Yongli Yang ◽  
Huili Zhu ◽  
...  
Keyword(s):  
United States ◽  
Statistical Significance ◽  
Temporal Analysis ◽  
The United States ◽  
Incidence Rates ◽  
Influenza Like Illness ◽  
Temporal Cluster ◽  
Control And Prevention ◽  
Spatio Temporal ◽  
And Control

Abstract Introduction: About 8% of Americans get influenza during an average season from the Centers for Disease Control and Prevention in the United States. It is necessary to strengthen the early warning of influenza and the prediction of public health. Methods In this study, we analyzed the characteristics of Influenza-like Illness (ILI) by Geographic Information System and SARIMA model, respectively. Spatio-temporal cluster analysis detected 23 clusters of ILI during the study period. Results The highest incidence of ILI was mainly concentrated in the states of Louisiana, District of Columbia and Virginia. The Local spatial autocorrelation analysis revealed the High-High cluster was mainly located in Louisiana and Mississippi. This means that if the influenza incidence is high in Louisiana and Mississippi, the neighboring states will also have higher influenza incidence rates. The regression model SARIMA(1, 0, 0)(1, 1, 0)52 with statistical significance was obtained to forecast the ILI incidence of Mississippi. Conclusions The study showed, the ILI incidence will begin to increase in the 45th week 2020 and peak in the 6th week 2021. To conclude, notable epidemiological differences were observed across states, indicating that some states should pay more attention to prevent and control respiratory infectious diseases.

Helium as a Replacement for Dichlorodifluoromethane in Class II Biological Safety Cabinet Integrity Testing

1997 ◽  
Vol 2 (2) ◽  
pp. 22-29 ◽  
Author(s):  
David G. Stuart ◽  
Daniel Ghidoni ◽  
Dennis Eagleson
Keyword(s):  
Environmental Protection Agency ◽  
The United States ◽  
Class Ii ◽  
International Agreement ◽  
Protection Agency ◽  
Tracer Gas ◽  
Leak Test ◽  
Biological Safety ◽  
Integrity Testing ◽  
Leak Testing

Dichlorodifluoromethane was commonly used for many years as a tracer gas for leak testing biological safety cabinets. International agreement to ban release of chlorofluorocarbons into the atmosphere led the United States Environmental Protection Agency to regulate the discharge limit to zero when adequate substitutes are available. Hence the need arose to develop a leak test using an alternative tracer gas that is environmentally friendly. Helium was compared to refrigerant 12 and found to be an adequate substitute in this testing of Class II Type A biological safety cabinets. A waiver was obtained from NSF International to permit the use of the proposed helium leak test as an alternative to the Halogen Leak Test.

scholarly journals Declining trends in the proportion of non-viral sexually transmissible infections reported by STD clinics in the US, 2000–10

Sexual Health ◽  
2014 ◽  
Vol 11 (4) ◽  
pp. 340 ◽  
Author(s):  
Kwame Owusu-Edusei ◽  
Bianca J. Sayegh ◽  
Alesia J. Harvey ◽  
Robert J. Nelson
Keyword(s):  
Transmitted Disease ◽  
The United States ◽  
Trend Test ◽  
Sti Prevention ◽  
Sexually Transmitted ◽  
Average Decrease ◽  
Sexually Transmissible Infections ◽  
The Us ◽  
Control And Prevention ◽  
And Control

Background Recent budget shortfalls may have resulted in decreases in the number of sexually transmissible infections (STIs) reported from sexually transmitted disease clinics (STDCs) in the United States (US). The objective of this study was to examine the proportion of cases reported from STDCs for three non-viral STIs in the last decade. Methods: Data from the national surveillance database on primary and secondary (P&S) syphilis, gonorrhoea and chlamydia cases for 2000–10 were extracted. The percentage of cases reported by STDCs for the nation and for each of the 48 contiguous states were then computed. Finally, the χ2 trend test for proportions was used to determine the annual average decrease/increase in the percentage of cases reported by STDCs for the nation and for each state. Results: Results demonstrate that the average annual declines in the proportion of P&S syphilis, gonorrhoea, and chlamydia cases reported from STDCs were 1.43% (P < 0.01), 1.31% (P < 0.01), and 0.31% (P < 0.01), respectively. Additionally, most of the states with statistically significant trends (P < 0.05) in the proportion of cases reported by STDCs had negative slopes: 86% (25/29) for P&S syphilis, 89% (34/38) for gonorrhoea, and 63% (27/43) for chlamydia. Conclusion: These results document the declining role of STDCs in STI prevention and control efforts in the US. Further studies are needed to assess the direct or indirect impact of the decline in the proportion of cases from STDCs on the overall STI control and prevention efforts in the US and its implications for the future.

scholarly journals Tobacco Harm Reduction as a Path to Restore Trust in Tobacco Control

2021 ◽  
Vol 18 (11) ◽  
pp. 5560
Author(s):  
Tamar M. J. Antin ◽  
Geoffrey Hunt ◽  
Rachelle Annechino
Keyword(s):  
Harm Reduction ◽  
Tobacco Control ◽  
Significant Proportion ◽  
The United States ◽  
Tobacco Prevention ◽  
Tobacco Harm Reduction ◽  
The People ◽  
Reduction Strategies ◽  
Control And Prevention ◽  
And Control

The controversy of tobacco harm reduction in the United States persists despite evidence that an important audience of tobacco prevention and control, i.e., the people who use or are likely to use nicotine and tobacco products, are engaging in practices that may be considered harm reduction. Despite this, a significant proportion of the US tobacco control and prevention field continues to be guided by a precept that there is “no safe tobacco,” therefore failing to acknowledge practices that may be used to reduce the harms associated with consuming combustible forms of nicotine and tobacco. In this commentary, we argue that ignoring the potential benefits of harm reduction strategies may unintentionally lead to an erosion of trust in tobacco control among some members of the public. Trust in tobacco control as an institution is crucial for the success of tobacco control efforts. To ensure trust, we must return to our basic principles of doing no harm, developing programs that are responsive to people’s experiences, and providing resources in assisting people to reduce the harms that may be associated with practices, such as smoking, which adversely affect health. Only by respecting an individual’s priorities can we cultivate trust and develop tobacco prevention efforts that are grounded in the realities of people’s lives and responsive to their needs.

scholarly journals Estimates of cases and hospitalizations averted by COVID-19 case investigation and contact tracing in 14 health jurisdictions in the United States

2021 ◽  
Author(s):  
Seonghye Jeon ◽  
Gabriel Rainisch ◽  
Ryan Lash ◽  
Patrick K Moonan ◽  
John E Oeltmann ◽  
...  
Keyword(s):  
The United States ◽  
Contact Tracing ◽  
Case Investigation ◽  
Percentage Points ◽  
Control And Prevention ◽  
Trained Staff ◽  
Nonpharmaceutical Interventions ◽  
The Impact ◽  
Overall Effectiveness ◽  
Do So

Context: The implementation of case investigation and contact tracing (CICT) for controlling COVID-19 (caused by SARS-Cov-2 virus) has proven challenging due to varying levels of public acceptance and initially constrained resources, especially enough trained staff. Evaluating the impacts of CICT will aid efforts to improve such programs. Objectives: Estimate the number of COVID-19 cases and hospitalizations averted by CICT and identify CICT processes that could improve overall effectiveness. Design: We used data on proportion of cases interviewed, contacts notified or monitored, and days from testing to contact notification from 14 jurisdictions to model the impact of CICT on cumulative cases counts and hospitalizations over a 60-day period. Using the Centers for Disease Control and Prevention (CDC)'s COVIDTracer tool, we estimated a range of impacts by assuming either contacts would quarantine only if monitored or would do so upon notification of potential exposure. We also varied the observed program metrics to assess their relative influence. Results: Performance by jurisdictions varied widely. Jurisdictions isolated between 12 and 86% of cases (including contacts which became cases) within 6 to 10 days after exposure-and-infection. We estimated that CICT-related reductions in transmission ranged from 0.4% to 32%. For every 100 cases prevented by nonpharmaceutical interventions, CICT averted between 4 and 97 additional cases. Reducing time to case isolation by one day increased averted case estimates by up to 15 percentage points. Increasing the proportion of cases interviewed or contacts notified by 20 percentage points each resulted in at most 3 or 6 percentage point improvements in averted cases. Conclusions: We estimated that case investigation and contact tracing reduced the number of COVID-19 cases and hospitalizations among all jurisdictions studied. Reducing time to isolation produced the greatest improvements in impact of CICT.

scholarly journals New guidelines on hepatitis in correctional settings in the United States

2003 ◽  
Vol 7 (7) ◽  
Author(s):  
R Gilbert
Keyword(s):  
United States ◽  
Prevention And Control ◽  
The United States ◽  
Federal Agencies ◽  
Hepatitis Viruses ◽  
Correctional Health ◽  
Control And Prevention ◽  
Correctional Settings ◽  
New Guidelines ◽  
And Control

The report on The Prevention and Control of Infections with Hepatitis Viruses in Correctional Settings (1) consolidates recommendations for the prevention and control of viral hepatitis in prisons. It was developed by the Centers for Disease Control and Prevention (CDC) in the United States (US) after consultation with federal agencies and specialists in the fields of corrections, correctional health care and public health at a meeting in Atlanta in March 2001.

When Temporal Orbits Collide: Embodied Trans Temporalities in U.S. Prisons

Somatechnics ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 74-94 ◽  
Author(s):  
Rae Rosenberg
Keyword(s):  
United States ◽  
Case Studies ◽  
The United States ◽  
Industrial Complex ◽  
Prison Industrial Complex ◽  
Trans Women ◽  
And Control

This paper explores trans temporalities through the experiences of incarcerated trans feminine persons in the United States. The Prison Industrial Complex (PIC) has received increased attention for its disproportionate containment of trans feminine persons, notably trans women of colour. As a system of domination and control, the PIC uses disciplinary and heteronormative time to dominate the bodies and identities of transgender prisoners by limiting the ways in which they can express and experience their identified and embodied genders. By analyzing three case studies from my research with incarcerated trans feminine persons, this paper illustrates how temporality is complexly woven through trans feminine prisoners' experiences of transitioning in the PIC. For incarcerated trans feminine persons, the interruption, refusal, or permission of transitioning in the PIC invites several gendered pasts into a body's present and places these temporalities in conversation with varying futures as the body's potential. Analyzing trans temporalities reveals time as layered through gender, inviting multiple pasts and futures to circulate around and through the body's present in ways that can be both harmful to, and necessary for, the assertion and survival of trans feminine identities in the PIC.

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