National Estimates of Home Care Workers Nonfatal Emergency Department-Treated Injuries, United States 2015-2020.

OBJECTIVE: Home care workers (HCWs) are a critical resource contributing to the well-being of others. Presented are data on HCWs nonfatal emergency department (ED)-treated injuries. METHODS: Nonfatal injuries among HCWs were extracted from the NEISS-Work data between 2015 and 2020. RESULTS: Review of NEISS-Work data indicated 117,000 HCWs with nonfatal ED-treated injuries; female HCWs accounted for 93%. Overexertion and bodily reactions accounted for 52% of the injuries. Violence and other injuries by persons or animals accounted for 15% and falls, slips, and trips also accounted for 15% of the HCWs ED-treated injuries. CONCLUSIONS: The growing demand for home care services is increasing the number of workers at risk for injury. Future analyses should prioritize injury events among HCWs to gain a better understanding of the events contributing to injuries among HCWs.

Reproducibility and validity of a handheld spirometer.

BACKGROUND: Handheld spirometers have several advantages over desktop spirometers, but worries persist regarding reproducibility and validity of data from handheld spirometers. We undertook an independent examination of the EasyOne handheld spirometer. METHODS: The laboratory testing included reproducibility and validity testing with a waveform generator. We used standard American Thoracic Society waveforms for in-line testing, calibration adaptor testing, and testing during compression of the mouthpiece. The clinical testing involved repeated tests with 24 spirometry-naïve volunteers and comparison to spirometry results from laboratory (volume-sensing dry rolling seal) spirometer. RESULTS: The EasyOne exceeded standard thresholds for acceptability with the American Thoracic Society waveforms. In-line testing yielded valid results from the EasyOne. Between the EasyOne and the reference spirometer readings the mean +/- SD difference was 0.03 +/- 0.23 L for forced vital capacity (FVC) and -0.06 +/- 0.09 L for forced expiratory volume in the first second (FEV(1)). The calibration adaptor showed no appreciable problems. Extreme compression of the mouthpiece reduced the measured values. In clinical testing the coefficients of variation and limits of agreement were, respectively, 3.3% and 0.24 L for FVC, 2.6% and 0.18 L for FEV(1), and 1.9% and 0.05 for the FEV(1)/FVC ratio. The EasyOne readings were lower than those from the reference spirometer; the differences were: -0.12 L for FVC, -0.17 L for FEV(1), and -0.02 for FEV(1)/FVC. The limits of agreement were within criteria for FVC but not for the FEV(1), possibly due to a training effect. CONCLUSION: The EasyOne spirometer yielded generally reproducible results that were generally valid, compared to the values from the laboratory spirometer. The use of the EasyOne in clinical, occupational, and research settings seems justified.

Work-related reactive airways dysfunction syndrome cases from surveillance in selected US states.

The objective was to elaborate the descriptive epidemiology of work-related cases of reactive airways dysfunction syndrome (RADS). Cases of work-related asthma (WRA) were identified in four states in the United States during 1993-1995 as part of the Sentinel Event Notification Systems for Occupational Risks (SENSOR). Information gathered by follow-back interview was used to describe 123 work-related RADS cases and to compare them to 301 other WRA cases whose onset of disease was associated with a known asthma inducer. RADS represented 14% of all new-onset WRA cases identified by the state SENSOR surveillance systems. RADS cases had significant adverse medical and occupational outcomes identified by follow-back interview. In particular, 89% still had breathing problems, 78% had ever sought emergency care and 39% had ever been hospitalized for work-related breathing problems, 54% had applied for worker compensation benefits, and 41% had left the company where they experienced onset of asthma. These values equaled or exceeded the comparable figures for those WRA cases whose onset was attributed to a known inducer. Work-related RADS represents a minority of all WRA cases, but the adverse impact of this condition appears to equal that of other WRA cases.