RESUMEN
Ensuring the safety and health of workers in this country, who are employed at millions of workplaces that present a dizzying array of hazards, is daunting. Every day, workers are maimed or die from workplace injuries or occupational illnesses. Hence, government agencies must use all available means to ensure the laws intended to keep workers safe and healthy in their workplaces are maximally effective in accomplishing that purpose. This paper addresses this challenge through the lens of strategic enforcement. It examines how federal and state authority are designed to interact to ensure worker protection in this space, and focuses on what tools for deterring violations - many unrecognized or underutilized by worker safety agencies - are available to leverage the limited resources that inevitably constrain the agencies' reach. The forthcoming Part II will, among other things, showcase a number of noteworthy state and local initiatives that exceed the federal standard.
Asunto(s)
Salud Laboral , Humanos , Salud Laboral/legislación & jurisprudencia , Salud Laboral/normas , Estados Unidos , Lugar de Trabajo/legislación & jurisprudencia , Lugar de Trabajo/normas , Administración de la Seguridad/legislación & jurisprudencia , Administración de la Seguridad/normas , Administración de la Seguridad/organización & administración , United States Occupational Safety and Health Administration/normas , United States Occupational Safety and Health Administration/legislación & jurisprudencia , Accidentes de Trabajo/prevención & control , Accidentes de Trabajo/legislación & jurisprudencia , Traumatismos Ocupacionales/prevención & controlRESUMEN
Purpose: To evaluate the noise levels recorded in a hospital-based pediatric dental clinic and evaluate the occupational exposure personnel have to potentially hazardous levels of noise. Methods: A SoundAdvisor™ Sound Level Meter Model 831C was used to gather 19 days of background sound data (equivalent continuous sound levels, measured as LAeq) in the open bay, quiet room, sedation suite, and operating room settings. A Spartan™ Wireless Noise Dosimeter Model 730 (Larson Davis) was utilized to capture data about personal noise exposure of pediatric dental residents over 81 clinic sessions. Personal noise exposure was compared to the Occupational Safety and Health Administration (OSHA) stand- ard. Results: Background A-weighted sound pressure level was significantly less for the open bay than in the operating room, quiet room, and oral sedation setting (P<0.05), while the operating room was significantly less than the oral sedation setting (P=0.038). Personal LAeq was significantly less for the open bay than the quiet room (P=0.007) and oral sedation settings (P=0.007). There was a significantly larger percentage of time above 80 dBA captured in the oral sedation suite compared to the open bay (P=0.010) or operating room (P=0.023). Conclusions: Daily occupational noise exposure did not exceed the thresholds set forth by OSHA. Sedation and quiet room treatment settings were noted to be the loudest pediatric dental clinical environments.
Asunto(s)
Ruido en el Ambiente de Trabajo , Exposición Profesional , Odontología Pediátrica , Humanos , Ruido en el Ambiente de Trabajo/efectos adversos , Clínicas Odontológicas , United States Occupational Safety and Health Administration , Estados Unidos , Niño , Quirófanos , Internado y ResidenciaRESUMEN
Halfmask air-purifying respirators are used by millions of workers to reduce inhaling air contaminants, both chemical (e.g., asbestos, styrene) and biological (e.g., SARS-CoV-2, Mycobacterium tuberculosis). In 2006, the federal Occupational Safety and Health Administration (OSHA) promulgated a standard that gave halfmask respirators an assigned protection factor (APF) of 10. This signified that OSHA assumes a fit-tested and trained wearer will experience a 10% maximum total inward leakage of contaminated air into the facepiece. To derive APF = 10, OSHA analyzed data from 16 workplace studies of the efficacy of halfmask respirators worn against particulate contaminants. In this commentary, I contend that, in considering the data, OSHA made several errors that overstated halfmask respirator efficacy. The errors were (i) failing to properly account for within-wearer and between-wearer variability in respirator efficacy; (ii) ignoring the effect of particle deposition in the respiratory tract; (iii) aggregating unbalanced data within and between studies, and effectively double-counting the data in some studies; and (iv) ignoring the effect that particle size exerts in penetrating respirator facepiece leak paths. The net result is that OSHA's APF = 10 can lead to excessive toxicant exposure for many workers.
Asunto(s)
Exposición Profesional , Dispositivos de Protección Respiratoria , United States Occupational Safety and Health Administration , Humanos , Exposición Profesional/prevención & control , Estados Unidos , COVID-19/prevención & control , COVID-19/epidemiología , Exposición por Inhalación/prevención & control , SARS-CoV-2RESUMEN
The American Iron and Steel Institute (AISI) gathered data between 1989 and 1997 to build an "objective database" to further understand the occupational exposures generated by the few asbestos-containing materials remaining at various steelmaking companies at this time. This paper analyzed the 520 samples from this campaign which occurred at five different steel manufacturers: Georgetown Steel Company, Inland Steel Company, Ling-Temco-Vought (LTV) Corporation, United States Steel Corporation, and Weirton Steel Corporation. This database is believed to have never previously been systematically organized. Samples were grouped based on sampling times to determine whether they should most appropriately be compared to the OSHA short-term excursion limit (EL) or the 8-hr time-weighted average (TWA) permissible exposure limit (PEL). Sampling times of 30 min or less were considered short-term samples, and samples of 180 min or greater were considered representative workday samples. Samples that did not fit into either category, with sampling times between 31 and 179 min, were considered task samples. Overall, the data indicated that the airborne concentrations were quite low in 1989 and they continued to be low through the study period which ended in 1997. Only seven out of 286 (approximately 2.5%) short-term or representative workday samples were in exceedance of the current OSHA OELs that were implemented in 1994 (short-term samples being compared to the 1 f/cc EL and representative workday samples being compared to the 0.1 f/cc 8-hr TWA PEL). Consistent with prior data, analysis of this dataset supports the view that materials containing asbestos were not used in many applications in the steel industry, and measured airborne concentrations of asbestos were almost always below the occupational exposure limits (OELs) in the post-OSHA era (1972-2000).
Asunto(s)
Contaminantes Ocupacionales del Aire , Monitoreo del Ambiente , Metalurgia , Acero , Humanos , Contaminantes Ocupacionales del Aire/análisis , Amianto/análisis , Monitoreo del Ambiente/métodos , Exposición Profesional/análisis , Estados Unidos , United States Occupational Safety and Health AdministrationRESUMEN
The Occupational Safety and Health Administration (OSHA) severe injuries reports include work-related injuries from establishments under federal OSHA jurisdiction that result in an amputation, loss of an eye, or inpatient hospitalization. Data from 32 jurisdictions were examined to determine oil and gas extraction industry-specific severe industry trends during January 2015-July 2022, using the 2012 North American Industry Classification System (NAICS) codes for oil and gas extraction. During this period, a total of 2,101 severe work-related injuries were reported in this sector. Among these severe work-related injuries, well service contract workers' injuries included the highest number of amputations (417) and hospitalizations (1,194), accounting for 20% and 57%, respectively, of all severe injuries reported. Overall, 895 (43%) of all severe injuries reported involved upper extremities. Contract workers in the service and drilling subindustries (NAICS codes 213112 and 213111, respectively) experienced disproportionately more work-related injuries compared with those in the operation subindustry (NAICS code 211). These injuries could be preventable by including contractors in worksite safety plans that administer the hierarchy of controls, are within an effective safety management system, and provide consistent safety training on work equipment, personal protective equipment, and daily site safety meetings that increase safety culture.
Asunto(s)
Accidentes de Trabajo , Traumatismos Ocupacionales , Estados Unidos/epidemiología , Humanos , Traumatismos Ocupacionales/epidemiología , United States Occupational Safety and Health Administration , Industrias , Lugar de TrabajoRESUMEN
INTRODUCTION: In 2014, the Federal Occupational Safety and Health Administration (OSHA) enacted a standard requiring employers to report work-related amputations to OSHA within 24 hours. We studied the characteristics of the injured workers and employer compliance with the regulation in Michigan. METHODS: Two independent data sets were used to compare work-related amputations from 2016 to 2018: employer reports to OSHA and the Michigan Multi-Source Injury and Illness Surveillance System (MMSIISS). We deterministically linked employer reports to OSHA with the MMSIISS by employee name, employer name, date, and type of amputation. RESULTS: We identified 1366 work-related amputations from 2016 to 2018; 575 were reported by employers to OSHA and 1153 were reported by hospitals to the MMSIISS. An overlap of 362 workers were reported in both systems, while 213 workers were only reported by employers to OSHA and 791 workers were only reported by hospitals. Employer compliance with the regulation was 42.1%. Employer compliance with reporting was significantly less in: agriculture, forestry, fishing, and hunting (14.6%); construction (27.4%); retail trade (20.7%); arts, entertainment, and recreation (7.7%); accommodation and food services (13.0%); and other services (27.0%). Large employers and unionized employers were significantly more likely (67.9% and 92.7%, respectively) and small employers were significantly less likely (18.2%) to comply with the reporting rule. Enforcement inspections at 327 workplaces resulted in 403 violations; of those, 179 (54.7%) employers had not corrected the amputation hazard before the time of inspection. DISCUSSION: Michigan employers reported less than half of the work-related amputations required by OSHA's reporting regulation. Noncompliance was greatest in small employers, and agriculture, forestry, fishing, and hunting; construction; arts, entertainment, and recreation; accommodation and food services; and retail and other service industries. Inspections found that over half of the employers had not corrected the hazard that caused the amputation at the time of the inspection's initial opening date; in these cases, abatement of any hazards identified would have occurred after the inspection. Improved compliance in employer reporting of work-related amputations will identify hazards posing a high risk of recurrence of injury to other workers from the same injury source. Greater compliance can also help target safety-related preventive and intervention efforts in industries that might otherwise be overlooked.
Asunto(s)
Traumatismos Ocupacionales , Lugar de Trabajo , Estados Unidos , Humanos , United States Occupational Safety and Health Administration , Michigan/epidemiología , Traumatismos Ocupacionales/epidemiología , IndustriasRESUMEN
PROBLEM: Employers are required to report severe work-related injuries (e.g., amputation, inpatient hospitalization, or loss of an eye), to the Occupational Safety and Health Administration (OSHA). This study examined the OSHA severe injury reports (SIRs) public microdata to understand time-related trends and patterns. METHODS: This study included all SIRs from January 2015 to December 2021 (84â¯months). We employed time series decomposition models (classical additive and multiplicative, X-11, and X-13ARIMA-SEATS) to evaluate monthly seasonal effect and seasonally adjusted trend of SIRs. We developed data visuals to display trends from different models with the original data series. We compared number of daily SIRs by day of the week, and yearly trends by 2-digit NAICS and separately by 1-digit OIICS injury event. RESULTS: There were a total of 70,241 SIRs in this 7â¯year period; ranging from 8,704 to 11,156 per year, and 600 to 1,100 per month. Seasonally adjusted trend indicated a gradual increase of SIRs over time until October 2018, then a steeper decrease until August 2020, and staying somewhat flat for the rest of the months. Seasonality indicated more SIRs were reported in the summer months (June, July, August). Daily SIRs indicated a weekday average of 34 (SDâ¯=â¯9) and weekend average of 11 (SDâ¯=â¯5). The Manufacturing and Construction industries reported the highest yearly SIRs. Contact with objects and equipment, and falls, slips, trips were the most numerous injury events associated with SIRs. DISCUSSION: Although Federal OSHA SIR data do not include SIRs from state-plan jurisdictions, the data provide a timely national trend of SIR. This is the first known time series analysis of SIRs. PRACTICAL APPLICATIONS: The findings of this study highlight the ability of researchers to use the SIRs as a timely indicator to understand occupational injury trends by specific industries and injury events.
Asunto(s)
Industria de la Construcción , Traumatismos Ocupacionales , Estados Unidos/epidemiología , Humanos , Factores de Tiempo , United States Occupational Safety and Health Administration , ComercioRESUMEN
All US nursing homes are required to report workplace injury and illness data to the Occupational Safety And Health Administration (OSHA). Nevertheless, the compliance rate for US nursing homes during the period 2016-21 was only 40 percent. We examined whether unionization increases the probability that nursing homes will comply with that requirement. Using a difference-in-differences design and proprietary data on union status from the Service Employees International Union for all forty-eight continental US states from the period 2016-21, we found that two years after unionization, nursing homes were 31.1 percentage points more likely than nonunion nursing homes to report workplace injury and illness data to OSHA. Data on injuries occurring in specific workplaces play a central role in injury prevention. Further unionization could help improve workplace safety in nursing homes, a sector with one of the highest occupational injury and illness rates in the US.
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Casas de Salud , Instituciones de Cuidados Especializados de Enfermería , Estados Unidos , Humanos , United States Occupational Safety and Health Administration , Lugar de Trabajo , SindicatosRESUMEN
BACKGROUND: Workers can be injured by animals such as mammals and insects. Previous studies found that most animal-related occupational fatalities were caused by horses and cattle. We analyzed characteristics of recent nonfatal severe animal-related injuries in US workers. METHODS: The severe injury reports (SIR) database, collected by the Occupational Safety and Health Administration, contains employer self-reports of inpatient hospitalizations and amputations. We used 2015-2021 SIR data to assess properties of animal-related injuries, including the type of animal involved, the nature of the injury, and the industry of the employer. Industry-specific incidence rates were calculated. RESULTS: We identified 788 severe animal-related injuries during the 7-year study period. Mammals caused over half of these injuries (476; 60.4%), followed by insects, arachnids, and mites (183; 23.2%) and reptiles (127; 16.1%). Two-thirds (529; 67.1%) of animal-related injuries were traumatic, while 211 (28.0%) injuries were due to poisoning or allergic reaction. The highest observed incidence was in livestock merchant wholesalers (59.6 severe injuries per 100,000 workers per year); injuries in this industry were often due to cattle. Mail delivery and landscape architecture, two industries in which animal contact is atypical, were also among the 10 industries with the highest incidence. CONCLUSIONS: Workers in many industries experienced severe injuries due to animals. Among workers whose job involves animal contact, cattle workers appear to be at highest risk. Outdoor workers in some industries require protection from bites of dogs, snakes, and insects.
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Traumatismos Ocupacionales , Estados Unidos , Humanos , Animales , Bovinos , Perros , Caballos , Traumatismos Ocupacionales/epidemiología , Traumatismos Ocupacionales/etiología , Accidentes de Trabajo/prevención & control , United States Occupational Safety and Health Administration , Industrias , MamíferosRESUMEN
The inaugural Workers' Voice Summit was held in Washington DC in 2022. Worker advocates from across the country spoke directly with the Occupational Safety and Health Administration (OSHA), part of the U.S. Department of Labor (DOL) about their concerns and ideas for solutions moving forward. Worker advocates shared their experiences with ineffective OSHA enforcement and a lack of accountability for poor employer behaviors. National Council for Occupational Safety and Health (COSH) network members developed priorities in advance of the summit that laid out a path for progress. Priorities included: engagement of workers and advocates as collaborators with OSHA; protection for workers from being silenced due to immigration status; enabling workers to fully participate in workplace investigations and enforcement proceedings; protection for temporary workers; and collaboration with state and federal agencies to maximize worker protections. The summit was a good start and worker advocates are prepared to keep pushing.
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Salud Laboral , Lugar de Trabajo , Estados Unidos , Humanos , United States Occupational Safety and Health Administration , Agencias GubernamentalesRESUMEN
Fifty-one (51) personal silica air samples were collected over 13 days on 19 construction employees while they performed five different construction tasks found in the Occupational Safety and Health Administration's (OSHA) respirable crystalline silica standard for construction, Table 1, which specifies engineering, work practice, and respiratory protection controls that employers can use in lieu of exposure monitoring to adhere to the standard. The average construction task time was 127 min (range: 18-240 min) with a mean respirable silica concentration of 85 µg m-3 (standard deviation [SD] = 176.2) for all 51 measured exposures. At least one OSHA-specified silica dust control measure was used during all 51 samples collected. The mean silica concentrations for the five tasks were: core drilling 11.2 µg m-3 (SD = 5.31 µg m-3), cutting with a walk-behind saw 126 µg m-3 (SD = 115 µg m-3), dowel drilling 99.9 µg m-3 (SD = 58.7 µg m-3), grinding 172 µg m-3 (SD = 145 µg m-3), and jackhammering 23.2 µg m-3 (SD = 5.19 µg m-3). Twenty four of 51 (47.1%) workers were exposed above the OSHA Action Level (AL) of 25 µg m-3 and 15 of 51 (29.4%) were exposed above the OSHA Permissible Exposure Limit (PEL) of 50 µg m-3 when exposures were extrapolated to an 8-h shift. When silica exposures were extrapolated to 4 h, 15 of 51 (29.4%) of workers sampled were exposed over the OSHA AL and 8 of 51 (15.7%) were exposed over the OSHA PEL. A total of 15 area airborne respirable crystalline silica samples were collected on days where the personal task-based silica samples were taken, with an average sampling time of 187 min. Of the 15 area respirable crystalline silica samples, only four were greater than the laboratory reporting limit of 5 µg m-3. The four area silica samples with reportable concentrations revealed background silica concentrations of 23 µg m-3, 5 µg m-3, 40 µg m-3, and 100 µg m-3. Odds ratios were used to analyze the apparent association between dichotomous background construction site exposures to respirable crystalline silica (detectable or not detectable), and personal exposure category (over or not over the OSHA AL and PEL) when exposure times were extrapolated to 8 h. The associations were strongly positive and significant between detectable background exposures and personal overexposures for workers conducting the five Table 1 tasks with engineering controls in place. The results of this study suggest that exposure to hazardous levels of respirable crystalline silica may be present even when OSHA-specified engineering controls are implemented. The current study findings also suggest that background construction site silica concentrations may potentially cause task-based overexposures, even when the OSHA Table 1 control methods have been put in place.
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Contaminantes Ocupacionales del Aire , Exposición Profesional , Estados Unidos , Humanos , Exposición Profesional/análisis , Contaminantes Ocupacionales del Aire/análisis , United States Occupational Safety and Health Administration , Exposición por Inhalación/análisis , Dióxido de Silicio/análisis , Polvo/análisisRESUMEN
INTRODUCTION: The US Integrated Management Information System (IMIS) contains workplace measurements collected by Occupational Safety and Health Administration (OSHA) inspectors. Its use for research is limited by the lack of record of a value for the limit of detection (LOD) associated with non-detected measurements, which should be used to set censoring point in statistical analysis. We aimed to remedy this by developing a predictive model of the volume of air sampled (V) for the non-detected results of airborne measurements, to then estimate the LOD using the instrument detection limit (IDL), as IDL/V. METHODS: We obtained the Chemical Exposure Health Data from OSHA's central laboratory in Salt Lake City that partially overlaps IMIS and contains information on V. We used classification and regression trees (CART) to develop a predictive model of V for all measurements where the two datasets overlapped. The analysis was restricted to 69 chemical agents with at least 100 non-detected measurements, and calculated sampling air flow rates consistent with workplace measurement practices; undefined types of inspections were excluded, leaving 412,201/413,515 records. CART models were fitted on randomly selected 70% of the data using 10-fold cross-validation and validated on the remaining data. A separate CART model was fitted to styrene data. RESULTS: Sampled air volume had a right-skewed distribution with a mean of 357 l, a median (M) of 318, and ranged from 0.040 to 1868 l. There were 173,131 measurements described as non-detects (42% of the data). For the non-detects, the V tended to be greater (M = 378 l) than measurements characterized as either 'short-term' (M = 218 l) or 'long-term' (M = 297 l). The CART models were complex and not easy to interpret, but substance, industry, and year were among the top three most important classifiers. They predicted V well overall (Pearson correlation (r) = 0.73, P < 0.0001; Lin's concordance correlation (rc) = 0.69) and among records captured as non-detects in IMIS (r = 0.66, P < 0.0001l; rc = 0.60). For styrene, CART built on measurements for all agents predicted V among 569 non-detects poorly (r = 0.15; rc = 0.04), but styrene-specific CART predicted it well (r = 0.87, P < 0.0001; rc = 0.86). DISCUSSION: Among the limitations of our work is the fact that samples may have been collected on different workers and processes within each inspection, each with its own V. Furthermore, we lack measurement-level predictors because classifiers were captured at the inspection level. We did not study all substances that may be of interest and did not use the information that substances measured on the same sampling media should have the same V. We must note that CART models tend to over-fit data and their predictions depend on the selected data, as illustrated by contrasting predictions created using all data vs. limited to styrene. CONCLUSIONS: We developed predictive models of sampled air volume that should enable the calculation of LOD for non-detects in IMIS. Our predictions may guide future work on handling non-detects in IMIS, although it is advisable to develop separate predictive models for each substance, industry, and year of interest, while also considering other factors, such as whether the measurement evaluated long-term or short-term exposure.
Asunto(s)
Exposición Profesional , Estados Unidos , Humanos , Exposición Profesional/análisis , United States Occupational Safety and Health Administration , Industrias , Lugar de Trabajo , Estirenos/análisisRESUMEN
BACKGROUND: The Occupational Safety and Health Administration (OSHA) implemented a new standard in 2014 requiring employers to report nearly all work-related inpatient hospitalizations within 24 h of the event. We examined the characteristics of the injured workers who were reported and the compliance of Michigan employers with the regulation. METHODS: From 2016 to 2018, we compared reports of acute nonmotor-vehicle work-related injuries and illnesses from two independent datasets, employer reports to OSHA and the Michigan Multi-Source Injury and Illness Surveillance System (MMSIISS) which collects injured worker hospital records from the 134 hospitals in Michigan. We matched records from employer reports to OSHA with the MMSIISS by employee's first and last name, company name, date of injury/illness, and type of injury/illness. RESULTS: We identified 2887 workers hospitalized with severe injuries/illnesses from 2016 to 2018 in Michigan; 1260 workers were reported by employers to OSHA and 2238 workers were reported by hospitals to the MMSIISS. There was an overlap of 611 workers reported in both systems, while 649 workers were only reported by employers to OSHA and 1627 workers were only reported by hospitals to the MMSIISS. Employer compliance with the regulation over the 3 years showed a nonsignificant increase; from 42.0% to 43.6% to 45.0%. Fractures were the most frequent type of injury (1238, 42.9%), then head injuries, including skull fractures (470, 16.3%). The median length of hospital stay was 3 days. Manufacturing (709, 25.5%) and construction (563, 20.3%), accounted for the greatest number of hospitalizations. Employer-reported cases to OSHA significantly undercounted hospitalized workers in agriculture, forestry, fishing, and hunting; construction; finance and insurance; real estate and rental and leasing; administrative and support and waste management and remediation services; arts, entertainment, and recreation; accommodation and food services; and other services except public administration. Companies with 250 or more employees were significantly more likely to comply and small companies with 10 or fewer employees were significantly less likely to comply with the reporting rule. Enforcement inspections at 465 of the workplaces where a hospitalization had occurred resulted in $1,017,835 in fines and identified 608 violations. Of the 465 inspections, 246 (52.9%) of the employers had not corrected the hazard before the inspection. CONCLUSIONS: This study identified that workers sustained severe injuries and illnesses on the job and that over half of the companies where a worker suffered an injury/illness leading to hospitalization were not in compliance with OSHA's reporting regulation. Furthermore, at the time of an inspection 1-5 months later, 50% of the companies had not corrected the hazard causing the hospitalization. Improvement in the reporting of work-related injuries/illnesses that result in hospitalization will identify more ongoing hazards in the workplace and improve where to focus preventive actions.
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Traumatismos Ocupacionales , Estados Unidos , Humanos , Traumatismos Ocupacionales/epidemiología , United States Occupational Safety and Health Administration , Hospitalización , Lugar de Trabajo , Michigan/epidemiologíaRESUMEN
This paper describes how a multi-armed randomized experiment was used to test multiple variants of a behaviorally informed marketing strategy. In particular, we tested whether specific behavioral messages could be used to increase demand for a safety consultation service offered by the U.S. Occupational Safety and Health Administration. Our experiment used a partial factorial design with 19 study arms and a very large research sample-97,182 establishments-to test the impact of various message, formats, and delivery modes compared with an existing (not behaviorally informed) informational brochure and a no-marketing counterfactual. A secondary research goal was to predict the impact of the most successful marketing strategy (i.e., combination of message, format, and mode) so that OSHA would know what to anticipate if that strategy were implemented at scale. We used two related (but distinct) methods to address these two goals. Both begin with a common mixed (i.e., fixed and random effects) ANOVA model. We addressed the first research goal primarily from the fixed effects; we addressed the second research goal by calculating best linear unbiased predictions (BLUPs) from the full mixed model, where the BLUP involves "shrinkage" as in empirical Bayes (EB) approaches. Marketing via brochures was effective overall, nearly doubling the rate of requests for services. However, the behaviorally informed materials performed no better than OSHA's existing informational brochure. This study also highlights the conditions under which a factorial design can be used to efficiently address questions about which of several program variants are most effective.
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Mercadotecnía , Administración de la Seguridad , Lugar de Trabajo , Teorema de Bayes , Mercadotecnía/métodos , United States Occupational Safety and Health AdministrationRESUMEN
OBJECTIVE: The qualitative fit testing procedure would be challenging due to severe shortages, high cost, and unavailability of commercial fit test kits in the marketplaces during pandemics of respiratory infectious diseases. Assessment of alternatives for commercial fit test kits to be prepared for emergencies is critically required. This study aimed to investigate the feasibility of an alternative of the Accumed NF60 nebulizer for the Occupational Safety and Health Administration (OSHA)-approved Allegro nebulizer. METHODS: Thirty-two participants were randomly allocated to 6 filtering facepiece respirators (FFRs). They were qualitatively fit tested by both manual Allegro and automated Accumed NF60 nebulizers. RESULTS: There was no statistically significant difference between the Allegro and Accumed NF60 nebulizers by passing rates. The odds for passing fit testing using the Accumed NF60 nebulizer was similar to that of the Allegro one (odds ratio=1.0, 95% confidence interval [0.58-1.74]). CONCLUSIONS: The Accumed NF60 nebulizer could be used as a cost-benefit substitute for the standard fit test nebulizers in the pandemic situation where there is a shortage and difficulty of access. It is more convenient, decreases the time investment, and reduces the contact stress in the operators' hands as it does not require squeezing the nebulizer bulb frequently. The test solutions' preparation and fit testing procedures on many personnel are more straightforward, efficient, and hygienic than the Allegro one.
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Exposición Profesional , Dispositivos de Protección Respiratoria , Infecciones del Sistema Respiratorio , Estados Unidos , Humanos , Pandemias , Estudios de Factibilidad , United States Occupational Safety and Health Administration , Nebulizadores y Vaporizadores , Ventiladores MecánicosRESUMEN
The Occupational Safety and Health Administration (OSHA) issued an emergency temporary standard (ETS) for COVID-19 applicable to private sector employers with 100 or more employees. Among other things, the ETS required employers either to mandate employee vaccination or weekly testing and wearing masks.