Identification of agricultural tasks important to cumulative exposures to inhalable and respirable dust in California.

Little data exists on the determinants of agricultural dust exposure, particularly in dry climates. Annual exposure indices to inhalable and respirable dust were constructed by exposure estimates for specific tasks, task duration, and task frequency. The estimates of exposure levels were based on actual field measurements and subjective dust exposure ranking. The task duration and frequency data were obtained by questionnaire from 546 farm operators in California. Annual exposure indices were analyzed to determine which tasks were major contributors to chronic dust exposure. The important tasks were identified by comparisons of the cumulative distribution of exposures for all tasks and the cumulative distribution of exposures with one task deleted. Thirteen and 11 tasks were identified to be important to both inhalable and respirable dust exposures, respectively. Tasks identified to be important to agricultural exposure may be ascribed to exposure duration more than to exposure intensity. Information on task-specific exposure is important for developing control strategies in the agricultural workplace.

Licensed caregiver characteristics and staffing in California acute care hospital units.

PURPOSE: Concerns about declining quality of care and nurse staffing shortages led to legislation mandating minimum nurse-to-patient ratios in the state of California. Although research finds that better registered nurse (RN) staffing results in higher quality of care, little evidence exists on which to base specific nurse-patient ratios. The authors describe the results of a California survey characterizing licensed caregivers, identifying staffing levels by unit type, and describing how staffing levels vary across hospital types. METHODS: A stratified random sample of general acute care hospitals was surveyed to collect cross-sectional data on hospitals' nursing workforce and staffing practices and to assess the impact of potential patient-to-nurse staffing ratios. All academic medical centers; rural, private, and city/county hospitals; and hospitals affiliated with a large group-model health maintenance organization (HMO) were eligible for inclusion. RESULTS: Eighty hospitals were surveyed, representing all major metropolitan areas in the state. Acute care hospitals in California have diverse nursing staffs with variations in education, experience, and employment status. Considerable variations in skill mix were identified, with the proportion of RNs ranging from 30% to 84%, depending on the unit type surveyed. CONCLUSIONS: As states struggle with an anticipated critical shortage of RNs, these results have several implications for health and education policy. Future studies of this type will be needed to evaluate the impact of anticipated changes in the regulation of nurse staffing.