Applying the CDC Science Impact Framework to the results of the National Institute for Occupational Safety and Health and the Bureau of Labor Statistics 2001 survey of respirator use and practices.

During 2001-2002, the National Institute for Occupational Safety and Health (NIOSH), at the United States Centers for Disease Control and Prevention, collaborated with the Bureau of Labor Statistics (BLS) at the United States Department of Labor to conduct a voluntary survey of U.S. employers regarding the use of respiratory protective devices. In 2003, the survey results were jointly published by NIOSH and BLS. This study highlights and evaluates the scientific impact of the 2001-2002 survey by using the Science Impact Framework which provides a historical tracking method with five domains of influence. The authors conducted interviews with original project management as well as a thorough document review and qualitative content analysis of published papers, books, presentations, and other relevant print media. A semi-structured and cross-vetted coding was applied across the five domains: Disseminating Science, Creating Awareness, Catalyzing Action, Effecting Change, and Shaping the Future. The 2001-2002 survey findings greatly enhanced understanding and awareness of respirator use in occupational settings within the United States. It also led to similar surveys in other countries, regulatory initiatives by the Occupational Safety and Health Administration and Mine Safety and Health Administration, and ultimately to a renewed partnership between NIOSH and BLS to collect contemporary estimates of respirator use in the workplace within the United States.

Occupational physical activity and cardiovascular disease in the United States.

BACKGROUND: Emerging evidence, predominately from European and Asian countries, describes opposing effects of occupational physical activity (OPA) and leisure-time physical activity (LTPA) on cardiovascular health. This analysis examined cardiovascular disease (CVD) prevalence associated with OPA and LTPA. METHODS: This cross-sectional analysis of 2015 National Health Interview Survey data (n=16 974) employed logistic regression to estimate odds (OR) of self-reported CVD (coronary heart disease, heart attack, stroke or angina) with self-reported total occupational activity (TOA), occupational exertion (OE), occupational standing and walking (OSW) and LTPA. OPA was measured using two questions: 'How often does your job involve…' (1) 'repeated lifting, pushing, pulling or bending?' (OE) and (2) 'standing or walking around?' (OSW) with responses on a 5-item Likert scale (0=never, 4=always). TOA was categorised similarly after summing OE and OSW scores. LTPA was defined as 0, 1-149 or ≥150 min/week of moderate-to-vigorous activity. All models adjusted for common socioeconomic variables and additional analyses were stratified by sex, smoking status and LTPA. RESULTS: Odds for CVD were higher when 'always' performing TOA (OR 1.99 95% CI 1.12 to 3.53), OE (OR 2.15, 95% CI 1.45 to 3.19) or OSW (OR 1.84, 95% CI 1.07 to 3.17) compared with 'never'. When restricting to never-smokers, odds for CVD were higher when 'always' performing TOA (OR 3.00, 95% CI 1.38 to 6.51) and OE (OR 3.00, 95% CI 1.80 to 5.02) versus 'never'. CONCLUSION: Associations of high OPA with CVD were equally apparent across sexes, stronger in lower LTPA levels and stronger in never-smokers. While uncontrolled confounding is still possible, even after extensive adjustment, the seemingly paradoxical adverse associations with OPA and CVD should be investigated further.

Speech intelligibility test methodology applied to powered air-purifying respirators used in healthcare.

Powered air-purifying respirators (PAPRs) are worn to protect workers from hazardous respiratory exposures in a wide range of workplaces, including healthcare. However, PAPRs may diminish the ability of wearers to correctly hear words spoken by others, potentially interfering with safe performance of healthcare duties. Accordingly, the impact of PAPRs during healthcare use on speech intelligibility (SI) and consequently on user safety, usability, and patient care is not well studied. The objectives of this study were to (1) determine a listener's ability to comprehend single-syllable words spoken by a PAPR wearer; (2) determine a PAPR wearer's ability to intelligibly hear and identify single-syllable words spoken by a PAPR wearer; (3) to assess the variability between speakers, listeners, and PAPR models; (4) to investigate the effects of PAPR design features on SI; and (5) inform a SI requirement for certifying future PAPRs for use in healthcare. This study utilized a Modified Rhyme Test to assess SI for PAPRs. The current National Institute for Occupational Safety and Health (NIOSH) methods for assessing SI are limited to the recently introduced PAPR100 respirator class and the class of respirators claiming chemical, biological, radiological, and nuclear (CBRN) protections. Four NIOSH-approved PAPRs were evaluated using four human subjects. Four experimental conditions were examined:(1) Speaker and Listener with no PAPR; (2) Speaker and Listener both wearing PAPRs; (3) Speaker with a PAPR, Listener without a PAPR; and (4) Speaker without a PAPR, Listener with a PAPR resulted in a total of 144 experiments. Statistical analysis showed that the SI performance ratings were not significantly different among the PAPR models, but experimental conditions had significant impact on SI. The pattern of SI across the conditions of the experiment also showed a significant difference depending on PAPR model. The SI performance rating for all PAPRs could meet the current NIOSH CBRN certification requirement for speech intelligibility.

Probability of hyperthermia in a hot environment while wearing a liquid cooling garment underneath firefighters' protective clothing.

Firefighters' protective clothing (FPC) can limit human thermoregulation due to limited water vapor permeability and insulation. This study investigated the effect of cooling on the physiological responses and probability of hyperthermia in subjects wearing FPC during exercise in a hot environment. Twelve males participated in this study. A maximal graded treadmill exercise test was performed to measure maximal oxygen uptake (V̇O2max) and to assess subjects' capacity to perform the assigned exercise. Exercise included treadmill walking at 40% V̇O2max in warm (30 °C) and humid (70% RH) conditions for 40 min while wearing FPC. Subjects participated in two randomly counterbalanced assigned experimental protocols: control (no cooling) and intervention (cooling). The experimental intervention consisted of a cooling garment infused with cooled water (18 °C) through silastic tubing sewn into the fabric and worn underneath FPC. Each subject served as their own control and, therefore, completed both the control and intervention of the protocol. A logistic regression model was used to analyze the interaction effect of cooling on the probability of progression to hyperthermia (Tc ≥ 38 °C). Subjects' physiological responses increased during exercise in a warm and humid environment. Active cooling decreased (p < 0.05) the thermal stress thereby reducing the probability of hyperthermia while exercising in hot and humid conditions. The results indicate that when cooling was used each subject, on average, was 91% less likely to reach the lower threshold limit of hyperthermia. Exercise in hot environments while wearing FPC results in significant physiological strain, which may lead to hyperthermia. Utilization of a cooling garment reduced physiological strain and the probability of hyperthermia.

Evaluation of total inward leakage for NIOSH-approved elastomeric half-facepiece, full-facepiece, and powered air-purifying respirators using sodium chloride and corn oil aerosols.

Recently, total inward leakage (TIL) for filtering facepiece and elastomeric half-mask respirators (EHRs) was measured according to the International Organization for Standardization (ISO) test method standard 16900-1:2014 that showed larger TIL for corn oil aerosol than for NaCl aerosol. Comparison of TIL measured for different aerosols for higher protection level respirators is lacking. The objective of this study was to determine TIL for EHRs, full-facepiece respirators, and loose-fitting and tight-fitting powered air-purifying respirators (PAPRs) using NaCl and corn oil aerosols to compare. TIL was measured for two models each of EHRs, full-facepiece respirators, and loose-fitting and tight-fitting PAPRs. After fit testing with a PortaCount (TSI, St. Paul, MN) using the Occupational Safety and Health Administration (OSHA) protocol, eight subjects were tested in the NaCl aerosol chamber first and then in the corn oil aerosol chamber, while another eight subjects tested in the reverse order. Subjects were randomly assigned to one of the two groups. TIL was measured as a ratio of mass-based aerosol concentrations inside the mask to the test chamber while the subjects performed ISO 16900-1-defined exercises using continuous sampling methods. The concentration of corn oil aerosol was measured with one light scattering photometer, alternately, and NaCl aerosol was measured using two flame photometers. Results showed the geometric mean TIL for EHR was significantly (p < 0.05) larger for corn oil aerosol than for NaCl aerosol. EHR models equipped with P100 filters showed relatively smaller TIL values than the same models with N95 filters showing that TIL was inversely related to filter efficiency. Interestingly, TIL was significantly (p < 0.05) larger for NaCl aerosol than for corn oil aerosol for PAPRs, but not for full-facepiece respirators. TIL was inversely related to fit factors of respirator types. Overall, filter efficiency and faceseal leakage determine TIL. The relative trends in TIL for the two aerosols' test methods differ between respirator types indicating that generalization of TIL for respirator types may not be appropriate when using different test agents.

Intersegmental differences in facial warmth sensitivity during rest, passive heat and exercise.

Background: Increased facial warmth sensations could lead to thermal discomfort, and different facial regions may demonstrate concurrent temperature differences. The study aim was examining facial warmth sensitivity differences by facial region under differing environmental conditions. Methods: Twelve men had heat flux measurements of six facial regions during 30 min each of rest in thermoneutral conditions (25 °C, 30% relative humidity (RH)), rest in warm conditions (40 °C, 30% RH), and cycling at 400 W of metabolic heat production (40 °C, 30% RH). Results: The forehead demonstrated highest temperatures at termination of all study conditions; lowest temperatures were noted for the nose under thermoneutral conditions and chin during warmth and exercise conditions. Five of six facial regions demonstrated significant differences in warmth sensitivity, decreasing to two of six regions during warm conditions and one of six regions during exercise, with the upper lip most sensitive in all conditions. Body thermal comfort (TC) perceptions, regressed individually on mean facial temperature (Tface) vs. core temperature (Tco), indicated that Tface was significantly more related than Tco to perceived TC (p = .001). Perceived TC, regressed individually on perceived overall body thermal sensation (TS) vs. facial TS, demonstrated that Tface was significantly more related to perceived TC (p = .004). Conclusion: There were regional differences in facial warmth sensitivity together with different facial temperatures moving toward equilibration when the body is subjected to heat-producing activities. Perceptions of TC were more strongly related to Tface than to Tco or overall body TS.

Critical investigation of glove-gown interface barrier performance in simulated surgical settings.

The barrier properties of personal protective equipment are vital to healthcare personnel to protect themselves from possible infectious body fluids. Intraoperative exposure of healthcare personnel to body fluids can be substantial in both inpatient and outpatient settings. The glove-gown interface is known as one of the weakest points of the whole personal protective equipment system. However, there is a lack of scientific research designed to investigate the problem. This paper reports the results of experiments using a new testing methodology developed to quantify fluid leakage through the glove-gown interface while simulating surgical settings in terms of operating room personnel activities, exposure types, exposure durations, and physical stresses applied on the interface. This study represents one of the first efforts investigating the amount of fluid leakage through the glove-gown interface for a number of surgical gown and glove models while considering glove material differences and single vs. double gloving. The test results showed that there is a significant difference in fluid leakage amounts between three gown models and four glove models studied. The results also demonstrated that double gloving significantly reduced the fluid leakage compared to single glove use. The mean fluid leakage was lower in the double synthetic glove configurations (M = 2.76g) compared with all other configurations (3GLV, M = 8.3g; 4GLV, M = 9.49g; 5GLV, M = 3.08g; 6GLV, M = 20.03g; double latex, M = 5.22g). Findings highlighted a significant interaction between glove and gown designs, which suggests that gown and gloves should be designed together as a system to minimize or eliminate the fluid leakage.

The role of risk avoidance and locus of control in workers' near miss experiences: Implications for improving safety management systems.

The process industry has made major advancements and is a leader in near-miss safety management, with several validated models and databases to track close call reports. However, organizational efforts to develop safe work procedures and rules do not guarantee that employees will behaviorally comply with them. Assuming that at some point, every safety management system will need to be examined and realigned to help prevent incidents on the job, it is important to understand how personality traits can impact workers' risk-based decisions. Such work has been done in the mining industry due to its characteristically high risks and the results can be gleaned to help the process industry realign goals and values with their workforce. In the current study, researchers cross-sectionally surveyed 1,334 miners from 20 mine sites across the United States, varying in size and commodity. The survey sought to understand how mineworkers' risk avoidance could impact their near miss incidents on the job - a common precursor to lost-time incidents. Multiple regressions showed that as a miner's level of risk avoidance increased by 1 unit in the 6-point response scale, the probability of experiencing a near miss significantly decreased by 30% when adjusting for relevant control variables. Additionally, a significant interaction between risk avoidance and locus of control suggested that the effect of risk avoidance on near misses is enhanced as a miner's locus of control increases. A one-unit increase in locus of control appends the base effect of risk avoidance on near misses with an additional 8% decrease in the probability. Findings are discussed from a near-miss safety management system perspective in terms of methods to foster both risk avoidance and locus of control in an effort to reduce the probability of near misses and lost time at the organizational level within the process industry and other high-hazard industries.

Examining Factors that Influence the Existence of Heinrich's Safety Triangle Using Site-Specific H&S Data from More than 25,000 Establishments.

In the 1930s, Heinrich established one of the most prominent and enduring accident prevention theories when he concluded that high severity occupational safety and health (OSH) incidents are preceded by numerous lower severity incidents and near misses. Seventy-five years of theory expansion/interpretation includes two fundamental tenets: (1) the ratio of lower to higher severity incidents exists in the form of a "safety-triangle" and (2) similar causes underlie both high and low severity events. Although used extensively to inform public policy and establishment-level health and safety priorities, recent research challenges the validity of the two tenets. This study explored the validity of the first tenet, the existence of the safety triangle. The advantage of the current study is the use of a detailed, establishment-specific data set that evaluated over 25,000 establishments over a 13-year time period, allowing three specific questions to be explored: (1) Are an increased number of lower severity incidents at an establishment significantly associated with the probability of a fatal event over time? (2) At the establishment level, do the effects of OSH incidents on the probability of a fatality over time decrease as the degree of severity decreases-thereby taking the form of a triangle? and (3) Do distinct methods for delineating incidents by severity affect the existence of the safety triangle form? The answer to all three questions was yes with the triangle form being dependent upon how severity was delineated. The implications of these findings in regard to Heinrich's theory and OSH policy and management are discussed.

Interstitial Lung Diseases in the U.S. Mining Industry: Using MSHA Data to Examine Trends and the Prevention Effects of Compliance with Health Regulations, 1996-2015.

Given the recent increase in dust-induced lung disease among U.S. coal miners and the respiratory hazards encountered across the U.S. mining industry, it is important to enhance an understanding of lung disease trends and the organizational contexts that precede these events. In addition to exploring overall trends reported to the Mine Safety and Health Administration (MSHA), the current study uses MSHA's enforcement database to examine whether or not compliance with health regulations resulted in fewer mine-level counts of these diseases over time. The findings suggest that interstitial lung diseases were more prevalent in coal mines compared to other mining commodities, in Appalachian coal mines compared to the rest of the United States, and in underground compared to surface coal mines. Mines that followed a relevant subset of MSHA's health regulations were less likely to report a lung disease over time. The findings are discussed from a lung disease prevention strategy perspective.

Impact of Pregnancy History and 17-Hydroxyprogesterone Caproate on Cervical Cytokines and Matrix Metalloproteinases.

OBJECTIVE: The objective of this study was to evaluate the impact of pregnancy history and 17-hydroxyprogesterone caproate (17-OHPC) treatment on cervical fluid cytokines and matrix metalloproteinases (MMPs). STUDY DESIGN: Cervical fluid was obtained between 160/7 and 246/7 weeks from women with only prior term births (controls, n = 26), women with one or more prior spontaneous preterm births (SPTBs) choosing to receive 17-OHPC (17-OHPC, n = 24), or to not receive 17-OHPC (refusers, n = 12). Cervical fluid collections were repeated 2, 4, and 8 weeks after the first sample and concentrations of MMPs and cytokines were measured by multiplex immune assay. RESULTS: Among women whose earliest prior delivery occurred between 16 and 23 weeks, cervical fluid concentration of interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-α at baseline were significantly elevated when compared with cervical cytokines of women whose earliest delivery occurred between 32 and 36 weeks (relative risk ratio was 3.37 for IL-6 [95% confidence interval, CI, 1.08-10.53, p < 0.05], 2.81 for IL-10 [95% CI, 1.39-5.70, p < 0.05], and 6.34 for TNF-α [95% CI, 2.19-18.68, p < 0.001]). Treatment with 17-OHPC had no significant impact on these cytokines. CONCLUSION: The cervical fluid of women with a history of an early prior SPTB is characterized by inflammation that is unaffected by 17-OHPC.

Using trunk posture to monitor heat strain at work.

This study aimed to determine if trunk posture during walking is related to increases in rectal temperature (Tre). 24 males treadmill walked in one of four conditions (1): 30 min at 3.0 mph and 0% grade, 20 °C and 50% relative humidity (RH), wearing healthcare worker (HCW) PPE; (2): 30 min at 3.0 mph and 0% grade, 27.5 °C and 60% RH, HCW PPE; (3): 30 min at 3.0 mph and 0% grade, 32.5 °C and 70% RH, HCW PPE; and (4): 40 min at 40% VO2max, 30 °C and 70% RH, wearing firefighter PPE. Trunk posture (Zephyr BioHarness 3) and Tre were measured continuously. Tre was positively related to trunk posture, controlling for covariates (B = 3.49, p < .001). BMI and age moderated this relationship (Tre×age, B = 0.76, p < .001; Tre*BMI, B = -1.85, p < .001). Trunk posture measurement may be useful in monitoring fall potential and magnitude of heat stress of workers in hot environments. Practitioner Summary: Occupational hyperthermia increases worker risk for heat illness and injury but is difficult to monitor in the field. This investigation shows that trunk posture is independently and positively related to core temperature. Non-invasive measurement or visual inspection of trunk posture could provide novel insight on individual heat strain level.

Umbilical temperature correlation with core and skin temperatures at rest, in the heat and during physical activity.

PURPOSE: to determine the correlation of umbilical temperatures (Tumb) with simultaneously recorded chest wall temperature (Tchest) and rectal temperature (Trectal) in adults during rest, heat exposure and exercise. METHODS: A total of 28 healthy men, wearing different types of clothing (athletic garb, a spandex full body heating garment, firefighter bunker gear) had average and peak umbilical, chest wall and rectal temperature measurements taken during sedentary temperature stabilisation stages, heat exposure periods and active exercise phases. RESULTS: Curvilinear relationships were noted between Tchest and Tumb compared with Trectal and their association became noticeably positive and linear at approximately 35.5 °C. Polynomial regression analysis of Trectal with linear and quadratic forms of Tchest and Tumb indicated an overall R2 of 0.657 and 0.767, respectively. Bivariate analysis of a restricted data set (where Tchest and Tumb ≥35.5°), indicated that Tumb was significantly associated with Trectal (raverage = 0.710, p <0.001; rpeak = 0.841, p <0.001) and Tchest was also significantly associated with Trectal, but less so (raverage = 0.570, p <0.001; rpeak = 0.699, p <0.001). CONCLUSIONS: the umbilicus offers a non-invasive, peripheral site for measurement of temperature that more closely correlated with body core temperature than Tchest when core temperature was ≥35.5 °C.

Transfer of bacteriophage MS2 and fluorescein from N95 filtering facepiece respirators to hands: Measuring fomite potential.

Contact transmission of pathogens from personal protective equipment is a concern within the healthcare industry. During public health emergency outbreaks, resources become constrained and the reuse of personal protective equipment, such as N95 filtering facepiece respirators, may be needed. This study was designed to characterize the transfer of bacteriophage MS2 and fluorescein between filtering facepiece respirators and the wearer's hands during three simulated use scenarios. Filtering facepiece respirators were contaminated with MS2 and fluorescein in droplets or droplet nuclei. Thirteen test subjects performed filtering facepiece respirator use scenarios including improper doffing, proper doffing and reuse, and improper doffing and reuse. Fluorescein and MS2 contamination transfer were quantified. The average MS2 transfer from filtering facepiece respirators to the subjects' hands ranged from 7.6-15.4% and 2.2-2.7% for droplet and droplet nuclei derived contamination, respectively. Handling filtering facepiece respirators contaminated with droplets resulted in higher levels of MS2 transfer compared to droplet nuclei for all use scenarios (p = 0.007). MS2 transfer from droplet contaminated filtering facepiece respirators during improper doffing and reuse was greater than transfer during improper doffing (p = 0.008) and proper doffing and reuse (p = 0.042). Droplet contamination resulted in higher levels of fluorescein transfer compared to droplet nuclei contaminated filtering facepiece respirators for all use scenarios (p = 0.009). Fluorescein transfer was greater for improper doffing and reuse (p = 0.007) from droplet contaminated masks compared to droplet nuclei contaminated filtering facepiece respirators and for improper doffing and reuse when compared improper doffing (p = 0.017) and proper doffing and reuse (p = 0.018) for droplet contaminated filtering facepiece respirators. For droplet nuclei contaminated filtering facepiece respirators, the difference in MS2 and fluorescein transfer did not reach statistical significance when comparing any of the use scenarios. The findings suggest that the results of fluorescein and MS2 transfer were consistent and highly correlated across the conditions of study. The data supports CDC recommendations for using proper doffing techniques and discarding filtering facepiece respirators that are directly contaminated with secretions from a cough or sneeze.

Interpreting MSHA citations through the lens of occupational health and safety management systems: investigating their impact on mine injuries and illnesses 2003-2010.

Since the late 1980s, the U.S. Department of Labor has considered regulating a systems approach to occupational health and safety management. Recently, a health and safety management systems (HSMS) standard has returned to the regulatory agenda of both the Occupational Safety and Health Administration (OSHA) and the Mine Safety and Health Administration (MSHA). Because a mandated standard has implications for both industry and regulating bodies alike, it is imperative to gain a greater understanding of the potential effects that an HSMS regulatory approach can have on establishment-level injuries and illnesses. Through the lens of MSHA's regulatory framework, we first explore how current enforcement activities align with HSMS elements. Using MSHA data for the years 2003-2010, we then analyze the relationship between various types of enforcement activities (e.g., total number of citations, total penalty amount, and HSMS-aligned citations) and mine reportable injuries. Our findings show that the reduction in mine reportable injuries predicted by increases in MSHA enforcement ranges from negligible to 18%. The results suggest that the type and focus of the enforcement activity may be more important for accident reduction than the total number of citations issued and the associated penalty amount.

The association between safety climate and noncombat injury events among United States Air Force workers.

INTRODUCTION: Work-related injuries are a common lagging safety indicator whereas safety climate assessments can help identify constructs serving as leading indicators. The National Institute for Occupational Safety and Health (NIOSH) partnered with the U.S. Department of the Air Force (DAF) Safety Center to examine the association between perceptions of safety climate survey constructs and the number of injury events within the DAF workforce. METHODS: The DAF administers voluntary, anonymous, occupation-specific safety climate surveys to DAF workers using the internal Air Force Combined Mishap Reduction System (AFCMRS). Survey responses from 2014 to 2018 provided by DAF workers and injury events in maintenance, support, and operations occupations were shared with NIOSH. Exploratory Factor Analysis revealed five constructs: Leadership and Communication; Organizational Safety Priority; Error Management; Resource Adequacy; and Deployment/Official Travel Impact. Squadron-level analysis included bivariate correlations and estimated Rate Ratios (RRs). RESULTS: 1,547 squadrons administered the survey, averaging 144 workers and 15.8 reportable injuries per squadron. Higher (more favorable) squadron-level construct scores were consistently correlated with fewer reported injuries (p < 0.001). Controlling for the number of workers, RRs revealed significant reductions in injury rates with each one-unit increase in responses: Leadership and Communication RR = 0.40 (95%CI: 0.32-0.48); Organizational Safety Priority RR = 0.50 (95%CI: 0.40-0.64); Error Management RR = 0.37 (95%CI: 0.30-0.47); Deployment/Official Travel Impact RR = 0.36 (95%CI: 0.29-0.45). Resource Adequacy revealed a non-significant lower injury rate RR = 0.87 (95%CI: 0.73-1.04). CONCLUSIONS: This unique study quantified safety climate and the association with injuries across a multi-year period. While safety climate measurements may be limited by frequent turnover and the self-reported, voluntary, anonymous nature of AFCMRS, the strength of this study is in the census of injuries. PRACTICAL APPLICATIONS: Future research should include longitudinal analyses to examine the impact on injuries when squadron leaders are provided feedback on safety climate survey results.

Evaluation of fluid leakage at the coverall and glove interface in single and double glove conditions.

BACKGROUND: Fluid leakage through the glove-protective clothing interface is an area of concern for many health care personnel, including emergency medical service providers, who may wear coveralls to protect themselves from multiple types of hazards. There is currently no established standard test method to specifically evaluate the barrier performance of the glove-protective clothing interface region for any personal protective equipment ensemble. OBJECTIVE: This study quantifies the fluid leakage at the coverall and glove interface using single and double gloving. METHODS: A robotic arm, which can simulate upper extremity movements of health care personnel, was used to test 5 coverall models and an extended examination glove model in single and double glove conditions. RESULTS: The results show that there was a significant difference in fluid leakage amounts between some of the coverall models and the number of glove layers studied. Findings also highlight that there is a high correlation between basis weight and stiffness of the coverall fabrics and the fluid leakage amounts. CONCLUSIONS: These results underline that coverall constructed from thin and less stiff fabrics can result in lower fluid leakage levels. Also, there was no significant difference in fluid leakage amounts between single and double gloves when tested with each of the coverall models, with the exception of the coveralls with the highest basis weight and stiffness.

Impact of surface tension on the barrier performance of gowns and coveralls.

BACKGROUND: Health care workers and laboratory workers who are routinely exposed to potentially life-threatening infectious diseases should wear protective clothing when anticipating contact with infectious materials. The most critical property of protective clothing is its ability to prevent liquids and viruses from passing through the garment. There are a number of potentially infectious liquids that workers may be exposed to during routine tasks. Each liquid has different physical and chemical properties that affect penetration. However, the current test methods use a limited number of liquids for classifying the barrier performance. The impact of the surface tension of the challenge liquid on the penetration resistance of gowns and coveralls was investigated in this study. METHODS: Eight isolation gowns and 2 coveralls were tested in accordance with American Association of Textile Chemists and Colorists 42 and American Association of Textile Chemists and Colorists 127 test methods, which were modified to incorporate the substitute challenge liquids. RESULTS: Although current standard test methods only use water to categorize the liquid penetration resistance of minimal to moderate barrier performance gowns, a significant difference in the penetration was found when simulated body fluids were used. CONCLUSIONS: The results suggest that safety professionals and wearers should consider the varying barrier performance of personal protective equipment with different liquids and the use limitations when selecting them for the required tasks. Furthermore, standard development organizations should consider multiple challenge liquids when classifying protective clothing for health care settings.

Behavioral safety compliance in an interdependent mining environment: supervisor communication, procedural justice and the mediating role of coworker communication.

Objectives. Although a focus on safety communication between managers and employees has been prevalent, research around coworker influence in this communication has been fragmented in the literature. Methods. To examine these issues, researchers gathered survey data from 1955 mine employees from surface stone, sand and gravel (SSG) and industrial mineral operations across the USA between 2016 and 2018, and studied the effects of relationships between justice perceptions, supervisor communication and coworker communication on behavioral safety compliance. Results. Using structural equation modeling, coworker communication partially mediated the direct effects of supervisor communication and justice perceptions on behavioral safety compliance - where the indirect effects were greater for justice perceptions. Conclusion. The results demonstrate the value in formal and informal communication paths to facilitate employee safety compliance; and that enhanced perceptions of job fairness and adaptability enhances coworker communication, further improving compliance in an interdependent environment.

Laboratory assessment of bacterial contamination of a sterile environment when using respirators not traditionally used in a sterile field environment.

OBJECTIVE: During infectious disease outbreaks or pandemics, an increased demand for surgical N95s that create shortages and necessitate the use of alternative National Institute for Occupational Safety and Health (NIOSH)-approved respirators that do not meet the Food and Drug Administration (FDA) additional requirements. The objective of this research was to quantify the level of bacterial contamination resulting from wearing NIOSH-approved respirators lacking the additional protections afforded by surgical N95s. METHODS: Participants performed simulated healthcare tasks while wearing 5 different respirators approved by the NIOSH. Sterile field contamination resulting from use of a surgical mask cleared by the FDA served as a baseline for comparison with the NIOSH-approved respirators. RESULTS: The bacterial contamination produced by participants wearing the N95 filtering facepiece respirators (FFRs) without an exhalation valve, the powered air-purifying respirators (PAPRs) with an assigned protection factor of 25 or 1,000 was not significantly different compared to the contamination resulting from wearing the surgical mask. The bacterial contamination resulting from wearing the N95 FFR with an exhalation valve and elastomeric half-mask respirator (EHMR) with an exhalation valve was found to be statistically significantly higher than the bacterial contamination resulting from wearing the surgical mask. CONCLUSIONS: Overall, NIOSH-approved respirators without exhalation valves maintain a sterile field as well as a surgical mask. These findings inform respiratory guidance on the selection of respirators where sterile fields are needed during shortages of surgical N95 FFRs.