[Trauma assessment and first aid in the confined spaces after major natural disasters].

Major natural disasters seriously threaten human life and health. After earthquakes and other catastrophes, survivors are often trapped in the confined spaces caused by the collapse of ground and buildings, with relative separation from the outside world, restricted access, complex environment, and oncoming or ongoing unsafety, leading to the rescue extremely difficult. In order to save lives and improve the outcome more efficiently in the confined spaces after natural disasters, it is very important to standardize and reasonably apply the trauma assessment and first aid workflow. This study focuses on trauma assessment and first aid. From the aspects of trauma assessment, vital signs stabilization, hemostasis and bandaging, post-trauma anti-infection, and the transportation of patients, a trauma first aid work process suitable for a small space of a major natural disaster is formed, It is helpful to realize the immediate and efficient treatment of trauma in the confined spaces after natural catastrophes, to reduce the rate of death and disability and improve the outcome of patients.

Assessment of Knowledge, Attitude, and Practice on Safe Working in Confined Space among Male Water Services Workers in the Central Region of Malaysia.

Employee performance in terms of knowledge of job scope, safe working practices, and safety-related attitude at work are used to measure an organization's success in managing employee welfare and safety to prevent workplace injury and death. This study aims to determine the level of knowledge, attitude, and practice on safe working in confined space among water services workers. A cross-sectional study involving a randomly selected 207 water services workers working in a confined space was performed in the central region of Malaysia. The assessment was performed using a validated Malay self-administered questionnaire. Descriptive statistics, Chi-square test and Logistic regression were used for data analyses. The study's participants were all men, with a mean (SD) age of 35.2 (8.83) years. The average working duration was 10.8 years. Overall, 67.1% of participants had good knowledge, while 65.7% had a positive attitude. The majority of the workers (60.4%) were found to follow safe working practices. Regression analysis revealed that significant predictors for knowledge were age [Adjusted odds ratio (Adj. OR) 2.793; 95% CI: 1.310, 5.955; p = 0.008] and attitude (Adj. OR 2.127; 95% CI: 1.011, 4.526; p = 0.048). Attitude was influenced by marital status (Adj. OR 4.126; 95% CI: 2.079, 8.186; p < 0.001) and knowledge level (Adj. OR 2.224; 95% CI: 1.025, 4.824; p = 0.043). A positive attitude was the sole predictor influencing the safe practice (Adj. OR; 1.878; 95% CI: 1.041, 3.388; p = 0.036). In conclusion, the workers' levels of knowledge, attitudes, and practices were relatively satisfactory. Extensive investment in workplace safety and health programs, appropriate training, growth opportunities, and effective employee performance evaluation methodologies may assist workers in performing at their best.

Risk Factors for Working in Confined Spaces: Contributions for Psychosocial Assessment / Fatores de Risco no Trabalho em Espaços Confinados: Contribuições para a Avaliação Psicossocial / Factores de Riesgo en el Trabajo en Espacios Confinados: Contribuciones para la Evaluación Psicosocial

Abstract The recommendation of standards for companies supports the safety of workers. This study aimed to describe the psychosocial risk factors perceived by personnel that work in confined spaces. Qualitative study, conducted via interviews with 50 employees. Data were processed using the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires software, with a descending hierarchical classification. The psychosocial risk management model identified five risk dimensions and described the interface between the categories of work context and content: interpersonal relationships (29.58%), task planning (23.50%), role in the organization (17.83%), home-work interface (15.10%), and workload and work pace (13.97%). The risk factors identified from the workers'' perspective allow reviewing psychosocial assessment, management practices, and the advancement of scientific knowledge, essential to rethink current legislation and mental health care for professionals that work in confined spaces.

Resumo As normas regulamentadoras oferecem diretrizes às empresas para execução do trabalho, inclusive para a área de segurança. O objetivo foi descrever fatores de risco psicossocial percebidos por trabalhadores atuantes em espaços confinados. Estudo qualitativo, conduzido por meio de entrevistas com 50 trabalhadores. Os dados foram processados, segundo classificação hierárquica descendente, pelo software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. O modelo de gestão de riscos psicossociais, identificou cinco dimensões de risco distribuídas nas categorias de contexto e conteúdo do trabalho: relacionamento interpessoal (29,58%), planejamento de tarefas (23,50%), papel na organização (17,83%), interface casa-trabalho (15,10%) e carga e ritmo de trabalho (13,97%). Os fatores de risco identificados, na perspectiva dos trabalhadores, possibilitam a revisão de práticas de avaliação psicossocial, gestão e o avanço no conhecimento científico, importantes para subsidiar tomadas de decisão para o cuidado à saúde mental de profissionais atuantes em espaços confinados.

Resumen Las normas de reglamentación contienen lineamientos de ejecución de trabajo para las empresas, incluso para el área de seguridad. El objetivo de este estudio fue describir los factores de riesgo psicosocial percibidos por los trabajadores que actúan en espacios confinados. Este estudio es cualitativo, en que se aplicaron entrevistas a 50 trabajadores. Los datos fueron procesados, según la clasificación jerárquica descendiente, por el programa Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. El modelo de gestión de riesgos psicosociales identificó cinco dimensiones de riesgo, distribuidas en las categorías de contexto y contenido del trabajo: relación interpersonal (29,58%); planificación de tareas (23,5%); papel en la organización (17,83%); interface casa-trabajo (15,1%); y carga y ritmo de trabajo (13,97%). Los factores de riesgo identificados por los trabajadores posibilitan la revisión de prácticas de evaluación psicosocial, gestión y avance en el conocimiento científico, importantes elementos para repensar la toma de decisión en la atención a la salud mental de profesionales que actúan en espacios confinados.

Associations between welding fume exposure and blood hemostatic parameters among workers exposed to welding fumes in confined space in Chonburi, Thailand.

BACKGROUND: Occupational welding fumes contain varieties of toxic metal particles and may affect cardiovascular system like the Particulate Matters (PM). Few studies have focused on the effects of toxic metals on the hemodynamic balance; however, the reporting results were not consistent. This study aimed to investigate the association between toxic metals exposure (Chromium (Cr), Manganese (Mn) and Lead (Pb)) and blood hemostatic parameters status after a 3-week exposure cessation among workers exposed to welding fumes. METHODOLOGY: Structured interviews and biological samplings were conducted for 86 male workers without a history of Anemia and Cardiovascular diseases (CVDs) and working in a confined space to construct crude oil tanks. Metal levels of Cr, Mn and Pb in urine were measured during the working days using Inductively Coupled Plasma Mass Spectrometer (ICP-MS) method. The concentrations of hemostatic proteins in blood (White blood cell counts (WBC), Lymphocytes, Monocyte, Eosinophil, Neutrophil, Hematocrit (Hct) were assessed after a 3 weeks exposure cessation. Workers were divided into groups based on occupation type (welder group and non-welder group), and based on metal levels (high and low exposure groups) for comparison. Linear regression models were used to explore the association between metal exposure and multiple blood hemostatic parameters adjusted for age, Body Mass Index (BMI), and smoking status. RESULTS: Urine Mn and Cr level of the welder group was significantly higher than the non-welder group (Mn: 0.96 VS 0.22 ug/g creatinine, p < 0.001; Cr: 0.63 VS 0.22 ug/g creatinine, p < 0.01). The mean value of Hct in the welder group was 44.58 ± 2.84 vol%, significantly higher than the non-welder group (43.07 ± 3.31 vol%, p = 0.026). The median value of WBC in the high Mn-exposed group (6.93 ± 1.59 X 106 Cell/ml) was significantly lower than the low Mn-exposed group (7.90 ± 2.13 X 106 Cell/ml, p = 0.018). The linear regression analyses showed that there was a significantly negative association between log transformed WBC value and the Mn exposure groups (high and low) after adjusting for age, BMI, and smoking status (ß = - 0.049, p = 0.045), but no significant result was found between WBC and occupation types (welder and non-welder) (p > 0.05). Multiple linear regression analysis also showed positive association between Hct and occupational types (welder and non-welders) (ß = 0.014, p = 0.055). The other hemostatic parameters were not different from controls when divided by occupation type or metal level groups. CONCLUSIONS: Our results showed that welders were exposed to about 3 to 4 times higher Mn and Cr concentrations than non-welders. Moreover, one third of the non-welders were exposed to high-exposure groups of Mn and Cr metals. Regression models revealed a significant association of the WBC counts with the Mn exposure group. Therefore, we infer that Mn exposure may play a significant role on the blood hemostatic parameters of workers in the confined space. Hazard identification for non-welders should also be conducted in the confined space.

Immunological Aspects of Isolation and Confinement.

Beyond all doubts, the exploration of outer space is a strategically important and priority sector of the national economy, scientific and technological development of every and particular country, and of all human civilization in general. A number of stress factors, including a prolonged confinement in a limited hermetically sealed space, influence the human body in space on board the spaceship and during the orbital flight. All these factors predominantly negatively affect various functional systems of the organism, in particular, the astronaut's immunity. These ground-based experiments allow to elucidate the effect of confinement in a limited space on both the activation of the immunity and the changes of the immune status in dynamics. Also, due to simulation of one or another emergency situation, such an approach allows the estimation of the influence of an additional psychological stress on the immunity, particularly, in the context of the reserve capacity of the immune system. A sealed chamber seems a convenient site for working out the additional techniques for crew members selection, as well as the countermeasures for negative changes in the astronauts' immune status. In this review we attempted to collect information describing changes in human immunity during isolation experiments with different conditions including short- and long-term experiments in hermetically closed chambers with artificial environment and during Antarctic winter-over.

Oxygen deficiency hazard in confined spaces in the steel industry: assessment through predictive models.

Objective. In the steel industry, performing activities in confined spaces where potential oxygen displacement can occur may expose workers to fatal consequences. To the best of our knowledge, no quantitative exposure assessment of oxygen deficiency in steel industry confined spaces is available in the literature. To overcome this gap, we performed oxygen deficiency hazard (ODH) assessments in real confined spaces using two existing models to identify the most critical parameters responsible for ODH, and suggest controls for mitigating the asphyxiation risk. Methods. We applied a well-mixed model and a near field-far field approach to estimate the indoor oxygen level with time during and following release of simple asphyxiants. Model inputs were mainly gathered thanks to audits and instrumental tests in three firms. Results. The most severe ODH exposures are posed in spaces with restricted volume and where accidental releases of inert gases can occur. Such exposures can be controlled through early release detections and augmented reality systems. Conclusions. ODH assessments in confined spaces of steel firms allow the identification of the most critical parameters from an oxygen depletion perspective, focusing on which data need careful measurement, and help to establish controls compatible with the operations conducted in these areas.

Rationing social contact during the COVID-19 pandemic: Transmission risk and social benefits of US locations.

To prevent the spread of coronavirus disease 2019 (COVID-19), some types of public spaces have been shut down while others remain open. These decisions constitute a judgment about the relative danger and benefits of those locations. Using mobility data from a large sample of smartphones, nationally representative consumer preference surveys, and economic statistics, we measure the relative transmission reduction benefit and social cost of closing 26 categories of US locations. Our categories include types of shops, entertainments, and service providers. We rank categories by their trade-off of social benefits and transmission risk via dominance across 13 dimensions of risk and importance and through composite indexes. We find that, from February to March 2020, there were larger declines in visits to locations that our measures indicate should be closed first.

Case Report of an Autopsy of a Child Who Died in a Drum-Type Washing Machine Tub: Pathophysiology Resulting in Death and Assessment of Previous Literature.

The patient was a 5-year-old boy who was found in a state of cardiorespiratory arrest in the tub of a washing machine without water with the door closed. The autopsy findings included severe facial congestion and petechiae of the facial skin and palpebral conjunctiva. Several organs exhibited congestion. Hemorrhagic spots were seen on the serous membranes of various organs, with particularly marked hemorrhagic spots seen on the lungs. The heart contained fluid blood without soft clots. There were no findings indicative of marked trauma, intoxication, or hyperthermia. The examination results suggested that asphyxia had occurred in this case. However, there were no findings indicative of cervical compression, oronasal obstruction, or the presence of a foreign body in the respiratory tract. Image analysis showed the child could make postural changes inside the washing machine tub. Consequently, impaired thoracic movement and postural asphyxia were considered unlikely to have occurred. The results of blood gas analysis showed no evidence of marked hypercapnia. We, therefore, concluded that the cause of the child's death was asphyxia due to hypoxia caused by being in a closed space, that is, a washing machine tub.

Exercícios ambulatórios para uma reflexão acerca das psicologias sociais e da cidade* / Ambulatory exercises for a reflection upon social psychologies and the city / Ejercicios ambulatorios para una reflexión acerca de las psicologías sociales y urbanas

Penso a relação entre diferentes psicologias sociais e as cidades. Para tanto, caracterizo tais psicologias como manifestantes que foram às ruas em 2013 nas chamadas "jornadas de junho". Faço, a partir desse experimento ficcional, uma reflexão acerca do compromisso ético e dos desafios práticos e epistêmicos que as psicologias sociais enfrentam em diferentes campos empíricos, tais como: a luta por direitos humanos; as políticas públicas; a prática científica e acadêmica; e os movimentos sociais. Neste processo, destaca-se a cidade em sua radical heterogênese como potência de desacomodação das formações estereotipadas que assombram as práticas e as pesquisas em Psicologia Social. Por fim, este texto relaciona estas reflexões com a temática do Encontro Regional Sul da ABRAPSO de 2014, em Londrina, que foi "O clamor das ruas", problematizando a dialética rua x interioridade que é constituinte da subjetividade contemporânea, com vistas à problematização de uma dimensão comum que tem na cidade seu modo de expressão por excelência.(AU)

I think on the relation between different social psychologies and the cities. In order to do that, I figure those social psychologies as demonstrators who took the streets in the so -called June Journeys in 2013. From this fictional experiment I make a reflection about the ethical engagement and the practical and epistemic challenges faced by social psychologies in different empirical fields: human rights struggle; public policies; scientific and academy practices; and social movements. By doing so, the city in its radical hetero engenderment is highlighted as a potential inconvenience to the stereotyped formations that haunts Social Psychology in praxis and research. By the end, this text relates those reflections with the theme from de Regional South Encounter of ABRAPSO in 2014, at Londrina, "The claim from the streets", questioning the dialectics street x interior which is constitutive of the contemporary subjectivity, in order to analyse a common dimension which has in the city its expression par excellence.(AU)

Pienso acerca de la relación de las distintas psicologías sociales y las ciudades. En este objetivo caracterizo estas distintas psicologías sociales como manifestantes que salieron a las calles en las llamadas "días de junio" en 2013. Pienso en la relación entre diferentes psicologías sociales y ciudades. Con este fin, caracterizo tales psicologías como manifestantes que salieron a las calles en 2013 en los llamados "viajes de junio". A partir de este experimento ficticio, reflexiono sobre el compromiso ético y los desafíos prácticos y epistémicos que enfrentan las psicologías sociales en diferentes campos empíricos, tales como: la lucha por los derechos humanos; políticas públicas; práctica científica y académica; y movimientos sociales. En este proceso, la ciudad se destaca en su heterogénesis radical como un poder desencadenante de formaciones estereotipadas que persiguen las prácticas e investigaciones de la Psicología Social. Finalmente, este texto relaciona estas reflexiones con el tema de la Reunión Regional del Sur ABRAPSO 2014 en Londrina, que fue "El clamor de las calles", problematizando la dialéctica calle x interioridad que es un componente de la subjetividad contemporánea, con miras a problematizar una dimensión común que tiene en la ciudad su modo de expresión por excelencia.(AU)

Elaboração de instrumento para identificação de fatores de risco psicossocial associados à atuação em espaços confinados / Elaboration of an instrument to identify psychosocial risk factors associated with working in confined spaces

No Brasil, são poucas as pesquisas desenvolvidas sobre mensuração dos fatores de risco psicossocial no trabalho em espaço confinado. Na maior parte dos estudos envolvendo essa temática são utilizados instrumentos para ambientes ou contextos em geral, sem considerar as especificidades do local. Dessa forma, é relevante a disponibilização de instrumentos específicos que possam auxiliar a construção do conhecimento em saúde do trabalhador. O objetivo deste estudo foi elaborar um instrumento de percepção dos fatores de risco psicossocial para trabalhadores que, dentre suas atividades laborais, executam atividades em espaços confinados. Trata-se de investigação metodológica desenvolvida junto à trabalhadores brasileiros de uma empresa de grau de nível elétrico 3, seguindo quatro etapas: 1) revisão da literatura e entrevista com trabalhadores para identificação dos atributos associados à percepção dos fatores de risco psicossocial no trabalho em espaço confinado; 2) categorização das falas em classes e elaboração dos itens; 3) validação semântica dos itens e escala de resposta e 4) validação de conteúdo dos mesmos com especialistas da área e com trabalhadores. Participaram das entrevistas e da validação semântica 50 e 18 trabalhadores, respectivamente. Da etapa de validação de conteúdo participaram 22 juízes, sendo 16 especialistas em fatores de risco psicossocial ou elaboração e validação de instrumentos e seis representantes da população que analisaram a relevância, a representatividade, a clareza e o formato dos itens, assim como das questões de caracterização dos trabalhadores. As variáveis de caracterização foram descritas por distribuições de frequências e medidas de tendência central e de dispersão. A validação semântica foi conduzida mediante aplicação de questionários DISABKIDS® adaptados com resultados apresentados em frequências absolutas e percentuais. O conteúdo das entrevistas foi organizado em corpus linguístico com as falas categorizadas segundo o referencial teórico adotado. O software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires foi utilizado para auxiliar a categorização das falas em classes. A validade de conteúdo foi analisada pelo Índice de Validade de Conteúdo. As falas foram categorizadas em cinco classes associadas aos atributos de risco psicossocial no trabalho: carga e ritmo de trabalho e papel na organização e relacionados ao trabalhador: planejamento das tarefas; relações interpessoais no ambiente de trabalho e interface casa-trabalho, a partir dos quais foram elaborados 46 itens. As sugestões, na validação semântica, geraram mudanças na forma da redação de 24 e acréscimo de seis itens. Na validação de conteúdo as sugestões geraram mudanças na forma e na redação de 36 e exclusão de sete, totalizando 45, que foram redistribuídos em oito atributos de risco psicossocial, nos cinco anteriores mais ambiente e equipamentos; função e cultura organizacional e latitude de decisão/controle. Estes foram distribuídos nos domínios "contexto" e "conteúdo". Os itens foram considerados importantes pelos participantes e pelos juízes desde sua primeira concepção e os resultados corroboraram sua aplicabilidade. O instrumento elaborado, dando voz aos trabalhadores, considera os aspectos psicossociais a partir de sua percepção e poderá subsidiar tomada de decisão no gerenciamento do trabalho em espaço confinado e na promoção da saúde mental dessa população

In Brazil, few studies have been carried out on the measurement of psychosocial risk factors related to work in confined spaces. In most studies involving this theme, instruments are used for environments or contexts in general, without considering the specificities of the place. Therefore, it is relevant to make specific instruments available that may help the construction of knowledge on workers' health. The aim of this study was to design an instrument for the perception of psychosocial risk factors for workers who, in their work activities, perform activities in confined spaces. This was a methodological study developed with Brazilian workers of a level 3 electrical company, following four stages: 1) literature review and interview with workers to identify the attributes associated with the perception of the psychosocial risk factors in confined space work; 2) categorization of the statements into classes and elaboration of items; 3) semantic validation of the items and response scale and 4) content validation of these with specialists of the area and with workers. A total of 50 workers participated in the interviews and 18 in the semantic validation. Regarding the content validation stage, 22 judges participated, of which 16 were specialists in psychosocial risk factors or the design and validation of instruments and six representatives of the population, who analyzed the relevance, representativeness, clarity and format of the items as well as the questions for the characterization of the workers. The characterization variables were described by frequency distributions and measures of central tendency and dispersion. Semantic validation was carried out through the application of adapted DISABKIDS® questionnaires, with the results presented in absolute frequencies and percentages. The content of the interviews was organized in a linguistic corpus with the statements categorized according to the theoretical framework adopted. The R interface for multidimensional analysis of texts and questionnaires software was used to support the categorization of the statements into classes. The content validity was analyzed through the Content Validity Index. The statements were categorized into five classes associated with the psychosocial risk at work attributes: workload and rhythm and role in organization, and related to the worker: task planning; interpersonal relations at work and homework interface, from which 46 items were designed. The suggestions in the semantic validation generated changes in the writing of 24 items and an increase of six items. In the content validation the suggestions generated changes in the form and in the writing of 36 items and the exclusion of seven, totaling 45 items, which were redistributed in eight psychosocial risk attributes, these being the five previous as well as environment and equipment; organizational function and culture; and latitude in decisions/control. These were distributed in the "context" and "content" domains. The items were considered important by the participants and the judges from their first concept and the results corroborated their applicability. The elaborated instrument, giving voice to the workers, considers the psychosocial aspects based on their perception and may support decision making in the management of work in confined spaces and in the promotion of the mental health of this population

Assessment of confined space entry and rescue training for aircraft rescue and fire fighting (ARFF) members in the United States.

INTRODUCTION: Fire and emergency service workers, including Aircraft Rescue and Fire Fighting members, may be called on to perform confined space entry and rescue operations. The purpose of the present study was to develop a comprehensive and valid understanding of the present state of confined space entry and rescue training effectiveness and resultant compliance or use of best practices among trained Aircraft Rescue and Fire Fighting personnel. METHOD: The study used a convergent, parallel mixed-methods approach. Qualitative data (n = 20) were collected via semi-structured interviews at four locations. Data were coded, analyzed and super-ordinate and sub-ordinate themes were derived. Quantitative data (n = 158) from Aircraft Rescue and Fire Fighting members were analyzed. RESULTS: Interviewees believed there is a lack of standardization in training, but believed training should not be completed in the same format every time. Several participants (50%) desired more realistic training. Other concerns were associated with staffing, personal readiness, and resource adequacy. With regard to survey outcomes, most respondents reported that their organizations completed confined space training (69.8%), but only 55.3% indicated this training was conducted as a full-scale exercise and nearly 40% indicated that rescue practice was not performed despite standards mandating annual rescue practice. Following training, 55.4% indicated training evaluation information was not presented. CONCLUSIONS: Participants mostly agreed their training effectively addressed OSHA requirements, such as how to test the atmosphere, the need for and use of personal protective equipment, how to identify pertinent permit information and methods to retrieve victims in limited space. Some gaps exist between current training practices and established training requirements and standards. PRACTICAL APPLICATIONS: Aircraft Rescue and Fire Fighting organizations need to bolster aspects of their training, particularly with regard to standardizing training efforts, practicing rescues, providing evaluation feedback and written materials and providing adequate resources.

Confined space manure storage and facilities safety assessment.

A mail survey of 1,200 farms across 16 states was conducted to identify the number, type, and size of manure storages per farm, as well as safety-related behaviors or actions related to entry into confined-space manure storage and handling facilities. Respondents provided data on 297 storage units and facilities, with approximately 75% reporting up to three storages per farm operation. Dimensions were provided for 254 manure pits: nearly 66% were less than or equal to 100 feet long, 75% were less than or equal to 40 feet wide, and 75% were less than or equal to 10 feet deep. Almost 14% of the reported storages were over 300 feet long, seven were wider than 100 feet, and 17 were more than 20 feet deep. Survey results suggest that most farm operations with confined-space manure storages do not follow best safety practices regarding their manure storages, including using gas detection equipment before entering a manure pit, using rescue lines when entering storages, or developing a written confined-space safety policy or plan. Survey results also suggest that few farmers post warning signs around their storages, post recommended ventilation times before entry, or conduct training for workers who enter confined-space manure storages. This article provides a benchmark against which the effectiveness of educational programs and design tools for confined-space manure pit ventilation systems and other confined-space manure pit safety interventions can be measured.

Use of a fiber optic camera to perform a trauma assessment during a confined space rescue.

OBJECTIVE: Accurate medical evaluation of victims injured during confined space rescues poses significant operational, medical, and logistical challenges for medical providers of all disciplines and experience levels. The Federal Emergency Management Agency (FEMA) teaches rescuers to begin their assessment as soon as verbal contact is obtained with the victim. While a significant amount of information can be obtained by talking to the victim, an accurate assessment of the victim's condition is often limited or impossible. Many professional rescue agencies currently use cameras to locate a victim's position or visualize obstacles that prevent the successful extraction of casualties. However, there is no published literature describing the use of a camera to complete a medical evaluation. RESULTS: The authors describe their use of a fiber optic camera to complete a limited but accurate primary and secondary trauma evaluation of a patient trapped inside an 18 in water pipe for a prolonged period of time. The providers' assessment provided critical information to the rescue team and assisted in the planning and eventual extrication of the patient from the confined space. Moreover, there was very little variation between the findings obtained during the assessment at the scene and the assessment in the receiving facility's trauma bay. CONCLUSION: When evaluating a trauma patient, there is no substitution for visual inspection and physical diagnosis. The use of a fiber optic camera can assist rescuers and medical providers in obtaining the information they desire, and enable the completion of an accurate patient assessment. The camera may also provide psychological reassurance and ease anxiety, as well as generate prehospital images that can be transmitted to the receiving facility for use in preparation of the casualty. Emergency medical service providers, urban search & rescue teams, fire departments, and other professional rescuers should be trained on the use and limitations of fiber optic cameras during confined space rescues. Furthermore, regulatory agencies such as FEMA should consider integrating the use of fiber optic camera and audiovisual devices into the current training courses offered to professional rescuers.

Energy costs of catfish space use as determined by biotelemetry.

Animals use dispersed resources within their home range (HR) during regular day-to-day activities. The high-quality area intensively used by an individual, where critical resources are concentrated, has been designated as the core area (CA). This study aimed to describe how animals utilize energy in the HR and CA assuming that changes would occur according to the size of the used areas. We observed energetic costs of space use in the largest European freshwater predator catfish, Silurus glanis, using physiological sensors. Catfish consumed significantly more energy within the CA compared to the rest of the HR area. In addition, energetic costs of space use within a large area were lower. These results generally indicate that utilization of larger areas is related to less demanding activities, such as patrolling and searching for new resources and mates. In contrast, fish occurrence in small areas appears to be related to energetically demanding use of spatially limited resources.

The need for a comprehensive approach to managing confined space entry: summary of the literature and recommendations for next steps.

Despite all the regulatory and standard-setting efforts that have been made in North America, judging from the most recent statistics many fatal incidents related to work in confined spaces still occur. In Canada, fatal incidents in the province of Quebec reveal failures in and absence of the identification and preparation of work situations in confined spaces and in risk management. In this study, we performed a literature review consisting of 77 documents on existing hazards and risk assessment for confined spaces. Moreover, we formulated proposals regarding the design of specific and improved tools for assessing such risks. We found that atmospheric hazards monopolized attention in the literature on confined spaces, while risk estimation specific to confined space interventions received little practical coverage overall, apart from atmospheric hazards. The parameters used to establish classes or groupings of confined spaces in existing tools were imprecise. The development of a risk analysis process that is (i) more systematic and based on the concepts recognized in risk management standards, (ii) multidisciplinary, and (iii) adapted to the specific characteristics of confined spaces is therefore needed. Such a process will better support managers and occupational health and safety (OH&S) personnel in their efforts to prioritize and reduce risks. Suggestions on such a risk analysis tool and categorization of interventions in confined spaces are proposed in this article. Lastly, risk analysis tools adapted to confined space interventions are needed to ensure the inherently safe design of these spaces.

Utah farm owner/operators' safety practices and risk awareness regarding confined space work in agriculture.

The purpose of this study was to describe current safety practices and risk awareness associated with confined spaces in agriculture among Utah farm owner/operators. There were 399 farm owner/operators in the sample. The final response rate was 82.2%. The typical farm owner/operator in this study was male, between the ages of 50 and 59, with some education beyond high school. Grain and dairy production comprised 48.7% of the operations responding to the survey. A majority (50.2%) of respondents reported having entered a confined space without an observer waiting from the outside. All but 9.5% of the respondents indicated that they had no written emergency response plan in the event of a confined space emergency involving an entrant. Only 49.1% of farm owner/operators perceived entering a grain bin while unloading as a high risk for fatal injury. More research is needed to determine the farmers' knowledge of the variety of hazards associated with confined space work. Few farm owner/operators reported using accessible safety equipment. A limited number of respondents indicated having access to gas monitors, lifeline and harness systems, or ventilation blowers with flexible ducting. This may be associated with the costs of the equipment, or lack of awareness of the need for specific safety equipment.

Mold growth in on-reserve homes in Canada: the need for research, education, policy, and funding.

The impact of mold growth in homes located on First Nations reserves in Canada is part of a national housing crisis that has not been adequately studied. Nearly half of the homes on reserves contain mold at levels of contamination associated with high rates of respiratory and other illnesses to residents. Mold thrives due to increased moisture levels in building envelopes and interior spaces. Increased moisture stems from several deficiencies in housing conditions, including structural damage to the building envelope, overcrowding and insufficient use of ventilation systems, and other moisture-control strategies. These deficiencies have developed due to a series of historical and socioeconomic factors, including disenfranchisement from traditional territory, environmentally inappropriate construction, high unemployment rates, lack of home ownership, and insufficient federal funding for on-reserve housing and socioeconomic improvements. The successful, long-term reduction of mold growth requires increased activity in several research and policy areas. First, the actual impacts on health need to be studied and associated with comprehensive experimental data on mold growth to understand the unique environmental conditions that permit the germination and growth of toxic mold species. Second, field data documenting the extent of mold growth in on-reserve homes do not exist but are essential in understanding the full extent of the crisis. Third, current government initiatives to educate homeowners in mold remediation and prevention techniques must be long lasting and effective. Finally, and most importantly, the federal government must make a renewed and lasting commitment to improve the socioeconomic conditions on reserves that perpetuate mold growth in homes. Without such improvement, the mold crisis will surely persist and likely worsen.

Physical activity under confinement and free-living conditions.

The objective of this study was to investigate the relationship between the physical activity (PA) and its related variables under confinement and in free-living conditions in Asian individuals, where no such information presently exists. The subjects consisted of eighty-six Japanese individuals with a mean age of 38+/-12 years. Under confinement in a large respiratory chamber, the energy expenditure (EE) was measured for 24h. In addition, two moderate walking exercises of 30 min each on a horizontal treadmill were assigned. Free-living measurements of 7 days were also performed using a validated accelerometer. The PA level in the chamber (1.47+/-0.11), expressed as a multiple of the basal EE, was lower than that in free-living conditions (1.53+/-0.12) (p<0.001). However, the two values were closely correlated (r=0.744, p<0.001). Conversely, a residual analysis showed a wide variation in the mean difference for both conditions and revealed a significant systematic error (r=-0.548, p<0.001), thus indicating an increased gap with increasing PA levels in free-living conditions. Similar results were obtained following the exclusion of the imposed exercise sessions. In contrast, the daily step counts under both conditions did not show any correlation. The PA level in the chamber (including and excluding imposed walking exercises) is compatible with the PA level in free-living conditions at the group level, although the daily step counts are unrelated. Thus, the PA level in the chamber may provide valuable information to help us achieve a better understanding of human PA in daily life as it is related to behavioral research.