RESUMO
BACKGROUND: Schools with formal sun safety polices generally show better sun safety practices than schools without. OBJECTIVES: To understand the extent to which Welsh primary schools have sun safety policies; to identify the key characteristics of policies; to assess whether policy adoption varies by school characteristics; and to consider what support schools need to develop sun safety policies. METHODS: An online multiple-choice survey on sun safety was distributed to all 1241 primary schools in Wales. RESULTS: In total, 471 (38.0%) schools responded. Of these, 183 (39.0%) reported having a formal sun safety policy. Welsh medium schools (P = 0.036) and schools in North Wales (P = 0.008) were more likely to report having a policy. Schools with a higher percentage of pupils receiving free school meals (P = 0.046) and with lower attendance rates (P = 0.008) were less likely to report having a sun safety policy. The primary reasons for schools not having a policy included being 'not aware of the need' (34.6%); 'need assistance with policy or procedure development' (30.3%); and 'not got around to it just yet' (26.8%). CONCLUSIONS: With less than half of schools reporting a sun safety policy and variation in the presence/absence of a policy by school characteristics, our survey revealed inconsistency in formal sun safety provision in Welsh schools. The findings also suggest that schools are unaware of the importance of sun safety and need support to develop and implement policies. This snapshot of the current situation in primary schools in Wales provides a basis upon which the comprehensiveness, effectiveness and implementation of sun safety policies can be further evaluated.
Assuntos
Instituições Acadêmicas , País de Gales , Humanos , Instituições Acadêmicas/estatística & dados numéricos , Criança , Queimadura Solar/prevenção & controle , Política de Saúde , Inquéritos e Questionários , Protetores Solares/uso terapêutico , Roupa de Proteção/estatística & dados numéricos , Luz Solar/efeitos adversos , Masculino , Feminino , Serviços de Saúde Escolar/normasRESUMO
The COVID-19 pandemic has laid bare the inadequacy of the U.S. healthcare system to deliver timely and resilient care. According to the American Hospital Association, the pandemic has created a $202 billion loss across the healthcare industry, forcing health care systems to lay off workers and making hospitals scramble to minimize supply chain costs. However, as the demand for personal protective equipment (PPE) grows, hospitals have sacrificed sustainable solutions for disposable options that, although convenient, will exacerbate supply strains, financial burden, and waste. We advocate for reusable gowns as a means to lower health care costs, address climate change, and improve resilience while preserving the safety of health care workers. Reusable gowns' polyester material provides comparable capacity to reduce microbial cross-transmission and liquid penetration. In addition, previous hospitals have reported a 50% cost reduction in gown expenditures after adopting reusable gowns; given the current 2000% price increase in isolation gowns during COVID-19, reusable gown use will build both healthcare resilience and security from price fluctuations. Finally, with the United States' medical waste stream worsening, reusable isolation gowns show promising reductions in energy and water use, solid waste, and carbon footprint. The gowns are shown to withstand laundering 75-100 times in contrast to the single-use disposable gown. The circumstances of the pandemic forewarn the need to shift our single-use PPE practices to standardized reusable applications. Ultimately, sustainable forms of protective equipment can help us prepare for future crises that challenge the resilience of the healthcare system.
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COVID-19/prevenção & controle , Equipamentos Descartáveis/economia , Reutilização de Equipamento/economia , Pessoal de Saúde/estatística & dados numéricos , Controle de Infecções/economia , Pandemias/prevenção & controle , Roupa de Proteção/economia , Adulto , Equipamentos Descartáveis/estatística & dados numéricos , Reutilização de Equipamento/estatística & dados numéricos , Feminino , Humanos , Controle de Infecções/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/economia , Exposição Ocupacional/estatística & dados numéricos , Pandemias/estatística & dados numéricos , Roupa de Proteção/estatística & dados numéricos , Estados UnidosRESUMO
OBJECTIVE: To examine the risk and preventive factors of working in a cement plant. METHODS: The cross-sectional study was conducted from July to September, 2016, at a leading cement manufacturing plant in the Khyber Pakhtunkhwa province of Pakistan. An interviewer-administered questionnaire was used to collect data about the characteristics of exposed and unexposed subjects. The characteristics and occupational illnesses were compared between exposed and unexposed workers. Logistic regression was applied to estimate the odds ratio for risk and preventive factors associated with pulmonary illnesses linked with the profession. RESULTS: Of the 550 workers contacted, 260(47.3%) agreed to participate. The mean age of the sample was 30.48}6.13 years. Of the total, 80(31%) were exposed and 180(69%) were unexposed. Overall, 96(37%) workers had medical coverage facility, while 114(63%) reported very good health. All socioeconomic and working characteristics were highly significant between exposed and unexposed workers (p<0.05). There were 67(25.7%) workers with pulmonary illnesses and the difference between the exposed and unexposed groups were significant (p<0.05). CONCLUSIONS: Pulmonary health among workers could be improved by implementing occupational health improving strategies..
Assuntos
Poeira , Pneumopatias/epidemiologia , Máscaras/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Roupa de Proteção/estatística & dados numéricos , Adolescente , Adulto , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Humanos , Seguro Saúde/estatística & dados numéricos , Modelos Logísticos , Masculino , Indústria Manufatureira , Instalações Industriais e de Manufatura , Pessoa de Meia-Idade , Paquistão/epidemiologia , Fumar/epidemiologia , Fatores de Tempo , Adulto JovemRESUMO
Importance: Understanding patterns of sun-protective behaviors and their association with sunburn can provide important insight into measurement approaches and intervention targets. Objective: To assess whether decision-based modeling can be used to identify patterns of sun-protective behaviors associated with the likelihood of sunburn and to compare the predictive value of this method with traditional (ie, composite score) measurement approaches. Design, Setting, and Participants: This cross-sectional study used a nationally representative sample of 31â¯162 US adults from the 2015 National Health Interview Survey, consisting of household interviews conducted in person and completed by telephone when necessary. Participants included civilian noninstitutionalized US adults. Data were collected from January 1 through December 31, 2015. Main Outcomes and Measures: The associations among sun sensitivity, multiple sun-protective behaviors (ie, using sunscreen, seeking shade, wearing a hat, and wearing protective clothing), and sunburn were examined using a χ2 automatic interaction detection method for decision tree analysis. Results were compared with a composite score approach. Results: In our study population of 28â¯558 respondents with complete data (54.1% women; mean [SD] age, 49.0 [18.0] years), 20 patterns of sun protection were identified. Among 15â¯992 sun-sensitive individuals, those who used only sunscreen had the highest likelihood of sunburn (62.4%). The group with the lowest likelihood of sunburn did not report using sunscreen but engaged in the other 3 protective behaviors (24.3% likelihood of sunburn). Among 12â¯566 non-sun-sensitive individuals, those who engaged in all 4 protective behaviors had the lowest likelihood of sunburn (6.6%). The highest likelihood of sunburn was among those who only reported sunscreen use (26.2%). The decision tree model and the composite score approach correctly classified a similar number of cases; however, the decision tree model was superior in classifying cases with sunburn (44.3% correctly classified in the decision tree vs 25.9% with the composite score). Conclusions and Relevance: This innovative application of a decision tree analytic approach demonstrates the interactive and sometimes counterintuitive effects of multiple sun-protective behaviors on likelihood of sunburn. These data show where traditional measurement approaches of behavior may fall short and highlight the importance of linking behavior to a clinically relevant outcome. Given the scope of those affected and enormous associated health care costs, improving efforts in skin cancer prevention has the potential for a significant effect on public health.
Assuntos
Árvores de Decisões , Comportamentos Relacionados com a Saúde , Roupa de Proteção/estatística & dados numéricos , Queimadura Solar/prevenção & controle , Protetores Solares/administração & dosagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/prevenção & controle , Queimadura Solar/epidemiologia , Luz Solar/efeitos adversos , Estados Unidos , Adulto JovemRESUMO
BACKGROUND: Childhood is a critical period for sun protection, when the skin is particularly susceptible to the carcinogenic effects of ultraviolet radiation. Children are dependent upon parents to implement sun protective measures. Existing qualitative research exploring parents' attitudes and beliefs underpinning children's sun protection is from Australia, which has the highest melanoma incidence rates globally, and thus benefits from widespread sun protection awareness campaigns. Parents' sun protective behaviour may, therefore, differ between Australia and the UK. This study investigates the topic in a UK context, using qualitative methodology to gain detailed insights into a relatively under-researched area. The aim of the study was to explore parents' knowledge and understanding of sun protection in children, and factors that motivate and challenge them in this area. Finally, it aimed to determine if and how ethnicity and skin type influence these attitudes and beliefs. METHODS: Twenty-two semi-structured individual interviews were carried out with parents of children aged 5 years or younger, recruited from local nurseries. Transcripts were analysed using thematic analysis. RESULTS: Four overarching themes emerged, each incorporating two to three sub-themes. 'Attitudes towards children's sun protection' refers to the fact that parents considered sun protection to be important for children, a finding which was consistent between different skin types. 'Sun protection practices' brings together several protective behaviours adopted in children and, to a lesser degree, in parents, and their associated disadvantages. 'Sun safety knowledge' refers to parents' awareness of the risks of sun exposure and the need for protection, and illustrates where gaps in knowledge exist, such as regarding the need for vitamin D, and the importance of vigilant sun protection even in the UK. Finally, 'motivating and facilitating factors' highlights motivations for sun protection in children, and factors that facilitate it in practice. CONCLUSION: This study found parents to be motivated and concerned about children's sun protection, irrespective of children's ethnicity, and aware of appropriate protective behaviours. It indicates key challenges which could be targeted in future campaigns in order to improve sun protection in children and reduce uncertainty and anxiety regarding sun safety amongst parents.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pais/psicologia , Proteção Radiológica , Raios Ultravioleta/efeitos adversos , Adulto , Pré-Escolar , Etnicidade/estatística & dados numéricos , Feminino , Humanos , Lactente , Masculino , Melanoma/epidemiologia , Melanoma/prevenção & controle , Motivação , Roupa de Proteção/estatística & dados numéricos , Pesquisa Qualitativa , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/prevenção & controle , Pigmentação da Pele , Queimadura Solar/epidemiologia , Queimadura Solar/prevenção & controle , Protetores Solares/uso terapêutico , Reino Unido/epidemiologiaRESUMO
BACKGROUND: Farm workers and female cotton pickers are exposed to residual impacts of pesticide use in cotton production, in addition to dust, ultraviolet radiation, etc. Cotton picking causes various health hazards among cotton pickers with varied health cost. A soil bacterium known as Bacillus thuringiensis (Bt) is incorporated in cotton seed through genetic modification and it has resistance against certain bollworms of cotton. So it is considered that Bt cotton fields have less pesticide exposure compared to non-Bt cotton fields. This study was designed to examine and compare the impacts and health cost of cotton picking among female cotton pickers working in Bt and non-Bt cotton fields. METHODS: The study used the data collected from Vehari district of Pakistani Punjab. Health hazards and associated health cost of the respondents involved in Bt cotton picking were compared with those who harvested non-Bt cotton. Comparative use of the personal protective measures among those respondents was also examined. Health cost function and its determinants were analyzed using ordinary least square method. RESULTS: Findings of the study showed that 61 % cotton pickers from Bt cotton households reported one or more health effects of pesticide during picking season whereas this percentage for non-Bt cotton households was 66 %. Health impacts included skin problems, headache, cough, flu/fever, eye irritation and sleeplessness, however, percentage of these health impacts was comparatively higher among non-Bt cotton households. Health cost from exposure to pesticide use in cotton was US$ 5.74 and 2.91 per season for non-Bt cotton and Bt cotton households, respectively. Education, picking in Bt cotton fields and preventive measures were significantly related with health cost. CONCLUSION: Cotton pickers working in Bt cotton fields are found to have less occupational health hazards compared to those working in non-Bt cotton fields. Thus generating awareness among cotton pickers for adopting precautionary measures during harvesting and the use of Bt cotton seed can result in a decline in the ill-effects of cotton picking.
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Agricultura/economia , Gossypium/efeitos adversos , Custos de Cuidados de Saúde , Doenças Profissionais/economia , Exposição Ocupacional/economia , Adulto , Agricultura/métodos , Bacillus thuringiensis , Estudos Transversais , Feminino , Gossypium/microbiologia , Humanos , Análise dos Mínimos Quadrados , Doenças Profissionais/etiologia , Exposição Ocupacional/efeitos adversos , Paquistão , Praguicidas/toxicidade , Plantas Geneticamente Modificadas/microbiologia , Plantas Geneticamente Modificadas/toxicidade , Roupa de Proteção/estatística & dados numéricos , Fatores de RiscoRESUMO
Manual handling of municipal solid waste is of serious concern owing to emerging occupational risks. Considering this, health risks of municipal solid waste workers involved in street sweeping, waste collection, waste processing and rag picking were assessed in Chandigarh, India, using an interview schedule as a study tool. Result shows that the waste worker profession is mainly dominated by males, except in rag pickers, and with a lower literacy rate. Age distribution shows that 16% of waste collectors and 11% of rag pickers were below 18 years of age. Daily income of the waste workers ranges from â¹100 to â¹200. It was observed that 22.2% of waste collectors, 43.2% of street sweepers and 25.5% of rag pickers do not use any type of protective gears owing to their casual attitude, which results in various types of injuries. The major occupational health issues reported by various categories of waste workers were respiratory disorders, injuries and allergies having prevalence of 12.3%-17.6%, 4.9%-44.4% and 35.3%-48.9%, respectively. Waste workers are vulnerable to occupational health hazards and hence there is a need to safeguard them through formulation of new laws and policies.
Assuntos
Doenças Profissionais/etiologia , Exposição Ocupacional/efeitos adversos , Eliminação de Resíduos/métodos , Adolescente , Adulto , Escolaridade , Feminino , Substâncias Perigosas , Humanos , Renda , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/epidemiologia , Roupa de Proteção/estatística & dados numéricos , Eliminação de Resíduos/economia , Fatores Socioeconômicos , Resíduos Sólidos , Adulto JovemRESUMO
OBJECTIVE: Protecting the skin from ultraviolet (UV) radiation is critical during adolescence to reduce the risk of developing skin cancer later in life, but adolescents tend to be less likely to engage in sun-protective behaviours than adults. The present study examined changes and trends (2001/02-2011/12) in sun-protection behaviours among adolescents living in Western Australia - a region with high levels of UV radiation. METHODS: A cross-sectional survey was conducted during 10 summers between 2001/02 and 2011/12 to investigate how often adolescents engaged in various sun-protection behaviours, including outdoor protective measures (wearing a hat, wearing protective clothing, using sunscreen, wearing sunglasses, seeking shade) and avoidance of UV radiation by staying inside. RESULTS: Hat use significantly decreased between 2001/02 and 2011/12, whereas use of sunscreen and wearing covering clothes were unchanged in most survey years relative to 2001/02. Use of sunglasses peaked in 2006/07 and 2007/08, but returned to first survey year levels in 2011/12, while staying inside was more frequently reported from 2006/07 onwards. CONCLUSIONS: New approaches are needed to minimise reactance responses in adolescents while fostering favourable attitudes to sun protection. Implications and opportunities for interventions to promote better sun-protection practices among adolescents are provided.
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Comportamento do Adolescente , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Neoplasias Cutâneas/prevenção & controle , Queimadura Solar/prevenção & controle , Adolescente , Austrália , Estudos Transversais , Feminino , Humanos , Masculino , Roupa de Proteção/estatística & dados numéricos , Protetores Solares/uso terapêutico , Inquéritos e QuestionáriosRESUMO
BACKGROUND: On July 1st, 2012, the University of Minnesota Medical Centers adopted a policy requiring all personnel to wear cover jackets in perioperative areas. This policy is based on the Association of Perioperative Registered Nurses recommended practice for cover jacket usage. We hypothesized that the cover jacket policy had no effect on the surgical site infection rate. METHODS: We compared surgical site infection data from 1 year before the policy and 1 year after the policy. Twenty six thousand three hundred procedures were included: 13,302 before the policy and 12,998 after the policy. Rates between periods were compared using the z-test for proportions. RESULTS: The SSI rate precover and postcover jacket policy was 2.42% and 2.76% respectively. The P value was .1998. Our hypothesis was rejected because the change in rate was not statistically significant. CONCLUSIONS: This study demonstrates that there was not a decrease in SSI rates with this cover jacket policy; in fact, the data show a trend toward an increase in SSI rate thus making the argument for the abandonment of the cover up jackets.
Assuntos
Salas Cirúrgicas/organização & administração , Roupa de Proteção/estatística & dados numéricos , Infecção da Ferida Cirúrgica/prevenção & controle , Estudos de Coortes , Feminino , Política de Saúde , Humanos , Incidência , Masculino , Assistência Perioperatória , Formulação de Políticas , Estudos Retrospectivos , Medição de Risco , Sensibilidade e Especificidade , Infecção da Ferida Cirúrgica/epidemiologiaAssuntos
Política de Saúde/legislação & jurisprudência , Governo Local , Doenças Profissionais/prevenção & controle , Exposição Ocupacional/efeitos adversos , Roupa de Proteção/estatística & dados numéricos , Neoplasias Cutâneas/prevenção & controle , Luz Solar/efeitos adversos , Protetores Solares/uso terapêutico , HumanosRESUMO
OBJECTIVE: To develop an inexpensive and easily adaptable semi-quantitative exposure assessment method to characterize exposure to pesticide in applicators and re-entry farmers and farm workers in Ethiopia. METHODS: Two specific semi-quantitative exposure algorithms for pesticides applicators and re-entry workers were developed and applied to 601 farm workers employed in 3 distinctly different farming systems [small-scale irrigated, large-scale greenhouses (LSGH), and large-scale open (LSO)] in Ethiopia. The algorithm for applicators was based on exposure-modifying factors including application methods, farm layout (open or closed), pesticide mixing conditions, cleaning of spraying equipment, intensity of pesticide application per day, utilization of personal protective equipment (PPE), personal hygienic behavior, annual frequency of application, and duration of employment at the farm. The algorithm for re-entry work was based on an expert-based re-entry exposure intensity score, utilization of PPE, personal hygienic behavior, annual frequency of re-entry work, and duration of employment at the farm. RESULTS: The algorithms allowed estimation of daily, annual and cumulative lifetime exposure for applicators, and re-entry workers by farming system, by gender, and by age group. For all metrics, highest exposures occurred in LSGH for both applicators and female re-entry workers. For male re-entry workers, highest cumulative exposure occurred in LSO farms. Female re-entry workers appeared to be higher exposed on a daily or annual basis than male re-entry workers, but their cumulative exposures were similar due to the fact that on average males had longer tenure. Factors related to intensity of exposure (like application method and farm layout) were indicated as the main driving factors for estimated potential exposure. Use of personal protection, hygienic behavior, and duration of employment in surveyed farm workers contributed less to the contrast in exposure estimates. CONCLUSIONS: This study indicated that farmers' and farm workers' exposure to pesticides can be inexpensively characterized, ranked, and classified. Our method could be extended to assess exposure to specific active ingredients provided that detailed information on pesticides used is available. The resulting exposure estimates will consequently be used in occupational epidemiology studies in Ethiopia and other similar countries with few resources.
Assuntos
Agricultura/métodos , Fazendeiros , Exposição Ocupacional/análise , Praguicidas/análise , Adulto , Algoritmos , Estudos Transversais , Etiópia , Feminino , Humanos , Masculino , Praguicidas/intoxicação , Roupa de Proteção/estatística & dados numéricos , Fatores de Risco , Inquéritos e QuestionáriosAssuntos
Traumatismos em Atletas/prevenção & controle , Futebol Americano , Protetores Bucais/estatística & dados numéricos , Educação Física e Treinamento , Roupa de Proteção/estatística & dados numéricos , Adolescente , Traumatismos em Atletas/etiologia , Criança , Comportamento Competitivo , Feminino , Política de Saúde , Humanos , Masculino , Educação Física e Treinamento/legislação & jurisprudência , Instituições Acadêmicas , Reino Unido/epidemiologiaRESUMO
Agricultural pesticide exposure has potential adverse health effects for farmworkers that may be reduced by pesticide protective behaviors (PPBs). The Environmental Protection Agency's (EPA) Worker Protection Standard (WPS) requires PPBs be taught to farmworkers prior to field work. Studies to date have not utilized observational methods to evaluate the degree to which PPBs are practiced by Latino migrant and seasonal farmworkers in the United States. The purpose of this study was to describe, compare, and contrast observed and self-reported PPBs used by Latino farmworkers; both PPBs that the WPS requires be taught and other PPBs were included. Observed and self-reported data were collected from 71 Latino farmworkers during the 2014 tobacco growing season in North Carolina. Participants were consistent in reporting and using long pants and closed shoes in the field most of the time. In addition, gloves, hats/bandanas, and water-resistant outerwear were frequently observed, although they are not required to be taught by the WPS. Farmworkers reported more long-sleeve (p=.028) and glove use (p=.000) than what was observed. It was uncommon to observe washing behavior before eating or drinking, even when washing supplies were available. Washing behaviors were significantly overreported for hand (p=.000; p=.000) and face (p=.000; p=.058) washing before eating and drinking in the field. This study documents that protective clothing behaviors that the WPS requires be taught, plus a few others are commonly practiced by Latino migrant and seasonal farmworkers, but washing behaviors in the field are not. Targeted strategies to improve washing behaviors in the field are needed.
Assuntos
Comportamentos Relacionados com a Saúde/etnologia , Hispânico ou Latino , Exposição Ocupacional/prevenção & controle , Resíduos de Praguicidas , Roupa de Proteção/estatística & dados numéricos , Migrantes , Agricultura , Higiene das Mãos , Hispânico ou Latino/estatística & dados numéricos , Humanos , North Carolina , Autorrelato , Migrantes/psicologiaRESUMO
INTRODUCTION: Adherence to sun-protection guidelines in developed countries is low, especially among people of low SES. Mechanisms underlying this social differentiation are poorly understood. This study aimed to examine the social differentiation of sun-protection behaviors and of two cognitive factors (knowledge about both sun health and behavioral risk factors for cancer) and to determine if these cognitive factors mediate the association between SES and sun-protection behaviors. METHODS: Data came from the 2010 Baromètre Cancer survey (analyzed in 2014), a random cross-sectional telephone survey conducted among the French general population (n=3,359 individuals aged 15-75 years). First, bivariate associations between a composite individual SES indicator (based on education level, occupation, and income) and both sun-protection behaviors and cognitive factors were tested with chi-square tests and ANOVA. Then, confirmatory factor analysis and structural equation modeling were used to test the mediating role of cognitive factors with a multiple mediation model including four latent variables. RESULTS: In bivariate analyses, the individual SES indicator was positively associated with sun-protection behaviors and both cognitive factors. Multiple mediation analyses showed that both cognitive factors partially mediated the effect of individual SES on sun-protection behaviors. The overall proportion of mediated effects was 48%. The direct effect of SES remained significant. CONCLUSIONS: These results suggest that interventions aimed at modifying the knowledge and perceptions of people of low SES might help to reduce social differentiation of sun-protection behaviors. Further qualitative research is needed to better understand these cognitive factors and develop suitable prevention messages.
Assuntos
Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Roupa de Proteção/estatística & dados numéricos , Neoplasias Cutâneas/prevenção & controle , Classe Social , Queimadura Solar/prevenção & controle , Protetores Solares/uso terapêutico , Adolescente , Adulto , Idoso , Estudos Transversais , Exposição Ambiental/efeitos adversos , Feminino , França , Inquéritos Epidemiológicos , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Luz Solar/efeitos adversos , Adulto JovemRESUMO
Infection control is a critical component of post-burn care with prevention of infection serving as a major cause of decreasing morbidity and mortality. One potential deterrent for infection is barrier protection during dressing changes; however, no evidence-based standard has been established among burn centers. The purpose of this study is to describe the current barrier techniques of American burn centers. A 24-question survey was sent to 121 burn center nurse managers within the United States. The survey was comprised of yes or no questions with comment sections available for further detail. Questions were constructed to gain insight into the variation and commonality that may exist between burn center barrier protocols. Forty-one out of 121 centers (34%) responded. Centers reported the use of head covers, masks, gowns, and gloves during admission of a new burn (71%, 82%, 95%, and 100% respectively); daily dressing changes (64%, 80%, 97%, and 100% respectively); postoperative dressing changes (64%, masks 80%, 97%, and 100% respectively); and dressing changes of a nonburn (66%, 82%, 97%, and 100% respectively). Burn centers reported their use of sterile gloves and gowns during typical burn dressing changes as occurring 20% and 10% of the time, respectively. Estimates for costs of these garments annually ranged from $0 to $250,000. A calculation performed for this study demonstrated that barrier garments used for dressing changes nationwide is approximately $2.43 million. We demonstrated the immense cost, to an institution and nationwide, of barrier garments used solely for dressing changes.
Assuntos
Bandagens , Unidades de Queimados , Queimaduras/terapia , Máscaras/estatística & dados numéricos , Roupa de Proteção/estatística & dados numéricos , Protocolos Clínicos , Humanos , Controle de Infecções/estatística & dados numéricos , Máscaras/economia , Roupa de Proteção/economia , Inquéritos e Questionários , Estados UnidosRESUMO
IMPORTANCE: Skin cancer prevention remains a national priority. Reducing chronic UV radiation exposure for outdoor workers through sun-safety practices is an important step to help reduce the incidence of skin cancer. OBJECTIVE: To determine the presence of occupational sun-safety policies at local government organizations in a single state. DESIGN, SETTING, AND PARTICIPANTS: Of 571 potentially eligible local government organizations of Colorado cities, counties, and special tax districts, we enrolled 98 in a randomized pretest-posttest controlled experiment starting August 15, 2010, that evaluated an intervention to promote the adoption of sun-safety policies. We used a policy-coding protocol to evaluate personal sun-protection practices, environmental and administrative controls, and policy directives for sun safety starting February 10, 2011. We report the baseline assessment of the occupational sun-protection policies of these organizations. MAIN OUTCOMES AND MEASURES: The presence of an occupational sun-safety policy. RESULTS: Overall, 85 local government organizations (87%) had policies that required personal sun-protection practices, including the use of eyewear, hats, and protective clothing. However, of the 98 responding organizations, only 8 hat policies (8%), 10 eyewear policies (10%), and 7 clothing policies (7%) mentioned sun protection as the intent of the policy. Only cosmopoliteness, operationalized as proximity to an urban area, was associated with the presence of a sun-safety policy (odds ratio, 0.99 [95% CI, 0.98-1.00]; P = .02). CONCLUSIONS AND RELEVANCE: Outdoor workers are at increased risk for skin cancer because of long-term exposure to solar UV radiation. Although organizational policies have the potential to increase sun protection in occupational settings, occupational sun-safety policies were uncommon among local governments. Opportunities exist for dermatologists and other physicians to influence occupational sun-safety practices and policies, which are consistent with other safety procedures and could easily be integrated into existing workplace practices.
Assuntos
Política de Saúde/legislação & jurisprudência , Governo Local , Doenças Profissionais/prevenção & controle , Exposição Ocupacional/efeitos adversos , Roupa de Proteção/estatística & dados numéricos , Neoplasias Cutâneas/prevenção & controle , Luz Solar/efeitos adversos , Protetores Solares/uso terapêutico , Colorado/epidemiologia , Humanos , Incidência , Doenças Profissionais/epidemiologia , Doenças Profissionais/etiologia , Estudos Retrospectivos , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/etiologiaRESUMO
This study identified the actual conditions for safe anticancer drug management among nurses and the relationship between level of awareness and performance of anticancer drug safety regulations in terms of preparation, administration, and disposal. The respondents were 236 nurses working with chemotherapy in wards and outpatient clinics in five hospitals in and near Seoul. Safety regulations provided for the anticancer drug the Occupational Safety Health Administration (OSHA, 1999), as modified for an earlier study, were used. The results showed that the level of awareness and performance on the anticancer drug safety regulations indicate their preparation (3.38±0.55, 2.38±0.98), administration (3.52±0.46, 3.17±0.70), general handling and disposal (3.33±0.54, 2.42±0.90) on a scale 0 to 5. Also, there were significant differences in job positions, work experience, type of preparation, and continuing education and a positive relationship between the level of awareness and nursing performance. Thus, nurses should receive continuing education on the handling of anticancer drugs to improve the level of performance following safety regulations.
Assuntos
Antineoplásicos/uso terapêutico , Fidelidade a Diretrizes/estatística & dados numéricos , Recursos Humanos de Enfermagem Hospitalar/educação , Exposição Ocupacional/prevenção & controle , Guias de Prática Clínica como Assunto , Roupa de Proteção/estatística & dados numéricos , Gestão da Segurança , Conscientização , Saúde Ambiental , Necessidades e Demandas de Serviços de Saúde , Humanos , Eliminação de Resíduos de Serviços de Saúde , Enfermagem Oncológica/educaçãoRESUMO
Agriculture is a unique US industry in how youth are involved. Youth employed in agriculture experience high rates of injury, and youth migrant and seasonal farmworkers may be extremely vulnerable. The primary aim for this analysis is to describe the personal characteristics, work characteristics, occupational safety behaviors, and occupational injuries of North Carolina youth farmworkers. This pilot study uses data from interviewer-administered questionnaires with 87 youth farmworkers. Participants included males (62.1%) and females (37.9%), with 26.4% aged 10-13 years, 39.1% 14-15 years, and 34.5% 16-17 years. The majority (78.2%) were born in the United States. Most worked in tobacco (46.0%), sweet potatoes (28.7%), and berries (28.7%). They were paid by the hour (54.0%) and piece rate (55.2%); 21.8% reported a problem getting paid the amount earned. Three quarters wore a hat, and 63.2% wore gloves while working. Five (5.7%) had received pesticide use training in the past year. Over half reported a musculoskeletal injury (54.0%), a traumatic injury (60.9%), or a dermatological injury (72.4%) in the last year. Six of the injuries led to medical treatment, and 10 resulted in missed school or work. Farmworker youth in North Carolina are at times not treated fairly when they work, occupational safety behaviors are limited (increasing exposure to pesticides and other environmental hazards), and they commonly experience injuries. Research on the occupational exposures and health experienced by youth farmworkers is needed to inform policy. Changes in policy are warranted to improve the safety of youth farmworkers.
Assuntos
Doenças dos Trabalhadores Agrícolas/epidemiologia , Agricultura/estatística & dados numéricos , Saúde Ocupacional/estatística & dados numéricos , Traumatismos Ocupacionais/epidemiologia , Roupa de Proteção/estatística & dados numéricos , Adolescente , Agricultura/economia , Criança , Feminino , Hispânico ou Latino , Humanos , Masculino , North Carolina , Exposição Ocupacional/estatística & dados numéricos , Traumatismos Ocupacionais/prevenção & controle , Projetos Piloto , MigrantesRESUMO
This study evaluated a tailored intervention to promote sun protection in parents and their children, hypothesizing that the tailored intervention would lead to improved skin cancer prevention behaviors compared to generic materials. Families were recruited through schools and community centers and were included if there was 1 child in Grades 1-3 at moderate to high risk for skin cancer. Participants were randomized into one of two intervention groups: a tailored intervention, in which they received personalized skin cancer education through the mail; or a control group who received generic skin cancer information materials. Before and after intervention, parents completed questionnaires about their and their children's skin cancer risk and prevention knowledge and behaviors. Parents also completed 4-day sun exposure and protection diaries for their child and themselves. Tailored group participants demonstrated significantly greater positive changes in prevention behavior after the intervention, including children's use of sunscreen, shirts, and hats, and parents' use of shade, and skin examinations. Effect sizes were small and perceived benefits and social norms mediated intervention effects. Findings from this study support the efficacy of focusing tailored communications to families in order to change skin cancer prevention practices in young children.
Assuntos
Comportamento Infantil/psicologia , Comportamentos Relacionados com a Saúde , Comunicação em Saúde/métodos , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Pais/psicologia , Neoplasias Cutâneas/prevenção & controle , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Roupa de Proteção/estatística & dados numéricos , Medição de Risco , Queimadura Solar/tratamento farmacológico , Queimadura Solar/prevenção & controle , Protetores Solares/uso terapêutico , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: Despite long-standing social psychological research supporting the influence of injunctive norms (i.e., what is commonly approved or disapproved) on behavior, support for this influence on health behaviors is limited. We examined the utility of correcting misperceptions of injunctive norms for improving sun protection and whether changes in attitudes mediated the injunctive norm-intention relationship. METHOD: At baseline 263 community residing primarily White women, aged 37 to 77 years, reported their beliefs about sun protection and tanning and their perceptions of "typical women's" approval of sun protection versus tanning. Women underestimated approval of sun protection and overestimated approval of tanning. In a randomized trial, 189 of these women received either information about sun protection or information plus personalized normative feedback (PNF). PNF compared each woman's own perceptions of typical women's approval of tanning and sun protection with actual normative values, both measured at baseline. PNF communicated that most women approve of others who sun protect. RESULTS: PNF led to more positive sun protection injunctive norms, attitudes, and intentions at immediate posttest and more positive intentions and self-reported behavior at 4-week follow-up. Baseline discrepancy between a woman's beliefs and actual normative values related negatively to changes in sun protection in the control condition but positively in the PNF condition. As hypothesized, changes in attitudes partially mediated the influence of PNF on changes in intentions. CONCLUSIONS: The present research demonstrates the utility of correcting injunctive norm misperceptions for promoting healthy behaviors. That attitudes changed in response to PNF and mediated the norm-intention relationship suggests a method for influencing attitudes that may limit reactance.