Servicio Autónomo Instituto de Altos Estudios "Dr. Arnoldo Gabaldon"

Ente adscrito al Ministerio del Poder Popular para la Salud que ofrece programas de formación de posgrado, formación permanente y de interacción social para dar respuesta a las necesidades del Sistema Público Nacional de Salud, eventos edición de publicaciones, incluyendo el Boletin de Malariología y Salud Ambiental.

Identification of critical industry skills in an industrial hygiene graduate training program.

Graduates of industrial hygiene training (IH) programs must be able to meet continuously evolving health and safety needs in a wide variety of occupational settings. Therefore, academic IH graduate programs must regularly evaluate their curricula and solicit input from industry professionals to make curricular changes that will better prepare their students for professional roles in industry. The purpose of this study was to identify the training gaps that existed between industry needs and the current curriculum for a United States-accredited IH graduate training program. The research team facilitated two group interviews with the IH program advisory board, collected alumni survey data, and performed a qualitative analysis to identify skills gaps/needs for the IH Program graduates. The research team identified 3 themes from participant interviews and alumni surveys (technical, applied, and essential skills) and selected several skills within each theme that interview participants thought were necessary proficiencies for junior IH professionals. The skills identified in the qualitative interview and survey data can be incorporated into the curriculum to improve the training of IH graduate students. Additionally, by using qualitative analysis, the researchers uncovered essential skills previously unidentified in IH needs assessments, providing valuable information for all IH graduate programs.

Representaciones sociales sobre seguridad y salud en el trabajo en universitarios / Social representations on safety and health at work in universities

Antecedentes y objetivo La seguridad y salud en el trabajo corresponde a una de las competencias específicas, que deben desarrollar los profesionales de fisioterapia en Colombia, pero también se puede profundizar en él, como un campo de acción profesional que debe certificarse a través de formación de posgrado. El objetivo del presente estudio buscó describir las representaciones sociales sobre seguridad y salud en el trabajo en estudiantes de fisioterapia en una universidad pública en la ciudad de Cali (Colombia). Métodos Estudio cualitativo de la teoría de las representaciones sociales, los datos se recogieron con la técnica de listados de palabras de asociación libre, aplicada a 37 estudiantes antes del inicio y transcurridas 12 semanas de la práctica de seguridad y salud en el trabajo. El análisis se realizó con el software libre Anthropac. Resultados El concepto de seguridad y salud en el trabajo se configuró en el núcleo central a través del lexema pausa activa. Las categorías emergentes fueron ergonomía y movimiento. Conclusiones Las representaciones sociales evocadas hacen parte de las competencias establecidas en el perfil profesional y competencias del fisioterapeuta en Colombia, mientras otras representaciones sociales son imaginarios que el estudiante considera debería conocer el fisioterapeuta sobre SST (AU)

Background and objective Occupational safety and health corresponds to one of the specific competencies that physiotherapy professionals in Colombia must develop, but it can also be deepened, as a professional field of action to be certified through postgraduate training. The objective of this study was to describe the social representations on safety and health at work in physiotherapy students at a public university in the city of Cali (Colombia). Methods Qualitative study of the theory of social representations, the data were collected with the free association word lists technique, applied to 37 students before the beginning and 12 weeks of the practice of safety and health at work. The analysis was performed with the free software Anthropac. Results The concept of occupational safety and health was configured in the core through the active pause lexema. Emerging categories were ergonomics and movement. Conclusions The social representations mentioned are part of the competencies established in the professional profile and competencies of the physiotherapist in Colombia, while other social representations are imaginary that the student considers should know the physiotherapist about OSH (AU)

Exploring Mentorship in Union and Non-Union Occupational Safety and Health Training Programs.

Few studies have explored mentorship's value in occupational safety and health (OSH) training that focuses on worker empowerment in blue-collar occupations. Through a university and union collaboration, we examined mentorship programs as a promising enhancement to ongoing OSH training to foster worker leadership development in organizations focused on worker empowerment. Union-based worker-trainers from 11 large manufacturing facilities across the United States and worker-trainers affiliated with 11 Latinx Worker Centers in the New York City area were interviewed. Rapid Evaluation and Assessment Methods informed study design. The themes that emerged, reflecting the value of mentorship in OSH training, were: characterizing the elements of mentoring, how mentorship can improve OSH training, and recommended practices for designing a program across two different work settings. We conceptualize the goals of mentorship within a broader social ecological framework, that is, to support OSH learning so workers will advocate for broader safety and health changes with credibility and a feeling of empowerment.

Accuracy of professional judgments for dermal exposure assessment using deterministic models.

The accuracy of exposure judgments, particularly for scenarios where only qualitative information is available or a systematic approach is not used, has been evaluated and shown to have a relatively low level of accuracy. This is particularly true for dermal exposures, where less information is generally available compared to inhalation exposures. Relatively few quantitative validation efforts have been performed for scenarios where dermal exposures are of interest. In this study, a series of dermal exposure judgments were collected from 90 volunteer U.S. occupational health practitioners in a workshop format to assess the accuracy of their judgments for three specific scenarios. Accuracy was defined as the ability of the participants to identify the correct reference exposure category, as defined by the quantitative exposure banding categories utilized by the American Industrial Hygiene Association (AIHA®). The participants received progressively additional information and training regarding dermal exposure assessments and scenario-specific information during the workshop, and the relative accuracy of their category judgments over time was compared. The results of the study indicated that despite substantial education and training in exposure assessment generally, the practitioners had very little experience in performing dermal exposure assessments and a low level of comfort in performing these assessments. Further, contrary to studies of practitioners performing inhalation exposure assessments demonstrating a trend toward underestimating exposures, participants in this study consistently overestimated the potential for dermal exposure without quantitative data specific to the scenario of interest. Finally, it was found that participants were able to identify the reference or "true" category of dermal exposure acceptability when provided with relevant, scenario-specific dermal and/or surface-loading data for use in the assessment process. These results support the need for additional training and education of practitioners in performing dermal exposure assessments. A closer analysis of default loading values used in dermal exposure assessments to evaluate their accuracy relative to real-world or measured dermal loading values, along with consistent improvements in current dermal models, is also needed.

Effectiveness and usability of real-time vibrotactile feedback training to reduce postural exposure in real manual sorting work.

Vibrotactile feedback training may be used as a complementary strategy to reduce time in demanding postures in manual handling. This study evaluated the short- and medium-term effects of concurrent posture-correction vibrotactile feedback training on trunk inclination exposure in real manual sorting work. Fifteen warehouse workers completed the training and the follow-up sessions. Trunk inclination angles were recorded using the ambulatory Smart Workwear System. Questionnaires were used for assessing system usability, perceived physical exertion, and work ability. The results showed reduced time in trunk inclination >30°, >45°, and >60°, and reductions in the 90th, 95th, and 99th percentile trunk inclination angles, when receiving feedback and immediately after feedback withdrawal. No significant reduction was retained after one and three weeks. The wearer's comfort was scored high, and the feedback did not increase the perceived cognitive demands. No significant effects attributed to changed trunk inclination exposure were observed for perceived physical exertion or work ability. The training program has the potential of contributing to reduced trunk inclination exposure in the short term. Future studies are needed to evaluate if improvements in the feedback training can transfer the short-term results to retained median- and long-term effects.Practitioner summary: A two-day training program with concurrent posture-correction vibrotactile feedback can contribute to reduced exposure of trunk inclination in real manual sorting work in the short term. More research is needed on how to design the feedback training programs in order to be effective in the long term.

Promoting good and sustainable work in occupational health education.

BACKGROUND: The world of work is facing severe challenges due to rapid technological change, globalization, climate change and, more recently, the Covid-19 pandemic. Occupational health professionals must deal with these challenges, but it is unclear how well they have been prepared for this task by their academic training programmes. AIMS: To explore content and learning objectives related to these challenges in the curricula of Occupational Medicine (OM) and Occupational Safety, Industrial Hygiene and Ergonomics (OSH), we conducted an online survey among academic leaders of these programmes in universities of several European countries. In addition, related programmes in Human Resource Management (HRM) training were included. METHODS: Selected study programmes were explored in terms of the main topics and learning objectives related to the challenges for promoting good and sustainable work in universities in Europe. The study programmes were identified through contacts with professional associations and a website search. Given the exploratory, non-representative study design, data analysis was limited to description. RESULTS: OM and OSH programmes addressed the above challenges to a very limited extent, except for their disciplinary approach to work-related diseases and injuries. In contrast, HRM programmes were dealing more extensively with globalization, climate change and digitisation. CONCLUSIONS: Significant limitations of knowledge and competences in dealing with the key challenges of the modern world of work were identified. More relational, ethical and interdisciplinary learning is needed in these programmes, addressing core issues of today's world of work.

Productividad laboral en pacientes con artritis reumatoide temprana / Work productivity in patients with early rheumatoid arthritis

Introducción: La artritis reumatoide tiene un importante impacto sobre la función física y la productividad laboral. Objetivo: Determinar la productividad laboral de los pacientes con artritis reumatoide temprana identificando su relación con variables sociodemográficas y clínicas. Método: Se realizó un estudio observacional descriptivo de corte transversal en 53 pacientes atendidos en el Centro de Referencia de Enfermedades Reumáticas entre enero a diciembre de 2019. Para evaluar la productividad laboral se utilizó el cuestionario WPAI-AR. Resultados: Predominaron los pacientes entre los 35-55 años de edad (60,4 por ciento), el sexo femenino (60,4 por ciento). La productividad laboral medida a través de WPAI-AR reportó durante los últimos 7 días una media de 4,64 horas laborales perdidas, secundaria a la artritis reumatoide, con un porciento de pérdida por ausentismo del 16,5 por ciento y presentismo del 59,6 por ciento. Conclusiones: El mayor porciento de afectación de la productividad laboral le correspondió al presentismo. Se encontró asociación entre la pérdida de productividad laboral y la actividad clínica, la discapacidad funcional y la calidad de vida relacionada con la salud(AU)

Introduction: rheumatoid arthritis has been reported to have a significant impact on physical function and work productivity. Objectives: To determine the labor productivity of patient's diagnosis with early rheumatoid arthritis and to identify its possible relationship with sociodemographic and clinical variables. Methods: A cross-sectional descriptive observational study was carried out in 53 patients treated at the Reference Center for Rheumatic Diseases between January to December 2019. To evaluate labor productivity, the WPAIR AR questionnaire was used. Results: patients between 35-55 years of age predominated 60.4 percent, the female sex 60.4 percent. Labor productivity measured by WPAI AR reported during the last 7 days an average of 4.64 working hours lost, secondary to early rheumatoid arthritis, with a percentage of loss due to absenteeism of 16.5 percent and presenteeism of 59.6 percent. Conclusion: Conclusion: the highest percentage of affectation of labor productivity corresponded to labor presenteeism. Loss of work productivity was significantly associated with clinical activity, functional capacity, and health-related quality of lifepor ciento(AU)

Expanding the Focus of Occupational Safety and Health: Lessons from a Series of Linked Scientific Meetings.

There is widespread recognition that the world of work is changing, and agreement is growing that the occupational safety and health (OSH) field must change to contribute to the protection of workers now and in the future. Discourse on the evolution of OSH has been active for many decades, but formalized support of an expanded focus for OSH has greatly increased over the past 20 years. Development of approaches such as the National Institute for Occupational Safety and Health (NIOSH)'s Total Worker Health® concept and the World Health Organization (WHO)'s Healthy Workplace Framework are concrete examples of how OSH can incorporate a new focus with a wider view. In 2019, NIOSH initiated a multi-year effort to explore an expanded focus for OSH. This paper is a report on the outputs of a three-year cooperative agreement between NIOSH and The University of Texas School of Public Health, which led to subject matter expert workshops in 2020 and an international conference of global interest groups in 2021. This article traces the background of these meetings and identifies and assesses the lessons learned. It also reviews ten thematic topics that emerged from the meetings: worker health inequalities; training new OSH professionals; future OSH research and practice; tools to measure well-being of workers; psychosocial hazards and adverse mental health effects; skilling, upskilling and improving job quality; socioeconomic influences; climate change; COVID-19 pandemic influences; and strategic foresight. Cross-cutting these themes is the need for systems and transdisciplinary thinking and operationalization of the concept of well-being to prepare the OSH field for the work of the future.

Working with alcohol prevention in occupational health services: "knowing how" is more important than "knowing that" - the WIRUS OHS study.

BACKGROUND: Alcohol consumption is a major public health challenge; the majority of employees consume alcohol regularly and a considerable proportion of employees can be characterized as risky drinkers in need of interventions. Occupational health services (OHS) are uniquely positioned for implementing alcohol prevention interventions targeting employees, but rarely do so. Studies have shown that lack of knowledge among OHS personnel is a barrier to alcohol prevention activity. This study aimed to explore OHS personnels' levels of theoretical and practical alcohol knowledge, and whether these two ways of knowing were differentially associated with alcohol prevention activity. METHODS: In this cross-sectional study, survey data were collected from 322 OHS personnel in Norway in 2018 (response rate = 53.6%). The survey included variables of two ways of knowing (theoretical and practical) and three types of doing (intervention frequency, conducting individual interventions, and conducting group interventions). Data were analyzed with descriptive statistics, paired sample t-tests, bivariate correlations, and adjusted linear and logistic regression analyses. RESULTS: OHS personnel rated their theoretical alcohol knowledge higher than their practical knowledge (η2 = 0.33, p < 0.001). Higher reported levels of practical knowledge were associated with higher intervention frequency (b = 0.39, ß = 0.60, p < 0.001) and greater likelihood of conducting individual interventions (OR = 1.60, p < .001) as well as group interventions (OR = 1.84, p < 0.001). Theoretical knowledge was not associated with conducting interventions, and there was no evidence of an interaction between the two ways of knowing in their association with doing. Sensitivity analyses did not indicate clustering effects of OHS personnel being employed within different units. CONCLUSIONS: Different ways of knowing about alcohol among OHS personnel were dissimilarly associated with conducting alcohol prevention interventions in occupational health settings. For doing, knowing how seems to be more important than knowing that. Training programs for OHS personnel should emphasize knowledge about how to deal with alcohol-related issues and how to conduct prevention interventions, rather than focus on detrimental effects of alcohol.

An error-based augmented reality learning system for work-based occupational safety and health education.

BACKGROUND: Errors can have dangerous consequences, resulting in a preventive strategy in most company-based technical vocational education and training (TVET). On the contrary, errors provide a useful opportunity for learning due to mismatches of mental models and reality and especially to improve occupational safety and health (OSH). OBJECTIVE: This article presents a didactic concept for developing a learning system based on learning from errors. Learners shall directly experience the consequences of erroneous actions through presenting error consequences in augmented reality to avoid negative, dangerous, or cost-intensive outcomes. METHODS: Empirical data prove errors to be particularly effective in TVET. A formal description of a work system is systematically adopted to outline a connection between work, errors concerning OSH, and a didactic concept. A proof-of-concept systematically performs a use case for the developed learning system. It supports critical reflections from a technical, safety, and didactical perspective, naming implications and limitations. RESULTS: By learning from errors, a work-based didactic concept supports OSH competencies relying on a learning system. The latter integrates digital twins of the work system to simulate and visualise dangerous error consequences for identified erroneous actions in a technical proof-of-concept. Results demonstrate the ability to detect action errors in work processes and simulations of error consequences in augmented reality. CONCLUSION: The technical learning system for OSH education extends existing learning approaches by showcasing virtual consequences. However, capabilities are limited regarding prepared learning scenarios with predefined critical errors. Future studies should assess learning effectiveness in an industrial scenario and investigate its usability.

Exposición a riegos en la sala de autopsias / Risk exposure in the autopsy room

Resumen Este artículo describe la exposición a riesgos laborales en la actividad laboral de las salas de autopsia abarcan de manera general las condiciones en las cuales los trabajadores de las salas de autopsia se exponen a condiciones y situaciones durante la realización de una necropsia, con el objetivo de generar conciencia en la minimización de los riesgos por medio de la gestión de estos a través de medidas de mitigación, prevención y protección. Para estos efectos se define, clasifica, y se recomiendan tópicos al respecto de los riesgos laborales, así como propone la creación de protocolos y programas de prevención de enfermedades y accidentes laborales en las salas de autopsia.

Abstract This article describes the exposure to occupational risks in the work activity of the autopsy rooms, covering in a general way the conditions in which the workers of the autopsy rooms are exposed to conditions and situations during the performance of a necropsy, with the objective of generate awareness in minimizing risks by managing them through mitigation, prevention, and protection measures. For these purposes, it defines, classifies, and recommends topics regarding occupational risks, as well as proposing the creation of protocols and programs for the prevention of occupational diseases and accidents in autopsy rooms.

Exploring the Formation Mechanism of Unsafe Construction Behavior and Testing Efficient Occupational Health and Safety (OHS) Programs.

Safety education and training for employees is important to ensure the safety of construction and improve the safety awareness of employees. It is difficult to meet the needs of the new situation of safety production with traditional safety education and training consequences of construction enterprises. To address this deficiency, this research analyzed the formation mechanism of safety behavior of personnel at different levels in construction enterprises from the perspective of behaviorist psychology and studied their different needs for safety training, designing training programs for simple safety behavior and complex safety behavior according to the degree of difficulty of the training content. This research also developed and tested models of training frequency and training times and carried out corresponding experimental research. Through the experiments of "safety behavior by wearing a helmet" and "fire control consciousness training", it was found that the training of consciousness of relatively complex safety behavior should follow the principles that each training should last longer and the training interval should not be too short, so as to minimize the cost of safety education and training while ensuring the quality of safety education and training.

Ranking and comparing occupational health and safety system performance indicators in hospitals by the analytic hierarchy process.

The main goal of this study was to identify whether changes and new applications were positively or negatively influencing safety performance among health-sector workers. The research is based on the opinion of 16 selected occupational health and safety (OHS) experts who evaluated five main groups of questions by the analytic hierarchy process (AHP). The results were compared to the same questionnaire's results applied previously at three main hospitals in Bingöl, Turkey. The results presented are predictable, such as that of private hospitals having better control and pressure on applying the OHS system; experts gave higher priority to OHS training; and staff considered that working according to OHS criteria was the most important problem. Caring about others' safety and protecting one's own life, being knowledgeable about risks, having practical OHS training and cooperation are other important criteria according to the experts.

Physical education teachers of the basic public education of Minas Gerais in the pandemic of Covid-19: working conditions, health and lifestyle / Professores de educação física da educação pública básica de Minas Gerais na pandemia da Covid-19: condições de trabalho, saúde e estilo de vida

ABSTRACT This study aimed to describe the working and health conditions of physical education teachers in public basic education in the state of Minas Gerais - Brazil during the COVID-19 pandemic. Cross-sectional study, carried out from August to September 2020, via digital form and had the support of the Minas Gerais State Department of Education. The instrument presented variables related to the sociodemographic profile, work and health conditions during the pandemic. The prevalences of the variables were presented. 1,016 physical education teachers participated in the study. Of these, 61.4% were female, 65.8% aged 21 to 40 years and 15.3% worked in the countryside. In relation to working conditions during the pandemic, 99% performed remote activities, 35.7% were dissatisfied with their work, 37% worked much more than they used to and 81.2% presented the interest of students/parents in classes as a difficulty. As for health conditions during the pandemic, 10.3% increased their consumption of alcoholic beverages, 26.1% did not practice physical exercise, 56.5% had increased body weight and 37.8% reported a lot of fear of COVID-19. Physical education teachers of basic education in the state of Minas Gerais were significantly affected by the pandemic, so it is important to implement support strategies.

RESUMO Este estudo objetivou descrever as condições de trabalho e saúde dos professores de educação física da educação básica pública do estado de Minas Gerais - Brasil durante a pandemia da COVID-19. Estudo transversal, realizado de agosto a setembro de 2020, via formulário digital e contou com o apoio da Secretaria de Estado de Educação de Minas Gerais. O instrumento apresentou variáveis referentes ao perfil sociodemográfico, condições de trabalho e saúde durante a pandemia. Foram apresentadas as prevalências das variáveis. Participaram do estudo 1.016 professores de educação física. Destes, 61,4% eram mulheres, 65,8% com idade de 21 a 40 anos e 15,3% trabalhavam na zona rural. Em relação às condições de trabalho durante a pandemia, 99% realizaram atividades remotas, 35,7% estavam insatisfeitos com o trabalho, 37% trabalharam muito mais que costumavam e 81,2% apresentaram como dificuldade o interesse dos alunos/pais pelas aulas. Quanto às condições de saúde durante a pandemia, 10,3% aumentaram o consumo de bebidas alcóolicas, 26,1% não praticaram exercício físico, 56,5% tiveram aumento de peso corporal e 37,8% relataram muito medo da COVID-19. Os professores de educação física da educação básica do estado de Minas Gerais foram significativamente afetados pela pandemia, portanto é importante implementação de estratégias de apoio.

Occupational exposures in the operating room: Are surgeons well-equipped?

BACKGROUND: Occupational health hazards are ubiquitously found in the operating room, guaranteeing an inevitable risk of exposure to the surgeon. Although provisions on occupational health and safety in healthcare exist, they do not address non-traditional hazards found in the operating room. In order to determine whether surgeons or trainees receive any form of occupational health training, we examine the associations between occupational health training and exposure rate. STUDY DESIGN: A cross-sectional survey was distributed. Respondent characteristics included academic level, race/ethnicity, and gender. The survey evaluated seven surgical disciplines and 13 occupational hazards. Multivariable logistic regression was used to examine the association between academic level, surgical specialty, and exposure rate. RESULTS: Our cohort of 183 respondents (33.1% response rate) consisted of attendings (n = 72, 39.3%) and trainees (n = 111, 60.7%). Surgical trainees were less likely to have been trained in cytotoxic drugs (OR 0.22, p<0.001), methylmethacrylate (OR 0.15, p<0.001), patient lifting (OR 0.43, p = 0.009), radiation (OR 0.40, p = 0.007), and surgical smoke (OR 0.41, p = 0.041) than attending surgeons. Additionally, trainees were more likely to experience frequent exposure to bloodborne pathogens (OR 5.26, p<0.001), methylmethacrylate (OR 2.86, p<0.001), cytotoxic drugs (OR 3.03, p<0.001), and formaldehyde (2.08, p = 0.011), to name a few. CONCLUSION: Although surgeon safety is not a domain in residency training, standardized efforts to educate and change the culture of safety in residency programs is warranted. Our study demonstrates a disparity between trainees and attendings with a recommendation to provide formal training to trainees independent of their anticipated risk of exposure.

Occupational health nurses' personal attitudes toward smoking: A cross-sectional study.

OBJECTIVES: This study aims to investigate if experience in smoking intervention training influences attitudes toward smoking, discuss the role of health management programs of small- and medium-sized enterprises, and analyze the current attitude of occupational health nurses regarding the hazards of smoking and responsibility to smokers to effectively facilitate smoking cessation support programs. METHODS: We conducted an anonymous self-administered cross-sectional survey of 108 nurses employed in occupational health services outsourcing specialized agency in Korea. We assessed the difference in attitude about smoking according to training experience in smoking interventions and perceived competence in counseling smokers using chi-square test and Fisher's exact test. RESULTS: Occupational health nurses with the training experience of smoking interventions tend to perceive the harmful effects of smoking more seriously, compared to occupational health nurses without the training experience (P = .024, Fisher's exact test) and the OHSO nurses with the training experience tend to have professional ethics as health care professionals (P = .017, Fisher's exact test). Occupational health nurses having expertise in smoking cessation counseling tended to have professional ethics (P = .047, Fisher's exact test) and social responsibility as health care professionals (P = .022, Fisher's exact test). CONCLUSION: The occupational health nurses with training experience and expertise in smoking cessation counseling perceive the harmful effects of smoking more strongly and can enhance their professional ethics and social responsibility as health care professionals.

Impact of California Safe Patient Handling Legislation: Health Care Workers' Perspectives.

BACKGROUND: Musculoskeletal injuries from patient handling are significant problems among health care workers. In California, legislation requiring hospitals to implement safe patient handling (SPH) programs was enacted in 2011. This qualitative study explored workers' experiences and perceptions about the law, their hospital's SPH policies and programs, patient handling practices, and work environment. METHODS: Three focus groups were conducted with 21 participants (19 nurses and 2 patient handling specialists) recruited from 12 hospitals located in the San Francisco Bay Area and San Joaquin Valley. Qualitative content analysis was used for data analysis. RESULTS: Multiple themes emerged from diverse experiences and perceptions. Positive perceptions included empowerment to advocate for safety, increased awareness of SPH policies and programs, increased provision of patient handling equipment and training, increased lift use, and improvement in safety culture. Perceived concerns included continuing barriers to safe practices and lift use such as difficulty securing assistance, limited availability of lift teams, understaffing, limited nursing employee input in the safety committee, blaming of individuals for injury, increased workload, and continuing injury concerns. Participants indicated the need for effective training, sufficient staffing, and management support for injured workers. CONCLUSIONS/APPLICATION TO PRACTICE: This study identified improvements in hospitals' SPH programs and practices since the passage of California's SPH law, as well as continuing challenges and barriers to safe practices and injury prevention. The findings provide useful information to understanding the positive impacts of the SPH law but also notes the potential limitations of this legislation in the view of health care workers.