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1.
Recurso de Internet en Inglés | LIS - Localizador de Información en Salud, LIS-ES-PROF | ID: lis-LISBR1.1-47001

RESUMEN

Informe del ECDC dirigido a autoridades de Salud Pública y administradores de hospitales de países de la UE/EEE, cuyo objetivo es apoyar los planes de preparación de salud pública, relacionados con los equipos de protección personal en los centros sanitarios en los que se estén tratando a pacientes infectados por el nuevo coronavirus 2019-nCoV o en los que se sospecha la infección.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus , Equipo de Protección Personal , Planificación en Desastres , Planes de Emergencia , Planes de Contingencia , Planificación Hospitalaria
2.
J Environ Public Health ; 2019: 3084501, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31611921

RESUMEN

Biomonitoring of pesticides exposure has currently become a matter of great public concern due to the potential health effects of pesticides. This study assessed levels of acetylcholinesterase (AChE) inhibition and associated health effects in uncontrolled smallholder farming systems in rural Tanzania. A cross-sectional study was conducted of 90 exposed farmers and 61 nonexposed controls from horticultural zones. A structured questionnaire was administered, and a capillary blood sample of 10 µl was used to measure AChE activity using an Erythrocyte Acetylcholinesterase Test Mate Photometric Analyzer kit (Model 400). A multiple logistic regression model was used to investigate determinants of pesticide exposure. The study revealed that smallholder farmers are occupationally exposed to pesticides. Exposed farmers had significantly lower AChE levels. The use of personal protective equipment (PPE) did not significantly reduce the likelihood of AChE inhibition. Women, younger and older farmers, and underweight, overweight, and obese farmers were at increased risk of AChE inhibition. Increase in age (10 years) increased likelihood of AChE inhibition by 6.7%, while decrease in BMI increased likelihood of AChE inhibition by 86.7% while increased pesticides contact hours increased risk of having lower AChE at about 3 times. The number of exposure symptoms (14.10 ± 7.70) was higher in exposed farmers than unexposed. Self-reported symptoms are confirmed to correlate to lower AChE. Prevalence of tiredness (71.6% against 15.5%), fatigue (64.8% against 27.6%), soreness in joints (59.1% against 20.7%), thirst (52.3% against 12.1%), skin irritation (52.1% against 17.2%), salivation and abdominal pain (50% against 8.6% and 31.0%, respectively), muscle weakness (47.7% against 24.1%), and memory loss (47.7% against and 29.3%) differed significantly between exposed and control. This study provides useful information regarding the level of occupational and environmental exposure to pesticides in smallholder horticultural production systems. Pesticides use needs to be controlled at farm level by developing pesticides monitoring and surveillance systems.


Asunto(s)
Acetilcolinesterasa/sangre , Agricultores/estadística & datos numéricos , Exposición Profesional/estadística & datos numéricos , Plaguicidas , Adulto , Enfermedades de los Trabajadores Agrícolas/inducido químicamente , Enfermedades de los Trabajadores Agrícolas/enzimología , Enfermedades de los Trabajadores Agrícolas/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Exposición Profesional/efectos adversos , Equipo de Protección Personal/estadística & datos numéricos , Plaguicidas/efectos adversos , Plaguicidas/análisis , Prevalencia , Factores de Riesgo , Población Rural , Autoinforme , Tanzanía
3.
BMC Public Health ; 19(1): 1368, 2019 Oct 24.
Artículo en Inglés | MEDLINE | ID: mdl-31651271

RESUMEN

BACKGROUND: To determine the potential risk factors for injury, estimate the annual injury rate and examine the safety perceptions, and use of personal protective equipment among small-scale gold miners in Ghana. METHODS: A cross-sectional survey was carried out with 494 small-scale gold miners from four major mining districts in Ghana. A household-based approach was used to obtain a representative sample of miners. The study was conducted from June 2015 to August 2016. A systematic sampling technique was used to select households and recruit respondents to interview. Miners were asked about any mining related injury that they had sustained in the past year. A logistics regression model was employed to examine the association between risk factors and injury. Data were analyzed with STATA version 14.0. RESULTS: The annual incidence rate of mining-related injury was 289 per 1000 workers. Injuries were mainly caused by machinery/tools 66(46.1%), followed by slip/falls 46(32.2%). The major risk factor for injury was underground work (adjusted odds ratio for injury 3.19; 95% CI = 1.42-7.20) compared with surface work. Higher education levels were protective, with adjusted odds ratios of 0.48 (95% CI = 0.24-0.99) for middle school education and 0.38 (95% CI 0.17-0.83) for secondary school compared with no schooling. Only 15(3.0%) of miners reported to have had safety training in the past year and 105(21.3%) indicated that there were safety regulations at their work place. A moderate number of workers reported using work boots 178(36.0%) and hand gloves 134(27.1%), but less than 10% of workers used other personal protective equipment. CONCLUSION: The annual injury incidence rate among small-scale gold miners is high. Potential targets for improving safety include increasing safety training, increasing use of personal protective equipment, and better understanding potential changes that can be made in the machinery and tools used in small-scale mining, which were associated with almost half of all injuries.


Asunto(s)
Oro , Mineros/estadística & datos numéricos , Minería , Traumatismos Ocupacionales/epidemiología , Accidentes por Caídas/estadística & datos numéricos , Adolescente , Adulto , Estudios Transversales , Femenino , Ghana/epidemiología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Equipo de Protección Personal/estadística & datos numéricos , Factores de Riesgo , Adulto Joven
4.
Rev Lat Am Enfermagem ; 27: e3194, 2019 Oct 14.
Artículo en Portugués, Inglés, Español | MEDLINE | ID: mdl-31618387

RESUMEN

OBJECTIVE: using the urinary cotinine biomarker to verify the occurrence of green tobacco sickness in workers who cultivate Burley tobacco. METHOD: paired case-control study, based on smoking status and on the 1:4 ratio, with participation of 20 case workers and 91 controls. Data collection included household surveys and urine collection for cotinine examination. Student's T-Test, the Mann-Whitney test, Pearson's chi-square or Fisher's exact tests were used. RESULTS: of the 23 suspected cases, 20 showed elevated levels of cotinine, signs and symptoms of headache, skin irritation, nausea, sickness and general malaise, especially in the morning. Most had worked with tobacco that was wet from the morning dew and when the weather was warm. CONCLUSION: there are signs suggestive of green tobacco sickness in Burley tobacco workers. The action of health professionals is necessary for the development of health promotion and preventive actions addressing work-related illness.


Asunto(s)
Enfermedades de los Trabajadores Agrícolas/diagnóstico , Cotinina/orina , Exposición Profesional/análisis , Adulto , Enfermedades de los Trabajadores Agrícolas/inducido químicamente , Enfermedades de los Trabajadores Agrícolas/epidemiología , Enfermedades de los Trabajadores Agrícolas/orina , Biomarcadores/orina , Brasil/epidemiología , Estudios de Casos y Controles , Femenino , Cefalea/inducido químicamente , Humanos , Indicadores y Reactivos/análisis , Masculino , Persona de Mediana Edad , Náusea/inducido químicamente , Nicotina/envenenamiento , Exposición Profesional/efectos adversos , Equipo de Protección Personal , Encuestas y Cuestionarios , Tabaco/envenenamiento
5.
Artículo en Inglés | MEDLINE | ID: mdl-31500229

RESUMEN

The widespread industrial application of nanotechnology has increased the number of workers exposed to engineered nanomaterials (ENMs), but it is not clear to what extent prevention guidance is practiced. Our aim was to explore the extent that companies manufacturing and/or using ENMs apply risk assessment and management measures. Thirty-four companies were surveyed with an international 35-item questionnaire investigating company and workforce features, types of ENM handled, and risk evaluation and preventive measures adopted. Among participating companies, 62% had a maximum of 10 employees. Metal-based nanomaterials were most frequently identified (73%). Environmental monitoring was performed by 41% of the companies, while engineering exposure controls were approximately reported by 50%. Information and training programs were indicated by 85% of the sample, only 9% performed specific health surveillance for ENM workers. Personal protective equipment primarily included gloves (100%) and eye/face protection (94%). This small-scale assessment can contribute to the limited amount of published literature on the topic. Future investigations should include a greater number of companies to better represent ENM workplaces and a direct access to industrial settings to collect information on site. Finally, deeper attention should be paid to define standardized frameworks for ENM risk assessment that may guide nano-specific preventive actions.


Asunto(s)
Monitoreo del Ambiente/métodos , Instalaciones Industriales y de Fabricación/estadística & datos numéricos , Nanoestructuras/análisis , Exposición Profesional/análisis , Exposición Profesional/prevención & control , Medición de Riesgo/métodos , Gestión de Riesgos/métodos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Equipo de Protección Personal
6.
Nephrol Nurs J ; 46(4): 423-452, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31490052

RESUMEN

Nurses should protect the affected extremities of patients who have a permanent arteriovenous access for hemodialysis by avoiding blood pressure measurements and venipuncture on access extremities. National recommendations include labeling the affected extremity with an alert mechanism, such as a wristband, to notify patients and staff of arteriovenous access. A policy change was enacted at an academic medical center in the Southeast to identify restricted extremities with a pink "limb alert" wristband after review of national recommendations on hemodialysis access preservation, individual facility procedures, product cost-benefit analysis, and unit and system educational methods. Keeping simplicity, nursing workload, and flexibility at the forefront of implementation, evaluation, and process revision, an overall adherence rate of 84.2% was achieved three months after implementation of the policy.


Asunto(s)
Derivación Arteriovenosa Quirúrgica/enfermería , Equipo de Protección Personal , Diálisis Renal , Centros Médicos Académicos/organización & administración , Humanos , Política Organizacional , Sudeste de Estados Unidos
7.
J Clin Neurosci ; 68: 28-32, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31399319

RESUMEN

Experiential knowledge was collated to improve understanding of the mechanism of vertebral artery dissection (VAD) and inform recommendations for risk-reduction strategies in sport. Fourteen experts from fields of neurology, forensic pathology, biomedical engineering, radiology, physiotherapy, and sport and exercise medicine participated in semi-structured interviews. Experts were asked to provide their hypothesised mechanism of VAD, and suggest strategies to reduce the risk of VAD in non-motorised sports. Experts agreed that there is no single mechanism of VAD. Factors relating to predisposition, susceptibility, and an inciting event exist on a spectrum, as does the severity of the resulting VAD. Particularly concerning inciting events which may occur during sports participation include blunt force impact to the specific area behind and below the ear; and extreme movement of the neck, which may be facilitated by impact to the head or neck. Risk reduction strategies must be feasible within the particular sporting context. Strategies include rules, personal protective equipment, and education to reduce the risk of impact to the head or neck. Education may also serve to improve early recognition of VAD. VAD is a risk (low frequency, severe consequence) in sports in which athletes are exposed to head or neck impact from an object or opponent. Best practice risk management suggests that sports governing bodies should assess VAD risk and consider risk controls.


Asunto(s)
Traumatismos en Atletas/etiología , Traumatismos en Atletas/prevención & control , Conducta de Reducción del Riesgo , Disección de la Arteria Vertebral/etiología , Disección de la Arteria Vertebral/prevención & control , Atletas , Humanos , Equipo de Protección Personal , Arteria Vertebral/patología
9.
S Afr Med J ; 109(8): 587-591, 2019 Jul 26.
Artículo en Inglés | MEDLINE | ID: mdl-31456554

RESUMEN

BACKGROUND: Funeral home personnel are at risk of exposure to infectious hazards. The high prevalence of infectious diseases in South Africa means that these workers and family members of deceased individuals are vulnerable to infection if proper safety measures and equipment are not used. OBJECTIVES:  To collect observational information on funeral industry practices in order to assess the safety of handling corpses and exposure to risk that could result in disease transmission. METHODS: A cross-sectional study was conducted across two locations from August to October 2015. Funeral homes in Klerksdorp and Soweto were approached. The study team did facility assessments and observed preparation practices, focusing on safety equipment, personal protective equipment (PPE) and contact with hazardous materials. Interviews with funeral home personnel and relatives of the deceased were also conducted. RESULTS: Of the funeral homes, 23.0% (20/87) agreed to participate. A median of 5 personnel (interquartile range 4 - 8) were employed per facility. It was observed that not all PPE was used despite availability. Gloves, aprons and face masks were most commonly worn, and no personnel were observed wearing boots, gowns or plastic sleeves. Funeral homes were located near food outlets, schools and open public spaces, and not all had access to proper biohazardous waste disposal services. Of 5 family members who were interviewed for the study, none reported being willing to partake in the funeral preparation procedure. CONCLUSIONS: There is a need to standardise the use of safety equipment, waste disposal methods and location designation in the funeral industry.


Asunto(s)
Funerarias , Eliminación de Residuos Sanitarios , Equipo de Protección Personal/estadística & datos numéricos , Administración de la Seguridad , Adulto , Anciano , Control de Enfermedades Transmisibles , Estudios Transversales , Transmisión de Enfermedad Infecciosa , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sudáfrica , Vacunación/estadística & datos numéricos , Instalaciones de Eliminación de Residuos , Heridas y Traumatismos/epidemiología
10.
Cien Saude Colet ; 24(8): 3117-3128, 2019 Aug 05.
Artículo en Portugués | MEDLINE | ID: mdl-31389558

RESUMEN

This study refers to the impact of the use of pesticides on human health in the São Francisco River Valley region, in which, through semi-structured interviews, the objective was to analyze the influence of social, cultural and economic determinants on the health-disease process of workers exposed to agrochemicals. For data collection, 339 rural workers from irrigated perimeters of the cities of Juazeiro, in the State of Bahia, and Petrolina, in the State of Pernambuco, were interviewed. All were male, of which 182 (53,7%) were rural owners and 157 (46,3%) were employees, predominantly between 40 and 59 years of age among owners and under 39 among workers. Over 50% have a low level of schooling and 55.2% of them have monthly incomes less than or equal to 2 minimum wages. Many of them know about the importance of wearing personal protective equipment (PPE) and the mandatory license for the use and purchase of agrochemicals. However, about 40% do not use PPE or use it inadequately and 28.9% do not have a license to purchase. More than 9% of participants reported cases of intoxication, however, less than 7% sought specialized care. Workers are aware of the risks that the use of agrochemicals expose them to risk situations, but this does not encourage them to change their worksite behavior.


Asunto(s)
Enfermedades de los Trabajadores Agrícolas/prevención & control , Agricultores/estadística & datos numéricos , Exposición Profesional/prevención & control , Plaguicidas/toxicidad , Adulto , Agricultura , Brasil , Granjas , Frutas , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Exposición Profesional/estadística & datos numéricos , Equipo de Protección Personal/estadística & datos numéricos , Población Rural
11.
Medicine (Baltimore) ; 98(29): e16416, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31335690

RESUMEN

Occupational exposure remains a serious problem for medical staff, especially those working in operation rooms. Hepatitis B virus (HBV) is prevalent in patients undergoing surgery, and anesthesiologists are at risk of occupational acquisition of blood-borne HBV infection. To the best of our knowledge, there are no data about HBV prevalence and vaccinations, as well as attitudes toward sharp injuries and gloving among anesthesiologists in China, where the HBV prevalence is high. To clarify these, the present study was conducted.An electronic questionnaire including HBV markers, gloving during practice, and reporting patterns of sharp injuries was created and sent to anesthesiologists.After excluding 10 uncompleted questionnaires, 1739 questionnaires were included in the final analysis. Of all analyzed anesthesiologists, 1599 (91.9%) had experienced sharp injuries, and 1313 (75.5%) had experienced >1 sharp injury. Considering HBV vaccination histories, 1381 anesthesiologists (79.4%) received 3 vaccination doses, and only half of the immunized anesthesiologists received reminder HBV vaccination doses after work before exposure. There were 696 anesthesiologists (40.0% of all participants) who were ever exposed to HBV, and nearly two-thirds of them (440) were exposed to HBV more than once. There was a more positive attitude toward gloving and double-gloving to reduce HBV exposure.The incidence of occupational HBV exposure among anesthesiologists is high, and its threat should be considered. HBV vaccinations and adherence to postexposure guidelines are recommended. The high prevalence of sharp injuries during anesthesia practice highlights the importance of safe anesthesia practices, such as gloving or double-gloving, especially when in contact with high-risk body fluids.


Asunto(s)
Anestesiólogos/estadística & datos numéricos , Actitud del Personal de Salud , Hepatitis B , Exposición Profesional , Traumatismos Ocupacionales , Gestión de Riesgos/organización & administración , Adulto , China/epidemiología , Femenino , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Evaluación de Necesidades , Exposición Profesional/análisis , Exposición Profesional/prevención & control , Traumatismos Ocupacionales/clasificación , Traumatismos Ocupacionales/prevención & control , Equipo de Protección Personal , Medición de Riesgo/métodos , Encuestas y Cuestionarios , Vacunación/estadística & datos numéricos
12.
Pan Afr Med J ; 32: 217, 2019.
Artículo en Francés | MEDLINE | ID: mdl-31312328

RESUMEN

Introduction: this study aims to describe the knowledge, attitude and practices of hairdressers about HIV infection in Lomé. Methods: we conducted a descriptive study whose population included hair salon owners and apprentices in the Agoè-Nyivé prefecture, Lomé, between October 1 2016 and March 31 2017. The different parameters studied were data on the general knowledge about HIV, attitudes and practices about HIV/AIDS in the hair salons. Results: a total of 203 owners and apprentices were interviewed in the 68 hair salons in the Agoè-Nyivé prefecture. The study population (100%) knew about HIV/AIDS. Among the participants, 79.3% of them defined it as a sexually transmitted infection. Gloves and aprons were worn before some hairstyling gestures in 33 (51.5%) and 35 (48.5%) hair salons respectively. Moreover, in 60 (88.2%) hair salons, sharp instruments were disinfected prior to their use. However, alcohol was the disinfectant the most commonly used by the majority of the staff of hairdressing salons (89.3%). Moreover, boiling for an average of 7 minutes was performed by 79.8% of hairdressers. In the event of blood exposure accident, 69.6% of staff of hair salons cleaned the exposed site with alcohol. Conclusion: this study shows that hairdressers and their apprentices have good knowledge about HIV infection/AIDS, its modes of transmission and prevention means in hair salons. However, it highlights that the disinfection of soiled equipment and the behaviour of hairdressers and their apprentices in the case of blood exposure accident are sometimes improper.


Asunto(s)
Industria de la Belleza , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Exposición Profesional/prevención & control , Adulto , Desinfección/métodos , Desinfección/normas , Femenino , Infecciones por VIH/transmisión , Humanos , Masculino , Persona de Mediana Edad , Equipo de Protección Personal , Profilaxis Posexposición/métodos , Profilaxis Posexposición/normas , Togo , Adulto Joven
13.
J Forensic Leg Med ; 66: 147-154, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31306914

RESUMEN

Spit guards, also known as spit hoods or spit masks (and occasionally bite guards) are devices intended to cover the mouth, face and sometimes the head of a restrained person in order to prevent them spitting at, or biting others. There is substantial controversy about their use with views often polarised between civil and human rights campaigners who express concerns about their utility, their safety, and their possible encroachment on human rights, and in contrast by (predominantly) law enforcement campaigners highlighting concerns about the possible risks of transmission of infection and subsequent need for prophylaxis by law enforcement professionals exposed to biological fluids. This study explored the extent to which police services deploy spit guards and the rationale underpinning their use. A mixed qualitative and quantitative approach was used to analyse data obtained from police services under the Freedom of Information Act. This study shows there is paucity of information readily available from police services in respect of quantifying the numbers of police officers who have contracted infectious disease as a result of spitting and/or bites, despite the fact that risk of infection and the need for subsequent prophylaxis is a driver of police services adopting the use of spit guard devices. Consideration must be afforded to the possibility that the use of spit guards represents a form of mechanical restraint rather than a means to prevent transmission of infection, especially given the paucity of information available from police services in respect of officers who have contracted infectious disease as a result of spiting and/or bites.


Asunto(s)
Transmisión de Enfermedad Infecciosa/prevención & control , Enfermedades Profesionales/prevención & control , Equipo de Protección Personal , Policia , Mordeduras Humanas/prevención & control , Inglaterra , Humanos , Irlanda del Norte , Saliva , Gales
14.
Appl Ergon ; 80: 187-192, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31280804

RESUMEN

BACKGROUND: There is a high rate of injury associated with firefighting: in 2016, 21% of all fireground injuries were attributed to falls, jumps and slips. Examining factors related to balance, including experience in wearing firefighter gear, may assist in reducing injury related to falls. OBJECTIVES: To assess the effects of wearing firefighter gear on postural balance in firefighters and non-firefighters in a rested condition. METHODS: Each subject attended two sessions. In session 1, informed consent was obtained, a threshold audiogram was collected, and the sensory organization test (SOT) and motor control test (MCT) were administered with the subject dressed in street clothes. The second session was comprised of three different conditions with the order of testing randomized across subjects: street clothing, firefighter protective garments (coat, pants, helmet, hood) with breathing apparatus but no facemask, and firefighter protective garments with breathing apparatus and facemask. Twenty subjects participated: ten firefighters (8 males) and sex and age-matched non-firefighters (8 males) completed the study. RESULTS: SOT scores were obtained for each sub-condition, including the overall performance score and sensory weightings. For the MCT, latency and amplitude data were obtained for the three forward and three reverse translation conditions. A significant difference was found for large forward surface translations in the MCT in firefighters. CONCLUSION: In spite of the altered center of balance created by breathing apparatus and the altered visual cues created by the facemask, wearing firefighter gear did not substantively affect anterior-posterior postural stability or motor response to linear translation in rested, healthy individuals. Firefighters and non-firefighters performed similarly across all except one of the experimental conditions.


Asunto(s)
Bomberos , Equipo de Protección Personal , Balance Postural , Ropa de Protección , Dispositivos de Protección Respiratoria , Adulto , Femenino , Voluntarios Sanos , Humanos , Masculino , Desempeño Psicomotor , Descanso
15.
Cochrane Database Syst Rev ; 7: CD011621, 2019 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-31259389

RESUMEN

BACKGROUND: In epidemics of highly infectious diseases, such as Ebola Virus Disease (EVD) or Severe Acute Respiratory Syndrome (SARS), healthcare workers (HCW) are at much greater risk of infection than the general population, due to their contact with patients' contaminated body fluids. Contact precautions by means of personal protective equipment (PPE) can reduce the risk. It is unclear which type of PPE protects best, what is the best way to remove PPE, and how to make sure HCW use PPE as instructed. OBJECTIVES: To evaluate which type of full body PPE and which method of donning or doffing PPE have the least risk of self-contamination or infection for HCW, and which training methods increase compliance with PPE protocols. SEARCH METHODS: We searched MEDLINE (PubMed up to 15 July 2018), Cochrane Central Register of Trials (CENTRAL up to 18 June 2019), Scopus (Scopus 18 June 2019), CINAHL (EBSCOhost 31 July 2018), and OSH-Update (up to 31 December 2018). We also screened reference lists of included trials and relevant reviews, and contacted NGOs and manufacturers of PPE. SELECTION CRITERIA: We included all controlled studies that compared the effects of PPE used by HCW exposed to highly infectious diseases with serious consequences, such as Ebola or SARS, on the risk of infection, contamination, or noncompliance with protocols. This included studies that used simulated contamination with fluorescent markers or a non-pathogenic virus.We also included studies that compared the effect of various ways of donning or doffing PPE, and the effects of training in PPE use on the same outcomes. DATA COLLECTION AND ANALYSIS: Two authors independently selected studies, extracted data and assessed risk of bias in included trials. We planned to perform meta-analyses but did not find sufficiently similar studies to combine their results. MAIN RESULTS: We included 17 studies with 1950 participants evaluating 21 interventions. Ten studies are Randomised Controlled Trials (RCTs), one is a quasi RCT and six have a non-randomised controlled design. Two studies are awaiting assessment.Ten studies compared types of PPE but only six of these reported sufficient data. Six studies compared different types of donning and doffing and three studies evaluated different types of training. Fifteen studies used simulated exposure with fluorescent markers or harmless viruses. In simulation studies, contamination rates varied from 10% to 100% of participants for all types of PPE. In one study HCW were exposed to Ebola and in another to SARS.Evidence for all outcomes is based on single studies and is very low quality.Different types of PPEPPE made of more breathable material may not lead to more contamination spots on the trunk (Mean Difference (MD) 1.60 (95% Confidence Interval (CI) -0.15 to 3.35) than more water repellent material but may have greater user satisfaction (MD -0.46; 95% CI -0.84 to -0.08, scale of 1 to 5).Gowns may protect better against contamination than aprons (MD large patches -1.36 95% CI -1.78 to -0.94).The use of a powered air-purifying respirator may protect better than a simple ensemble of PPE without such respirator (Relative Risk (RR) 0.27; 95% CI 0.17 to 0.43).Five different PPE ensembles (such as gown vs. coverall, boots with or without covers, hood vs. cap, length and number of gloves) were evaluated in one study, but there were no event data available for compared groups.Alterations to PPE design may lead to less contamination such as added tabs to grab masks (RR 0.33; 95% CI 0.14 to 0.80) or gloves (RR 0.22 95% CI 0.15 to 0.31), a sealed gown and glove combination (RR 0.27; 95% CI 0.09 to 0.78), or a better fitting gown around the neck, wrists and hands (RR 0.08; 95% CI 0.01 to 0.55) compared to standard PPE.Different methods of donning and doffing proceduresDouble gloving may lead to less contamination compared to single gloving (RR 0.36; 95% CI 0.16 to 0.78).Following CDC recommendations for doffing may lead to less contamination compared to no guidance (MD small patches -5.44; 95% CI -7.43 to -3.45).Alcohol-based hand rub used during the doffing process may not lead to less contamination than the use of a hypochlorite based solution (MD 4.00; 95% CI 0.47 to 34.24).Additional spoken instruction may lead to fewer errors in doffing (MD -0.9, 95% CI -1.4 to -0.4).Different types of trainingThe use of additional computer simulation may lead to fewer errors in doffing (MD -1.2, 95% CI -1.6 to -0.7).A video lecture on donning PPE may lead to better skills scores (MD 30.70; 95% CI 20.14,41.26) than a traditional lecture.Face to face instruction may reduce noncompliance with doffing guidance more (OR 0.45; 95% CI 0.21 to 0.98) than providing folders or videos only.There were no studies on effects of training in the long term or on resource use.The quality of the evidence is very low for all comparisons because of high risk of bias in all studies, indirectness of evidence, and small numbers of participants. AUTHORS' CONCLUSIONS: We found very low quality evidence that more breathable types of PPE may not lead to more contamination, but may have greater user satisfaction. Alterations to PPE, such as tabs to grab may decrease contamination. Double gloving, following CDC doffing guidance, and spoken instructions during doffing may reduce contamination and increase compliance. Face-to-face training in PPE use may reduce errors more than video or folder based training. Because data come from single small studies with high risk of bias, we are uncertain about the estimates of effects.We still need randomised controlled trials to find out which training works best in the long term. We need better simulation studies conducted with several dozen participants to find out which PPE protects best, and what is the safest way to remove PPE. Consensus on the best way to conduct simulation of exposure and assessment of outcome is urgently needed. HCW exposed to highly infectious diseases should have their use of PPE registered and should be prospectively followed for their risk of infection in the field.


Asunto(s)
Personal de Salud , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Equipo de Protección Personal , Líquidos Corporales , Guantes Protectores , Fiebre Hemorrágica Ebola/prevención & control , Fiebre Hemorrágica Ebola/transmisión , Humanos , Ropa de Protección , Ensayos Clínicos Controlados Aleatorios como Asunto , Síndrome Respiratorio Agudo Grave/prevención & control , Síndrome Respiratorio Agudo Grave/transmisión
16.
Prev Vet Med ; 169: 104711, 2019 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-31311640

RESUMEN

Veterinarians play a crucial role in zoonotic disease detection in animals and prevention of disease transmission; reporting these zoonoses to public health officials is an important first step to protect human and animal health. Evidence suggests veterinarians and their staff are at higher risk for exposure to zoonoses because of possible interactions with infected animals. We examined the knowledge, attitudes, and practices of veterinarians regarding zoonotic disease reporting to public health agencies and associated infection prevention (IP) practices such as personal protective equipment (PPE) use, and the need for targeted education and outreach for veterinarians in Arizona. An online questionnaire was developed and distributed by email in September 2015 and was available through November 2015 to all 1,100 members of the Arizona Veterinary Medical Association. Chi-square and logistic regression analyses were performed. In total, 298 (27%) veterinarians from all 15 Arizona counties completed the survey; the majority (70%) were female, practiced small animal medicine (84%), and reported practicing veterinary medicine for ≥10 years (75%). Only 57% reported they knew when to report a suspected zoonotic disease and 60% reported they knew how to make that type of report. The majority said they would report rabies (97%), plague (96%), and highly pathogenic avian influenza (91%) to a state agency. Most respondents reported using PPE (e.g., masks, face shields, and gloves) when performing a surgical procedure (96%) or necropsy (94%), although fewer reported using PPE for handling clinically ill animals (37%) or healthy animals (17%). Approximately 70% reported always using PPE when in contact with animal birthing fluids, urine, or feces, and 47% for contact with animal blood, saliva, or other body fluids. Veterinarians who agreed that they knew the appropriate actions to protect themselves from zoonotic disease exposures were more likely to report always washing their hands before eating or drinking at work (OR = 3.81, 95% confidence interval (CI) [1.97-7.35], P < 0.01). Responses for when to make a report and how to report were not significantly different by gender, years of practice, or holding additional degrees, but did differ by practice type, age, and number of veterinarians in the practice. Small animal veterinarians were less likely to report knowing when to make a report compared to other veterinarians (P < 0.01). Respondents demonstrated suboptimal zoonotic disease reporting and IP practices, including PPE use. Public health agencies should improve outreach and education to veterinarians to facilitate better zoonotic disease prevention practices and reporting.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Control de Infecciones/métodos , Exposición Profesional/prevención & control , Veterinarios/psicología , Zoonosis/prevención & control , Zoonosis/psicología , Adulto , Animales , Arizona , Estudios Transversales , Femenino , Adhesión a Directriz , Guías como Asunto , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Equipo de Protección Personal/estadística & datos numéricos , Sociedades Veterinarias , Encuestas y Cuestionarios
17.
Biomed Instrum Technol ; 53(3): 196-201, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31162954

RESUMEN

Effective personal protective equipment (PPE) is critically important to preventing the spread of infectious diseases. Appropriate test systems and test soils are needed to adequately evaluate PPE. ASTM test method F903, which specifies the test method setup also used in ASTM F1670/F1670M-17a and ASTM F1671/F1671M-13, has been used for decades to test liquid penetration resistance of fabrics. All three standards require at least 60 mL of challenge liquid, such as synthetic blood solution (F1670) or bacteriophage in nutrient broth (F1671). The three ASTM test methods also are labor intensive and prone to exhibiting problems with leakage around the gaskets. Previous work comparing the F903 test apparatus with a modified dot-blot apparatus to evaluate the visual penetration of a blood test soil in series of commercially available gowns and drapes demonstrated that the methods are comparable and revealed that penetration through PPE material may depend on the test solution. The study described here evaluated a series of clinically relevant test soils (blood, vomit, urine, and feces) in penetration of PPE garments using the modified dot-blot apparatus. The results indicated that a vomit test soil penetrates PPE material more often than blood, urine, or fecal test soils and that the blood test soil has the least number of PPE failures. Incorporating clinically relevant, chemically defined test soils to evaluate PPE material should be considered to protect healthcare workers and reduce the spread of infectious material.


Asunto(s)
Equipo de Protección Personal , Suelo , Personal de Salud , Ropa de Protección
18.
Artículo en Inglés | MEDLINE | ID: mdl-31195677

RESUMEN

Wastewater workers are exposed to different occupational hazards such as chemicals, gases, viruses, and bacteria. Personal protective equipment (PPE) is a significant factor that can reduce or decrease the probability of an accident from hazardous exposures to chemicals and microbial contaminants. The purpose of this study was to examine wastewater worker's beliefs and practices on wearing PPE through the integration of the Health Belief Model (HBM), identify the impact that management has on wastewater workers wearing PPE, and determine the predictors of PPE compliance among workers in the wastewater industry. Data was collected from 272 wastewater workers located at 33 wastewater facilities across the southeast region of the United States. Descriptive statistical analysis was conducted to present frequency distributions of participants' knowledge and compliance with wearing PPE. Univariate and multiple linear regression models were applied to determine the association of predictors of interest with PPE compliance. Wastewater workers were knowledgeable of occupational exposures and PPE requirements at their facility. Positive predictors of PPE compliance were perceived susceptibility and perceived severity of contracting an occupational illness (p < 0.05). A negative association was identified between managers setting the example of wearing PPE sometimes and PPE compliance (p < 0.05). Utilizing perceived susceptibility and severity for safety programs and interventions may improve PPE compliance among wastewater workers.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Equipo de Protección Personal/estadística & datos numéricos , Eliminación de Residuos Líquidos/instrumentación , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Exposición Profesional/análisis , Sudeste de Estados Unidos , Aguas Residuales , Adulto Joven
19.
J Sports Sci Med ; 18(2): 376-383, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31191109

RESUMEN

The objective of the study was to evaluate and compare different brands of forearm, shin, hand and foot protective equipment used in Taekwondo. The most popular brands of large forearm, shin, hand and foot protectors (D®, A®, K ®), approved by the World Taekwondo and Korean Taekwondo Association, were examined. A drop test was used to test the protective equipment using impact levels of 3J, 9J, 12J and 15J for the forearm and shin guards, and 3J and 9J for the hand and foot protectors. The protective equipment was hit ten times from each of the designated drop heights. The drop test is described in the European standards manual of protective equipment for martial arts (SRPS EN 13277-2). The maximum force (MF) and impulse were lowest for brand K® (2610.3 ± 1474.1 N), and brand A® (9.6 ± 3.1 Ns), respectively, for the forearm guards; for brand A® (2053.4 ± 1267.1 N) and brand K® (9.8 ± 3.5 Ns), respectively, for the shin guards; for brand K® (4486.5 ± 1718.4 N), and brand A® (6.3 ± 1.1 Ns), respectively for the hand protectors; and for brand A® (3733.7 ± 2465.3 N), and brand D® (6.8 ± 0.6 Ns), respectively, for the foot protectors. For the forearm guard brand and impact level, there was a significant interaction effect for the MF (F=42.44, η2=.677, p <0.001) and impulse (F = 33.97, η2 = 0.626, p <0.001). Based on the MF, brand K® performed the best for the forearm guards and hand protectors, and brand A®, for the shin guards and foot protectors. The best results for the impulse were for brand A® (forearm guards and hand protectors), brand K® (shin guards) and brand D® (foot protectors).


Asunto(s)
Artes Marciales , Equipo de Protección Personal , Equipo Deportivo , Traumatismos en Atletas/prevención & control , Pie , Antebrazo , Mano , Humanos , Pierna , Ensayo de Materiales
20.
J Sci Med Sport ; 22(9): 1010-1013, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31160233

RESUMEN

OBJECTIVES: To investigate the association between air jacket usage and rider injury severity in equestrian eventing competition falls world-wide. DESIGN: Retrospective data analysis. METHODS: An analysis was conducted on Fédération Equestre Internationale data for 1819 riders who fell wearing an air jacket and 1486 riders who fell while not wearing an air jacket from 2015 to 2017. Injury data were categorised as either 'no/slight injury' or 'serious/fatal injury'. A chi-square test determined whether an association was present between injury severity category and air jacket usage and binary logistic regression determined the effect size of this association. RESULTS: As a result of falls, 3203 riders sustained no/slight injuries and 102 sustained serious/fatal injuries. While 55.0% of riders who fell were wearing an air jacket, they represented 67.6% of the serious/fatal injury outcomes. Air jacket usage was significantly associated with serious/fatal injuries in falls (X²â€¯= 6.76; p = 0.009). Riders wearing an air jacket had 1.7 times (95%CI 1.14-2.64) increased odds of sustaining a serious or fatal injury in a fall compared to riders not wearing an air jacket. CONCLUSIONS: Riders wearing an air jacket were over represented in the percentage of serious or fatal injuries in falls compared to riders who only wore a standard body protector. Further research is needed to understand the reason(s) for this finding. It is recommended that additional data on injury outcomes, rider characteristics and the biomechanics of falls be examined in future analyses, and that air jacket and body protector characteristics be further investigated.


Asunto(s)
Accidentes por Caídas , Traumatismos en Atletas/prevención & control , Equipo de Protección Personal , Deportes , Animales , Traumatismos en Atletas/mortalidad , Caballos , Humanos , Estudios Retrospectivos , Factores de Riesgo
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