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1.
Eur J Vasc Endovasc Surg ; 57(5): 730-739, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31005510

RESUMEN

OBJECTIVE: The aim was to determine whether lead containing and lead free composite garments in current use provide the level of radiation protection stated by manufacturers. METHODS: Fifteen garments, produced by five different manufacturers using eight different composites, were randomly selected for testing from four hospitals in South Australia. Labelling, material composition, design, and condition of the garments were assessed by direct garment examination, garment label, and product information. Garment attenuation was tested in a simulated angiography suite using a Siemens Ysio Max digital Xray machine. The front and back panels of each garment were tested under direct beam at 100 kVp. A Perspex phantom was used to simulate the density and scatter properties of the human abdomen. The front panels of each garment were tested under scattered radiation at Xray tube voltages of 50 and 70 kVp. RESULTS: Forty-seven per cent of front panels and 90% of back panels provided lower lead equivalence than claimed by the manufacturer. Twenty per cent of front panels and 62% of back panels tested did not meet the minimum International Electrotechnical Commission requirements for angiographic use. There was a 38 fold difference in front panel performance of garments to scatter radiation, which were all labelled 0.5 mm lead equivalence. 56% of garments had differences in scatter transmission of at least 49% when tested at 50 and 70 kVp. CONCLUSION: The results show that lead containing and lead free composite garments probably provide less radiation protection than manufacturer stated lead equivalence. The demonstrated wide variations in attenuation of scatter radiation are greater than previously reported. It was found that most garments failed to comply with labelling standards. The study highlights challenges in radiation shielding and the need to identify composites that consistently provide better attenuation per unit weight than lead.


Asunto(s)
Ropa de Protección/normas , Protección Radiológica/instrumentación , Protección Radiológica/normas , Angiografía , Diseño de Equipo , Análisis de Falla de Equipo , Humanos , Etiquetado de Productos/normas , Dosis de Radiación , Servicio de Radiología en Hospital , Dispersión de Radiación , Australia del Sur
3.
Work ; 62(3): 497-505, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30909265

RESUMEN

BACKGROUND: Firefighters must complete a physical ability test to assess work readiness. There is a lack of understanding of how personal protective clothing (PPC) affects functional performance tests for work readiness, e.g. Triple Hop for Distance (THD) and Triple Hop for Work (THW). OBJECTIVE: To examine firefighter PPC's effect on the THD and THW measures. METHODS: Thirty-one healthy, untrained participants (male = 20, female = 11; age = 23±3 years; height = 175.30± 11.12 cm; mass = 77.94±14.24 kg; mass in PPC = 89.14±14.68 kg) completed three successful trials of the THD on their dominant and non-dominant leg, with and without PPC. The main outcome measures included maximum and mean distances on the THD with and without PPC and THW. RESULTS: We identified a significant decrease in THD measures (mean difference = 97.83 cm; p <  0.001) and THW measures (mean difference = -326.61J; p <  0.001) when donning PPC in the dominant leg. We identified a significant decrease in THD (mean difference = 121.48 cm; p <  0.001) and THW (mean difference = 493.15J; p <  0.001) for females, and a significant difference for THD (mean difference = 84.83 cm; p <  0.001) for males when donning PPC. CONCLUSIONS: The addition of PPC decreased the THD and THW measures. The additional mass of the PPC required the more energy to move the same distance without the PPC.


Asunto(s)
Prueba de Esfuerzo/métodos , Bomberos/estadística & datos numéricos , Ropa de Protección/normas , Adulto , Índice de Masa Corporal , Brasil , Estudios Transversales , Prueba de Esfuerzo/estadística & datos numéricos , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Masculino , Persona de Mediana Edad , Ropa de Protección/efectos adversos , Estadísticas no Paramétricas
4.
Traffic Inj Prev ; 20(2): 169-173, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30888879

RESUMEN

OBJECTIVE: Fractures are a common injury among motorcycle riders and can have serious health implications. Impact protection (IP) has been designed to help prevent fractures, yet there are conflicting opinions as to whether this IP does in fact help prevent fractures in real-world crashes. This work aimed to (1) use simulated dummy impacts to examine whether existing types of IP could reduce the force transferred to the underlying bone to below fracture tolerance levels and (2) investigate whether current European Standard (EN 1621-1) test procedures for impact protectors designed for motorcyclists are sufficient to ensure fracture protection. METHOD: Twenty-three shoulder and 7 knee IP specimens were tested using a 23-kg impactor contacting axially along the clavicle and femur of an anthropomorphic test device (ATD) at an energy level corresponding to the fracture tolerance of these bones. Sixteen IP specimens were the same as those worn by motorcycle riders involved in crashes where injury outcome was known (knee: n = 3; shoulder: n = 13) and the IP had been previously tested to EN 1621-1. Other IP tested represented a wide range of IP available for purchase at a motorcycle accessory store. Double and triple layers of IP were also tested. Energy attenuated during the dummy impacts was compared to energy attenuated when tested to EN 1621-1. RESULTS: Of the 23 shoulder IP tested, the average percentage reduction of transferred force to the shoulder from the baseline test was 7.6 ± 4.8%. The percentage reduction of transferred force to the knee from the baseline was 43.9 ± 7.5%. The entire group of knee IP tested reduced the transferred force to the knee to below the 10-kN injury threshold for the femur. There was a positive but nonsignificant correlation between the ATD test and the EN 1621-1 impact test performance, suggesting that the European standard test method likely provides a good indication of IP performance. However, given the low correlation coefficient, the relationship between IP performance in the European standard test method and injury protection remains unclear. CONCLUSION: Though the energy attenuation test method in the European standard may be an appropriate approach, distinct differences in injury protection performance observed between knee and shoulder IP indicate that there may be a need for different performance criteria for IP designated to protect different body regions.


Asunto(s)
Accidentes de Tránsito , Fracturas Óseas/prevención & control , Traumatismos de la Rodilla/prevención & control , Motocicletas , Ropa de Protección/normas , Lesiones del Hombro/prevención & control , Antropometría/instrumentación , Humanos , Maniquíes
5.
J Infect Chemother ; 25(7): 489-493, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30827859

RESUMEN

BACKGROUND: Ebola virus disease (EVD) was endemic to Africa in 2014-2016. Supportive therapies have been shown to improve the outcome of EVD, and additional supportive therapy including blood transfusion therapy and external circulation could be needed in the event of a future global outbreak. However, pre-transfusion testing policies and guidelines have not yet been established in Japan. METHODS: We conducted a cross-sectional study of blood transfusion therapy for EVD patients at three designated hospitals for serious communicable diseases in Tokyo. In each hospital, we surveyed blood transfusion therapy policy, blood transfusion protocol, presence of a specialist in the department of transfusion medicine, facility capacity for pre-transfusion compatibility testing, and types of personal protective equipment available. RESULTS: One hospital had a cross-matched compatible blood transfusion policy, one had a cross-matched compatible blood transfusion policy only when the patient's ABO and RhD type is previously known, and the third had not created a policy. Two hospitals had a department of transfusion medicine. These two hospitals had a special testing unit for serious communicable diseases, while the other had a portable unit for testing. There were no major differences noted in available personal protective equipment. CONCLUSION: Policies and protocols differ among hospitals. The choice of blood transfusion policy and pre-transfusion testing is largely dependent on equipment and human resources. Further discussion is required to develop national guidelines for blood transfusion therapy in patients with serious communicable diseases, including countermeasures against complications and ethical issues related to the safety of patients and healthcare workers.


Asunto(s)
Transfusión Sanguínea/normas , Enfermedades Transmisibles/terapia , Fiebre Hemorrágica Ebola/terapia , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Reacción a la Transfusión/prevención & control , Enfermedades Transmisibles/transmisión , Estudios Transversales , Personal de Salud/normas , Fiebre Hemorrágica Ebola/transmisión , Humanos , Políticas , Guías de Práctica Clínica como Asunto , Ropa de Protección/normas , Tokio
6.
Am J Surg ; 218(3): 447-451, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-30808508

RESUMEN

BACKGROUND: Recent AHRQ/Joint Commission guidelines mandate additional barrier attire for all operating room personnel to target infection. The scientific basis for this is unclear. STUDY DESIGN: Patients undergoing abdominal surgery at our institution were identified from institutional NSQIP database before and after March 2016, when guidelines were implemented. Patient-level variables were compared for the pre- and post-implementation groups. Multivariable regression evaluated associations between implementation and surgical site infection (SSI) and other outcomes. RESULTS: 1122 patients (including 60.9% laparoscopic and 16.4% bowel resection procedures) were included. There were 607 patients post-implementation and 515 pre-implementation; cohorts were similar in risk factors for SSI. Fifty-seven patients developed SSI. On multivariable analysis, laparoscopy, bowel resection and operating duration, but not barrier attire, were associated with SSI. Implementation of attire did not significantly impact SSI (p = 0.4), hospital readmission (p = 0.4), or reoperation (p = 0.9). CONCLUSIONS: These data question the rationale for the new more stringent operating room attire guidelines which burden hospitals with additional cost, time and resources, and could detract efforts to target important factors that really influence outcomes.


Asunto(s)
Abdomen/cirugía , Quirófanos , Ropa de Protección/normas , Infección de la Herida Quirúrgica/prevención & control , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
7.
J Therm Biol ; 79: 33-41, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30612683

RESUMEN

Many documented studies have demonstrated the human mortality rate increases during severe heatwaves. There remains a need for further explore ecologically valid cooling strategies to alleviate body heat strain during extreme heatwaves. The main aim of this work was to explore whether intermittent wetting clothing can be served as an ecologically valid cooling strategy to mitigate heat stress on inactive vulnerable populations not having access to air-conditioning during a severe heatwave. Ten young male subjects underwent two 90-min separate trials: a dry clothing trial (i.e., CON) and a wetted clothing cooling trial (i.e., WEC). A set of light summer wear was chosen and intermittently wetted by tap water at intervals of every 30 min. Physiological and perceptual responses of subjects were examined and compared. All trials were performed in a chamber with an air temperature of 43 ±â€¯0.5 °C, RH= 57 ±â€¯5% and an air velocity of 0.15 ±â€¯0.05 m/s (WBGT=37.35 °C). Results demonstrated that WEC, compared with CON, could significantly reduce both the mean skin temperature and the core temperature throughout the 5-90th min and 25-90th min of the trial, respectively (p < 0.05). Besides, WEC could also remarkable reduce local skin temperatures at those body sites covered by wet clothing (p < 0.05). In comparison, no significant difference was found between WEC and CON on perceptual responses. Further, it was also found from PHS simulations that conditions with a partial water vapour pressure ≤ 3.1-3.5 kPa would not induce pronounced core temperature rises at 43 °C. Finally, it may be concluded that intermittent wetting clothing could be served as an ecologically valid cooling strategy to reduce thermophysiological strain of vulnerable populations while seating during humid heatwaves and thereby improve their health and safety.


Asunto(s)
Regulación de la Temperatura Corporal , Trastornos de Estrés por Calor/prevención & control , Ropa de Protección/normas , Humectabilidad , Adulto , Calor/efectos adversos , Humanos , Masculino , Distribución Aleatoria , Temperatura Cutánea
8.
Int J Occup Saf Ergon ; 25(2): 268-277, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29570426

RESUMEN

Research into newly developed ballistic vests to be worn by police officers under clothing was carried out with air temperature conditions of +20 °C. A ballistic vest should incorporate protective features, comfort and ergonomics. The thermal strain on users who wore the vests was evaluated as an average and individually, after they had been conditioned in high (+50 °C), low (-40 °C) or neutral (+20 °C) air temperatures, while performing various occupational activities. Research involved six police officers aged 36-42 years, who wore civilian clothing used in moderate environmental conditions. During the tests, physiological parameters (internal temperature, local skin temperatures and amount of sweat secreted) were determined. The ease of doing exercises while wearing the vests, vest service and level of discomfort in use were assessed. Research showed that the vests tested, both as an average and individually, meet the requirements of Standard No. PN-V-87000:2011 (clause 4.5).


Asunto(s)
Ropa de Protección/normas , Temperatura Cutánea/fisiología , Sudoración/fisiología , Adulto , Ergonomía , Ejercicio/fisiología , Humanos , Masculino , Policia , Temperatura Ambiental
9.
Ind Health ; 57(3): 306-325, 2019 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-30089764

RESUMEN

Personal protective clothing (PPC) is mandatory in hazardous industrial workplaces, but can increase thermophysiological strain, causing fatigue, reduced productivity, illness and injury. We systematically reviewed the literature on PPC and heat stress, focusing on research relating to working conditions of high temperature and humidity. PPC must protect industrial workers from a wide variety of hazards, including sun damage, abrasion, chemical spills and electrical burns; these competing demands inevitably compromise thermal performance. Fiber type, textile material construction and treatment need to be considered alongside garment fit and construction to design functional PPC providing wearers with adequate protection and comfort. Several approaches to materials and PPC testing-objective benchtop evaluation, mathematical modelling, and physiological testing-can be combined to provide high-quality thermal and vapor performance data. Our review provides a foundation and directions for further research in low-level risk PPC, where current research in fabrics and clothing in this category is very limited, and will help designers and manufacturers create industrial workwear with improved thermal management characteristics.


Asunto(s)
Diseño de Equipo , Trastornos de Estrés por Calor/prevención & control , Ropa de Protección/normas , Regulación de la Temperatura Corporal/fisiología , Calor , Humanos , Humedad , Ensayo de Materiales , Exposición Profesional/prevención & control , Textiles , Lugar de Trabajo
10.
Bull Cancer ; 106(1S): S1-S9, 2019 Jan.
Artículo en Francés | MEDLINE | ID: mdl-30580913

RESUMEN

Allogeneic hematopoietic cell transplantation (HCT) is part of the standard of care for many hematological diseases. Over the last decades, significant advances in patient and donor selection, conditioning regimens as well as supportive care of patients undergoing allogeneic HCT leading to improved overall survival have been made. In view of many new treatment options in cellular and molecular targeted therapies, the place of allogeneic transplantation in therapy concepts must be reviewed. Most aspects of HCT are well standardized by national guidelines or laws as well as by certification labels such as FACT-JACIE. However, the requirements for human resources, construction and layout of a unit treating patients during the transplantation procedure and for different complications are not well defined. Here, we describe the process of planning a transplant unit in order to open a discussion that could lead to more precise guidelines in the field of personnel and infrastructural requirements for hospitals caring for people with severe immunosuppression.


Asunto(s)
Trasplante de Médula Ósea/normas , Ambiente de Instituciones de Salud/normas , Enfermedades Hematológicas/terapia , Trasplante de Células Madre Hematopoyéticas/normas , Aire/normas , Tratamiento Basado en Trasplante de Células y Tejidos/normas , Selección de Donante/normas , Francia , Personal de Salud/normas , Unidades Hospitalarias/normas , Humanos , Higiene , Inmunosupresión/normas , Monitoreo Fisiológico/métodos , Ropa de Protección/normas , Sociedades Médicas , Esterilización/normas , Trasplante Homólogo/normas , Visitas a Pacientes
11.
J Therm Biol ; 78: 343-351, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30509656

RESUMEN

Quantifying the impact of clothing thermal and evaporation resistance is essential to providing representative boundary conditions for physiological modeling. In many models, sweat is assumed to drip off the skin surface to the environment and is not captured in clothing. In high metabolic rate and high temperature and humidity conditions the sweat produced by the body has the potential to saturate semipermeable clothing ensembles, changing the assumptions of the model. Workers, athletes and soldiers commonly wear encapsulating versions of such clothing to protect against environmental hazards. A saturated clothing model is proposed based on the ASHRAE two-node model using a saturated spot element in parallel with the existing method to account for sweat absorbed in the clothing. The work uses fundamental heat and mass transfer principles, modifying the existing formula using clothing measurements and basic assumptions. The effectiveness of the model is demonstrated by comparing the predictions of the original and proposed models, to the results of 21 soldiers exercising. The soldiers wore combat pants and shirt, helmet, gloves, shoes, socks, and underwear, and walked in a thermal chamber for 2 h at 42.2 °C dry bulb temperature, 54.4 °C wet bulb temperature, 20% relative humidity, and airspeed of 2 m/s. Core temperature, seven skin temperatures, heart rate, and total sweat loss were measured. The original model provides an average core temperature difference compared with the human subject results of 1.31 °C (SD = 0.557 °C) while the modified model improves the final prediction of core temperature to within an average of 0.15 °C (SD = 0.383 °C). The new model shows an improvement in the prediction of human core temperature under the tested conditions where dripping sweat will saturate clothing. The format can be used in multi-segmented thermal models and can continue to be developed and improved as more information on wetted clothing properties become available.


Asunto(s)
Regulación de la Temperatura Corporal , Calor/efectos adversos , Modelos Teóricos , Ropa de Protección/normas , Adulto , Metabolismo Energético , Femenino , Humanos , Masculino , Humectabilidad
12.
Ann Work Expo Health ; 62(9): 1147-1158, 2018 11 12.
Artículo en Inglés | MEDLINE | ID: mdl-30239593

RESUMEN

Vegetable farmers applying the herbicide alachlor may be highly exposed through dermal contact when spraying. Dermal patches were attached to 10 locations on the farmers' skin when they mixed and applied alachlor in vegetable farming areas in Thailand. Measurements were made on farmers using either a backpack sprayer with a 2 stroke gasoline motor and fan or a battery operated pump. Forty-seven vegetable farmers in Bungphra subdistrict of Thailand participated in this study. Both motorized and battery pump backpack sprayers wearing long-sleeve shirts had significantly lower alachlor concentrations on the dermal patches under their long-sleeve shirts compared to those who wore only short-sleeve shirts, regardless of the sprayer type. Moreover, sprayers wearing long pants had significantly lower alachlor concentrations on dermal patches placed under the pants on the lower legs than those wearing short pants, regardless of the sprayer type. The highest estimated alachlor exposures were found on the upper legs (median = 9.29 µg/h) for those using a 2 stroke engine/fan backpack sprayer and on the lower legs (2.87 µg/h) for those using the battery operated pump backpack sprayer. The estimated total body alachlor exposures of applicators using the 2 stroke engine/fan backpack sprayer (219.48 µg/h) were significantly higher than those using the battery operated pump backpack sprayer (15.50 µg/h). Using long-sleeve shirts as personal protection reduced alachlor exposures for the arms 97-99% and wearing long pants reduced alachlor exposure to the legs for 81-99%. Thus, training about the protection provided by clothing choices would be one step in improving the health and safety of Thai farmers.


Asunto(s)
Acetamidas/análisis , Agricultura , Herbicidas/análisis , Exposición Profesional/análisis , Acetamidas/toxicidad , Adulto , Enfermedades de los Trabajadores Agrícolas/prevención & control , Femenino , Herbicidas/toxicidad , Humanos , Masculino , Persona de Mediana Edad , Exposición Profesional/prevención & control , Ropa de Protección/normas , Análisis de Regresión , Pruebas Cutáneas/métodos , Tailandia , Verduras
13.
Rev. Asoc. Esp. Espec. Med. Trab ; 27(3): 175-181, sept. 2018. tab
Artículo en Español | IBECS | ID: ibc-175367

RESUMEN

Para minimizar el riesgo de exposición a sustancias químicas y de infección cruzada entre el paciente y el personal médico, es necesario utilizar medidas de protección individuales, como guantes. De acuerdo con las recomendaciones de los Centros para el Control y la Prevención de Enfermedades (CDC) y la Organización Mundial de la Salud (OMS), siempre se deben usar guantes protectores en caso de contacto con sangre, mucosa, piel lesionada u otro material potencialmente infeccioso asi como contra agentes químicos y medicación peligrosa. Además, los profesionales que trabajan en el sector de la salud deben estar formados en la selección de guantes adecuados para el ejercicio de las actividades asistenciales y en la optimización del uso de guantes en toda la organización de la asistencia sanitaria. Objetivos: el objetivo de esta revisión es estructurar la elección del guante en función del riesgo específico de exposición a agentes médicos físicos, químicos, biológicos y peligrosos. Metodos: la información se basa en una revisión de la literatura científica y experiencias prácticas


To minimize the risk of chemicals exposure and cross-infection between the patient and the medical staff, it is necessary to use individual protective measures such as gloves. According to the recommendations of the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), protective gloves should always be used upon contact with blood, mucosa, injured skin or other potentially infectious materia. In addition, professionals working in the health sector should be guided in the selection of suitable gloves for the exercise of health care activities and in the optimisation of the use of gloves throughout the health care organisation. Objectives: the aim of this review is to structure the choice of glove according to the specific risk of exposure to physical, chemical, biological and dangerous medicinal agents. Methods: the information are based on a review of the scientific literature and practical experiences


Asunto(s)
Humanos , Guantes Protectores/normas , Guantes Protectores , Equipos de Seguridad/economía , Exposición a Compuestos Químicos , Evaluación de Costo-Efectividad , Exposición Profesional/prevención & control , Ropa de Protección/normas
14.
Surgery ; 164(5): 921-925, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30072247

RESUMEN

BACKGROUND: Recommendations of the Joint Commission discourage the use of surgical skull caps in favor of bouffant or helmet headwear; however, data supporting such recommendations are limited and have been questioned in recent studies, as well as by our departmental and hospital leadership. At the end of December 2015, surgical caps were removed from our institution with the theoretic goal of decreasing surgical site infections. We aimed to assess the impact of this intervention on surgical site infection occurrence at our institution. METHODS: Using our institutional American College of Surgeons National Surgical Quality Improvement Program General and Vascular procedure-targeted data, we identified patients undergoing any surgical procedure classified as clean or clean-contaminated during a 12-month period before and after implementation of the surgical headwear policy. Patients without complete 30-day follow-up were excluded. Cases with active infection at the time of operation were excluded. Vascular surgery operations were excluded because of the implementation of a separate intervention to decrease surgical site infections during the study period. Patients were grouped according to timing of the operation in relation to the policy change (12 months before or after). Descriptive statistics focused on proportions and adjusted logistic regression models were used to investigate the association of alternative headwear use with any type of surgical site infection. Models were adjusted for potential confounders that included demographics and clinical characteristics (age, sex, race or ethnicity, obesity, diabetes, steroid use, smoking status, cancer, urgency of the operation, and wound classification). RESULTS: A total of 1,901 patients underwent 1,950 procedures during the study period, with 767 (40%) before and 1,183 (60%) after the headwear policy measure was adopted. The most common procedures overall were colectomy (18%), pancreatectomy (13.5%), and ventral hernia repair (8.9%). The overall rate of any surgical site infection was 5.4%, with no difference before and after policy implementation (5.3% versus 5.5%; P = .81). Multivariate analysis controlling for age, sex, race or ethnicity, obesity, diabetes, smoking status, steroid use, cancer diagnosis, and type of wound classification showed no association between implementation of this new policy and surgical site infections occurrence (odds ratio 1.12 [95% confidence interval 0.73-1.71]; P = .59). CONCLUSION: In our institution, the strict implementation of bouffant or helmet headwear, with removal of skull caps from the operating room, was not associated with decreased surgical site infections for clean and clean-contaminated cases. Further evidence is required to assess the validity of this headwear guideline of the Joint Commission and support nationwide implementation of this policy.


Asunto(s)
Quirófanos/normas , Ropa de Protección/normas , Procedimientos Quirúrgicos Operativos/efectos adversos , Infección de la Herida Quirúrgica/epidemiología , Anciano , Femenino , Humanos , Incidencia , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Guías de Práctica Clínica como Asunto , Mejoramiento de la Calidad/estadística & datos numéricos , Estudios Retrospectivos , Factores de Riesgo , Procedimientos Quirúrgicos Operativos/normas , Infección de la Herida Quirúrgica/etiología , Infección de la Herida Quirúrgica/prevención & control , Factores de Tiempo
15.
Ann Work Expo Health ; 62(8): 907-922, 2018 10 15.
Artículo en Inglés | MEDLINE | ID: mdl-30084914

RESUMEN

This review describes an evaluation of the effectiveness of Risk Management Measures (RMM) for nanomaterials in the workplace. Our aim was to review the effectiveness of workplace RMM for nanomaterials and to determine whether established effectiveness values of conventional chemical substances applied for modelling purposes should be adopted or revised based on available evidence. A literature review was conducted to collate nano-specific data on workplace RMM. Besides the quantitative efficacy values, the library was populated with important covariables such as the study design, measurement type, size of particles or agglomerates/aggregates, and metrics applied. In total 770 records were retrieved from 41 studies for three general types of RMM (engineering controls, respiratory equipment and skin protective equipment: gloves and clothing). Records were found for various sub-categories of the different types of RMM although the number of records for each was generally limited. Significant variation in efficacy values was observed within RMM categories while also considering the respective covariables. Based on a comparative evaluation with efficacy values applied for conventional substances, adapted efficacy values are proposed for various RMM sub-categories (e.g. containment, fume cupboards, FFP2 respirators). It is concluded that RMM efficacy data for nanomaterials are limited and often inconclusive to propose effectiveness values. This review also shed some light on the current knowledge gaps for nanomaterials related to RMM effectiveness (e.g. ventilated walk-in enclosures and clean rooms) and the challenges foreseen to derive reliable RMM efficacy values from aggregated data in the future.


Asunto(s)
Exposición por Inhalación/prevención & control , Nanoestructuras/efectos adversos , Exposición Profesional/prevención & control , Gestión de Riesgos/normas , Lugar de Trabajo/normas , Humanos , Exposición por Inhalación/análisis , Nanoestructuras/análisis , Exposición Profesional/análisis , Ropa de Protección/normas , Ventilación/normas
16.
J Occup Environ Hyg ; 15(11): 792-802, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30111264

RESUMEN

Often male and female workers wear protective garments of identical construction and style, with females typically wearing small-sized men's garments. Consequently, the air spaces under garments worn by male and female wearers can substantially differ in size and distribution affecting the physiological comfort of firefighters' protective clothing. The present study was designed to investigate the effects of varying dimensions and distributions of air spaces in the next-to-skin microclimate under firefighters' protective jackets on attributes relevant to the thermal comfort of wearer, not only in relation to garment construction and fit, but also to human body geometry using 3D body scanning. Analysis of 20 scans demonstrated that jackets of the same size and construction create larger air spaces under them worn on a female as opposed to on a male body form. Both thermal and vapor resistance of clothing were affected significantly by the volume of trapped air.


Asunto(s)
Regulación de la Temperatura Corporal , Bomberos , Ropa de Protección/normas , Tamaño Corporal , Femenino , Humanos , Humedad , Masculino , Maniquíes , Caracteres Sexuales , Termodinámica
17.
Health Phys ; 115(2): 281-294, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29957689

RESUMEN

Retrospective dose assessment following acute radiation exposures during radiological incidents can be difficult and inaccurate due to the large uncertainties associated with dose estimation. However, rapid and accurate dose assessment is critical following an incident so that appropriate treatment can be provided to the patient as early as possible. Incident dose assessment relies heavily on biological dosimetry with corresponding large uncertainties for inhomogeneous exposures, resulting from the estimates of whole-body doses, while the assessment of absorbed doses to individual tissues might actually be more appropriate for acute radiation exposures. Incident exposure scenarios for orphan sources placed in a breast or back pants pocket were modeled using the International Commission on Radiological Protection computational reference male and female and the Monte Carlo N-particle code MCNP6 to compute absorbed dose conversion coefficients for organs of interest for monoenergetic photon and beta sources. The absorbed dose conversion coefficients are intended for use in conjunction with source information to rapidly estimate absorbed doses to organs of interest from radiological sources in one of the two pocket geometries. Absorbed dose conversion coefficients also have been calculated specifically for Co, Cs, and Ir. Those absorbed dose conversion coefficients were applied to data from a radiological incident in Yanango, Peru, for comparison with published dose assessments; the results agree within 20%. The conversion coefficients are expected to provide an accurate tool for assessing doses for the modeled geometries, provided uncertainties due to the exact source-body geometry and exposure time are considered.


Asunto(s)
Partículas beta/efectos adversos , Rayos gamma/efectos adversos , Fantasmas de Imagen , Ropa de Protección/normas , Exposición a la Radiación/análisis , Protección Radiológica/métodos , Irradiación Corporal Total/efectos adversos , Femenino , Humanos , Masculino , Dosis de Radiación , Radiometría , Estudios Retrospectivos
18.
Ergonomics ; 61(11): 1496-1506, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-29920147

RESUMEN

Acceptable footwear fit, particularly width, is subjective and vaguely quantified. Proper shoe fit is important because it affects both comfort and the potential to prevent injury. Although mismatches between the feet of underground coal miners and their internal boot dimensions are known, no research has been undertaken to determine the impact of these mismatches on worker perceptions of fit, comfort and pain. This study aimed to quantitatively assess mining work boot fit relative to underground coal miners' subjectively rated work boot fit and comfort, reported foot problems, lower limb pain and lower back pain in order to develop evidence-based work boot fit recommendations. Traditional footwear fitting methods based predominantly on foot length are insufficient for underground coal mining-specific footwear. Instead, fit at the heel, instep and forefoot must be considered when fitting underground coal mining work boots, in conjunction with the traditional length measurement.Practitioner summary: Underground coal miners report their work boots fit but are uncomfortable. This study assessed actual fit relative to perceived fit, comfort, foot problems, lower limb pain and lower back pain of 197 miners. Fit at the heel, instep and forefoot must be considered when fitting mining work boots.


Asunto(s)
Minas de Carbón , Ergonomía , Pie/anatomía & histología , Ropa de Protección/normas , Zapatos/normas , Adulto , Humanos , Dolor de la Región Lumbar/etiología , Masculino , Enfermedades Profesionales/etiología , Dolor/etiología , Zapatos/efectos adversos
19.
Ann Work Expo Health ; 62(6): 754-764, 2018 07 06.
Artículo en Inglés | MEDLINE | ID: mdl-29762654

RESUMEN

Background: Diisocyanates (isocyanates), including methylene diphenyl diisocyanate (MDI), are the primary reactive components of spray polyurethane foam (SPF) insulation. They are potent immune sensitizers and a leading cause of occupational asthma. Skin exposure to isocyanates may lead to both irritant and allergic contact dermatitis and possibly contribute to systemic sensitization. More than sufficient evidence exists to justify the use of protective garments to minimize skin contact with aerosolized and raw isocyanate containing materials during SPF applications. Studies evaluating the permeation of protective garments following exposure to SPF insulation do not currently exist. Objectives: To conduct permeation testing under controlled conditions to assess the effectiveness of common protective gloves and coveralls during SPF applications using realistic SPF product formulations. Methods: Five common disposable garment materials [disposable latex gloves (0.07 mm thickness), nitrile gloves (0.07 mm), vinyl gloves (0.07 mm), polypropylene coveralls (0.13 mm) and Tyvek coveralls (0.13 mm)] were selected for testing. These materials were cut into small pieces and assembled into a permeation test cell system and coated with a two-part slow-rise spray polyurethane foam insulation. Glass fiber filters (GFF) pretreated with 1-(9-anthracenylmethyl)piperazine) (MAP) were used underneath the garment to collect permeating isocyanates. GFF filters were collected at predetermined test intervals between 0.75 and 20.00 min and subsequently analyzed using liquid chromatography-tandem mass spectrometry. For each garment material, we assessed (i) the cumulative concentration of total isocyanate, including phenyl isocyanate and three MDI isomers, that effectively permeated the material over the test time; (ii) estimated breakthrough detection time, average permeation rate, and standardized breakthrough time; from which (iii) recommendations were developed for the use of similar protective garments following contamination by two-component spray polyurethane foam systems and the limitations of such protective garments were identified. Results: Each type of protective garment material demonstrated an average permeation rate well below the ASTM method F-739 standardized breakthrough rate threshold of 100.0 ng/cm2 min-1. Disposable latex gloves displayed the greatest total isocyanate permeation rate (4.11 ng/cm2 min-1), followed by the vinyl and nitrile gloves, respectively. The Tyvek coverall demonstrated a greater average rate of isocyanate permeation than the polypropylene coveralls. Typical isocyanate loading was in the range of 900 to 15,000 ng MDI/cm2. Conclusion: Permeation test data collected during this study indicated that each type of protective garment evaluated, provided a considerable level of protection (i.e. 10-110-fold reduction from the level of direct exposure) against the isocyanate component of the SPF insulation mixture. Nitrile gloves and polypropylene coveralls demonstrated the lowest rate of permeation and the lowest cumulative permeation of total isocyanate for each garment type.


Asunto(s)
Isocianatos/análisis , Ensayo de Materiales/métodos , Exposición Profesional/análisis , Poliuretanos/análisis , Ropa de Protección/normas , Guantes Protectores/normas , Humanos
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