The effect of long working hours on cerebrovascular and cardiovascular disease; A case-crossover study.

BACKGROUND: This study investigated the relationship between weekly working hours and the occurrence of cerebro-cardiovascular diseases using a case-crossover study design. METHODS: We investigated average working hours during the 7 days before the onset of illness (hazard period) and average weekly working hours between 8 days and 3 months before the onset of cerebro-cardiovascular diseases (control period) for 1,042 cases from the workers' compensation database for 2009. RESULTS: Among all subjects, the odds ratio by conditional logistic regression for the risk of cerebro-cardiovascular diseases with a 10 hr increase in average weekly working hours was 1.45 (95% confidence interval [CI]: 1.22-1.72), a significant association. CONCLUSIONS: An increase in average weekly working hours may trigger the onset of cerebro-cardiovascular disease. Am. J. Ind. Med. 60:753-761, 2017. © 2017. Wiley Periodicals, Inc.

Effect of daily chlorhexidine bathing on the acquisition of methicillin-resistant Staphylococcus aureus in a medical intensive care unit with methicillin-resistant S aureus endemicity.

BACKGROUND: Universal decolonization is recommended in intensive care units (ICUs) that have unacceptably high rates of methicillin-resistant Staphylococcus aureus (MRSA) despite implementation of basic prevention strategies. METHODS: An interrupted time series study was performed to evaluate the effect of daily chlorhexidine bathing on the acquisition of MRSA in a medical ICU with MRSA endemicity. There was a 14-month control period and a 16-month chlorhexidine bathing period. Segmented Poisson regression analysis was performed to assess the impact of daily chlorhexidine bathing on the incidence density of MRSA. Also, chlorhexidine susceptibility testing with polymerase chain reaction for the qacA/B gene was performed on MRSA isolates collected during the chlorhexidine bathing period. RESULTS: There was a significant reduction in trend (-0.056; 95% confidence interval, -0.095 to -0.017; P = .005) of incidence density of MRSA despite a significant increase in both level and trend of MRSA prevalence rates during the chlorhexidine bathing period. However, there was no significant reduction in level of incidence density of MRSA during the interventional period. Minimum inhibitory concentration of chlorhexidine and the detection rates of the qacA/B gene for a total of 174 MRSA isolates did not increase during the chlorhexidine bathing period. CONCLUSIONS: Daily chlorhexidine bathing resulted in a significantly decreasing trend of MRSA acquisition rates irrespective of increased MRSA prevalence rates in the medical ICU. There was no shift of chlorhexidine-resistant MRSA strains.

Qualitative content analysis of psychologic discomfort and coping process after needlestick injuries among health care workers.

BACKGROUND: This study was designed to survey psychologic discomfort and coping processes of health care workers that suffered needlestick injuries (NSIs). METHODS: This qualitative analysis was performed with 15 health care workers who experienced NSIs. Data were collected using face-to-face interviews. The study subjects were asked the following: please describe the psychologic discomfort that you experienced after the NSI incidence. Data were evaluated by qualitative content analysis. RESULTS: Types of psychologic discomfort after NSI among health care workers included anxiety, anger, and feelings of guilt. Some personnel adopted active coping strategies, such as seeking first aid or reporting the incident to a monitoring system, whereas others used passive coping methods, such as avoidance of reporting the incident, vague expectancy to have no problems, and reliance on religious beliefs. Recommended support strategies to improve the prevention of NSIs were augmenting employee education and increasing recognition of techniques for avoiding NSIs. CONCLUSION: Medical institutions need to provide employees with repeated education so that they are familiar with guidelines for preventing NSIs and to stimulate their alertness to the risk of injuries at any time, in any place, and to anybody.

Effect of daily chlorhexidine bathing on acquisition of carbapenem-resistant Acinetobacter baumannii (CRAB) in the medical intensive care unit with CRAB endemicity.

BACKGROUND: There is insufficient evidence for daily chlorhexidine bathing to reduce nosocomial spread of carbapenem-resistant Acinetobacter baumannii (CRAB) in endemic situations. METHODS: An interrupted time series study was performed to evaluate the effect of daily chlorhexidine bathing on the acquisition of CRAB in a medical intensive care unit (ICU) with CRAB endemicity. There was a 14-month control period and 12-month chlorhexidine bathing period. Segmented Poisson regression analysis was performed to assess the impact of chlorhexidine bathing on the level and trend of the series of prevalence rates and incidence density. Also, chlorhexidine susceptibility testing was performed on CRAB isolates collected during the chlorhexidine bathing period. RESULTS: There was a 51.8% reduction of CRAB acquisition rates after an introduction of daily chlorhexidine bathing (44.0 vs 21.2 cases/1,000 at-risk patient days, P < .001). There was a significant reduction in the level (-0.604; 95% CI, -0.904 to -0.305; P < .001) of incidence density of CRAB, whereas there was no significant change in both level and trend of CRAB prevalence rates. Minimum inhibitory concentration of chlorhexidine against a total of 98 CRAB isolates ranged from 8-64 µg/mL. CONCLUSION: Daily chlorhexidine bathing significantly reduces the acquisition of CRAB in a medical ICU with CRAB endemicity.

Occupational reproductive function abnormalities and bladder cancer in Korea.

The purpose of this study was to review occupational reproductive abnormalities and occupational bladder cancer in Korea and to discuss their toxicological implications. Reproductive dysfunction as a result of 2-bromopropane poisoning was first reported in Korean workers. In 1995, 23 of the 33 workers (25 female and 8 male workers) who were exposed to 2-bromopropane during the assembly of tactile switch parts developed reproductive and/or hematopoietic disorders. A total of 17 (68%) workers were diagnosed with ovarian failure. Two of the eight male workers experienced azoospermia and four workers experienced some degree of oligospermia or reduced sperm motility. In summary, 2-bromopropane poisoning caused severe reproductive effects in Korean workers. The prognosis was poor for reproductive dysfunction. A few cases of occupational bladder cancer have been reported in Korea, whereas other cancers of the urinary tract have not been reported after occupational exposure. A few cases of benzidine-induced cancer have been reported in Korea and 592 workers in Japan have received compensation for benzidine and ß-naphthylamine-induced cancer. In conclusion, a few cases of benzidine-induced occupational bladder cancer have been reported in Korea. However, benzidine-induced bladder cancer will likely be an important occupational health issue in Korea in the coming years.