A pilot study of core body temperatures in healthcare workers wearing personal protective equipment in a high-level isolation unit.

Personal protective equipment used by healthcare workers to mitigate disease transmission risks while caring for patients with high-consequence infectious diseases can impair normal body cooling mechanisms and exacerbate physiological strain. Symptoms of heat strain (e.g., cognitive impairment, confusion, muscle cramping) are especially harmful in the high-risk environment of high-consequence infectious disease care. In this pilot study, the core body temperatures of healthcare workers were assessed using an ingestible, wireless-transmission thermometer while performing patient care tasks common to a high-level isolation unit setting in powered air purifying respirator (PAPR)-level. The objective was to determine the potential for occupational health hazard due to heat stress in an environmentally controlled unit. Maximum core temperatures of the six participants ranged from 37.4 °C (99.3 °F) to 39.9 °C (103.8°F) during the 4-hr shift; core temperatures of half (n = 3) of the participants exceeded 38.5 °C (101.3 °F), the upper core temperature limit. Future investigations are needed to identify other heat stress risks both in and outside of controlled units. The ongoing COVID-19 pandemic offers unique opportunities for field-based research on risks of heat stress related to personal protective equipment in healthcare workers that can lead to both short- and long-term innovations in this field.

Construction glass and glazing job description: a qualitative case study.

Construction workers regularly experience heavy workloads and various physical stressors that can result in work-related musculoskeletal disorders (WRMSDs). According to the Bureau of Labor Statistics, construction glass and glazing (CGG) workers had a higher rate of injuries and illnesses than the national average for all occupations. In 2010, CGG contractors presented the highest rate of back injuries reported by the Center for Construction Research and Training. This study aimed to develop a detailed job description that includes the CGG definition, tasks, activities and work conditions. A qualitative case study was conducted, and data were collected through CGG workers' interviews and observations. This information is not currently available in government publications, published research or job training materials for CGG workers and contractors. The results of this study can help facilitate the ergonomics analysis in future studies to eliminate or reduce the risk of WRMSDs in CGG work.

Review of Literature for Air Medical Evacuation High-Level Containment Transport.

INTRODUCTION: Aeromedical evacuation (AE) is a challenging process, further complicated when a patient has a highly hazardous communicable disease (HHCD). We conducted a review of the literature to evaluate the processes and procedures utilized for safe AE high-level containment transport (AE-HLCT) of patients with HHCDs. METHODS: A literature search was performed in PubMed/MEDLINE (from 1966 through January 2019). Authors screened abstracts for inclusion criteria and full articles were reviewed if the abstract was deemed to contain information related to the aim. RESULTS: Our search criteria yielded 14 publications and were separated based upon publication dates, with the natural break point being the beginning of the 2013-2016 Ebola virus disease epidemic. Best practices and recommendations from identified articles are subdivided into pre-flight preparations, inflight operations, and post-flight procedures. CONCLUSIONS: Limited peer-reviewed literature exists on AE-HLCT, including important aspects related to healthcare worker fatigue, alertness, shift scheduling, and clinical care performance. This hinders the sharing of best practices to inform evacuations and equip teams for future outbreaks. Despite the successful use of different aircraft and technologies, the unique nature of the mission opens the opportunity for greater coordination and development of consensus standards for AE-HLCT operations.

Need for Aeromedical Evacuation High-Level Containment Transport Guidelines.

Circumstances exist that call for the aeromedical evacuation high-level containment transport (AE-HLCT) of patients with highly hazardous communicable diseases. A small number of organizations maintain AE-HLCT capabilities, and little is publicly available regarding the practices. The time is ripe for the development of standards and consensus guidelines involving AE-HLCT.

Assessing the effects of slippery steel beam coatings to ironworkers' gait stability.

Since ironworkers walk and perform their tasks on steel beams, identifying the effects of slippery steel beam surfaces on ironworkers' gait stability-which can be related to safety risk-is critical. However, there is no accepted or validated standard for measuring the slipperiness of coated steel beams, which makes evaluating and controlling for slipperiness a challenge. In this context, this study investigated the effect of the slipperiness of steel beam coatings on ironworkers' gait stability. Accordingly, to identify the relationships between coefficient of friction, perceived slipperiness, and gait stability-represented as the Maximum Lyaponuv exponent (Max LE)-an experiment was conducted with eight different surfaces and sixteen subjects with varying experience as ironworkers. The experiment's results indicate that the slipperiness of the various surfaces greatly affect ironworkers' gait stability while they walk on coated steel beam surfaces. In detail, the Max LE of two subject groups-experienced and inexperienced ironworkers-highly correlated with both the dynamic coefficient of friction values measured by following ANSI B101.3 and with the subjective rating scores of the inexperienced subject group. Unlike subjective rating scores-which were particularly incongruent among experienced workers-the Max LE of inexperienced and experienced subjects has a consistent pattern. This study result highlights an opportunity for using gait stability measurements to quantify and differentiate the safety risks caused by slippery coated steel beams in the future.

Is depression a risk factor for meatpacking injuries?

BACKGROUND: While meatpacking is a physically demanding industry, the effect of depression on risks for injury has not been studied. OBJECTIVE: To assess depressive disorders (major depression and dysthymia) using a validated screening tool administered to injured and uninjured meatpacking workers in two Midwestern plants. METHODS: Matched case-control analyses were conducted among 134 workers to evaluate the association between depressive disorder and the occurrence of laceration injury. RESULTS: Of the 268 workers, 13.8% screened positive for depressive disorder, whereas the general population prevalence estimate for depressive disorder using the same tool was 3.4% . Depressive disorder was not associated with an increased risk for injury; 17% of cases who experienced a laceration injury and 15% of uninjured controls reported depressive disorder (OR 0.81, 95% CI: 0.39-1.69). CONCLUSIONS: Evaluation of depression causes among meatpacking workers is needed to elucidate prevention and treatment strategies.

A case-crossover study of laceration injuries in pork processing.

OBJECTIVES: The authors estimated the associations between transient risk factors and laceration injuries in workers at two meatpacking plants in the Midwest. METHODS: The case-crossover design was used to collect within-subject transient work task and personal-level exposure information. RRs of laceration injuries were estimated by comparing exposures during the 'hazard' period (just before the laceration injury) with exposures in the 'control' period (the previous workweek). Stratified analyses were utilised to estimate the effects of gender, ethnicity, training and the number of adjacent coworkers on each transient risk factor. RESULTS: The authors interviewed 295 meatpacking workers with laceration injuries (mean age 36.6 years, SD 11.2, 75% men, 48% Hispanic). Recent tool sharpening (RR 5.3, 95% CI 3.8 to 7.4) and equipment malfunction (RR 5.3, 95% CI 3.9 to 7.3) were associated with the highest RR for laceration injury, followed by using an unusual work method to accomplish a task (RR 4.1, 95% CI 2.6 to 6.4) and performing an unusual task (RR 2.3, 95% CI 1.8 to 3.0). Rushing and being distracted were not significantly associated with an elevated RR of a laceration injury. In stratified analyses, there were a number of significant differences in laceration risk factors by gender, ethnicity, training, and number of workers on the line. CONCLUSIONS: Sharpening tools, equipment malfunction, using an unusual work method to accomplish a task and performing an unusual task were all associated with increased risk of lacerations. Expanded training in atypical work circumstances and evaluation of tool sharpening procedures are intervention areas in meatpacking that need examination.

Near-miss reporting system as an occupational injury preventive intervention in manufacturing.

BACKGROUND: a database of near-misses (NM), minor injuries, and OSHA recordable injuries was established at a mid-size electrical manufacturing plant as part of injury prevention efforts. The utility of a NM reporting system was evaluated by estimating its impact on the annual incidence of minor and OSHA recordable injuries. METHODS: logistic regression was performed to examine the effects of predictor variables (year, age, duration of employment) on the type of event (NM, minor, OSHA recordable). Poisson regression was fit to model the annual rate of OSHA recordable injuries as a function of time. RESULTS: 1690 events were reported between 1999 and 2006 including 261 NM, 1205 minor, and 205 OSHA recordable injuries. The expected rate of OSHA recordable injuries decreased by 0.84 (95% CI: 0.73-0.97) annually. CONCLUSIONS: the implementation of a NM reporting system was associated with decrease in the rate of OSHA recordable injuries. NM reporting systems may be valuable injury interventions in manufacturing.

A case-crossover study of occupational laceration injuries in pork processing: methods and preliminary findings.

OBJECTIVES: Meatpacking remains a hazardous and largely unexamined industry. Despite prevention efforts, laceration injuries, among others, remain high. We estimated the magnitude of associations between transient exposures such as equipment malfunction, performing an unusual work task, rushing, and occurrence of laceration injuries. METHODS: Injured workers were recruited from two pork-processing plants, one in Iowa and one in Nebraska. A telephone interview was conducted within 7 days of the injury, on average to collect information on fixed and transient exposures preceding the injury event. Case-crossover methodology was used to evaluate case and control data within the same subject, thus controlling for between-subject confounding. A Mantel-Haenszel estimator for person-time data was used to estimate the relative risks of injury and transient exposures of interest. RESULTS: Of the 362 workers with lacerations between April 2006 and October 2007, 153 (42%) were interviewed (74% male, 41% Hispanic). Forty-eight per cent were injured by a knife or a knife-like object such as scissors or a band saw. Other sources of lacerations included sharp edges and hooks. Tool sharpening was associated with the highest RR of laceration (RR 8.4, 95% CI 5.4 to 12.8) followed by slipping (RR 74.8, 95% CI 30.5 to 183.3), equipment malfunction (RR 3.8, 95% CI 2.8 to 5.3), and performing an unusual task (RR 3.7, 95% CI 2.6 to 5.2). Being tired, distracted, or rushing were not significant risk factors for a laceration. CONCLUSIONS: Aspects of the physical environment and work practices appear to be significant risk factors for laceration injury in meatpacking. Personal risk factors were less significant in this study.

Validation of self-reported occupational exposures in meatpacking workers.

OBJECTIVE: The ability of workers to accurately recall exposures that occur on the day of their injury is considered a potential limitation of case-crossover studies. This study assessed validity of occupational exposures reported by uninjured workers at a Midwestern meatpacking plant. METHODS: One hundred thirty-six workers were observed for 60 min while working and then interviewed within 8 days (median 3 days) about exposures during the observation period. The level of agreement between self-reports and direct observations was assessed using kappas and intraclass correlation coefficients. RESULTS: Excellent agreement was found between observed and reported work location (kappa = 0.97, 95% CI: 0.92-1.0), task (kappa = 0.83, 95% CI: 0.76-0.91) and tools used (kappa = 0.88, 95% CI: 0.81-0.95). Personal protective equipment varied by work type and location, and agreement between observed and reported usage varied from excellent to poor for various items. Excellent agreement was found for tool sharpening (kappa = 0.89, 95% CI: 0.82-0.97); good agreement for occurrence of break during the observation period (kappa = 0.60, 95% CI: 0.45-0.74); and poor agreement for equipment malfunction, line stoppages, being tired, unusual task, unusual work method, being distracted, rushing, slipping, or falling. CONCLUSIONS: Agreement between observed and reported occupational exposures varied widely. Self-reported exposures are utilized in many occupational studies, and future exposure validity assessment studies should continue to improve retrospective study methods. Valid exposures will allow researchers to better understand injury etiology and ultimately prevent injuries from occurring.

Laceration injuries among workers at meat packing plants.

BACKGROUND: Employees in meat packing experience one of the highest occupational laceration injury rates in the US. METHOD: A retrospective study was conducted using OSHA 200 injury and illness logs and First Reports of Injury from two large US meat packing plants from 1998 to 2000. The total workers observed during the study period ranged between 2,449 and 2,682 per year. RESULTS: Laceration injury incidence rates in Plant 1 were 14.0 injuries per 200,000 person hours (per 100 workers per year) in 1998, 11.5 in 1999, and 8.3 in 2000, whereas in Plant 2 the overall incidence rate was 3.7 in 1998, 4.8 in 1999, and 3.0 in 2000. Laceration injury rates in Plant 2 were close to the expected OSHA recordable laceration injury rate in 1999 (3.0 per 100 workers per year), but Plant 1 was considerably higher. Plant 1 had a kill support department, and removed animal hides whereas Plant 2 did not. Handheld non-powered tools were the most common contact objects whereas the slaughter department had the highest number of injuries. Finger injuries from a handheld non-powered tool were the most frequent. CONCLUSIONS: Findings confirm the high rate of injury from laceration in this industry and indicate hazard varies across time into shift, task being performed, and type of tool being used.