Philip L. Bigelow

The individual, environmental, and organizational factors that influence nurses' use of facial protection to prevent occupational transmission of communicable respiratory illness in acute care hospitals

n n Backgroundn Communicable respiratory illness is an important cause of morbidity among nurses. One of the key reasons for occupational transmission of this illness is the failure to implement appropriate barrier precautions, particularly facial protection. The objectives of this study were to describe the factors that influence nurses decisions to use facial protection and to determine their relative importance in predicting compliance.n n n Methodsn This cross-sectional survey was conducted in 9 units of 2 urban hospitals in which nursing staff regularly use facial protection.n n n Resultsn A total of 400 self-administered questionnaires were provided to nurses, and 177 were returned (44% response rate). Less than half of respondents reported compliance with the recommended use of facial protection (eye/face protection, respirators, and surgical masks) to prevent occupational transmission of communicable respiratory disease. Multivariate analysis showed 5 factors to be key predictors of nurses compliance with the recommended use of facial protection. These factors include full-time work status, greater than 5 years tenure as a nurse, at least monthly use of facial protection, a belief that media coverage of infectious diseases impacts risk perception and work practices, and organizational support for health and safety.n n n Conclusionn Strategies and interventions based on these findings should result in enhanced compliance with facial protection and, ultimately, a reduction in occupational transmission of communicable respiratory illness.n n

Effectiveness of health promotion programmes for truck drivers: A systematic review

Objective: To review the characteristics of effective health promotion interventions for reducing chronic diseases and their risk factors in truck drivers. Methods: MEDLINE (PubMed), SCOPUS, Web of Science Conference Proceedings, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and the National Transportation Library were searched using keywords related to ‘truck driver’, ‘commercial driver’, and ‘health promotion’. Reference lists of relevant documents were hand-searched. Results: The search strategy identified 2,372 non-duplicate citations, of which nine met the inclusion criteria. These nine articles represented eight unique interventions. No studies measured chronic disease as an outcome. Six interventions incorporated multiple components and reported positive findings on various intermediate health outcomes (i.e. body mass index [BMI], % body fat) or health behaviours (i.e. nutrition, physical activity). The other two interventions modified work practices only, and found no significant improvements on fatigue and psychosocial measures. Conclusion: Health promotion interventions for truck drivers can improve both intermediate health outcomes and health behaviours over the short term. The small body of literature on health promotion interventions is a concern given that truck drivers are an at-risk population and their health impacts the safety of the driving public. Studies primarily focused on changes at the individual level and this is also a concern as environmental and work organisation factors are important determinants of both chronic disease outcomes and health-related behaviours in truck drivers. Future research should also include economic evaluations as well as methods to determine facilitators and barriers to programme participation and continuation.

Behind the mask: Determinants of nurse's adherence to facial protective equipment

n n Backgroundn As the predominant occupation in the health sector and as the health worker with the most patient interaction, nurses are at high risk for occupational transmission of communicable respiratory illness. The use of facial protective equipment (FPE) is an important strategy to prevent occupational transmission.n n n Methodsn A 2-phased study was conducted to examine nurses adherence to recommended use of FPE. Phase 1 was a cross-sectional survey of nurses in selected units of 6 acute care hospitals in Toronto, Canada. Phase 2 was a direct observational study of critical care nurses.n n n Resultsn Of the 1,074 nurses who completed surveys (82% response rate), 44% reported adherence to recommended use of FPE. Multivariable analysis revealed 6 predictors of adherence: unit type, frequency of equipment use, equipment availability, training, organizational support, and communication. Following the survey, 100 observations in 14 intensive care units were conducted that revealed a 44% competence rate with proper use of N95 respirators and knowledge as a significant predictor of competence.n n n Conclusionn Whereas increasing knowledge should enhance competence, strategies to improve adherence to recommended use of FPE in a busy and complex health care setting should focus on ready availability of equipment, training and fit testing, organizational support for worker health and safety, and good communication practices.n n

Integrative interventions for MSDs: Nature, evidence, challenges & directions

Background: When applied to workplace interventions, integrative may be seen in various ways, requiring elucidation. Methods: Identification of primary studies through systematic reviews, limited bibliographic literature searches, the Cochrane Occupational Health Field database on intervention studies, and authors’ files. Focus was 2000 on. Categorization according to the Cochrane classes and lenses on integrative. Synthesis as narrative review. Results: Examples of each lens on integrative were uncovered: biomechanical and psychosocial, multiple component, primary and secondary prevention, organizational, and system. Each contributed different understanding to the potential impacts on different knowledge, exposure, behavior, health and administrative outcomes. Conclusions: Considerable opportunities exist to expand the range of integrative interventions, particularly at the organizational and system levels, and incorporate a combination of knowledge transfer and exchange with intervention evaluation.

Perspectives on safety and health among migrant and seasonal farmworkers in the United States and México: a qualitative field study.

CONTEXTnA large number of hired farmworkers in the United States come from México. Understanding safety and health concerns among the workers is essential to improving prevention programs.nnnPURPOSEnThe purpose of this pilot study was to obtain detailed information about safety and health concerns of hired farmworkers in Colorado and in México.nnnMETHODSnA total of 10 migrant farmworkers from northern Colorado and 5 seasonal farmworkers from Guanajuato, México, were interviewed using a semi-structured interview process. The social cognitive theory (SCT) served as a framework to gain understanding of safety and health among workers.nnnFINDINGSnTopics of concern identified included causes of farm, home and motor vehicle injuries, and treatment preferences for injuries and illnesses. Four main themes emerged: safety and health concerns, personal control and prevention strategies, factors affecting control and prevention strategies, and the importance of family.nnnCONCLUSIONSnFurther study of the themes using a revised semi-structured interview will be done in a larger study among hired farmworkers. The results add to the current work to understand specific health and safety concerns among these workers.

Comparative Analysis of Safety Culture Perceptions among HomeSafe Managers and Workers in Residential Construction

AbstractConstruction workers continue to experience high rates of injury and illness compared with many other industries. Growing evidence suggests that safety culture has a direct effect on safety performance. This study investigated measures of safety culture and risk perception among a residential-home-building cohort within the HomeSafe Pilot Program in the Denver metro area of Colorado. Investigators compared group-level responses of management to frontline construction workers. Results indicate that managers appraised the overall safety culture at higher levels compared with the workers. Managers also perceived a higher level of management commitment to safety and health than that reported by workers.

Low Back Pain Among Residential Carpenters: Ergonomic Evaluation Using OWAS and 2D Compression Estimation

Occupational low back pain (LBP) remains a leading safety and health challenge. This cross-sectional investigation measured the prevalence of LBP in residential carpenters and investigated ergonomic risk factors. Ninety-four carpenters were investigated for LBP presence and associated risk factors. Ten representative job-tasks were evaluated using the Ovako Working Posture Analysis System (OWAS) and ErgoMaster™ 2D software to measure elements of posture, stress, and risk. Job-tasks were found to differ significantly for total lumbar compression and shear at peak loading (p < .001), ranging from 2 956 to 8 606 N and 802 to 1 974 N respectively. OWAS indicated that slight risk for injury was found in 10 job-tasks while distinct risk was found in 7 of the 10 job-tasks. Seven of the 10 job-tasks exceeded the National Institute for Occupational Safety and Health (NIOSH) action limit of 3 400 N for low back loading. The point prevalence for LBP was 14% while the annual prevalence was 38%.

Something Might be Missing From Occupational Health and Safety Audits: Findings From a Content Validity Analysis of Five Audit Instruments

Objective: The objective was to examine the content validity of occupational health and safety (OHS) management audit methods. Methods: The documentation used by five broader public sector service organizations to audit OHS management in workplaces was analyzed with reference to a recent OHS management standard (CSA Z1000). Results: A relatively high proportion of CSA Z1000s content (74%) was partially or fully represented on average in the audit methods. However, six management elements were found to be incompletely represented in three or more of the methods. The most extreme example is the Internal Audits element whose content was completely missing for three of the audit methods. Conclusion: Some OHS management audit instruments in current use are incomplete relative to a recent OHS management standard. It may be that some instruments warrant revision to better reflect current expert consensus.

The HomeSafe Pilot Program: a novel approach to injury prevention in residential construction

Workers in the residential construction industry face unacceptably high risk of injury, disability and death. Attempts to implement comprehensive health and safety programs in this industry have met with little success. The HomeSafe Pilot Program is a novel residential construction safety program developed and sponsored by the Occupational Safety and Health Administration (OSHA) Region VIII and the Home Builders Association of Metropolitan Denver (HBA). Test subjects represent over 7475 persons employed in residential construction in the six county Denver Metro area of Colorado. The HomeSafe Pilot Program includes primary behavioral, engineering and administrative interventions to improve safe work practices in residential construction. It has some unique features of brevity, specificity and incentives not seen elsewhere in the construction industry. Its overall goal is to guide residential construction companies along a path of progressive development of comprehensive safety and health programs. The HomeSafe Pilot Program is introduced and compared to other safety and health program models developed by OSHA and the HBA. This study began in January 1997 and will continue through the millennium.

Low back pain in Hispanic residential carpenters

OBJECTIVEnLow back pain (LBP) is a leading cause of lost work time and has been recognized as Americas number one workplace safety challenge. Low back pain is occurring at epidemic proportions among construction workers, and minority populations have been underinvestigated for risk of back injury. This project investigated the multiple potential risk factors for occupational LBP among Hispanic residential carpenters.nnnMETHODSnThis investigation evaluated 241 Hispanic residential framing carpenters. Data for this study were collected using a 91-question survey. End points of interest included point, annual, and lifetime prevalence of LBP.nnnRESULTSnNineteen percent of respondents reported they had an episode of LBP in their lifetime.nnnCONCLUSIONSnHispanic residential carpenters reported less than expected prevalence of LBP compared with non-Hispanic counterparts in the same trade and location. Job tasks and personal and workplace risk factors, including psychological and morphological characteristics, affect the prevalence of LBP among Hispanic framing carpenters.