Respirer pourrait tuer

Source : Travail et santé.
L’article passe en revue, l’obligation de l’employeur, le programme de protection respiratoire, le choix d’un APR, l’essai d’ajustement et la morphologie du visage, l’entretien et l’entreposage, la formation des travailleurs et finalement l’évaluation médicale.

Modeling the Effect of the 2018 Revised ACGIH® Hand Activity Threshold Limit Value® (TLV) at Reducing Risk for Carpal Tunnel Syndrome

Source : Journal of Occupational and Environmental Hygiene.
Recent studies have shown the 2001 American Conference of Governmental Industrial Hygienists (ACGIH®) Threshold Limit Value (TLV®) for Hand Activity was not sufficiently protective for workers at risk of carpal tunnel syndrome (CTS). These studies led to a revision of the TLV and Action Limit. This study compares the effect of applying the 2018 TLV vs. the 2001 TLV to predict incident CTS within a large occupational pooled cohort study (n = 4,321 workers). Time from study enrollment to first occurrence of CTS was modeled using Cox proportional hazard regression. Adjusted and unadjusted hazard ratios for incident CTS were calculated using three exposure categories: below the Action Limit, between the Action Limit and TLV, and above the TLV. Workers exposed above the 2001 Action Limit demonstrated significant excess risk of carpal tunnel syndrome, while the 2018 TLV demonstrated significant excess risk only above the TLV. Of 186 total cases of CTS, 52 cases occurred among workers exposed above the 2001 TLV vs. 100 among those exposed above the 2018 value. Eliminating exposures above the 2001 TLV might have prevented 11.2% of all cases of CTS seen in our pooled cohort, vs. 25.1% of cases potentially prevented by keeping exposures below the 2018 value. The 2018 revision of the TLV better protects workers from CTS, a recognized occupational health indicator important to public health. A significant number of workers are currently exposed to forceful repetitive hand activity above these guidelines. Public health professionals should promulgate these new guidelines and encourage employers to reduce hand intensive exposures to prevent CTS and other musculoskeletal disorders.

Prevalence, Recognition of Work-Relatedness, and Effect on Work of Low Back Pain Among U.S. Workers

Source : Annals of Internal Medicine.
The employment of patients with back pain has implications for both the factors causing or contributing to the pain and its effects, but few estimates of the proportion of back pain that is related to work in the United States are available (1). In 2015, the NHIS (National Health Interview Survey) collected supplemental data about the work-relatedness and the effects on work of back pain—specifically, low back pain (LBP)—among U.S. workers for the first time since 1988. The objective of this article was to estimate the burden of LBP among U.S. workers, its work-relatedness, and its effect on work.

Peaks, Means, and Determinants of Real-Time TVOC Exposures Associated with Cleaning and Disinfecting Tasks in Healthcare Settings

Source : Annals of Work Exposures and Health.
Cleaning and disinfecting tasks and product use are associated with elevated prevalence of asthma and respiratory symptoms among healthcare workers; however, the levels of exposure that pose a health risk remain unclear. The objective of this study was to estimate the peak, average, and determinants of real-time total volatile organic compound (TVOC) exposure associated with cleaning tasks and product-use.

An Interdisciplinary Approach: Answering the How, When, and Where of Early Mobility Technology

Source : International Journal of SPHM.
Evidence supporting frequent and progressive early mobility is well established, such that many clinicians recognize the benefits of early mobility on the human body. Practically, however, patients still suffer deleterious effects of bed rest while hospital-acquired conditions from immobility are still being reported. We propose that practical knowledge about early mobility technology will enhance clinical decision-making so that early mobility can be accomplished more easily, safely, effectively, and efficiently. We summarize the advantages, disadvantages, methods of use, and pricing so that clinicians are prepared to recommend or utilize technology in early mobility efforts. This article serves as a bridge connecting the substantiated reasons why we do early mobility to the practical applications of how, when, and where we do early mobility in, around, and beyond the bed.

Effectiveness of Friction-Reducing Patient-Handling Devices on Reducing Lumbosacral Spine Loads in Nurses: A Controlled Laboratory Simulation Study

Source : International Journal of SPHM.
Nurses and nursing aides suffer high levels of musculoskeletal disorders, especially low back injuries. Two of the more risky tasks that are performed by these healthcare workers are repositioning the patient up in bed and laterally transferring the patient from the bed to a stretcher. Sixteen (8 males and 8 females) participants completed repositioning and lateral transferring of simulated patients in a laboratory study with 6 devices including the (1) draw sheet, (2) reusable air-assisted device, (3) disposable air-assisted device, (4) dual friction-reducing sheets, (5) slide board, and (6) friction-reducing covered board (lateral transfer only). The outcome variables include the model-estimated peak lumbosacral compression and shear loads and self-reported perceptions of discomfort and exertion. The air-assisted devices produced the lowest 3-dimensional loads compared to the other devices during both repositioning and lateral transferring (about 30% lower). Small spine load differences were found for the other devices as compared to the draw sheet method. Not all friction-reducing devices appeared to reduce these forces, and some ultimately had little impact on the spine loads. Air-assisted devices were identified as the most effective.

Reality of Safe Patient Handling Policies and Programs in Hospitals Across the United States

Source : International Journal of SPHM.
Safe patient handling and mobility (SPHM) equipment has continued to be purchased with inconsistent compliance on the part of healthcare facilities. Face-to-face interviews about SPHM equipment and the perceived difficulties with SPHM tasks and SPHM policies were completed during this study which included 1,328 nurses across 49 hospitals. Additional data about injury rates, incurred costs, and lost and restricted workdays were obtained from company records. There were 5 major findings from the study: (1) Repositioning of the patient was by far the riskiest task performed; (2) nurses suffer the most injuries in hospitals; (3) the average cost of a reported injury is about $22,100 with an average of 22 lost or restricted days and was independent of hospital size; (4) medical/surgical units have the most injuries; and (5) few nurses (~2%) actually had any knowledge of the safe patient handling policy and procedures in their facility. Taken altogether, there appears to be strong levels of inconsistency in the way many hospitals implement their SPHM policies and procedures that are designed to ensure proper usage of the SPHM equipment they purchased. The SPHM program needs to address this issue of compliance to be successful and concentrate efforts on repositioning handling activities. Hospitals should recognize the added risk to nurses and put additional focus on protecting them as well as the other caregivers.

Moving and handling people: Reducing the risk

Source : WorkSafe Bulletin.
Moving and handling people are leading causes of injury among workers in health care and community social services. Workers who manually move or handle people are at significant risk of musculoskeletal injuries (MSIs) such as sprains or strains. This bulletin includes information about control measures, eliminating or minimizing risks, and the importance of training to help reduce the risk of MSI when moving or handling people. The bulletin can be used as an aid or discussion point at your next safety talk or joint health and safety committee meeting.

All Newfoundland workers to be covered by PTSD presumption

Source : Canadian Occupational Safety.
The Government of Newfoundland and Labrador has introduced amendments to the Workplace Health, Safety and Compensation Act that would provide presumptive coverage for work-related post-traumatic stress disorder (PTSD) for all workers. “With this new legislation, our government is recognizing the impacts that a workplace can have on any worker, in any occupation. Presumptive coverage for post-traumatic stress disorder will benefit many individuals who may have previously suffered in silence,” said Premier Dwight Ball.