Personal Protective Equipment Program Research Articles

Factors affecting and strategies for safe handling of chemotherapy: A narrative review

Background: Chemotherapy poses significant occupational hazards to healthcare professionals, particularly nurses, with exposure to cytotoxic drugs linked to severe health consequences such as cancer, infertility, and miscarriages. This review examines factors influencing safe chemotherapy handling and identifies strategies to minimize exposure risks. Methods: A comprehensive literature search was conducted using databases and keywords like "chemotherapy," "safe handling," "hazardous drugs," and "nurses." Studies on individual and organizational factors influencing safe practices were included, while review articles and theses were excluded. The findings from multiple sources were synthesized to highlight key strategies for improving chemotherapy safety. Results: Individual factors affecting safe handling include knowledge of chemotherapy hazards, self-efficacy in using personal protective equipment (PPE), and perceived risk of exposure. Organizational factors include workplace safety climate, clear policies and procedures, availability of PPE, workload, staffing ratios, managerial support, and comprehensive training programs. Conclusion: Ensuring safe chemotherapy handling requires a multi-faceted approach addressing both individual and organizational factors. Key strategies include enhancing knowledge through education, promoting self-efficacy, fostering a positive safety climate, developing clear policies, ensuring adequate resources, optimizing staffing, providing managerial support, and implementing continuous training programs to improve safe practices.

Respiratory protection for health care workers: A 2020 COVID-19 perspective.

As the US health care system began to respond to the coronavirus disease‐2019 pandemic, demand for respiratory personal protective equipment (PPE) increased precipitously, as did the number of users. This commentary discusses ensuing deviations from accepted respiratory PPE program practices, which potentially increased risk to health care workers. Such lapses included omitting user training and fit testing, provision of unapproved devices, and application of devices in settings and ways for which they were not intended. The temporary compromise of professionally accepted standards due to exigencies must not become the new normal. Rather, the current attention to PPE should be leveraged to enhance practice, motivate vital research, and strengthen professional, governmental, and institutional capabilities to control health care worker exposures to infectious hazards.

Using Risk Based Decision Making to Select Personal Protective Equipment for Oil Spill Responders

ABSTRACT Typically, personal protective equipment (PPE) is the primary control measure employed during emergency response operations. PPE and administrative controls rise to the forefront of oil spill response activities due to inherent delays and feasibility issues involved in the implementation of effective engineering controls. Response organizations, possibly due to a failure to assess the hazards appropriately, overprescribe PPE in an attempt to ensure both compliance and protection; however, this approach may actually increase the risk of injury or illness. Choosing and implementing PPE as a response control measure is never a “one-size-fits- all” solution. The proper selection of PPE requires a risk assessment that takes into account the responders, working conditions, tasks and their associated hazards. Moreover, as the work and conditions change, a reassessment is necessary. This paper outlines a summary of the methodology for conducting an evaluation of the conditions and choosing the appropriate PPE by assessing the hazards associated with the work environment. The process consists of a Job Hazard Analysis (JHA) combined with a Risk Assessment (RA) in order to develop a complete Job Safety Analysis (JSA). Oftentimes, the JHA is done without the RA leading to the inappropriate selection of PPE as the JHA alone does not consider the potential hazards created by the use of PPE. Additionally, as the work, environment, or responder conditions change, or if there is an indication that the control measures are not working as intended (e.g., several responders have heat-related injuries), the JSA process is repeated to ensure that control measures are still current and effective. This methodology will create an effective PPE program by 1) ensuring that the selected PPE is the best suited for that particular job; 2) attempting to reduce responder discomfort; 3) potentially reducing waste and disposal of PPE; and 4) maximizing responder efficiency and effectiveness by avoiding unnecessary stress. All of this information and support appendices have been published by the American Petroleum Institute (API) in a document titled: Recommended Practice 98, Personal Protective Equipment Selection for Oil Spill Responders (2013) available through API at: http://www.techstreet.com/api/products/1862449.

Exposure to Pesticides and Metal Contaminants of Fertilizer among Tree Planters

In British Columbia, Canada, harvested forests are manually replanted by seasonal workers. The work is known to be physically demanding and ergonomically difficult, and recently, there have been concerns over chemical exposures due to pesticide residues on seedlings, fertilizers (often applied alongside seedlings), and potential metal contamination of these fertilizers. This study aimed to characterize metal and pesticide exposure among a sample of British Columbia tree planters. Between May 2006 and April 2007, exposure measurements were taken from 54 tree planters at five geographically disperse worksites throughout British Columbia. Four worksites were using fertilizer and one was not. Metal concentrations were measured by inductively coupled plasma mass spectrometry on post-shift hand wipes, full-shift personal air sample, bulk soil, seedling root balls, and fertilizer samples. Pesticides were measured on post-shift hand wipes and on bulk seedling samples. Seedling nursery pesticide application records were used to focus pesticide analyses on pesticides known to have been applied to the seedlings used at the study sites. Carbamate pesticides were analyzed by high-performance liquid chromatography/mass spectroscopy and all other pesticides by gas chromatography mass spectrometry. No evidence was found that tree planters who worked with fertilizer were at an elevated risk of exposure to arsenic, lead, cadmium, chromium, and nickel relative to tree planters who did not. Pesticide residues were found on seedlings taken from work sites early in the tree planting season in April 2007. At these worksites, the fungicides chlorothalonil and iprodione were found on the skin of workers at low levels (range 0.37-106.3 ng cm(-2) and 0.48-15.9 ng cm(-2), respectively), providing evidence for exposure potential. Very poor hygiene conditions were observed at all tree planting work sites. Hand washing facilities were not available at work sites and only 5.6% of subjects reported hand washing during the work day, including prior to eating or smoking. Gloves were worn by all subjects but no personal protective equipment programs existed to train workers in the correct use or selection of gloves, and consequentially, many glove choices were inappropriate. The lack of hand washing facilities combined with incorrect glove use could increase the duration of dermal exposure and increase the risk of hand-to-mouth ingestion exposure.

Asthma death after spraying polyurethane truck bedliner

Isocyanate exposure is the most common cause of work-related asthma. In 2003, a male in his mid-40s died of an acute asthmatic reaction approximately 1 hr after he sprayed the inside of a cargo van with an isocyanate-containing truck bedliner. This is the first reported death attributable to this type of isocyanate application. The Michigan Fatality Assessment and Control Evaluation (MIFACE) program investigated this work-related fatality to identify the factors that contributed to his death. The investigation included site visits, personal interviews, and a review of pertinent documents. Factors contributing to his death included: the vehicle type; lack of engineering controls; lack of a company safety and health program, including a personal protective equipment program, medical monitoring, and employee training; and a lack of recognition of work-relatedness of the deceased's respiratory problems by a health care provider. This work-related fatality investigation demonstrates the need for isocyanate manufacturers/formulators to inform end users of their products of appropriate health and safety work practices associated with new technologies. In addition, health care providers need more education and assistance to recognize and manage work-related asthma.

Effectiveness of Personal Protective Equipment: Relevance of Dermal and Inhalation Exposure to Chlorpyrifos Among Pest Control Operators

This study assessed the effectiveness of a custom fit personal protective equipment (PPE) program aimed at reducing occupational exposure to pesticides. The intervention study was carried out on 15 pest control operators (PCOs) during mixing/loading and application of chlorpyrifos. Each worker was measured twice; first while the worker used PPE as normal (baseline measurement), and second after making some adjustments to the PPE (postintervention measurement). The applied intervention consisted of a tight-fitting, full-face respirator, fit-testing, long gloves, chemical-proof boots, a Tyvekreg; hood, and an instruction video that was shown prior to putting on the PPE. A comprehensive evaluation program was used for the within-subject comparisons, including assessment of potential dermal exposure, actual dermal exposure, inhalation exposure, and internal dose as measured by the urinary metabolite 3,5,6-trichloro-2-pyridinol (TCP). The PPE program resulted in a significant increase in fit factors from a mean of 670 to 132,000. Actual dermal exposure levels decreased on average by fourfold after implementation of the PPE program (baseline AM = 132.1 μg; postintervention AM = 32.6 μg). The TCP levels in urine collected 24–32 hours after spray activities were lower in the postintervention data set (AM = 21.2 μg TCP/g creatinine vs. AM = 13.9 μg TCP/g creatinine). However, it is impossible to attribute these differences totally to the PPE program since workers had significant and varying urinary TCP levels before onset of spraying activities. Linear regression models showed that dermal exposure was only a predictive parameter for TCP levels in urine in the baseline data set. Although the results should be interpreted cautiously this study suggests a protective effect of the evaluated PPE program.

Does a Cheaper Mask Save Money? The Cost of Implementing a Respiratory Personal Protective Equipment Program

Does a Cheaper Mask Save Money? The Cost of Implementing a Respiratory Personal Protective Equipment Program

Does a cheaper mask save money? The cost of implementing a respiratory personal protective equipment program.

To determine the annual cost of implementing and maintaining a respiratory personal protective equipment (PPE) program at an urban hospital. St Clare's Hospital and Health Center, a 250-bed hospital in Manhattan that treats 60 to 100 cases of tuberculosis annually. Review of Purchasing Department records for all masks acquired by the hospital from 1992 to 1995, and an estimate of administrative time spent developing and implementing the guidelines recommended by various agencies during the study interval. Respiratory isolation was provided for 6,360 to 10,883 days annually during the 4-year interval. Yearly costs for the PPE program ranged from $86,560 to $175,690. Of note, the daily cost for a respiratory isolation day decreased dramatically between 1994 and 1995 ($25/day to $13/day), when the high-efficiency particulate air-filter (HEPA) respirator was used by all staff. The decrease occurred because of lower administrative costs and a sharp decrease in the numbers of HEPA units purchased. Objective measures of worker compliance with HEPA respirators demonstrated the decrease was not due to less HEPA use but rather that employees were using each HEPA unit for several weeks, as recommended. We found a significant decrease in cost in the second year of our HEPA program due to increasing employee familiarity with the program. Newly approved, cheaper, but less durable, N-95 masks are unlikely to withstand multiple wearings and may be discarded after a few uses. Thus, cheaper masks may result in a more expensive PPE program.

Does a Cheaper Mask Save Money? The Cost of Implementing a Respiratory Personal Protective Equipment Program

Does a Cheaper Mask Save Money? The Cost of Implementing a Respiratory Personal Protective Equipment Program

Occupational exposure of workers to 1,3-butadiene.

Researchers from the National Institute for Occupational Safety and Health (NIOSH) conducted an extent-of-exposure study of the 1,3-butadiene monomer, polymer, and end-user industries to determine the size of the exposed workforce, evaluate control technologies and personal protective equipment programs, and assess occupational exposure to 1,3-butadiene. A new analytical method was developed for 1,3-butadiene that increased the sensitivity and selectivity of the previous NIOSH method. The new method is sensitive to 0.2 microgram per 1,3-butadiene sample. Walk-through surveys were conducted in 11 monomer, 17 polymer, and 2 end-user plants. In-depth industrial hygiene surveys were conducted at 4 monomer, 5 polymer, and 2 end-user plants. Airborne exposure concentrations of 1,3-butadiene were determined using personal sampling for each job category. A total of 692 full shift and short-term personnel and 259 area air samples were examined for the presence of 1,3-butadiene. Sample results indicated that all worker exposures were well below the current OSHA PEL of 1000 ppm. Exposures ranged from less than 0.006 ppm to 374 ppm. The average exposure for all samples was less than 2 ppm. The present American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit value for 1,3-butadiene is 10 ppm. To reduce the potential for occupational exposure, it is recommended that quality control sampling be conducted using a closed loop system. Also all process pumps should be retrofitted with dual mechanical seals, magnetic gauges should be used in loading and unloading rail cars, and engineering controls should be designed for safely voiding quality control cylinders.