Personnel Protective Equipment Research Articles

Use of mask at public places among health care professionals following COVID-19 postquarantine period in Southern Haryana, India

Introduction: The instances of social stigma and violence against health care worker was already prevalent but during COVID-19, such instances have reached its peak. So, this global health crisis of COVID-19 pandemic offers a unique opportunity to investigate the level of perceptions and practices regarding use of mask or personnel protective equipment (PPE) in public places amongst health care professionals following COVID-19 postquarantine period.Materials and Methods: The study included 100 health care personnel working in COVID-19 outpatient and wards as participants who have completed their quarantine period after being sent on quarantine at home/hostels or state-run facilities during the 3rd week of June 2020. After obtaining informed consent from participants, a structured questionnaire was used to collect the data. All the tests were performed at significance level of 5%.Results: More than two third of the participants (69.0%) were using mask/PPE at all in public places. Around two third of participants were willing to wear mask/PPE in public places like local markets/street (64.0%); bus/train/flight (74.0%); institution/college (61.0%) and malls/shopping complex (73.0%). Only 58.0% of study participants were having overall good perception score for wearing mask/PPE.Conclusions: The present study made an attempt to find out the perceptions and practices of health care personnel regarding mask/PPE use while they are in public place and it was observed that perception and practices were not satisfactory in this regard. The need of hour is psychological support for health care workers to overcome such stigma fear and the findings might help local administration to enhance that support.

Challenges in radiology in dealing with chest radiography in novel covid 19 patients among adults as well as pediatric cases: Review of literature and current scenario

Pulmonary illness in novel coronavirus disease 2019 (nCOVID-19) has been the main manifestation since the time of outbreak of the novel coronavirus in December 2019. Many pneumonia like resembling illnesses with similar type of findings can be a diagnostic challenge. The symptomatology is milder in children as compared to adults. In this scenario to get the radiological investigations done especially radiography of chest has posed a great concern for the radiographers as well as radiologists. Although this is less sensitive than computerized tomography but is the frontline investigation in COVID-19 patients. We have highlighted the various grey areas which are still to be elaborated more to minimize the morbidity as well as mortality of this menace. One should carry out radiological investigations judiciously to dispel the diagnostic dilemma. The use of personnel protective equipment (PPE) and shift rotation will further help in curbing the COVID-19 spread. The diagnostic chest evaluation of chest by Point of care ultrasound (POCUS) is also being considered in children to avoid unnecessary exposure to radiation. Conclusion: The limited experience had been taken in cognizance for the description of various issues related to COVID-19in carrying out chest radiography. This will help in better understanding for the radiologist, pediatricians and physicians in the right direction of management, progression and follow up of the disease.

Nursing Students’ Occupational Health and Safety Problems in Surgical Clinical Practice

Student nurses are exposed to hazards in terms of occupational health and safety (OHS) problems in Turkey. Researching these problems in the clinical setting, improving the health and safety of student nurses is an issue that needs to be investigated. The aim of this study is to present OHS-related impressions and OHS experiences of nursing students in relation to the risk assessment process and from an educational perspective. A descriptive and cross-sectional study was conducted with 140 students at a nursing school. The study indicated that almost all of the students’ OHS knowledge and awareness level were low, were exposed to contact with blood and body fluids as most dangerous situations, have difficulties in the provision of personnel protective equipment (PPE), were subjected to verbal assault, and experienced anxiety and irritability. They encountered dangerous situations applying treatment in the clinic, preparing drugs, following vital signs, giving general care, and during the intervention in the emergency room, and experienced back pain, headache, increased tendency to sleep, fatigue, and forearm, wrist, hand, and finger injuries. Because of contact with hand antiseptic/latex, skin irritation, and burning eyes, nose, and throat, allergy symptoms were detected. Carelessness and intensive work tempo were the most common causes of workplace accidents. The clinical practice areas are limited in terms of OHS; students are exposed to physical, psychological, and chemical risks with respect to OHS, and they are most psychologically affected by experiencing anxiety and irritability, as well as physiologically, and have symptoms similar to burnout syndrome; they are at risk of getting burnout syndrome.

A multicentric study to ascertain knowledge, attitude and practices for infection prevention and control amongst nurses

Background: Infection prevention and control (IPC) is the key component to curtail the spread of infections and combating rising antimicrobial resistance (AMR) amongst bacteria. Objectives: The present study was conducted to assess the knowledge, attitude and practices (KAPs) for IPC amongst nurses. Materials and Methods: A cross-sectional, multicentric, hospital-based survey was conducted on 328 nurses from January to November 2018 using a self-administered questionnaire from public and private quaternary-, tertiary- and secondary-level hospitals. Results: The overall score for infection control practices was low, with knowledge score being 51%, attitude 73% and good practices score 57%. The gaps were identified across all components with major gaps in the knowledge of care of devices (74%), barrier nursing/isolation precautions (60%), indications of using hand rub (55%), understanding the meaning of healthcare-associated infections, AMR (50%) and optimum use of personnel protective equipment (44%). In attitude and practices, injection safety emerged as the weakest area, with >40% of nurses being neither aware nor practicing the correct techniques of reconstituting, administering injectable medicines and maintaining asepsis. Conclusion: There is an urgent need of rigorous, regular, restructured, standardised training programmes focussing on the weak areas for nurses in healthcare settings. Training programmes need supervision and provision of enabling environment in healthcare settings to facilitate the implementation of evidence-based IPC guidelines.

Assessment of Hazards and Safety Practices in Food and Beverage Industry in Nigeria

The assessment of safety hazards is fundamental to an effective risk management in any industry. Food and beverage production involves a variety of industrial processes with associated hazards. Effective safety practices are used to reduce workplace hazards and promote safety in the work environment. This paper evaluated safety hazards and safety practices in the food and beverage industry (FBI) in South-South, Nigeria. A structured questionnaire designed in accordance with World Health Organization standard was administered to a total of 144 workers, out of which 134 (93.0%) were completed and returned. The questionnaire was fashioned to extract information on types of hazards, awareness of safety hazards, implementation of hazards and risks control measures and the effectiveness of safety hazards and risk management programmes in the food and beverage industry. A modified four-point Likert Scale was used to analyze and evaluate the questionnaire. A Proportional Importance Index (PII) was used to rank each factor variable in the questionnaire. The study identified the major hazards in the FBI as working at height (with PII = 3.3, respondents = 91%); high voltage areas (PII = 3.1 and respondents = 90%), loud noise (PII = 3.0, respondents = 80%), machines and equipment vibration (PII = 2.8, respondents = 69%) and faulty machines and equipment (PII = 2.7, respondents = 65%). The level of awareness on safety hazards amongst the workers was statistically significant (p < 0.05, 95%CI; PII = 3.1 - 3.6). The outcome of intervention showed that FBI-2 improved from 79.62% to 96.82%, FBI-3 improved from 89.81% to 96.18%, FBI-4 improved from 78.34% to 95.54% on worker’s knowledge on the assessment of hazards and risk in the FBIs. There was effective implementation of safety hazards and risks management programmes and controls in the FBI. Administrative control measures are used to reduce hazards and workers make adequate use of personnel protective equipment. There is need to evaluate the risks associated with identified high ranking hazards and develop a risk management framework for the industry based on ISO 31000 and other relevant safety regulations and guidelines.

Menentukan Faktor-Faktor Budaya Keselamatan dalam Kalangan Tenaga Pengajar Teknikal Menggunakan Pendekatan Analisis Berstruktur

Studies on safety culture have been increasing and several proposed models have been developed and evaluated to identify their key dimensions contributed to many occupational sectors. However, less of safety culture studies focused at education sector especially in Malaysia. This study aims to seek a deeper understanding of the structures of safety culture in Malaysian education sector mainly at Technical and Vocational Education Training (TVET). The objective also to investigate the relationship between psychological, behaviourial and situational dimension with safety culture, and to find out what can be done by the top management to increase safety culture in education sector. Data was collected from 391 Vocational Colleges’ (VC) instructor all over Malaysia that being selected using multistage sampling. Data was analyzed using SPSS 24 and SmartPLS-Structural Equation Modeling (SEM) technique. Partial least squares analysis revealed Influence of Peers, Safety Knowledge, Safety Communication, Safety Rules, Personnel Protective Equipment and Safety Training plays a pivotal role in inspiring the safety culture among the instructor. Assessment of Importance Performance Matrix Analysis (IPMA) showed that Safety Knowledge, Safety Rule, Influence of Peers and Safety Training are very important factors in determining a safety culture due to their relatively higher importance values compared to the rest of the variables. The study will help to improve safety culture in education sector and expected to bring in more safety awareness among instructor, which will inevitably bring in a culture of safe behavior. The ultimate result will be a substantial reduction or elimination in safety-related incidents and make an education sector as a safe workplace. Only a very few have examined the safety culture factors among VCs’ instructor as one of the TVET organisastion, and the used of Smart PLS is a novel idea, with the post analysis of IPMA gives an indicator to the top management of TVET’s education and Malaysia Ministry of Education (MOE) in build safety culture in this sector. Compliance of OSHA 1994 is seen as a good measure to build an education sector as a safe workplace.

Hajj abattoirs in Makkah: risk of zoonotic infections among occupational workers.

At completion of Hajj, the Islamic pilgrimage to Makkah, pilgrims give thanks for the blessing, and acceptance, of Hajj, marking the end of the pilgrimage by sacrificing an animal and distributing the sacrificial meat to the poor. With over two million Muslims making Hajj, each Hajj, more than 1.2 million heads of cattle: sheep, goats and camels are slaughtered. Over 16 000 abattoir workers work around the clock to sacrifice and process the cattle in keeping with Islamic law and public health guidelines. Because of their proximity to high densities of cattle and cattle meat, Makkah's abattoir workers are at risk of zoonosis. This was a longitudinal study aimed at determining the risk of some zoonotic diseases among male permanent abattoir workers during Hajj. Specifically, seroprevalence of antigens for Brucella, Crimean–Congo haemorrhagic fever (CCHF), Alkhurma haemorrhagic fever (AHF) and Rift Valley Fever (RVF) were determined, among the study participants. An enrolment questionnaire, and a follow‐up questionnaire, with provision of 10 mL blood for testing 2 days before intense Hajj animal exposure, up to 20 days after intense animal exposure and between 30 and 42 days after Hajj butchering exposures. While working with livestock, study participants were interrogated on hand hygiene and personal protection. Eighty male permanent abattoir workers participated in the study. Majority, 96.25% (n = 77) declared washing their hands with soap and water, most 98.75% (n = 79) never used eye protection, few occupational workers dressed in personal protective clothing or footwear. All workers tested negative for CCHF and RVF, one was positive for AHF and six for Brucella. The risk of some zoonotic infections like Brucella and AHF is low among permanent occupational workers in the slaughtering house in Makkah during Hajj 2013. No serological evidence for CCHF and RVF viruses, even though workers showed low compliance with use of personnel protective equipment.

Combined effect of coal dust exposure and smoking on the prevalence of respiratory impairment among coal miners of West Bengal, India

Accelerating prevalence of coal workers pneumoconiosis is considered as a serious occupational health problem. This cross-sectional study was designed to determine the prevalence of lung function impairment of underground coal miners in West Bengal, India. A total of 230 underground coal dust-exposed subjects and 130 nonexposed subjects were examined for lung function test and also information on sociodemographic characteristics, addiction, respiratory morbidity, personnel protective equipment and dust exposure were collected. Lung function impairment was significantly higher in exposed group than nonexposed group and personnel dust exposure level were exceeded above the NIOSH recommended level. In addition, respiratory ailments were found to be higher in exposed group than the nonexposed group. So, this study has established the need for an advanced understanding of the quantifiable and measurable remedies for protection of lung disorder of coal mine workers.

Good laboratory practices guarantee biosafety in the Sierra Leone-China friendship biosafety laboratory.

BackgroundThe outbreak of Ebola virus disease (EVD) in West Africa between 2014 and 2015 was the largest EDV epidemic since the identification of Ebola virus (EBOV) in 1976, and the countries most strongly affected were Sierra Leone, Guinea, and Liberia.FindingsThe Sierra Leone-China Friendship Biological Safety Laboratory (SLE-CHN Biosafety Lab), a fixed Biosafety Level 3 laboratory in the capital city of Sierra Leone, was established by the Chinese government and has been active in EBOV detection since 11 March 2015. Complete management and program documents were created for the SLE-CHN Biosafety Lab, and it was divided into four zones (the green, yellow, brown, and red zones) based on the risk assessment. Different types of safe and appropriate personnel protection equipment (PPE) are used in different zones of the laboratory, and it fully meets the Biosafety Level 3 laboratory standards of the World Health Organization.ConclusionGood preparedness, comprehensive risk assessment and operation documents, appropriate PPE, effective monitoring and intensive training, together with well-designed and reasonable laboratory sectioning are essential for guaranteeing biosafety.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-016-0154-5) contains supplementary material, which is available to authorized users.

U.S. Medical Support in a Developing World Health System - a Partnership Made in Africa for a "New Normal" Strategy.

The United States Government (USG) is deeply interested in political stability and economic prosperity within each of the sovereign states of Africa. Part of the “whole-ofgovernment approach,” the Department of Defense (DoD) is responsible for lines of effort that place uniformed service members and U.S. Embassy officials at risk. Current USG missions on the African continent typically involve small travelling contact teams, special operators, and diplomatic missions without robust medical support. Beyond Self Aid and Buddy Care (SABC) and unit medics, there is no capacity to support U.S. assets during the golden hour of trauma. Civilian and military assets are integrated with variable success on an ad hoc basis (e.g., Theater Patient Movement Requirement Center coordinates with International SOS, as needed, to arrange medical evacuation by the most effective means possible, usually a civilian aircraft). Those unstable for evacuation are transported to the nearest medical facility where service members and diplomats receive the best care available, which may be different from the standard of care available in other countries. Despite historical precedence and known risks, the USG does not have a robust response capability for medical crisis that involves USG representatives on the African continent. Many proposals exist to push specific medical capabilities closer to U.S. personnel in Africa, but few use evidencebased tactics aligned to strategic end-state objectives. The tactical capabilities proven to save lives and reduce the burden of disease are clear: personnel protective equipment (e.g., body armor and tourniquets), SABC, tactical combat casualty care, casualty evacuation, forward access to trauma surgery, reliable blood bank and laboratory support, evidencebased critical care, and robust medical evacuation. We propose a strategy to assist development of African regional training institutions to teach, train, evaluate, and maintain these specific evidence-based tactical medical capabilities. In this strategy, host nation (HN) training institutions selected based on willingness, regional consensus, and funding legitimacy would draw medics from the region to complete standardized training at a center of excellence, staffed and led by HN medics to serve both the health security objectives of the USG, the training requirements of all partners, and the health care objectives of the HN. The end-state objective directly supports U.S. Africa Command Lines of Effort and a whole-of-government approach to Global Health Engagement. Measurable outcomes based upon this strategy must directly support desired end states, and should include: HN medics graduated from mandatory training, HN medic performance during training exercises, time-distance from U.S. Embassy to accessible Role 2 care, reliable access to accredited blood bank, sustainable information technologies to support unimpeded access to medical subspecialist consultation, incorporation of Millennium Development Goals or the future Sustainable Development Goals, access to 5,000-foot runway and helipad, flexible and integrated AE routes, and HN certified as United Nation/African Union interoperable combat medics with civilian health care credentials. In the initial effort of this Global Health Engagement strategy, HN personnel assigned to military or civilian units responsible for disaster response will receive tactical training based on HN and partner requirements. One training source is the Defense Institute for Medical Operations with extant courses categorized as Health Systems Management, Disaster Management and Consequence Management, Public Health and Force Health Protection, and Patient Transport and Evacuation. Unique courses offer by DoD include the following: SABC, Combat Casualty Care Course, and tactical combat casualty care. Department of State, DoD, and U.S. Agency for International Development (USAID) have the capacity to train Basic Life Support, Advanced Cardiac Life Support, Pre-Hospital Trauma Life Support, Advanced Trauma Life Support, and Advanced Life Support in Obstetrics. Indeed, such training is currently happening in African nations with train-the-trainer follow-up with external instructors. However, African International Health Specialist Team USAFE/AFAFRICA SGXD Unit 3050, Box 170 Ramstein, APO AE 09094-0170. The views expressed are those of the authors and do not reflect the official policy or position of the U.S. Africa Command, the U.S. Air Force, the Department of Defense, or the U.S. Government. doi: 10.7205/MILMED-D-15-00413

Assessment of Knowledge, Attitude and Practices Among Solid Waste Collectors in Lideta Sub-city on Prevention of Occupational Health Hazards, Addis Ababa, Ethiopia

Municipal solid waste workers are exposed to a number of pathogens (bacteria, fungi, viruses, parasites and cysts), toxic substances, chemicals that come from the waste itself and from its decomposition. While standards and norms for handling municipal solid waste in industrialized countries have reduced occupational and environmental impacts significantly, the risk levels are still very high in most developing countries including Ethiopia because of inadequate understanding of the magnitude of the problem. Despite the severity of occupational health hazards encounter by solid waste collectors their provision, knowledge and usage of personnel protective equipment is low and there is no adequate and credible evidence on occupational health risks of solid waste collectors in Ethiopia. Therefore, this study was aimed to assess the knowledge, attitude and practices of solid waste collectors towards prevention of occupational health hazards in Lideta sub-city in Ethiopia. A cross-sectional survey was conducted among four hundred six solid waste collectors for this work. The data was collected by using semi-structured questionnaire and observational checklist, which was completed from December 2014 to February 2015. The data was entered into epi info version 3.5.1 and exported to SPSS 20 version for analysis. Multiple logistic regression analysis had been performed. Adjusted odds ratio with confidence interval had been computed to see the presence of association between the dependent and selected independent variables. The results on this finding were reported using different descriptive statistics. The response rate of this study was 94.8%. Female respondents accounted 69.7%. The mean age of the study subjects was 35 years, which varied from 17 to 65 years. About 60.8% of the study participants had satisfactory knowledge on preventing occupational health risks associated with solid waste handling. Most (75.9%) of the solid waste collectors had favorable attitude while only 37.2% of them had safe practice on preventing occupational health hazards. As compared to workers who were satisfied on their job, odds of having safe occupational health practice were 2.8 higher (AOR = 2.8, 95% CI: 1.84 - 4.26). The knowledge and attitudes of workers about prevention of occupational health hazards were moderate but the magnitude of having safe occupational health practice was very low. So, implementation of basic occupational health services with provision of personal protective equipment’s and supervising waste handlers on appropriate utilization is advisable.

Non-Invasive Optical Sensor Based Approaches for Monitoring Virus Culture to Minimize BSL3 Laboratory Entry.

High titers of infectious viruses for vaccine and diagnostic reference panel development are made by infecting susceptible mammalian cells. Laboratory procedures are strictly performed in a Bio-Safety Level-3 (BSL3) laboratory and each entry and exit involves the use of disposable Personnel Protective Equipment (PPE) to observe cell culture conditions. Routine PPE use involves significant recurring costs. Alternative non-invasive optical sensor based approaches to remotely monitor cell culture may provide a promising and cost effective approach to monitor infectious virus cultures resulting in lower disruption and costs. We report here the monitoring of high titer cultures of Human Immunodeficiency Virus-1 (HIV-1) and Herpes Simplex Virus-2 (HSV-2) remotely with the use of optical oxygen sensors aseptically placed inside the cell culture vessel. The replacement of culture media for cell and virus propagation and virus load monitoring was effectively performed using this fluorescent sensor and resulted in half the number of visits to the BSL3 lab (five versus ten).

Hazardous Material Information Sytem-A Review

Hazardous Material Information System (HMIS) is one of the simplest inclusive hazard communication systems by which worker gets informed about the workplace hazards proactively, thereby receives appropriate training to work safely. The system therefore creates a safer workplace by making workers aware of hazards as a means of quick and emergency access relatively. The system is to reduce the likelihood of exposure of workers from workplace injuries, illness and accidents by proactive information through cautionary labels and symbols (with the perspective of layman) of hazards, adequate (PPE) personnel protective equipment, appropriate fire extinguishing media. This can be achieved by management commitment via communicating and displaying HMIS at the notice boards and giving training to the workers for ensuring better and safer workplace. This system is one of the attempts for the safe management of hazardous chemicals in the workplace by providing a user-friendly interface to vendors, clients and employees.

Control of an Outbreak ofAcinetobacter baumanniiin Burn Unit in a Tertiary Care Hospital of North India

Acinetobacterinfection is increasing in hospitals and now it is considered as a global threat, as it can be easily transmitted and remain viable in the hospital environment for a long time due to its multidrug-resistant status, resistance to desiccation, and tendency to adhere to inanimate surfaces. Outbreaks caused by multidrug-resistantAcinetobacter baumannii(MDRAB) are difficult to control and have substantial morbidity and mortality, especially in vulnerable host. Here we are describing an outbreak of multidrug-resistantAcinetobacter baumanniiin burn unit of a tertiary care hospital in India followed by its investigation and infection control measures taken to curtail the outbreak. Outbreak investigation and environmental sampling are the key factors which help in deciding the infection control strategies for control of outbreak. Implementation of contact precautions, hand hygiene, personnel protective equipment, environmental disinfection, isolation of patients, and training of health care workers are effective measures to control the outbreak of MDRAB in burn unit.

Design of Setting Management System of Relay Protection to Anti-Grade Trip in Coal Mine Based on Serial Communication

Because of personnel deployment flow, protection equipment and electric device replacement, and enterprise scale expansion, setting management is more difficult. It is easy to be out of control and become the main reason for the anti-grade trip. To solve the anti-grade trip problem of setting mismanagement, this paper designed one setting management system, which is composed of slave controller and upper server. After analysis, the communication process based on the TCP/IP protocols, the communication scheme is chosen between slave controller and upper server. Software within upper server is designed based on database technology. Slave controller gets the setting from relay protection device, by using IEC 60870-5-103 protocols based on serial communication, and sends to the software within the upper server, which can monitor, display and record. Setting management problem was solved, which is caused by the personnel deployment flow, protection equipment replacement, and enterprise scale expansion. This method can be widely used.

Experiences Managing Radioactive Material at the National Ignition Facility

The National Ignition Facility at Lawrence Livermore National Laboratory is the world's largest and most energetic laser system for inertial confinement fusion and experiments studying high energy density science. Many experiments performed at the National Ignition Facility involve radioactive materials; these may take the form of tritium and small quantities of depleted uranium used in targets, activation products created by neutron-producing fusion experiments, and fission products produced by the fast fissioning of the depleted uranium. While planning for the introduction of radioactive material, it was recognized that some of the standard institutional processes would need to be customized to accommodate aspects of NIF operations, such as surface contamination limits, radiological postings, airborne tritium monitoring protocols, and personnel protective equipment. These customizations were overlaid onto existing work practices to accommodate the new hazard of radioactive materials. This paper will discuss preparations that were made prior to the introduction of radioactive material, the types of radiological work activities performed, and the hazards and controls encountered. Updates to processes based on actual monitoring results are also discussed.

Simulation-based assessment for construction helmets

In recent years, there has been a concerted effort for greater job safety in all industries. Personnel protective equipment (PPE) has been developed to help mitigate the risk of injury to humans that might be exposed to hazardous situations. The human head is the most vulnerable to impact as a moderate magnitude can cause serious injury or death. That is why industries have required the use of an industrial hard hat or helmet. There have only been a few articles published to date that are focused on the risk of head injury when wearing an industrial helmet. A full understanding of the effectiveness of construction helmets on reducing injury is lacking. This paper presents a simulation-based method to determine the threshold at which a human will sustain injury when wearing a construction helmet and assesses the risk of injury for wearers of construction helmets or hard hats. Advanced finite element, or FE, models were developed to study the impact on construction helmets. The FE model consists of two parts: the helmet and the human models. The human model consists of a brain, enclosed by a skull and an outer layer of skin. The level and probability of injury to the head was determined using both the head injury criterion (HIC) and tolerance limits set by Deck and Willinger. The HIC has been widely used to assess the likelihood of head injury in vehicles. The tolerance levels proposed by Deck and Willinger are more suited for finite element models but lack wide-scale validation. Different cases of impact were studied using LSTC's LS-DYNA.

Sharps injuries and exposure to blood and bloodstained body fluids involving medical waste handlers

Exposure to healthcare waste can result in disease or injury. Though much attention is paid to the safety of healthcare professionals and their protection from sharps injury and exposure to blood and bloodstained body fluids (BBFs), the welfare and safety of non-healthcare professionals who are collecting, transporting and disposing waste has received very little attention. The objective of this study was to understand the incidence of sharps injury and occupational BBF exposure of mucous membranes involving medical waste handlers (MWHs). A cross-sectional study was carried out using a self-administered questionnaire, observation and interview. Data analysis was performed using SPSS version 16. The χ(2) value was calculated and P <0.05 was considered statistically significant. One or more incidents of sharps injuries and BBF exposures to mucous membranes occurred among 42.1% and 67.5% of MWHs respectively. None of the respondents was immunized with hepatitis B vaccine owing to the high cost of immunization and absence of free universal availability of the vaccine for the adult population. Less than 50% of MWHs wore either gloves or boots while performing their activities. Even though all knew about HIV, most of the respondents demonstrated a lack of knowledge regarding viral hepatitis. The risk of sharps injury and BBF exposure appeared high in MWHs. The establishment of safe waste-management techniques and the appropriate use of personnel protective equipment among MWHs in Addis Ababa is urgently required.

Qualitative interview study of clinicians’ opinions of which intubation aids to use following a CBRN incident

Aim: to ascertain what intubation aids clinicians believed should be consideredfor further evaluation for use while wearing CBRN-PPE Introduction: Intubation remains a key treatment option for the managementof casualties with respiratory failure following a chemical biological radiationnuclear (CBRN) incident. However, CBRN personnel protective equipment (CBRN-PPE) adversely affects intubation performance. To date, only the IntubatingLaryngeal Mask airway has been evaluated as an intubation aid for use whilewearing CBRN-PPE within a randomized control study. Methods: This is a qualitative, interview based study involving 25 clinicians fromvarious backgrounds. All interviewees had previously been involved in a numberof manikin based CBRN-PPE research studies involving airway managementincluding intubation. Results: Five different intubation aids were identified by the interviewees, including the gum elastic bougie, Airtraq™, stylet, Intubating Laryngeal MaskAirway and the McCoy laryngoscope as well as non intubation aids such aspractising intubation techniques while wearing CBRN-PPE, training with regardsto optimal techniques for intubation/airway management while wearing CBRN-PPE, correct/optimal patient position as well as the availability of a skilledassistant. Conclusion: This interviewed opinion based study involving UK clinicianswith experience of performing intubation and other related resuscitationtechniques while wearing CBRN-PPE has identified a number of intubation aidsthat clinicians believe may assist with intubation performance by potentiallyimproving speed and/or intubation success within the CBRN environment.However, the loss of fine motor movement and tactile sensation has beenidentified as a possible limitation of the devices and therefore these intubationaids warrant further evaluation. The role of training in skill performance andsimulation based practise, while wearing CBRN-PPE, also requires furtherinvestigation.

Evaluating the effectiveness of ergonomics application

The effectiveness of ergonomics application is achieved in the course of this research by reviewing ergonomics literature, Internet searches and case studies of a number of work related musculoskeletal disorders (WMSD's) and other ergonomic related workplace incidence rate. The results of ergonomic intervention control measures such as engineering controls, administrative controls and personnel protective equipment were also studied. The findings in this paper may help to development model for analysing and solving ergonomic problems in the workplace. It concludes on the need for management to support ergonomics intervention programme for effective cost saving, litigation avoidance and better productivity.