Proper Personal Protective Equipment Research Articles

Knowledge, attitudes and practices regarding respirable silica exposure and personal protective equipment use among brick kiln workers in Nepal

ObjectivesBrick kiln workers in Nepal are a neglected population who are exposed to high respirable silica concentrations, and few use interventions to reduce exposure. We aimed to characterise the prevalence...

Guarding Our Guardians: Navigating Adverse Reactions in Healthcare Workers Amid Personal Protective Equipment (PPE) Usage During COVID-19.

The widespread utilization of personal protective equipment (PPE) during the COVID-19 pandemic has been crucial for reducing transmission risk among healthcare workers (HCWs) and the public. However, the extensive use of PPEhas brought about potential adverse reactions, particularly among HCWs. This study aims to investigate the prevalence and characteristics of adverse skin reactions associated with PPE use among different categories of HCWs, including faculty, residents, and nursing officers (NOs), in a dedicated tertiary care COVID-19 hospital. The study design was a hospital-based cross-sectional analytical study conducted over one month, involving a total of 240 participants. The participants were required to complete a pre-tested semi-structured questionnaire that covered demographic information, PPE-related data, preventive measures, observed reactions, and self-management strategies. Results indicated that adverse skin reactions were common among HCWs, with reactions reported by all participants. The most commonly used PPE included N95 masks, goggles, gloves, face shields, isolation gowns, and medical protective clothing. Excessive sweating (60% residents, 21.1% NOs, and 16.25% faculties), facial rash, dry palms (>70% of HCWs), and itching were among the most prevalent adverse reactions. Urticarial lesions (28.5% among NOs), pressure marks and pain (100% on the cheek among all HCWs), fungal infections (18.5% among residents at the web space of fingers), and skin breakdown were also reported. Factors such as age, gender, pre-existing skin problems, and oily/acne-prone skin history were found to be significantly associated with adverse skin reactions. In conclusion, the findings highlight the common adverse reactions reported by HCWs during the use of different PPEs. Certain steps taken by HCWs for the prevention of adverse reactions due to PPE emphasize the importance of tailored preventive measures and strategies to mitigate these adverse reactions, such as proper PPE selection, well-fitting equipment, regular breaks, and appropriate skincare practices. These insights contribute to the development of guidelines for optimal PPE usage and support the well-being of HCWs in their essential roles.

Deep Learning for Detection of Proper Utilization and Adequacy of Personal Protective Equipment in Manufacturing Teaching Laboratories

Occupational sectors are perennially challenged by the potential for workplace accidents, particularly in roles involving tools and machinery. A notable cause of such accidents is the inadequate use of Personal Protective Equipment (PPE), essential in preventing injuries and illnesses. This risk is not confined to workplaces alone but extends to educational settings with practical activities, like manufacturing teaching laboratories in universities. Current methods for monitoring and ensuring proper PPE usage especially in the laboratories are limited, lacking in real-time and accurate detection capabilities. This study addresses this gap by developing a visual-based, deep learning system specifically tailored for assessing PPE usage in manufacturing teaching laboratories. The method of choice for object detection in this study is You Only Look Once (YOLO) algorithms, encompassing YOLOv4, YOLOv5, and YOLOv6. YOLO processes images in a single pass through its architecture, in which its efficiency allows for real-time detection. The novel contribution of this study lies in its computer vision models, adept at not only detecting compliance but also assessing adequacy of PPE usage. The result indicates that the proposed computer vision models achieve high accuracy for detection of PPE usage compliance and adequacy with a mAP value of 0.757 and an F1-score of 0.744, obtained with the YOLOv5 model. The implementation of a deep learning system for PPE compliance in manufacturing teaching laboratories could markedly improve safety, preventing accidents and injuries through real-time compliance monitoring. Its effectiveness and adaptability could set a precedent for safety protocols in various educational settings, fostering a wider culture of safety and compliance.

Exploring the Oral Manifestations and Hazards to Dental Professionals During the COVID-19 Pandemic: A Scoping Review.

The novel coronavirus (COVID-19) has inundated the whole world by causing severe acute respiratory syndrome in humans, thus posing serious public health concerns. The oral and olfactory systems are significantly impacted by the COVID-19 condition, in addition to the respiratory and digestive systems. Oral symptoms of COVID-19 can be caused by a loss in oral hygiene, immune system suppression, a decline in general health, and candidiasis due to prolonged antibiotic use. Because many aerosols and droplets are produced during various dental operations, dental professionals and dentists are at a significant risk of contracting the COVID-19 infection. Few precautionary measures include performing a pre-appointment health screening for all patients, performing aerosol-producing procedures in a designated space or operatory, using proper personal protective equipment and disinfecting the operatory between patients, and limiting the number of dental procedures at one time. Against this background, the purposes of this article are to explore the oral presentations of COVID-19 infection and to emphasize the hazards to dental professionals during COVID-19 pandemic. Additionally, few preventive measures are also highlighted.

Treatment and Management of Acinetobacter Pneumonia: Lessons Learned from Recent World Event.

Acinetobacter pneumonia is a significant healthcare-associated infection that poses a considerable challenge to clinicians due to its multidrug-resistant nature. Recent world events, such as the COVID-19 pandemic, have highlighted the need for effective treatment and management strategies for Acinetobacter pneumonia. In this review, we discuss lessons learned from recent world events, particularly the COVID-19 pandemic, in the context of the treatment and management of Acinetobacter pneumonia. We performed an extensive literature review to uncover studies and information pertinent to the topic. The COVID-19 pandemic underscored the importance of infection control measures in healthcare settings, including proper hand hygiene, isolation protocols, and personal protective equipment use, to prevent the spread of multidrug-resistant pathogens like Acinetobacter. Additionally, the pandemic highlighted the crucial role of antimicrobial stewardship programs in optimizing antibiotic use and curbing the emergence of resistance. Advances in diagnostic techniques, such as rapid molecular testing, have also proven valuable in identifying Acinetobacter infections promptly. Furthermore, due to the limited availability of antibiotics for treating infections caused A. baumannii, alternative strategies are needed like the use of antimicrobial peptides, bacteriophages and their enzymes, nanoparticles, photodynamic and chelate therapy. Recent world events, particularly the COVID-19 pandemic, have provided valuable insights into the treatment and management of Acinetobacter pneumonia. These lessons emphasize the significance of infection control, antimicrobial stewardship, and early diagnostics in combating this challenging infection.

The application of PPE at the Juanda meteorological station (BMKG)

The application of Personal Protective Equipment (PPE) at the Meteorology, Climatology, and Geophysics Agency (BMKG) is an important step in maintaining employees’ safety and health in their work environment. Even though BMKG is not involved in heavy industrial activities, there are still potential hazards and risks that need to be addressed in carrying out meteorological, climatological, and geophysical tasks. This study aims to describe the importance of implementing PPE in the BMKG environment, especially the Aviation Meteorological Station, where we took a case study at the Juanda Meteorological Station. First, we identify potential hazards that may be faced by BMKG employees, such as radiation risk, potential for hazardous gas explosions or fires, extreme weather conditions, and risks of physical injury. In the face of these risks, the use of proper PPE can help protect employees from hazardous exposures, and gas explosions and prevent injury. Next, we discuss the factors that need to be considered in implementing PPE at the BMKG. This includes a comprehensive risk assessment, identification of appropriate PPE for specific hazards, training of employees on the use and care of PPE, and regular monitoring and maintenance of the PPE used. Therefore, by implementing the Occupational Health and Safety Management System, in this case, the application of PPE, BMKG can ensure that employees have a safe and healthy work environment, reduce the risk of work accidents, and comply with applicable regulations and standards related to work safety.

An assessment of the immune status of some stone quarry workers in Ondo state, Nigeria.

Stone quarry activities in Nigeria are mostly unregulated such that the workers in these quarries are continuously exposed to the inhalation of silica dust. It has been observed that silica dust particles negatively impact the health of stone quarry workers which usually manifest as respiratory difficulties, asthma-like illnesses and other adventitious events of the lungs. The study was designed to evaluate the probable immunological impact of silica dust inhalation from stone crushing by workers. Blood samples were collected from consenting workers and analyzed for total white blood cells and their subsets. Absolute CD4 cells numbers were also determined. The results indicated that neutrophils and eosinophils numbers increased significantly (P < .05) and CD4 counts declined significantly (P < .001). Alteration in these proportions is a pointer to the injurious impact of silica dust on the immune system of these workers. The findings in this study should spur actions in the education of these workers on the need for the use of proper personal protection equipment and the establishment of a scheme to periodically carry out a health assessment check to identity those at most risk of developing chronic illnesses.

Determining the nurses' perception regarding the effectiveness of COVID-19 protocols implemented in Eastern Province: Saudi Arabia.

The global impact of Coronavirus Disease 2019 (COVID-19) has been profound, affecting public health, the global economy, and overall human life. Past experiences with global pandemics underscored the significance of understanding the perception of HCWs and hospital staff in developing and implementing preventive measures. The World Health Organization (WHO) provided protocols to manage the spread of COVID-19 and assist healthcare workers and health systems globally in maintaining high-quality health services. This study aims to assess nurses' perception, awareness, and compliance regarding the implementation of COVID-19 protocols and explore factors influencing their perception. A quantitative cross-sectional survey-based study was conducted, distributing a constructed survey among nurses in the Eastern Province of Saudi Arabia. Out of 141 participants, most adhered to protocols such as hand sanitization, social distancing, and proper personal protective equipment (PPE) usage. The predominant age group among respondents was 31 to 40 years (n = 71, 50%). A significant portion of participants reported holding a bachelor's degree (n = 86, 61%), with only 14% possessing advanced degrees (n = 19). Nearly a third of the nurses in the study had accumulated 6 to 10 years of professional experience (n = 49, 34.8%). A noteworthy percentage of nurses were engaged in daily shifts exceeding 8 h (n = 98, 70%). Gender differences were observed, with females exhibiting a higher tendency to avoid shaking hands and social gatherings. Saudi nationals were more inclined to shake hands and engage in gatherings. Non-Saudi nurses and those aged between <25 to 40 years demonstrated proper donning/doffing practices. Nurses with over 6 years of experience avoided social gatherings, while those working >8 h adhered better to PPE usage, proper donning/doffing, and disposal of PPE in designated bins. Understanding COVID-19 protocols is crucial for tailoring interventions and ensuring effective compliance with COVID-19 preventive measures among nurses. More efforts should be made toward preparing the healthcare nursing to deal with the outbreak. Preparing healthcare nursing with the right knowledge, attitude, and precautionary practices during the COVID-19 outbreak is very essential to patient and public safety.

Managing Occupational Health and Safety Risks in Construction Projects to Achieve Social Sustainability – A Review of Literature

This systematic literature review aims to thoroughly examine the relationship between Occupational Health and Safety (OHS) and project management in construction projects. The construction industry is known for its high accident rates among workers, and it is important to understand the factors that contribute to these accidents to develop effective OHS management practices. The review highlights the significance of legal compliance in OHS management and the challenges and opportunities presented by the integration of OHS laws in construction project management. One of the main factors that contribute to high accident rates among construction workers is inadequate training and a lack of proper safety equipment. The review also identifies common types of accidents and their factors on construction sites, such as falls from heights, electrical hazards, and heavy machinery accidents. Additionally, it suggests measures for improving OHS management practices, such as regular safety inspections and training programs, implementing safety policies and procedures, and providing proper personal protective equipment to workers. Overall, the research indicates that OHS is an essential aspect of construction project management, and effective OHS management can improve project performance by reducing accidents and injuries, improving worker morale and productivity, and enhancing the project’s reputation. The review provides insights on how to develop, implement and continuously improve OHS management practices in construction projects.

Analysis of Barbie medical and science career dolls: descriptive quantitative study.

To identify Barbie brand dolls that had medicine and science themed professions in comparison with other career dolls and to determine their accuracy in meeting clinical and laboratory safety standards. Descriptive quantitative study. Visual and data analysis of web searches. To identify the kinds of medical and scientific subspecialties that the Barbie dolls (and a comparison doll group) worked in; and to determine whether these medical professional and scientist dolls met laboratory and clinical safety standards. Additional data about doll demographics (ie, age, ethnic group, and sex) were also collected. 92 Barbie brand dolls were analyzed: doctor (n=53), scientist (n=10), science educator (n=2), nurse (n=15), dentist (n=11), and paramedic (n=1). 65 non-Barbie brand dolls were also analyzed for comparison purposes: doctor (n=26), scientist (n=27), nurse (n=7), dentist (n=2), engineer (n=2), and magnetic resonance imaging (MRI) technician (n=1) dolls. Barbie brand medical professional dolls (n=80) largely treated children (66%, n=53/80), with only three (4%) medical professional dolls being directly depicted working with adults. Of the 12 scientist Barbie brand dolls, none met all proper personal protective equipment requirements related to hair and clothing. Barbie brand dolls often came with items, such as laboratory coats, microscopes, stethoscopes, and glasses, that children stereotypically associate with doctors and scientists. While comparison dolls offered a wider range of age and ethnic groups than the Barbie doll group did, the dolls similarly struggled to portray a wide range of medical and scientific subfields and most comparison dolls did not wear proper personal protective equipment. Medicine and science themed dolls help to inspire tomorrow's medical professionals and scientists. All toy companies should ensure that future medical professional and scientist dolls meet clinical and laboratory safety standards and diversify the types of medical and scientific professions represented (especially among male dominated fields). For young girls' sakes as much as her own, Barbie must keep shattering glass ceilings.

Risk Identification Of Roll Forming Machine Area With The (HIRARC) Approach at PT. Bumi Lestrai Karya Perkasa

PT. Bumi Lestari Karya Perkasa experiences 25 workplace accidents in a year. The purpose of this study is to estimate the amount of potential work accident risks in the field of roll forming machines and to control risks with appropriate Personal Protective Equipment (PPE) to reduce occupational risks. The Hazard Identification Risk Assessment and Risk Control (HIRARC) method was used in this study. This research is a qualitative research. Field observations, literature study of company documents, and in-depth interviews with the SMK3 division at PT. Bumi Lestari Karya Perkasa is used to collect data. The risk score is calculated first in the analysis. This research resulted in identification of companies in an effort to improve the safety of all work in the roll forming machine area to avoid unsafe actions and unsafe conditions, as well as the use of Personal Protective Equipment (PPE) by adjusting the type of work being carried out and the lack of awareness about the importance of tools. Personal Protection (PPE). Highlights : Quantifying Risk: Using HIRARC method to assess and quantify potential work accident risks provides a structured approach to understanding and addressing safety concerns. Qualitative Research Approach: Employing field observations, literature study, and in-depth interviews allows for a comprehensive understanding of the factors contributing to workplace accidents. Emphasis on Prevention: Identifying unsafe actions and conditions underscores the importance of proactive measures, such as proper PPE usage and raising awareness among employees, to mitigate occupational risks. Keywords - Work Risk; Work Accident; Roll Forming

Integrated approaches to prevent exposure risks related to latex-derived products

Natural rubber latex is a widely used industrial raw material to produce many consumer and commercial products. Chronic exposures to latex allergenic proteins residual in the finished products can promote hypersensitive immune responses, which affects millions of workers and the general public worldwide. Research has shown the average prevalence of latex allergy worldwide remains approximately 10% among healthcare workers, 7% among susceptible patients, and 4% among general population. Although most effective in preventing latex allergy, completely avoiding contact to latex-derived products is extremely challenging, given the fact that millions of products possibly contain latex, but few are regulated and properly labeled. Due to the difficulty to assure a product completely absent of latex allergens, the United States Food and Drug Administration has recommended to stop using labels like “latex-free” or “does not contain latex.” Here we evaluate published data, industrial standards and regulations, identify possible countermeasures, and propose an integrated strategy, including some more practicable approaches (e.g., education/training, product labeling, the use of proper personal protective equipment, occupational selection, and searchable product database) and novel medical treatments (e.g., immunotherapy) to help decreasing latex allergy prevalence.

Leptospirosis seroprevalence and risk factors among slaughterhouse workers in Burkina Faso

ObjectivesThe objectives of this study were to determine the seroprevalence and risk factors of leptospirosis among slaughterhouse workers in Burkina Faso. MethodsWe performed a cross-sectional survey of slaughterhouse workers from Ouagadougou and Bobo Dioulasso between March and April 2021. Blood was collected by venipuncture and serum samples were tested using enzyme-linked immunosorbent assay and microscopic agglutination test. Questionnaires were used to collect information from these workers on sociodemographic characteristics, work activities, knowledge of zoonosis, and risky behaviors. ResultsOf the 172 subjects investigated, 28 (16.28%) were found seropositive for leptospirosis using enzyme-linked immunosorbent assay or microscopic agglutination test. The main Leptospira infecting serogroup were Mini, Autumnalis, Canicola, Copenhageni, L. mayottensis (ND), Icterohaemorrhagiae, Pyrogenes/Tarassovi (cross reaction), Panama, and Ballum. Risk factors according to multivariate analysis, included residence (P = 0.02), working at the bleeding station (P = 0.03), contact with feces and urine (P = 0.04), and the practice of agriculture outside the slaughterhouse (P = 0.05). ConclusionThese findings indicate that a significant proportion of slaughterhouse workers are being exposed to pathogenic Leptospira. Public-health interventions against leptospirosis will need to target this occupational group. Proper personal protective equipment and information about the disease should be disseminated among slaughterhouses.

Factors Associated With HIV-Related Stigma Among Indonesian Healthcare Workers: A Cross-Sectional Online Survey.

Despite worldwide advances in HIV care and growing scientific knowledge about HIV, stigma and prejudice continue to hinder people living with HIV/AIDS (PLWHA) from seeking treatment and care. HIV-related stigma among healthcare workers in Indonesia has been investigated and measured in only a few empirical studies. This study was developed to identify factors related to holding stigmatizing attitudes toward PLWHA among professional healthcare providers in Indonesia. A cross-sectional survey approach using convenience and snowball sampling techniques was used. Data were collected in February and March 2022. All of the participants were healthcare workers in Indonesia who had completed an online survey that collected demographic data and measured HIV-related stigma, fear of HIV transmission, and HIV-related knowledge. Bivariate analysis and multiple linear regression were used to investigate the association between the independent and dependent variables. The study enrolled 252 participants, including eight physicians (3.2%), 200 nurses (79.4%), and 44 midwives (17.5%). Over two thirds of the participants (65.1%) had no formal HIV training. Stigmatizing attitudes were associated with lower levels of HIV knowledge ( B = -0.480, p < .01), fear of becoming infected with the HIV virus ( B = 0.354, p < .05), and type of HIV care setting ( B = -2.913, p < .05). Of the three participant categories, physicians had the highest levels of both HIV knowledge and PLWHA-related stigma. The findings indicate many healthcare workers in Indonesia receive limited formal training on HIV, have low levels of HIV knowledge, and fear HIV transmission. Therefore, providing comprehensive and up-to-date education about HIV for health workers and proper personal protective equipment should be incorporated into programs aimed at reducing stigmatizing attitudes against patients with HIV among healthcare workers in Indonesia.

Management Orthopedic Patient With Covid 19, A Picture Of Patient Safety

This study will describe management policies to maintain hospital services by putting safety and analyze epidemiological data on orthopedic patient with covid-19 infection who were admitted during covid-19 pandemic. A retrospective descriptive study of orthopedic patients with covid-19 infection profile during 1st wave of covid-19 Pandemic (January - March 2021). Modification of patient and staff work flow were also made, based on risk of transmissions, this include rescheduling elective surgery and promoting telemedicine. For patient who were admitted for urgent surgery, transition room were made for screening covid-19 infection before operation, there also a negative pressure operation room for patient who need an emergency operation. There were 38 orthopedic patients admitted to transition room, 18 patient (47.36%) were confirmed covid-19 infection. There are slight fewer female patient with confirmed Covid-19, compare to the male patient 8 (44.4%) vs 10 (55.6%) patient. The Patient’s age ranged from 5 to 79 years old, with average of 46.27 years old (SD 20.63). With most patient were 56-65 years old. The patients’ diagnosis and demographics data were described in table 1. Five patients (27.8 %) with mild covid-19, nine patients (50 %) with moderate covid-19 and four patients (22.2 %) with severe covid-19. Among 18 patients with confirmed covid-19, seven patients (38.9%) had hypertension and three patients(16.7%) had diabetes . The Laboratory data shows 13 patients (72.7%) had abnormal NLR with all patients had increased D Dimer. Average length of stay were 12.78 days, Range 2 days to 21 days; SD 5,53) with eleven patients (61.1%) underwent operation procedure and 7 (38.9%) patients were on conservative treatment. There was 1 (1.8%0 death case recorded, among patients with confirmed COVID-19, this was a C3 Spinal Cord Injury patient with tetraplegia and respiratory failure. During this period there were 16 (2.5% from 636 staff) were diagnosed with covid-19, among them 60% in red area ( operation room, Emergency unit, polyclinics, isolation room and laboratory). There were no documented in hospital death among orthopedic patient with confirmed covid-19 who underwent surgery procedure. Covid-19 had disrupted many aspects in hospital services. Our Hospital had develop new policies and strategies to minimize covid-19 transmission during the 1st wave covid-19 pandemic. Preoperative screening, proper personal protective equipment’s, and strict transmissions control successfully minimize covid-19 transmission in our hospital. Orthopedics patient with Covid-19 infection, that require urgent surgery were admitted to isolation room. Prompt treatment according to WHO Guideline were given.

Dental professionals' use of personal protective equipment during COVID-19: a cross-sectional study in China.

Appropriate use of personal protective equipment (PPE) could significantly reduce the risk of viral transmission and infection. This study aimed to assess the use of PPE among dentists during the COVID-19 pandemic in China, explore its influencing factors, and provide some practical recommendations. An online cross-sectional survey was conducted among 384 Chinese dentists in September 2022. The questionnaire comprised a series of questions about demographic characteristics, compliance with proper PPE use, personal barriers to use, and exposure risk estimation. Of the 384 respondents, 57.3% had unacceptable compliance with the proper use of PPE during COVID-19. Medical surgical mask is the most common for dental professionals to wear (93.8%), followed by goggles or face shield (63.8%), and isolation gown (53.1%). Unexpectedly, only 63.3% of respondents always change masks with guidelines. The condition for changing goggles/face shields and isolation gowns is even worse (45.6 and 37.0%, respectively). Visual barriers, physical discomfort, complex procedures, and heavy workload were the most common personal barriers to use. According to the results of Chi-square test and correlation analysis, PPE use compliance was associated with age, years of practice, medical institution type, and exposure risk estimation. Chinese dental professionals need to improve their compliance with the proper use of PPE, especially those in the 31-40 age group, with 11-15 experience years and working in private dental clinics. Increasing compliance with PPE may be achieved by addressing personal barriers to use, human resource shortages, and perceptions of exposure risk.

Unsafe actions and unsafe conditions in cement production workers: A Cross Sectional Study

Occupational accidents are all unplanned events that cause or have the potential to cause injury, illness, damage or other losses, both for workers and for the company. This study aims to determine the factors associated with work accidents in Cement Production workers at PT. Cement Bosowa Maros. The type of research used is quantitative with an analytic observational approach using a cross sectional design. The population in this study are cement production workers at PT. Semen Bosowa Maros with a total sampling technique of 86 people. The results showed that the variables related to work accidents were unsafe action (p-value=0.032), unsafe condition (p-value=0.002). While the unrelated variables are age (p-value = 0.244), and length of work (p-value = 1000). It is recommended to the company PT. Semen Bosowa Maros is advised to ensure that workers use proper and correct personal protective equipment while working, and conduct OHS training so that workers understand more about safe behavior and conditions so that work accidents do not occur due to unsafe behavior and conditions. And ensure a safe and comfortable work environment for workers.

Assessing personal protective equipment compliance in a polish healthcare setting during the COVID-19 pandemic – A pilot case study

Objective: The purpose of this study is to identify failures in proper Personal Protective Equipment (PPE) usage in a healthcare hospital environment to enhance PPE compliance through proper donning and doffing procedures.Methods: We used naturalistic observation (shadowing) of PPE donning and doffing by healthcare medical staff in their hospital work setting to identify non-conformities to compliant donning and doffing of PPE.Results: We found an average of 1.84 non-conformances per healthcare worker across the donning procedures and 2.06 non-conformances in the doffing procedures per healthcare provider. Nurses experienced 1.94 average non-conformances in the donning procedures, while physicians average 1.75 non-conformances. Nurses experienced 2.29 average doffing nonconformances, while physicians averaged 1.85 average doffing non-conformances during the study. PPE compliance is critical to protect both healthcare workers and patients in the healthcare setting, as well as building a culture of safety.Research implications: Appropriate training and compliance should be performed to ensure appropriate PPE donning and doffing protocols are adhered to, so that it reduces the transmission of disease and infections. Future studies will explore the environmental, cultural and operational factors that contribute to PPE compliance in healthcare.Conclusions: This is the first study to quantify donning and doffing errors of personal protective compliance within the realm of environmental and cultural impacts.

Lessons Learned: Benzene Distillation Vapor Explosion and Fire

We present here a narrative of an incident that occurred in a chemistry laboratory while purifying benzene using a distillation apparatus. The incident resulted in an injury to a graduate student and a fire that caused approximately $3.5 million in damage including repair/refurbishment costs. Unfortunately, due to the extent of the fire, a direct cause of the incident could not be determined. The lessons learned from this incident that could have potentially prevented the incident altogether, or at least reduced damage, include performing a risk assessment of both the experiment and the situation at the time, maintaining proper housekeeping of the lab, maintaining an updated and accurate chemical inventory, checking in on long duration experiments, always calling for back-up, ensuring the lab and buildings are up to code, wearing proper personal protective equipment, and always calling 911 in an emergency.

Normalized Deviance from Approved Personal Protective Equipment (PPE) Donning and Doffing Protocol—Towards a Hazard Reduction Index

Introduction:Reusing PPE is not recommended but was common during COVID-19 pandemic. Limited guidance on proper PPE use and its reuse heightened the hazards to health care worker (HCW) safety. Emerging data on PPE use suggests that most HCWs were contaminated by donning and doffing of PPE while adhering to standards of care.Method:A prospective observational study was conducted to understand HCW behaviors in donning, doffing, and reusing PPE. Emergency Department physicians and nurses were video-recorded donning, doffing, and reusing PPE within a simulated acute care environment. Participants performed five donning and doffing PPE procedures. PPE kit included gown, face shields, and N95 respirator masks. Participants had access to disposable gloves and hand sanitizer. Recordings were reviewed and coded independently by two trained coders based on checklist of key behaviors. Agreement between coders was high (81.9%). All participants reported completing PPE training.Results:28 videos of participants capturing 278 procedures were reviewed. None of the participants followed the CDC’s order for donning across five scenarios. Majority of participants failed to perform hand hygiene before donning or re-donning PPE or when doffing PPE. For contaminant spread risk, 92.85% (n=26) touched patient-facing side of PPE during re-donning and/or doffing PPE (M= 3.75, SD= 2.37, Median = 4; 0-9 times). The most common area of self-contamination was hands (n= 111 across all participants in 5 donning/doffing sequences). Touching patient-facing side of PPE was more likely to occur during donning than doffing (70.5% vs. 20.1% of sequences).Conclusion:The study found wide variation in PPE donning/doffing practices among HCW in violation of CDC guidance. This first study to review PPE reuse through a human factors lens, identifyied deviant behaviors that contribute to HCW self-contamination. Efforts are needed to redesign PPE and develop effective ways to train staff using PPE equipment safely.