Protective Precautions Research Articles

Mothers' Knowledge Levels Related to Poisoning

SUMMARYObjectivesThis study was done to evaluate mothers’ level of knowledge regarding poisoning, to plan training for issues with an identified lack of knowledge, to collect required data regarding protection and approach issues on poisoning cases which may occur in children for various reasons.MethodsThis descriptive study was performed after obtaining permission from the County Health Department and involved mothers who applied to Family Health Centers No. 1-7 between April 1st and May 31st 2012, and who agreed to participate in the study (n=290). The questionnaire was composed of three parts: “Personal Information Form,” “House Poisoning Evaluation Form” and “Home Poisoning Prevention Knowledge Level Form.”ResultsParticipant ages were between 16 and 50 years and the mean age was 33.09±7.10 years. The number of children ranged from 1 to 6, and 203 people had seven children under the age of six. 37.6% of the mothers were primary school graduates, while 74.5% were housewives. There was a significant relationship between the knowledge score of the mothers on poisoning and education, career, neighborhood, and social security (p<0.05).ConclusionsChildhood poisoning is the most common cause of admission to the hospital. Protective precautions such as family education, storage of medication out of reach of children and use of secure lids are thought to be important.

Sex-Related Marijuana Expectancies of Social Desirability Among Detained Male and Female Adolescent Offenders in the USA

Background: Research supports that adolescents involved with the criminal justice system engage in significantly more sexual risk behaviors than those never adjudicated, including use of drugs prior to/during sexual intercourse. Previous research has focused on incarcerated adolescents, with limited if any attention on the tenable relationship between social desirability with respect to marijuana use on STI risk practices. The purpose of this investigation is to conduct an exploratory study designed to identify differences, if any, in terms of marijuana use and social desirability as it pertains to risk for STIs among a sample of adolescent offenders in Georgia as a function of gender. Methods: Participants were 2260 juvenile offenders housed at selected Youth Development Campuses (YDCs) in the state of Georgia. Frequencies and descriptive statistics were performed prior to hypothesis testing to describe male and female adolescent offenders and ANOVA was selected for a detailed examination of variation in items possible range of scoring self-reported marijuana social by respondents’ gender. Results: Significant differences between male and female adolescent offenders regarding the belief that using marijuana made them feel closer to a sexual partner (F=61.81, P=0.001), being more sexually responsive (F=82.50, P=0.001), less nervous about sex (F=50.98, P=0.001) and to have sex with people they normally would not have sex with (F=156.20, P=0.001) were observed. In all cases, male respondents being more likely than females to agree with the aforementioned statements. Females in our sample were also more than males to disagree with using marijuana made sex more enjoyable with (F=93.67, P=0.001), made them a better lover with (F=108/19, P=0.001) or make them less likely to take protective precautions when having sex with (F=74.75, P=0.001). Conclusion: The present findings further suggest that associations of marijuana use and sexual risk behavior can be moderated by individual difference variables, including marijuana expectancies.

Incidence of Cisplatin Ototoxicity in Head and Neck Cancer Patients

Objectives: Elucidate the incidence of cisplatin-induced ototoxicity in patients treated for head and neck cancer. Methods: This was an institutional review board approved retrospective study of patients treated with cisplatin for cancer at a tertiary referral hospital. The charts of patients of any age that had undergone cisplatin therapy from 1995 to the present were reviewed. We then narrowed this group down to those who had a diagnosis of cancer of the head and neck (hypopharyngeal, laryngeal, nasopharyngeal, oropharyngeal, scalp/face skin cancer, temporal, thyroid) and had pre- and posttreatment audiologic testing. Results: There were 1565 patients that had undergone therapy with cisplatin from 1995 to 2014. Of those, 203 patients had pre- and posttreament audiologic testing. Twenty patients had diagnosis of cancer involving the head and neck. The cochlear radiation doses were also collected from these patients. Preliminary results demonstrate that patients with head and neck cancer that were treated with cisplatin and had a sizable cochlear radiation dose had significantly more permanent hearing loss following treatment. Conclusions: The incidence of cisplatin induced ototoxicity was significantly more prevalent in head and neck cancer patients. These patients should be thoroughly screened and protective precautions should be taken to limit ototoxicity in this population.

Evaluation of practice of cross infection control for dental impressions among laboratory technicians and prosthodontists in KSA

The purpose of the present study was to assess the current practice of cross infection control of dental impressions in governmental and private dental labs and prosthodontic clinics of MoH, Al-Qassim, KSA, evaluating how dentists are communicating with lab personnel about impression disinfection and detecting awareness about infection control practices in dental laboratories. This study was a cross-sectional study using self-administered anonymous questionnaires. The sample included 50 dental technicians and 55 dentists in two cities. Technicians and prosthodontists were subjected to questionnaires consisting of 25 and 13 questions, respectively. Forty six questionnaires were completed for technicians and 48 for prosthodontists. More than 60.00% of technicians knew that impressions have been disinfected and 56.25% of dentists notified technicians that impressions have already been disinfected. About 64.00% of technicians had an agreed protocol between lab and clinic, and 40.74% of prosthodontists notified technicians through notes on impression bags. About 61.00% reported that all technicians in lab were vaccinated for HBV. Only 6.40% of technicians apply all protective precautions when receiving impressions. Fifty percent of the prosthodontists aren’t sure that technicians disinfect impressions before pouring. About 65.00% of technicians feel that laboratories are adequately instructed for disinfection techniques of different impression materials and on contrary, 66.67% of prosthodontists didn’t feel that. Lack of communication between prosthodontists and their dental technicians was noticeable. Significant nonconformity of view between dental technicians and prosthodontics was reported.

Assessing the survival ofMycobacterium tuberculosisin unembalmed and embalmed human remains

Anatomy and mortuary technical staff faces an ever existing risk of contracting an infectious disease, such as Mycobacterium tuberculosis (MTB), when exposed to human remains. The transfer and handling of a corpse expels air from the lungs of the diseased and this aerosolizes the bacilli. It is for this reason that personal protective equipment and work space precautions such as ultraviolet germicidal irradiation is a necessity. In this study, the authors explore the viability of MTB before and after embalming. Briefly, lung tissue samples, both apical and hilar, were obtained from 20 cadavers whose death certificate indicated MTB as cause of death. The first sample was taken before embalming and second set 3 weeks after embalming. Tissue was deposited into sterile specimen containers and transported for analysis which included Mycobacterium growth indicator tube cultures and polymerase chain reaction. Results demonstrated that both the apical and the perihilar sample tested positive prior to embalming, 36 days after death. After three weeks post-embalming none tested positive. The results demonstrated that MTB can remain viable after death for up to 36 days. This viability extends beyond the documented cases and highlights the need for precautionary measures and standard operating procedures in accordance with occupational health and safety guidelines.

Effects of noise pollution over the blood serum immunoglobulins and auditory system on the VFM airport workers, Van, Turkey

Noise pollution is a common health problem for developing countries. Especially highways and airports lead to noise pollution in different levels and in many frequencies. In this study, we focused on the effect of noise pollution in airports. This work aimed measurements of noise pollution levels in Van Ferit Melen (VFM) airport and effect of noise pollution over the immunoglobulin A, G, and M changes among VFM airport workers in Turkey. It was seen that apron and terminal workers were exposed to high noise (>80 dB(A)) without any protective precautions. Noise-induced temporary threshold shifts and noise-induced permanent threshold shifts were detected between the apron workers (p < 0.001) and terminal workers (p < 0.005). IgA values of apron terminal and control group workers were approximately the same in the morning and increased in a linear manner during the day. This increase was statistically significant (p < 0.001). IgG and IgM values of apron, terminal, and control group workers were approximately same in the morning. Apron and terminal workers IgG and IgM levels were increased until noon and then decreased until evening as compare to control group, but these changes were not statically significant (p > 0.05). These findings suggested that the noise pollution in the VFM airport could lead to hearing loss and changes in blood serum immunoglobulin levels of airport workers. Blood serum immunoglobulin changes might be due to vibrational effects of noise pollution. Airport workers should apply protective precautions against effect of noise pollution in the VFM airport.

Oculo-visual status of the welders in the Capricorn District of the Limpopo Province of South Africa*

The process of welding can lead to several ocular disorders when adequate protective precautions are not taken. There is a possibility that welders in the Limpopo Province of South Africa are not taking adequate precautions due to lack of knowledge on the adverse effects of welding. Good vision is also important for effective and injury-free welding. This study therefore screened welders in the Capricorn district of the Limpopo Province for oculo-visual disorders. Case history established visual symptoms among the welders and ophthalmic tests such as visual acuity (VA) measurement, pinhole, ophthalmoscopy, external assessment of the adnexa and Amsler grid were used to determine their oculo-visual status. One hundred and fifty welders were included in the study and their ages ranged from 18 to 65 years with a mean of 39 ± 14.9 years. Reduced distance vision was reported by 32% of the welders, 14% reported reduced vision at near; 43% reported double vision and 11% reported colour vision anomaly. Forty seven percent of the welders had VA less than 6/6 at distanceand 8% could only read 1M or larger print at near Following the pinhole test, there was no improvement in 7% of the welders who had VA less than 6/6, indicating a possibility of pathological conditions. Amsler grid showed that 6% of the welders had possible macular disorders. Ophthalmoscopy and external observations revealed that 7% of the welders had cup disc ratio (H/V) of more than 0.6/0.5, Fourteen percentage (14%) had pterygia and 5% had pinguecula. The study established that although many of the welders had normal oculo visual status, there were a few with ocular disorders which warrant further assessment and managemenby eye care professionals.

Teenagers and music induced hearing loss

A 2002 survey of knowledge about music-induced hearing loss (via www.mtv.com) revealed that, although nearly half of the respondents admitted symptoms such as tinnitus or hearing loss after loud music exposure, only a minority were aware of the risk to their hearing. A follow-up study was performed by the same group in 2007, and, although most respondents indicated that they would adopt protective precautions if made aware of the risk, most were still unaware of the risks of hearing loss following loud music exposure.

The Indoor Air Quality of Bank Offices in Skyscrapers and Sick Building Syndrome in Istanbul-Turkey

P-303 Introduction: Indoor air quality has recently attracted attention in developed countries as an important public health problem. This study aims to research indoor air quality and the frequency of sick building syndrome in the bank offices found in the ever-increasing number of skyscrapers in Istanbul, one of the world's largest metropolitan cities, by using objective ambient measurements and a questionnaire. Methods: For the purpose of this study, twenty-five bank offices in five skyscrapers with central air-conditioning and windows that could not be opened were chosen as the study group. Twenty-five bank offices with local air-conditioning and windows that could be opened were chosen as the control group. The buildings were on the main streets of the city, which, although is not industrial, has heavy traffic. The pollutants measured were: carbon monoxide, carbon dioxide, ozone, formaldehyde, total bacteria and mould fungus. In addition, measurements of the environmental temperature and humidity were also taken. A questionnaire was also applied in order to determine the health complaints of the employees and the characteristics of the work environment. Results: The results of the 809 questionnaires evaluated showed that many of the symptoms of sick building syndrome, occurred more in the offices of the study group than in the control group. The frequency of occurrence of sick building syndrome in men and women was different. There was a statistical difference between the average humidity levels of the study and control offices. The levels of the chemical pollutants measured were below the international reference values. The tests of all the mould fungi showed that high densities of penicillium and aspergillus spores were found in the study offices, while high densities of cladasporium and alternia spores occurred in the control offices. The total bacteria levels of the control offices were higher than those of the study offices. Conclusion: While the results reflect heterogeneity, they do emphasize a positive relation between the structure of the building and the sick building syndrome. In order to understand the reasons behind the health complaints of those working in skyscrapers and to develop protective precautions, it is necessary to conduct continuous detailed evaluations of suspicious indoor environmental risk factors such as humidity and mould fungi.

O-55: Fertility and infertility: What do students at an Ivy League college really know?

To assess the knowledge of college students regarding fertility and reproductive health. In particular, we sought to determine how students view the relationship between age and infertility, and whether they have concerns about their own reproductive potential. Cross sectional survey of undergraduate students. IRB approval was obtained. 390 students then completed the survey anonymously. In addition to demographic information participants were asked the following questions: 1) Do you believe that infertility is a prevalent health care problem, 2) What percentage of couples are affected by infertility, 3) Until what age do men and women remain fertile, 4) At what time is a woman most fertile during her menstrual cycle, 5) For how long can sperm remain viable in the female reproductive tract, 6) Once ovulation occurs, how long is an oocyte capable of being fertilized, 7) Do you have concerns about your own reproductive potential, and 8) Do you think there are any daily precautions that can protect your future fertility? 58.9% of participants felt that infertility was a prevalent healthcare issue, and 74.9% felt that infertility treatments should be covered by insurance. Only 53.4% of study participants estimated the prevalence of infertility to be less then 20%. When asked until what age women are fertile, the mean response was 46.1 years while for men it was 64.2 years. When asked when a woman is most fertile during her menstrual cycle, only 27.5% (382) of respondents were able to correctly identify the proper time period. When asked to estimate how long sperm can stay alive in the reproductive tract, the median response was 24 hours, and only 20.4% of all respondents correctly identified the time interval between 3-5 days. Similarly, when asked how long an oocyte is fertilizable after ovulation the median response was 72 hours, and only 19.7% of respondents correctly identified the time interval between 12 and 24 hours. Although the majority of respondents (78.8%) were not worried about their own fertility, 55.3% believed that there are daily precautions one can take to protect one’s fertility, most often citing diet, exercise and staying drug free as protective precautions. Most study participants at this college believe that infertility is a prominent healthcare issue, advocate for its coverage under insurance and appreciate that there is a relationship between age and reproductive potential. However, the majority of these undergraduates have surprisingly limited knowledge about basic reproductive physiology.

Transmission of hepatitis C by blood splash into conjunctiva in a nurse

The risk of transmission of hepatitis C virus (HCV) infection is an important problem for the health care worker. HCV transmission by blood splashing into eyes is very rare. In a hemodialyses department, a 23-year-old female nurse splashed blood from a patient who was anti-HCV positive into her eyes. She washed her eyes with water immediately and reported to the infection control department. She had never used intravenous drugs nor received transfusions. At the time of exposure, there was no abnormality in her laboratory tests. Her anti-HCV and HCV-RNA tests produced negative results. She was followed up for anti-HCV and alanine aminotransferase activity. After 6 months, she presented with sore throat, nausea, vomiting, fatigue, and weight loss. She had icterus and hepatomegalia. In laboratory tests, alanine aminotransferase level was 504 U/L, aspartate aminotransferase level was 388 U/L, and anti-HCV and HCV-RNA tests produced positive findings. She was treated with interferon alfa-2a for a 1-year period. After treatment, an HCV-RNA test produced negative results and transaminase levels were normal. In conclusion, splashing blood from patients who are HCV positive into the face or eyes is a risk for health care workers. They should be educated to prevent a nosocomial acquisition of bloodborne infection and they should observe protective precautions.

The Due Process Right to a Safe and Humane Environment for Patients in State Custody: The Voluntary/Involuntary Distinction

In December 1995, the Eighth Circuit decided Kennedy v. Schafer, holding that a teenage patient who committed suicide while under treatment at a state psychiatric facility had a constitutionally protected liberty interest in a safe and humane environment under the Due Process Clause of the Fourteenth Amendment if her status changed from voluntary to involuntary during the course of her admission. The fifteen year old patient, Kathleen Kennedy, had been identified as a suicide risk, and had been placed on “Protective Suicide Precautions,” which required a designated staff member to keep her in constant eyesight and to interact with her at fifteen to twenty minute intervals. Despite these stringent requirements for supervision and contact, Kathleen was found dead in her room more than two hours after her last contact with a staff member. Her parents brought suit under 42 U.S.C. § 1983 against state and hospital officials, alleging that chronic understaffing and falsification of the records used to determine staffing levels amounted to a pattern of deliberate indifference to patient safety which violated their daughter’s protected liberty interest in a safe and humane environment.

Combustion Products from Advanced Composite Materials

ABSTRACTRecent advances in armament and materials applications are beginning to outpace the development of adequate safety characterizations. To avoid unnecessary and restrictive regulations implemented to protect individuals from potential toxic consequences resulting from exposure to combustion products of advanced composite materials (ACM); this laboratory has begun an investigation of combustion characteristics. In this preliminary investigation we have assessed the production of particulate matter and the production of organic compounds contained in both the combustion vapor phase or associated with the particulate matter. The results of these investigations have revealed that a substantial fraction of the particulates appear to be in the respirable range and that a high number of organic compounds and potential toxicants are associated with particulate matter. These findings are the first to describe the production of potentially toxic atmospheres from the combustion of advanced composite materials and indicate the usefulness of further investigations to quantify the risk of exposure to humans. These and forthcoming data will be useful in determining proper protective equipment and precautions required to protect human health during exposures to products from the combustion of advanced composite materials.

Prevention of Occupational Cyanide Exposure in Autopsy Prosectors

Autopsy prosectors examining individuals with cyanide poisoning are at risk for occupational cyanide exposure. No protective autopsy precautions to mitigate this risk have been published. We report an autopsy on an individual with cyanide poisoning where the procedure was performed in a negatively pressured isolation room and the stomach was opened under a biosafety cabinet hood. None of the three autopsy prosectors had measurable cyanide in pre or post procedure blood specimens. We recommend that similar precautions be taken in all autopsies where cyanide is suspected as a possible cause of death.

Attitudes, knowledge, and practices of otolaryngologists treating patients infected with HIV

The AIDS epidemic has become one of the most important public health problems of this century. As the prevalence of HIV infection continues to rise, health care practitioners in all geographic regions can expect greater clinical exposure to patients infected with HIV. We conducted an anonymous survey of all practicing otolaryngologists in Ohio and California to investigate regional differences in attitudes, knowledge, and practices regarding the care of patients infected with HIV. We also examined the data with respect to year of completion of residency training to identify differences in attitudes or practices among otolaryngologists who trained in the era of AIDS (post-1982 graduates) in comparison with their predecessors (pre-1982 graduates). In comparison with Ohio otolaryngologists, California otolaryngologists reported more frequent clinical encounters with HIV-infected patients and displayed significantly better knowledge regarding the otolaryngologic aspects of HIV infection. Californians were more likely to support the right of an HIV-infected physician to maintain an unrestricted practice and would be less likely to disclose their HIV status to their patients and hospital if they were to become infected with HIV. Post-1982 graduates had more frequent encounters with HIV-infected patients than did pre-1982 graduates and demonstrated a better fund of knowledge. Although Californians were more likely than Ohioans to routinely double glove in surgery, the overall double gloving rate was low at 21%. Californians were no more likely than Ohioans to routinely use protective eyewear, water-impervious gowns, or indirect instrument-passing techniques in surgery. No differences were observed in prevalence of protective surgical precautions between pre-1982 and post-1982 graduates. The results of the survey indicate a need for broader acceptance and use of "universal" surgical precautions among otolaryngologists. (OTOLARYNGOL HEAD NECK SURG 1995;113:733-9.)

Contact with body fluids when performing gynaecological and obstetric procedures

SummarySummaryWe prospectively recorded the frequency with which personnel performing or assisting at gynaecological and obstetric procedures came in contact with patient body fluids, to provide a basis for recommending protective precautions. In 387 of 450 instances (86 per cent; 95 per cent confidence interval 82–89 per cent) contact between patient body fluid and protected or unprotected parts of the health care worker occurred. Contact with the hand occurred in 385 instances (86 per cent). Contact with arm. body, mouth and eye occurred in 12, 4, 0·7 and 0·7 per cent respectively. Protective devices failed to prevent direct contact in 9 cases; penetrating accidents with sharp objects occurred in two cases (0·4 per cent; 95 per cent confidence interval 0·05–2 per cent). For each procedure the rate and nature of contact with body fluid is listed, and the implications concerning prevention of infection with blood borne pathogens, especially HIV, are discussed.

Prevention of oral bacterial flora transmission by using mouth-to-mask ventilation during CPR

The Emergency Cardiac Care Committee of the American Heart Association has recently recommended utilizing protective barrier precautions during CPR (1,2). We assessed 17 mask and faceshield resuscitation devices for adequacy of barrier protection. Eight of the devices were faceshields (CPR Microshield®, Hygenic®, MedCare Masks®, Resusci®, Samaritans®, Sealeasy®, Portex®); 8 were mask devices (Laerdal®, Dyna Med®, MTM Emergency Lung Ventilators, MTM Emergency Resuscitator®, Res-Q-Flog®, Rightway Mouth-to-Mask Resuscitation®, Truflt®), and one of the devices did not meet the criteria for either faceshield or mask (Lifesaver®). All masks were disinfected, applied to the investigator's face as directed by the manufacturers' instructions, and then cultured for oral aerobic bacterial flora on the rescuer side. No mask devices cultured positive for oral aerobic bacterial flora, while 6 of 8 faceshield devices cultured positive for oral aerobic bacterial flora ( P < 0.007). The CPR Microshield® and the Portex® faceshield were the only devices that did not develop a positive culture. We conclude that all ventilation devices with a one-way valve, except the Sealeasy® device, provide adequate barrier type protection from oral aerobic bacterial flora when simulating mouth-to-barrier type protection when performing mouth-to-mouth ventilation.

Procedure-related rate of contact of intensive care unit personnel with patient body fluids

We prospectively recorded the frequency with which ICU personnel came in contact with body fluids in order to provide an empirical basis for the recommendation of relevant protective precautions. ICU personnel completed a questionnaire when performing a range of 29 standardized procedures. The rate of contact with body fluid was: manual ventilation (55%); catheterization of peripheral vein (36%); insertion of central venous catheter (69%); arterial puncture (18%); tracheal intubation (76%); tracheal extubation (87%); suction from mouth, pharynx or trachea (82%); drawing of blood sample (52%); establishing or discontinuing blood transfusion (50%); establishing or discontinuing infusion (20%); changing of wound dressing (52%). We suggest that the contact rates observed should be used in combination with a universal precautions policy, in order to identify procedures that are likely to involve contact with body fluid. By using gloves 95% of contacts to body fluid would have been prevented.

Serum screening for oncogene proteins in workers exposed to PCBs.

A cohort of 16 municipal workers engaged in cleaning oil from old transformers was examined for possible health effects from exposure to polychlorinated biphenyls (PCBs). In addition to the evaluation of routine clinical parameters (history, physical examination, liver function tests, serum triglycerides, serum PCB values), a new screening technique for the presence of oncogene proteins in serum using monoclonal antibodies was used to ascertain the potential carcinogenic risk from exposure in these workers. Except for one individual, serum PCB concentrations were found to be relatively low in this cohort, probably due to the observance of appropriate protective precautions. The results of liver function test were within normal limits and serum triglyceride concentrations showed no consistent relation to PCB concentrations. Six individuals, all of whom were smokers, showed abnormal banding patterns for fes oncogene related proteins. The individual with the highest serum PCB concentration also exhibited significantly raised levels of the H-ras oncogene related P21 protein in his serum. These oncogene protein findings may be indicative of an increased risk for the development of malignant disease in these individuals.

Blackening of unprotected dental X-ray films due to scattered radiation.

Unexposed films awaiting exposure as well as exposed films awaiting processing are subjected to scattered radiation if kept unprotected in the dental X-ray clinic. The purpose of the present study was to analyze the influence of various storing principles, film speed, and distance from X-ray source upon the degree of film blackening. Test films were subjected to scattered radiation from 150 exposures. Maximum additional blackening (0.27 D) was recorded for type E films not protected by lead foil at the shortest distance studied (55 cm). At a distance of 200 cm blackening was reduced to 0.02 D and could be further reduced by utilizing the inherent protective effect of the lead foil. It is concluded that if dental X-ray films not in use are kept at a distance of 200 cm from the X-ray source and protected by lead foil additional blackening due to scattered radiation is negligible and further protective precautions are unnecessary.