The noise hazard in a large health care facility
Article Abstract:
Occupational noise-induced hearing loss (NIHL) is an irreversible injury, and is among the 10 leading causes of occupational disease in the US and Canada. NIHL is usually associated with work in airports and factories. Although usually considered hearing-safe occupations, jobs in hospitals and health care facilities can exposure workers to high noise levels and increase the risk for NIHL. Exposure to high noise levels can occur in hospitals in the machinery spaces, laundries, food service areas, and office and data processing areas. Earlier Canadian studies indicated the presence of unsafe noise levels in some areas of Canadian hospitals. US and Canadian occupational safety regulations require hearing conservation programs, protective devices, or process controls and engineering modifications as decibel levels (dBA) increase. This study was conducted in a 1,110-bed, tertiary care facility in Manitoba to determine to what extent noise was a risk for exposed persons who should be included in a hearing conservation program. The prevalence of NIHL among the employees and the extent to which previous exposure may have contributed to NIHL were also assessed. Baseline noise levels were obtained throughout the hospital and known high-risk areas; those producing instantaneous measurements of 80 dBA or greater were identified for more intense study. Calibrated personal noise dosimeters were placed on employees exposed to the highest risk. Audiometric measurements and testing were administered to these staff members. Readings of up to 110 dBA were made in the central energy plant. Dietetics, housekeeping, central processing, materials handling, print shops, and rehabilitation engineering yielded readings of 90 dBA. Powered instruments and motors, pots, pans, and trays, cleaning machines, and printing devices generated the most noise. NIHL was found in 321 noise-exposed employees. These findings demonstrate that employees of health care facilities are at risk for NIHL and should be provided with intervention programs and protection from high noise levels as required. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Occupational Medicine
Subject: Health care industry
ISSN: 0096-1736
Year: 1991
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Vaccine choice and program participation rates when two hepatitis B vaccines are offered
Article Abstract:
Hepatitis B virus (HBV) is the cause of up to 300,000 acute infections annually, a large number of which occur in health care workers. These acute cases add approximately 15,000 new cases to an estimated 400,000 to 1,000,000 chronic cases in America today. Chronicity increases the future risk of cirrhosis (degeneration of the liver) and hepatoma (cancer of the liver). The plasma-derived vaccine against HBV that has been developed has not been well accepted by health care workers. Fear of the human immunodeficiency virus (HIV), associated AIDS, has probably been a factor in the lack of use of this blood-based vaccine. Rush-Presbyterian-St Luke's Medical Center (RPSLMC) initiated a free immunization program for high-risk employees, and made it available at cost for others. The initial response (from 1983 to 1987) was the enrollment of 47 percent of the nursing staff, 36 percent of the physicians, and 17 percent of the laboratory staff. The later development of a recombinant vaccine (Recombivax) gave employees a choice of vaccines. During a 10-month period, 173 employees enrolled in a study to ascertain their vaccine choice, if any, and the reasons for their selection. All employees expressed a preference; 69 percent selected the recombinant vaccine and 31 percent chose the plasma-based vaccine. The expected greater safety of the recombinant vaccine did not appear to increase the total number of health care workers who were vaccinated. It appears that full staff immunization may not be achieved unless mandated. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Occupational Medicine
Subject: Health care industry
ISSN: 0096-1736
Year: 1991
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Disease clusters: a central and ongoing role in occupational health
Article Abstract:
The workplace provides a special source of information that aids in the identification and evaluation of disease clusters. These are: natural denominator boundaries (the population at risk is defined), shared exposures, the ability to form intermediate hypotheses, and the possibility of locating comparable study populations. A total of 87 original disease clusters were identified in a literature review from the year 1775 to 1990, which established occupational-related disease toxin connections. Cluster disease data appeared early in the history of occupational health; arsenic and lead intoxication data were among the earliest. Today, the employee, along with the physician, is a responsible source of information and is frequently the initiator of cluster investigations. The literature and methodology of cluster data collection are reviewed. An extensive appended bibliography is also included. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Occupational Medicine
Subject: Health care industry
ISSN: 0096-1736
Year: 1991
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