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Protective clothing manufacturers routinely test their products for resistance to liquid and viral penetration. Several of the test methods specified by the American Society for Testing and Materials (ASTM) and the International Organization for Standardization (ISO) for penetration testing produce binary results (i.e. pass or fail), deliver imprecise pressure regulation, and do not record the location at which penetration events occur. Instead, our approach measures a continuous variable (time of penetration) during a slow and continuous increase of hydrostatic pressure and retains the location of penetration events. Using a fluorescent dye to enhance visual detection, we evaluate temporal and spatial patterns of penetration events. We then compare the time of liquid penetration with the time of penetration of two bacteriophages (Phi-X174 and MS2). For the fabric tested, the mean viral penetration occurred 0.29 minutes earlier than liquid penetration when solved by logistic regression. The breakthrough time of MS2 was not different from the Phi-X174 bacteriophage. The time of liquid penetration was a latent indicator of the time of viral penetration.

Healthcare personnel are at high risk for exposure to influenza by direct and indirect contact, droplets and aerosols, and by aerosol generating procedures. Information on air and surface influenza contamination is needed to assist in developing guidance for proper prevention and control strategies. To understand the vulnerabilities of healthcare personnel, we measured influenza in the breathing zone of healthcare personnel, in air and on surfaces within a healthcare setting, and on filtering facepiece respirators worn by healthcare personnel when conducting patient care. Thirty participants were recruited from an adult emergency department during the 2015 influenza season. Participants wore personal bioaerosol samplers for six hours of their work shift, submitted used filtering facepiece respirators and medical masks and completed questionnaires to assess frequency and types of interactions with potentially infected patients. Room air samples were collected using bioaerosol samplers, and surface swabs were collected from high-contact surfaces within the adult emergency department. Personal and room bioaerosol samples, surface swabs, and filtering facepiece respirators were analyzed for influenza A by polymerase chain reaction. Influenza was identified in 42% (53/125) of personal bioaerosol samples, 43% (28/ 96) of room bioaerosol samples, 76% (23/30) of pooled surface samples, and 25% (3/12) of the filtering facepiece respirators analyzed. Influenza copy numbers were greater in personal bioaerosol samples (17 to 631 copies) compared to room bioaerosol samples (16 to 323 copies). Regression analysis suggested that the amount of influenza in personal samples was approximately 2.3 times the amount in room samples (Wald χ2 = 16.21, p<0.001). Healthcare personnel may encounter increased concentrations of influenza virus when in close proximity to patients. Occupations that require contact with patients are at an increased risk for influenza exposure, which may occur throughout the influenza season. Filtering facepiece respirators may become contaminated with influenza when used during patient care.

BackgroundEmerging evidence, predominately from European and Asian countries, describes opposing effects of occupational physical activity (OPA) and leisure-time physical activity (LTPA) on cardiovascular health. This analysis examined cardiovascular disease (CVD) prevalence associated with OPA and LTPA.MethodsThis cross-sectional analysis of 2015 National Health Interview Survey data (n=16 974) employed logistic regression to estimate odds (OR) of self-reported CVD (coronary heart disease, heart attack, stroke or angina) with self-reported total occupational activity (TOA), occupational exertion (OE), occupational standing and walking (OSW) and LTPA. OPA was measured using two questions: ‘How often does your job involve…’ (1) ‘repeated lifting, pushing, pulling or bending?’ (OE) and (2) ‘standing or walking around?’ (OSW) with responses on a 5-item Likert scale (0=never, 4=always). TOA was categorised similarly after summing OE and OSW scores. LTPA was defined as 0, 1–149 or ≥150 min/week of moderate-to-vigorous activity. All models adjusted for common socioeconomic variables and additional analyses were stratified by sex, smoking status and LTPA.ResultsOdds for CVD were higher when ‘always’ performing TOA (OR 1.99 95% CI 1.12 to 3.53), OE (OR 2.15, 95% CI 1.45 to 3.19) or OSW (OR 1.84, 95% CI 1.07 to 3.17) compared with ‘never’. When restricting to never-smokers, odds for CVD were higher when ‘always’ performing TOA (OR 3.00, 95% CI 1.38 to 6.51) and OE (OR 3.00, 95% CI 1.80 to 5.02) versus ‘never’.ConclusionAssociations of high OPA with CVD were equally apparent across sexes, stronger in lower LTPA levels and stronger in never-smokers. While uncontrolled confounding is still possible, even after extensive adjustment, the seemingly paradoxical adverse associations with OPA and CVD should be investigated further.

This study revealed significantly less favorable perceptions of the existing organizational safety climate among workers in the underground coal-mining sector compared with those in the industrial-minerals and sand, stone and gravel (SSG) sectors. Consequently, it is important to consider pragmatic ways in which health and safety management systems (HSMS) in coal mines can alter processes to improve these perceptions. Given the interdependencies of safety climate factors and HSMS elements, researchers explored mineworker perceptions of the supportiveness of organizational safety climate factors among mineworkers and identified significant differences in perceptions across sectors. In this paper, we suggest that health and safety professionals in underground coal mining and organizations with fewer resources or less mature HSMSs focus on these factors to bolster support for proactive safety performance. Potential barriers to implementing or improving relevant HSMS elements and ideas to help foster more favorable perceptions of organizational safety climate are also discussed.

U.S. health care personnel (HCP) have reported that some respiratory protective devices (RPD) commonly used in health care have suboptimal tolerability. Between 2012 and 2016, the U.S. National Institute for Occupational Safety and Health, and the Veterans Health Administration collaborated with two respirator manufacturers, Company A and B, to bring new RPD with improved tolerability to the U.S. health care marketplace. The purpose of this study was to compare the tolerability of four new prototype RPD to two models commonly used in U.S. health care delivery. A randomized, simulated workplace study was conducted to compare self-reported tolerability of four new prototype RPD (A1, A2, B1, and B2) worn by HCP and two N95 control respirators commonly used in U.S. health care delivery, the 1870 and 1860, manufactured by 3M Corporation. A new survey tool, the Respirator Comfort, Wearing Experience, and Function Instrument (R-COMFI), developed previously in part for the current study, was used as the primary outcome metric. With a maximum total score of 47, lower R-COMFI scores reflected better self-reported tolerability. Poisson regression analyses were used to estimate prototype relative risks compared to controls. Conducted between 2014 and 2015 in two inpatient care rooms at the North Florida/South Georgia Veterans Health System, among 383 participants who enrolled, 335 (87.5%) completed the study. Mean total R-COMFI scores for the 3M 1870, 3M 1860, and prototypes A1, A2, B1, and B2 were 8.26, 9.36, 5.79, 7.70, 6.09, and 5.71, respectively. Compared to the 3M 1870, total R-COMFI unadjusted relative risks (RR) and 95 percent confidence intervals (CI) were A1 (RR 0.70, CI 0.60, 0.82), A2 (RR 0.93, CI 0.82, 1.06), B1 (RR 0.74, CI 0.64, 0.85), and B2 (RR 0.69, CI 0.60, 0.80). Compared to the 3M 1860, prototype total R-COMFI unadjusted RR and 95 percent CI were A1 (RR 0.62, CI 0.53, 0.72), A2 (RR 0.82, CI 0.73, 0.93), B1 (RR 0.65, CI 0.57, 0.74), and B2 (RR 0.61, CI 0.53, 0.70). Similarly, models adjusted for demographic characteristics showed that prototypes A1, B1, and B2 significantly improved tolerability scores compared to both controls, while prototype A2 was significantly improved compared to the 3M 1860. Compared to the 3M 1870 and 3M 1860, two RPDs commonly used in U.S. health care delivery, tolerability improved for three of four newly developed prototypes in this simulated workplace study. The R-COMFI tool, used in this study to assess tolerability, should be useful for future comparative studies of RPD.

This study compared exercise performance and comfort while wearing an N95 filtering facepiece respirator (N95), cloth mask, or no intervention control for source control during a maximal graded treadmill exercise test (GXT). Twelve Division 1 athletes (50% female, age = 20.1 ± 1.2, BMI = 23.5 ± 1.6) completed GXTs under three randomized conditions (N95, cloth mask, control). GXT duration, heart rate (HR), respiration rate (RR), transcutaneous oxygen saturation (SpO2), transcutaneous carbon dioxide (TcPCO2), rating of perceived exertion (RPE), and perceived comfort were measured. Participants ran significantly longer in control (26.06 min) versus N95 (24.20 min, p = 0.03) or cloth masks (24.06 min, p = 0.04). No differences occurred in the slope of HR or SpO2 across conditions (p > 0.05). TcPCO2 decreased faster in control (B = −0.89) versus N95 (B = 0.14, p = 0.02) or cloth masks (B = −0.26, p = 0.03). RR increased faster in control (B = 8.32) versus cloth masks (B = 6.20, p = 0.04). RPE increased faster in the N95 (B = 1.91) and cloth masks (B = 1.79) versus control (B = 1.59, p < 0.001 and p = 0.05, respectively). Facial irritation/itching/pinching was higher in the N95 versus cloth masks, but sweat/moisture buildup was lower (p < 0.05 for all). Wearing cloth masks or N95s for source control may impact exercise performance, especially at higher intensities. Significant physiological differences were observed between cloth masks and N95s compared to control, while no physiological differences were found between cloth masks and N95s; however, comfort my differ.

Objective:During infectious disease outbreaks or pandemics, an increased demand for surgical N95s that create shortages and necessitate the use of alternative National Institute for Occupational Safety and Health (NIOSH)–approved respirators that do not meet the Food and Drug Administration (FDA) additional requirements. The objective of this research was to quantify the level of bacterial contamination resulting from wearing NIOSH-approved respirators lacking the additional protections afforded by surgical N95s.Methods:Participants performed simulated healthcare tasks while wearing 5 different respirators approved by the NIOSH. Sterile field contamination resulting from use of a surgical mask cleared by the FDA served as a baseline for comparison with the NIOSH-approved respirators.Results:The bacterial contamination produced by participants wearing the N95 filtering facepiece respirators (FFRs) without an exhalation valve, the powered air-purifying respirators (PAPRs) with an assigned protection factor of 25 or 1,000 was not significantly different compared to the contamination resulting from wearing the surgical mask. The bacterial contamination resulting from wearing the N95 FFR with an exhalation valve and elastomeric half-mask respirator (EHMR) with an exhalation valve was found to be statistically significantly higher than the bacterial contamination resulting from wearing the surgical mask.Conclusions:Overall, NIOSH-approved respirators without exhalation valves maintain a sterile field as well as a surgical mask. These findings inform respiratory guidance on the selection of respirators where sterile fields are needed during shortages of surgical N95 FFRs.

Consider these three related truisms: To err is human. Workers are fallible. Errors are inevitable (as well as predictable). These are some fundamentals of the human performance approach to understanding safety. Generally speaking, human performance encompasses the way workers, the organization, the environment and the management system (e.g., programs and processes) work synergistically as an entire sys-tem. Workers are the focal points of this system, since any flaws in the system can affect workers’ performance and, conversely, any worker flaws can affect the system. Errors are largely viewed as consequences of working in a flawed system. Given this human performance perspective, it should not be surprising that work-place incidents are triggered by human actions and in many cases the human actions causing these events are errors (which are unintentional actions without malice or forethought). About 80%: of all incidents are attributed initially to human error (Perrow, 1984; Reason, 1990; U.S. DOE, 2009a). The remainder involves elements such as equipment and material failures. But, when the 80% human error is analyzed in detail, the analysis reveals that most errors are associated with events that stem from latent organizational weaknesses, whereas about 30%: are caused by individual workers interfacing \"erroneously\" with systems and equipment (U.S. DOE, 2009). Thus, incidents result from a combination of factors both within and beyond the control of workers.Although error is universal, the traditional belief that human performance is a worker-controlled phenomenon and that failures are introduced to the system only through the inherent unreliability of workers is in itself an error of understanding. Since experience indicates that weaknesses in organizational processes and cultural values are involved in most incidents, reducing human errors that are often the result of organizational weaknesses will reduce the likelihood that such events will occur.Susceptibility to error is heightened when workers operate within complex systems that contain concealed weaknesses. These latent conditions either provoke error or weaken controls against the consequences of error. From a human performance perspective, Figure 1 diagrams the framework for incidents involving these organizational and human elements. The two ways to prevent human error from affecting operations are to 1) keep workers from making errors (error prevention) or 2) stop the errors from having an effect (controls). Figure 1 provides clues regarding intervention mechanisms that workers can use to prevent human error arising from the provocation of error at the workplace or the weakening of controls. Breaking the component linkages as presented in this figure prevents events from occurring. Using this model, events can be avoided.

Situational Factors in Mining SAFETY CLIMATE IS OFTEN STUDIED AND REFERENCED as a leading indicator of incidents (Beus et al, 2010; Haas & Yorio, 2016; Mearns et al, 2001) and must be considered within any occupational health and safety management system (OHSMS; National Research Council, 2013). A derived-importance approach determines the weight of specific characteristics and is often used in marketing research to understand what influences purchase intent and customer satisfaction (Anton, 1996; Berger et al, 1993; Chu, 2002; Klaus & Maklan, 2013). A primary purpose of safety climate research is to understand the perceptions and values that influence workers' safety behavior (Mearns et al., 2003; Zohar, 1980). Because the core components of customer satisfaction and safety climate are based on tangible and intangible elements of individuals' perceived experiences, it is plausible that adopting a derived-importance model is a viable approach for organizations to prioritize actions within their OHSMS. [...]although this study utilizes a similar survey approach, it uses a derived-importance framework to analyze and present the results.