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HEALTHCARE AND SOCIAL ASSISTANCE

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Activities: NIOSH Research Projects

Chemical Agents

Orthophthaldehyde (OPA) Hazard Assessment

This project will assess occupational exposures to OPA and determine if healthcare workers are experiencing adverse effects associated with exposure. To assess exposure, this study will also develop analytical methods for environmental monitoring of OPA and determine the feasibility of an OPA biomarker. Because of the absence of published toxicological data on OPA, testing will be conducted in experimental animals. The toxicological testing will focus on dermal and respiratory irritation and sensitization. Dose-response data will be obtained for hazard identification risk assessment, which, along with health assessments, will serve as the basis for establishing exposure limits.

Project Contact: Mark Toraason
Division of Applied Research and Technology
(513) 533-8462
Project Period: 10/01/2009 –09/30/2011


Education, Training and Information Dissemination

Training to Design Age-Friendly Workplaces for Nurses

Hospital-based nurses face a wide range of working conditions that pose increasing risks with age. An important first step in addressing these risks is to educate and train both nurses and managers regarding the effects of aging, and provide practical strategies for creating an age-friendly workplace. The current project seeks to accomplish this goal through the development of a training workshop designed specifically for nurses who work in a hospital environment.

Project Contact: James Grosch
Division of Applied Research and Technology
(513) 533-8462
Project Period: 02/01/2010 – 09/30/2012

Diffusion of O&H Research: Home Healthcare Workers

This project proposes to expand tenets of diffusion of innovation theory (DOI) to improve the demand for occupational safety and health information among intermediary stakeholders involved in the provision of HCW services. The DOI theory posits that the spread of innovation depends on mass communication to create awareness and knowledge of innovation among individuals and organizations that are then influenced by their social networks to adopt new and/or innovative products or processes. The World Wide Web, now the dominant method of mass and individual communication, has created enormous change in mass communication which has great potential for connecting with broad-based audiences at modest cost. This project proposes to explore how these changes can be used to better diffuse and deliver occupational health and safety practices to the highly diverse audiences involved with providing in-home health and supportive services.

This project will meet this goal by conducting market research to determine the communication channels through which HCW-related employers, community service agencies, workers, and clients and their families receive information and make decisions related to how HCW services are to be provided. With the information gathered, a dissemination plan will be developed integrating mass and social media channels to deliver both general awareness and specific educational messages and products to the target audiences. Key stakeholders and other opinion leaders, influential in spreading information to HCWs and their clients, will be involved in identifying the most important target audiences and communication messages. The project will provide an opportunity to demonstrate new approaches to and develop guidance for future sector-focused communication and dissemination strategies.

Project Contact: Sherry Baron
Division of Surveillance, Hazard Evaluations and Field Studies
(513) 841-4428
Project Period: 04/09/2010 – 09/30/2013

Creation of a Series of Home Healthcare Fast Fact Cards

An aging population and rising hospital costs have created new and increasing demand for innovative healthcare delivery systems in the United States. Home healthcare provides vital medical assistance to ill, elderly, convalescent, or disabled persons in their own homes and is one of the most rapidly expanding industries in this country. The Bureau of Labor Statistics projects that home healthcare employment will grow 49% from 2006–2016, making it the fastest growing occupation of the next decade. Home healthcare workers, while contributing greatly to the well-being of others, face unique risks on the job to their own personal health and safety. During 2007 alone, 27,400 recorded injuries occurred among more than 896,800 home healthcare workers. A NIOSH Hazard Review: Occupational Hazards in Home Healthcare was published during FY10, DHHS (NIOSH) Publication No. 2010-125. The Hazard Review is a 50+ page document aimed to raise awareness and increase understanding of the safety and health risks involved in home healthcare. This document is geared to the owners, managers and workers in the home healthcare industry and suggests prevention strategies (for managers and workers) to reduce the number of injuries and illnesses that too frequently occur among workers in this industry. The NIOSH Hazard Review will be the foundation of a series of six easy-to-read Fast Fact cards that will be targeted directly to the home healthcare workers.

Project Contact: Laura Hodson
Education and Information Division
(513) 533-8302
Project Period: 01/15/2010 – 09/30/2012


Hazardous drugs

Operating Room Personal Exposure to Chemotherapy Drugs

The goal of this new project is to reduce occupational exposure to antineoplastic drugs in operating rooms (OR) where a new procedure is employed to treat cancer patients. To accomplish this, NIOSH will identify potential drug exposure to personnel by measuring drugs on work surfaces, in air samples, and in the urine of personnel. If exposures are identified, recommendations will be made for changes in work practices or types of safety equipment to help protect workers. The workplace will be re-evaluated following these interventions and findings will be reported to stakeholders.

Project Contact: Tom Connor
Division of Applied Research and Technology
(513) 533-8462
Project Period: 10/01/2008 –09/30/2012

NIOSH Hazardous Drugs List Update

This continuing project will provide a mechanism to update the definition and list of hazardous drugs in the NIOSH Alert. Updates to the list are needed because the FDA has approved a number of new drugs and issued warnings for existing drugs since the publication of the Alert in 2004. In order to provide guidance to healthcare institutions and other locations where hazardous drugs are handled on which drugs should be considered hazardous, NIOSH plans on updating the list in FY10 and again in FY12. NIOSH receives many inquiries about the list of hazardous drugs and many institutions in the U.S. and in other countries will utilize the updated list as the basis for their institution’s list.

Project Contact: Barbara MacKenzie
Division of Applied Research and Technology
(513) 533-8462
Project Period: 11/11/2009 –09/30/2012

Direct Reading Monitors for Antineoplastic Drug Detection

The purpose of this project is to prevent exposure to healthcare workers from antineoplastic drugs by developing portable, near real time, direct reading instruments to measure surface contamination by these drugs. These monitors can be used by healthcare workers to improve work practices and protective equipment. The monitors will be tested in the laboratory and used in the field by healthcare workers. After development, commercial partners will be found to manufacture and market the monitors to healthcare workers to make the monitors widely available to workers. Expected outcomes are commercially available monitors that are widely used by healthcare workers to lower exposure.

Project Contact: Jerome Smith
Division of Applied Research and Technology
(513) 533-8462
Project Period: 10/01/2008 – 09/30/2012

5-Fluorouracil Exposure in Healthcare Workers

The objective of this project is to develop a sensitive, selective, and precise analytical method to measure markers of exposure to the antineoplastic drug 5-fluorouracil in urine. A liquid chromatography tandem mass spectrometry method will be developed and applied to a set of specimens from a recent NIOSH healthcare worker study that involved pharmacy and nursing personnel from three large U.S. cancer centers. This project targets the NORA Healthcare and Social Assistance Sector and also aligns with goals in the Exposure Assessment Cross-Sector and the Cancer, Reproductive, and Cardiovascular Diseases Cross-Sector. The laboratory results will be presented at meetings, published in journals, posted on the NIOSH website, and shared with pharmacy and nursing groups. The analytical method will also be published in appropriate journals.

Project Contact: Dale Shoemaker
Division of Applied Research and Technology
(513) 533-8462
Project Period: 10/01/2009 – 09/30/2012


Infectious Diseases

Persistence of Influenza Virus in Aerosols

The overall goal of this project is to better understand transmission of the influenza virus. The proposed research will develop improved methodologies to determine the viability of airborne influenza virus and then use these methodologies to assess viable viruses in public locations such as healthcare facilities. One of the most important factors governing the airborne transmission of any disease is the amount of airborne infectious material that is present in the environment where uninfected individuals could potentially inhale it. This project will improve and validate methods for viral aerosol sample collection using the NIOSH sampler and will lead to applications of the sampler in clinical setting where viable airborne influenza can be evaluated. The information generated will help bridge public health knowledge and environmental by providing evidence-based approaches to infection control policies that provide an adequate level of protection for HCWs. This project should result in peer reviewed journal articles that will provide scientific data regarding the mechanism of Influenza transmission. The knowledge gained from this study will address specific NIOSH research goals to reduce or eliminate transmission of infectious diseases in healthcare settings among workers in the healthcare and social assistance sector.

Project Contact: Don Beezhold
Health Effects Laboratory Division
(304) 285-6121
Project Period: 10/01/2009 – 09/30/2013

Development of Methodology to Detect Viable Airborne Influenza Virus Using Personal Aerosol Samplers

The goal of this project is to better understand transmission of the influenza virus. One of the most important factors governing the airborne transmission of any disease is the amount of airborne infectious material that is present in the environment where uninfected individuals could potentially inhale it. During environmental decontamination of an area containing airborne viruses, re-aerosolization issues may also arise from workers or clean-up disturbing the area. The aims of this project are to evaluate the ability of the NIOSH bioaerosol sampler to collect viable airborne viruses and to devise techniques to preserve the viability of airborne viruses during and following collection. Improved and validated methods for aerosol sample collection using the NIOSH sampler will lead to joint applications of the sampler that will help bridge public health and environmental concerns. This project should result in peer reviewed journal articles that will provide scientific data regarding the mechanism of Influenza transmission. The knowledge gained from this study will address specific NIOSH research goals to reduce or eliminate transmission of infectious diseases in healthcare settings among workers in the healthcare and social assistance sector.

Project Contact: Don Beezhold
Health Effects Laboratory Division
(304) 285-6121
Project Period: 10/01/2009 – 09/30/2011

Factors Influencing the Transmission of Influenza

The goal of this project is to better understand transmission of the influenza virus. One of the most important factors governing the airborne transmission of any disease is the amount of airborne infectious material that is present in the environment where uninfected individuals could potentially inhale it. This project is designed to support ongoing studies to evaluate the ability of the NIOSH bioaerosol sampler to collect viable airborne viruses under various environmental conditions and efforts to devise techniques to preserve the viability of airborne viruses during collection. Improved and validated methods for viral aerosol sample collection using the NIOSH sampler will lead to joint applications of the sampler that will help bridge public health and environmental concerns. This project should result in peer reviewed journal articles that will provide scientific data regarding the mechanism of Influenza transmission. The knowledge gained from this study will address specific NIOSH research goals to reduce or eliminate transmission of infectious diseases in healthcare settings among workers in the healthcare and social assistance sector.

Project Contact: Don Beezhold
Health Effects Laboratory Division
(304) 285-6121
Project Period: 10/01/2009 – 09/30/2013

Characterization/Quantification of TB/Mycobacteria Aerosols

The goal of this project is to reduce occupational exposure to TB in healthcare institutions. To accomplish this goal, an optimized, rapid, sensitive, quantitative sampling and analytical method will be developed for airborne TB. Such a method could permit early detection of the infectious TB patient, especially the “super spreader”. Isolation of that infectious TB patient will mitigate the transmission of airborne TB to healthcare workers, other patients and the general public.

Project Contact: Millie Schafer
Division of Applied Research and Technology 
(513) 533-8462
Project Period: 10/01/2009 – 09/30/2013


Injuries

Best Practices for Bariatric Patient Handling

The purpose of this project is to identify and promote the safest methods for lifting and moving bariatric (obese, morbidly obese) patients in order to reduce the risk of overexertion injury in healthcare workers. Best practices for bariatric patient handling will be determined by evaluating the effectiveness of safe lifting programs in several hospitals which provide bariatric surgery (gastric by-pass, stomach stapling) and critical care for bariatric patients. Recommendations for safe bariatric lifting practices will be developed and communicated to healthcare workers and managers through healthcare websites, conferences and journals. It is anticipated that the recommendations, including training on best practices, will be implemented in numerous healthcare settings, including hospitals, nursing homes, and home healthcare.

Project Contact: Traci Galinsky
Division of Applied Research and Technology
(513)533-8462
Project Period: 10/01/2008 - 10/01/2012

“Best Practices” Patient Lifting Intervention in a Hospital

A pre/post intervention trial and cost-benefit analysis will assess the effectiveness of a “best practices” safe patient lifting program being implemented by Northwestern Memorial Hospital (NMH) and the University of Pennsylvania Medical Center. The program consists of ceiling-mounted and portable patient-lifting equipment and lateral transfer aids. We hypothesize that health outcomes (back and shoulder injuries) will be significantly reduced following implementation of the program. Workers’ compensation data, OSHA logs and personnel records will be collected for three years pre- and three years post-intervention. Injury rates will be computed by job title, age, gender, length of employment, and shift. Lost workday injury rates and restricted injury rates will be compared pre- and post-intervention. A cost-benefit analysis will examine costs of the capital investment to establish the program relative to changes in workers’ compensation benefits.

Project Contact: James Collins
Division of Safety Research
(304) 285-5894
Project Period: 04/01/2007 – 09/30/2011


Interventions

Priority Populations: Homecare Workers

This is a 5 year community based participatory research project that will develop and evaluate a model intervention program for one large population of predominately female low income, minority and immigrant home care workers (HCWs) in Alameda County, California. The focus of the intervention will be the development of an interactive checklist and accompanying educational materials aimed at improving awareness and knowledge about safety and health risk factors and improving the ability of HCWs, their consumers, social workers and others to identify simple, available interventions. The target population is multi-lingual (English, Spanish and Chinese) and of low literacy level. The project includes an evaluation component. During the first 3 years of the project we have conducted focus groups with consumers, workers, and stakeholders to develop intervention materials. We have consulted with health communication specialists and have designed the content and format for the education intervention materials. We have trained a group of worker and consumer leaders who will be testing the materials prior to finalization and formal evaluation.

Project Contact: Sherry Baron
Division of Surveillance, Hazard Evaluations and Field Studies
(513) 841-4428
Project Period: 03/01/2005 – 09/30/2011


Respirators

Reusability of Filtering Facepiece Respirators

This project focuses on the reusability of NIOSH certified filtering facepiece respirators (FFR) that are used for respiratory protection against influenza and other infectious aerosols. Laboratory studies will be conducted to understand the efficacy and impact of decontamination methods on respirator performance and to understand the risks associated with handling a respirator contaminated with virus. These studies will be used by NIOSH and CDC to develop scientific recommendations on respiratory protection for healthcare workers, emergency responders, and the general public. These studies will also be used by national and international standards development organizations to support new test methods. Project

Contact: Ron Shaffer
National Personal Protective Technology Laboratory
(412) 386-6111
Project Period: 10/01/2006 – 09/30/2011

Protecting Workers Against Aerosol Transmissible Diseases

Workers in the HCSA sector face new and emerging infectious disease threats, such as Severe Acute Respiratory Syndrome (SARS) and potentially pandemic influenza strains, as well as long standing or re-emerging threats, such as tuberculosis (TB) and pertussis. Use of personal protective equipment, including respirators, is an important component of plans to minimize occupational transmission of such infectious agents. Healthcare workers are considered to be emergency responders and serve as critical first receivers of patients in emergencies such as the current H1N1 outbreak. The overall aim of this project is to identify: 1) barriers to using respirators, 2) practical strategies to address those barriers, and 3) organizational policies and procedures to prevent airborne infectious disease exposure in the HCSA sector by taking advantage of a unique new initiative in California.

Project Contact: Sherry Baron
Division of Surveillance, Hazard Evaluations and Field Studies
(513) 841-4428
Project Period: 01/01/2010 – 09/30/2012


Surveillance

Health and Safety Practices Survey of Healthcare Workers

The purpose of this hazard surveillance project is to characterize health and safety practices including the use of exposure controls (and barriers to use) by healthcare workers who are likely to use or come in contact with hazardous chemical agents in their job. The hazardous chemical agents include aerosolized medications, anesthetic gases, antineoplastic agents, chemical sterilants, high level disinfectants and surgical smoke. This information will be collected using a web-based survey which is scheduled to be launched in January 2011. The target population is members of twenty-two (22) professional organizations which have partnered with NIOSH and make the survey available to members. Over 25,000 healthcare workers representing a variety of healthcare occupations and work settings will be invited to participate in the survey. The survey is expected to provide valuable information to guide health and safety promotion, interventions and future research.

Project Contact: Jim Boiano
Division of Surveillance, Hazard Evaluations and Field Studies
(513) 841-4428
Project Period: 10/01/2007 - 09/30/2011

National Healthcare Safety Network Occupational Surveillance

The broad, long term objective of this proposed project is to improve the working conditions of healthcare workers by enhancing the healthcare personnel surveillance component of the National Healthcare Safety Network so that healthcare facilities can collect and use data to establish and evaluate prevention activities for common occupational health problems among their personnel. The proposed project focuses on surveillance and prevention of four occupational health outcomes that are common among healthcare workers: 1) traumatic injuries in the workplace, 2) dermatitis due to workplace exposures, 3) work-related asthma, and 4) airborne transmission of tuberculosis in the workplace. Key findings will be translated into tools to eliminate or reduce hazards, exposures, and adverse outcomes in the healthcare industry.

Project Contact: Ahmed Gomaa
Division of Surveillance, Hazard Evaluations and Field Studies
(513) 841-4428
Project Period: 05/01/2009 – 09/30/2013

Risk for Adverse Reproductive Outcomes Among Nurses

Female nurses may be at increased risk of adverse reproductive outcomes through exposure to a variety of reproductive hazards. This project will characterize the impact of chemical and physical exposures, and work schedules on reproductive health. This study contributes to the NORA target areas of cancer, reproductive, and cardiovascular disease cross-sector, healthcare and social assistance sector. The study population is the ongoing Harvard Nurses’ Health Study II (NHS-II), in addition to the proposed NHS III. The work is being conducted via a research contract with the Harvard Nurses' Health Study team. Results of the first analysis were published in 2007, and results will continue to be reported in scientific journals, as well as nursing journals and nursing newsletters.

Project Contact: Christina Lawson
Division of Surveillance, Hazard Evaluations and Field Studies
(513) 841-4428
Project Period: 10/01/2001 – 09/30/2011

Surveillance Needs for Emergency and Epidemic Preparedness and Response

This project is to provide expertise and support as needed for components of the NIOSH Emergency Preparedness and Response (EPR) Program. The mission of the NIOSH Emergency Preparedness and Response (EPR) Program Portfolio is to advance research and collaborations to protect the health and safety of emergency response providers and recovery workers by preventing diseases, injuries, and fatalities in anticipation of and during responses to natural and man-made disasters and novel emergent events. As surveillance needs and activities have increasingly been defined by agencies (such as in accordance with the Homeland Security Act of 2002) and the occupational component of emergency response and preparedness has been recognized, the Surveillance Branch of DSHEFS has been asked to contribute its expertise in such efforts. This project is intended to allow such activities.

Project Contact: Karl Sieber
Division of Surveillance, Hazard Evaluations and Field Studies
(513) 841-4428
Project Period: 10/01/2007 - 09/30/2012


Violence

Work Organization and Workplace Violence

The purpose of this project is to provide data on workplace aggression and bullying and its relationship to work organization factors and worker health, safety, and well-being outcomes. NIOSH will collaborate with the National Opinion Research Center (NORC) and the National Science Foundation (NSF) on a psychological aggression and bullying module for the 2010 General Social Survey (GSS). These data will be used to develop in formational materials and to develop and evaluate workplace violence interventions.

Project Contact: Paula Grubb
Division of Applied Research and Technology
(513) 533-8462
Project Period: 04/01/2002 – 09/30/2014

Health Violence Prevention On-Line Best Practices Course

A review of the literature and dialog with project partners indicates that nurses and other healthcare professionals are not receiving training on workplace violence prevention in most educational settings (i.e. nursing schools, continuing education courses, workplace training, etc.). This project will use a NIOSH developed free on-line best practices program to fill this gap and to provide free continuing education units (CEU) to healthcare workers for completing this much needed training program. This training will include topics such as risk factors that cause or contribute to assaults; early recognition of escalating behavior and warning signs; personal mediation strategies; and situations that may lead to assaults.

Project Contact: Daniel Hartley
Division of Safety Research
(304) 285-5894
Project Period: 12/01/2009 – 09/30/2012

 

 
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  • Page last reviewed: October 31, 2012
  • Page last updated: October 31, 2012
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