|
|
|
|
|
|
|
NIOSH Programs > Health Care and Social Assistance > NIOSH Research Projects
Health Care and Social AssistanceActivities: NIOSH Research ProjectsAccidents/ InjuriesSlips and Falls Prevention in Healthcare WorkersThe objective of this study is to develop, implement, and evaluate a slip, trip, and fall (STF) prevention program in three hospitals. A case-crossover method will be used to interview injured workers and identify specific risk factors for STF incidents. A laboratory study will examine the slip-resistance characteristics of six nursing shoes on samples of hospital flooring measured with four contaminants. Slip-resistant shoes, mats, an aggressive housekeeping program based on a written policy, audits to identify STF hazards, prompt cleaning of spills and debris, keeping stairs and walkways clear, and other countermeasures will be introduced in three hospitals. The impact of the intervention will be assessed by comparing 6-year pre-intervention with 4-year post intervention injury experience. Project contact: Jennifer Bell Emerging IssuesEmerging Issues in Occupational Respiratory Disease Lab ResearchThis project provides a mechanism for the coordination of laboratory projects and laboratory support provided to the Division. Activities include initial program/project development; response to new research issues; participating in national consensus groups to develop standards for ventilation systems for industrial and agricultural tractor cabs, and for the use of respiratory protection; participating in the NIOSH Respirator Policy Group; and participating in CDC workgroups developing recommendations on occupational respiratory disease. In fiscal year (FY) 2006, activities include: work on a method to detect volatile organic compounds emitted by molds; determine the efficacy of ultraviolet germicidal irradiation (UVGI) in keeping ductwork clean; characterize the need for engineering controls to protect construction workers and HCWs from infectious disease during health care facility construction activities; and investigate the use of EBCs for detecting sensitization to beryllium. Project contact: Chris Coffey Emerging Issues in Occupational HIV PreventionThis project defines evolving risks of exposure to BBPs among all workers to prevent occupational transmission of HIV among workers who encounter unique risks and to lessen the associated morbidity and mortality after exposure. Research findings will be disseminated relating to the unique risks encountered by individual workers. In collaboration with the World Health Organization (WHO) and the Pan American Health Organization (PAHO), this project will adapt and translate a Toolkit already developed and tested by WHO in Asia and in Africa. The goal is to contribute to reducing work-related bloodborne illnesses among HCWs in Latin America through training, information sharing and global research capacity building. In addition, the risk of BBP exposures to non-health care worker occupations in the U.S. will be evaluated and targeted; practical health communication products will be developed. Project contact: Ahmed Gomaa Engineering ControlsExpedient Patient Isolation for Bioterroism and Epidemic ResponseThis project seeks to identify and provide detailed implementation guidance on expedient patient isolation techniques that are affordable, easily implemented, provide effective isolation, reduce potential healthcare worker exposures, and do not interfere with hands-on healthcare activities. Recommendations originating from this research will benefit multiple population demographics. Urban healthcare centers will be able to incorporate the recommendations to accommodate large-population events. Rural facilities, which generally lack patient isolation capabilities, will be able to obtain such capabilities with only minimal expense. Globally, variations of the guidance could assist in affording isolation capacity at remote facilities, close to the source of new outbreaks with epidemic potential. Application to non-hospital settings such as homeless shelters, jails, ambulances, etc. will also result. Project contact: Kenneth Mead Hazardous DrugsHazardous Drug Containment in HealthcareThe purpose of this research is to continue studying engineering controls to help determine why healthcare workers thought to be using proper work practices and engineering controls while handling hazardous drugs are still being exposed. Several weaknesses in current engineering systems as identified by the NIOSH Hazardous Drug Safe Handling Working Group will be researched. The study will begin to 1) determine if it is a safe practice to supply pharmacy room air with air exhausted from ventilated cabinets used to prepare hazardous drugs, 2) determine if the wide variety of ventilated cabinets used to prepare hazardous drugs are offering adequate worker protection, and 3) determine if supplemental controls used to prepare hazardous drugs will be able to offer adequate worker protection. Project contact: Duane Hammond Determination of Antineoplastic Drug Exposure in Healthcare WorkersThis project evaluates the exposure of nurses and pharmacists to antineoplastic drugs to determine if these healthcare workers are still being exposed after revision of OSHA guidelines in 1995. Air and surface levels of antineoplastic drugs will be measured along with a number of internal biological measurements. A second goal is to determine if chronic low level exposure to antineoplastic agents may cause changes in biological markers that would be useful as early indicators of effect to aid in intervention efforts. Project contact: Thomas Connor HIVDSHEFS HIV Program Management, Communication, and EvaluationThis project provides technical direction to the NIOSH HIV/Bloodborne Pathogens Activity for planning, conducting, monitoring, and evaluating HIV/AIDS and other bloodborne pathogens projects relating to healthcare and other workers potentially exposed to blood. Ongoing products include the continuously updated NIOSH bloodborne pathogens website and responses to public inquiries related to occupational blood exposures. Previous products include "Best Practices" reports posted on the NIOSH website related to the selection of safety devices and the production and distribution of materials promoting the National Clinicians' Post-Exposure Prophylaxis Hotline (PEPline). Future products include communication products leading to a reduction in the occupational transmission of HIV and other bloodborne pathogens among first responders and law enforcement officers. Project contact: Ahmed Gomaa Infectious DiseaseAerosol Generation By CoughThe purpose of this project is to study the creation of aerosols of airway fluids by coughing. Cough-generated aerosols are an important means for transmission of infectious diseases, such as TB, influenza, SARS, and potential bioterrorism agents like bubonic plague. This work will study the effect of airway fluid properties on aerosol production, the quantity and size distribution of aerosol particles generated by coughing, and the effectiveness of disposable masks and respirators at preventing the release of cough-generated aerosols. The information gained in the studies will help scientists and health professionals to better understand the airborne transmission of disease and to assess the potential effectiveness of preventive measures. Project contact: William Lindsley Intervention EffectivenessHomecare WorkersThis is a five-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 multilingual (English, Spanish and Chinese) and of low literacy level. The project will use a combination of qualitative and quantitative methods to gather information about HCWs safety and health needs and available materials and resources to address those needs. NIOSH investigators will construct a prototype of a checklist using information from focus groups, key informant interviews, and observational site visits. Community outreach workers, using peer education techniques, will field test the efficacy of the intervention materials with other HCWs and consumers. The completed checklist will be evaluated using a randomized experimental design to examine the HCWs' and their consumers' improvement in safety and health awareness and ability to identify and change hazards in the work environment utilizing the checklist materials. Project contact: Sherry Baron Effectiveness of Training and Controls in Nursing HomesThe purpose of this project is to evaluate engineering controls, training and information dissemination programs for injury prevention in a sample of nursing homes in the State of Ohio . Injury experience will be derived from Workers Compensation (W.C.) claims. The Bureau of Workers Compensation in Ohio makes available intervention programs for targeted industries, including nursing homes, but lacks resources to evaluate their effectiveness. W.C., OSHA-related and other interventions that employers have implemented will be classified and described, as will their W.C. claim rates and costs over time. The purpose will be to estimate what effects various intervention programs have had on reducing workers compensation claims and costs. Project contact: Robert Park Musculosketetal DisordersUpper Limb Work-Related Musculoskeletal DisordersThe purpose of the project is to quantify exposure-response relationships between physical job stressors and the prevalence and incidence of upper limb MSDs, and to develop and test practical exposure methods. The anticipated impact of this project is that policy makers will be able to make more informed decisions regarding guidelines for preventing upper limb MSDs, and practitioners in occupational health fields will be able to use improved exposure assessment methods to easily and accurately determine whether job tasks represent low, moderate or high risk for upper limb MSDs. It is anticipated that the end result will be more effective job design changes or interventions in existing jobs to prevent these disorders Project contact: Susan Burt Organization of WorkWork Schedule Designs to Reduce Job StressThe purpose of Work Schedule Designs to Reduce Job Stress, a continuing project, is to evaluate the effectiveness of changed work schedules to reduce health and safety risks associated with job stress, high workloads, or excessive fatigue. Health and safety compromises are associated with demanding work schedules. The present project is evaluating pre- and post-work schedule designs to determine the most successful intervention factors for reducing risks of injuries and illnesses. Targeted analysis outcomes include health and safety indices (e.g., work absences, visits to health clinics, injury and incident rates, and changes in somatic complaints) and behavioral/psychological indices (e.g., changes in perceived stress, fatigue, recovery, and satisfaction with domestic and other social relations). Resulting work schedule design recommendations will help to reduce the associated health and safety risks. Project contact: Claire Caruso Work Organization, Cardiovascular Disease, and DepressionThis study is part of a larger research effort on work organization, cardiovascular disease, and depression. This component will investigate the relationships between specific aspects of work organization (job stressors) and depression among 10,000 men and 10,000 women in a five-year prospective study. Specifically, we will identify relationships between these 14 job stressors (as well as perceived family-related demands and discrimination), depression, and CVD. Project contact: Paula Grubb Work Organization Predictors of Depression in WomenThe goal of this study is to examine the relationship between non-traditional job stressors (e.g., work-family conflicts, harassment, discrimination), traditional job stressors (e.g., demands, control), and levels of depression in working women. Additionally, the moderating effects of specific workplace policies, practices, and procedures which may attenuate the effects of work organization stressors on depression will also be investigated. It is anticipated that findings from this study will enhance our knowledge of workplace antecedents of depression among working women and provide a better understanding of which, if any, workplace policies, programs, and procedures might reduce depression prevalence among working women. Project contact: Naomi Swanson Reproductive OutcomesRisk for Adverse Reproductive Outcomes Among NursesFemale nurses may be at increased risk of adverse reproductive outcomes through exposure to a variety of reproductive hazards. This project seeks to better understand the impact of chemical and physical exposures on reproductive health. The study population is the ongoing Harvard Nurses' Health Study (NHS). In 2001, an occupational supplement was mailed to a subset of the NHS-II cohort who had reported at least one recent pregnancy. Data from this supplement and from the prior NHSII surveys will be used for this project. The work will be conducted via a research contract with Harvard Nurses' Health Study cohorts. Analysis began in FY05 and results will be reported in scientific journals and nursing union newsletters. Project contact: Christina Lawson Research to PracticeHazards in HealthcareProject will develop a series of educational and technical documents critically assessing available data on occupational safety and health hazards to healthcare workers in hospitals, homes, and other settings. The series, currently under development, will address subjects such as: violence, ergonomic stressors, glutaraldehyde, waste anesthetic gases, nitrous oxide, stress, antineoplastic agents, ethylene oxide, latex allergy, needle sticks, and tuberculosis. Preventive strategies will also be discussed. This information is intended for use by safety and health professionals, workers and employers. Educational brochures will be prepared on each topic as well. Additionally, this project focuses on several priorities under the National Occupational Research Agenda - disease/injury (allergic and irritant dermatitis, asthma, musculoskeletal disorders, and work organization). This research to practice project will produce communication products supporting the NIOSH mission to assure a safe and healthful workplace. Project contact: Christy Forrester HIV Information Dissemination Demonstration ProjectThe purpose of this project has been to develop and pilot a health communication intervention to: 1) raise the awareness of healthcare workers (clinical and non-clinical) and administrators about the recommendations in the NIOSH Needlestick Alert and future NIOSH publications; and 2) decrease occupational exposure to HIV by increasing prevention behaviors among workers, and influencing administrator's policy-decisions and buying behaviors. An information dissemination project is being conducted in Columbia , South Carolina over a period of five years. During the project, multiple messages have been delivered to the three target audiences: clinical healthcare workers, non-clinical workers, and health facility managers. The project has conducted the demonstration project over time to accommodate (a) sufficient time needed to build trusting relationships with multiple partners, (b) the amount of work required to reach multiple large target populations, (c) emerging prevention methods, and (d) the complexities of reaching agreements on message content with partner organizations. An article on the merits of conceptualizing occupational safety and health problems at the community level is in preparation. Preliminary analyses of data are accomplished and ongoing. Presentations on intervention techniques have been done. Project contact: Raymond Sinclair NIOSH NPPTL Protection Planning Tool for the Hospital-Based Healthcare WorkforceThis project seeks to evaluate the potential exposure of First Receivers involved in responses to terrorism incidents or to exposures to toxic industrial chemicals in order to develop appropriate standards and criteria for Personal Protective Equipment in these scenarios. The possibility of victim dispersal of agents to First Receivers and others in the healthcare facility will be evaluated in a three component analysis: decontamination efforts, facility risk analysis for dissemination of agent(s), and econometric evaluation of the costs of adequate Personal Protective Equipment. The ultimate goal of the project is to develop a tool that will assist healthcare institutions to tailor their approach to protective strategies (individual and institutional) when faced with the myriad possible scenarios of terrorist incidents or exposures to toxic industrial chemicals. Project contact: Risk AssessmentEvaluation of the REL for Toluene and Waste Halogenated Anesthetic Gases: Isoflurane, Desflurane, and SevofluraneThe toluene project will evaluate revising the NIOSH recommended occupational exposure limits (REL) published in 1973. The REL for toluene is 375 mg/m3. Recent toxicology literature reports health effects (reproductive/neurological disorders, adverse effects to the reproductive system, liver and kidney damage) with exposures at the current REL. The project on waste halogenated anesthetic gases (isoflurane, desflurane, and sevoflurane) will evaluate the data and determine if they provide a sufficient basis for a REL. Project contact: Henryka Bialkowska Nagy Microbial Aerosol Risk AssessmentMicrobiological hazards to workers have become of greater concern in recent years. This project is designed to determine if it is feasible to develop quantitative methods for assessing the risk to workers from breathing in suspended bacteria and viruses in workplace air. This is of particular concern to healthcare workers and emergency responders. If this project is successful, the methods developed will help NIOSH to make better, science-based recommendations to protect workers. If the outcome is that developing methods is infeasible at this time, the obstacles will be identified and a detailed description of the research needs. Microbiological hazards to workers have become of greater concern in recent years. This project is designed to determine if it is feasible to develop quantitative methods for assessing the risk to workers from breathing in suspended bacteria and viruses in workplace air. This is of particular concern to healthcare workers and emergency responders. If this project is successful, the methods developed will help NIOSH to make better, science-based recommendations to protect workers. If the outcome is that developing methods is infeasible at this time, the obstacles will be identified and a detailed description of the research needs. Project contact: Christine Sofge Revised REL for GlutaraldehydeThe purpose of this project is to develop a policy document to update the existing REL for glutaraldehyde [NIOSH, 1988]. Contact dermatitis and asthma have been noted in workers with exposure below the existing NIOSH REL (0.2 parts per million [ppm], ceiling). In accordance with NIOSH's mission to assure a safe and healthful workplace, a policy document will be developed to provide a summary of the relevant health effects data, a revised REL and guidelines to reduce the risk of adverse health effects in workers across two NORA Sectors (Manufacturing and Health Care). This revised REL will commit the latest research to the practice of protecting working men and women from the health effects of occupational glutaraldehyde exposure. Project contact: Christy Forrester SurveillanceSurveillance of Bloodborne PathogensThis project supports subprojects to conduct occupational surveillance studies related to occupational exposures to blood and bloodborne pathogens. A cooperative agreement assessing exposures to blood among paramedics ended last year, and NIOSH staff are contributing to the journal articles being prepared. A cooperative agreement assessing exposures to blood among registered nurses not working in hospitals was completed in FY03. Four new extramural projects (R01 grants) funded by the HIV Activity began in FY2005, each one investigating exposures to blood among home healthcare workers. The feasibility of initiating an intramural occupational bloodborne pathogen surveillance system will be assessed. Consultation on other occupational bloodborne pathogen exposure surveillance projects, such as CDC/NCID's NaSH and NaSH Lite projects and evaluation of smallpox vaccination bifurcated needles with engineered sharps protections is also provided, as requested. Project contact: Ahmed Gomaa National Exposures at Work Survey (NEWS) - Feasibility StudiesThe purpose of the feasibility project is to: 1) assess whether self-administered survey questionnaires accurately elicit information on hazards and exposures, exposure controls, and H&S practices and perceptions among healthcare workers and management via post-survey validation; 2) evaluate two modes of administration (web-based and paper) and distribution of employee questionnaires in two pilot tests at Federal medical centers; and 3) evaluate whether methodology is feasible for a national scale survey of the health services sector. The following products/outcomes will be available at the conclusion of this project: a final report with recommendations; validated employee and management survey questionnaires; and all system and program flowcharts and software developed to implement the NEWS website. Findings of the feasibility evaluation (response rates, data quality, questionnaire validation, etc) will be disseminated through peer-refereed publications and presentations at scientific meetings. Project contact: Jim Boiano Tuberculosis (TB)New Approaches to Medical Screening for Latent TBWhen people are first infected by inhaling TB, they usually are able to control, but not eliminate, the infection. This situation can last for years and is called latent TB infection (LTBI). Eventually, infected people loose the ability to control the TB infection and develop active disease. This is when they become contagious to others. Since active disease can be prevented by treatment of LTBI, it is important to diagnose LTBI. This is usually done using a skin test, which has many problems. The ultimate purpose of this study is to develop and evaluate improved laboratory methods for diagnosis of LTBI. Project contact: Rodney Brundage Quantitative TB/Mycobacteria PCR Air Sampling MethodA quantitative bioaerosol sampling and analytical method will be developed for TB and other mycobacteria. No culturing is required. The method will permit exposure assessment of environments suspect for hazardous mycobacteria bioaerosols including TB. Project contact: Millie Schafer |
|
NIOSH Program:Health Care and Social Assistance |
|||||
