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HHE Search Results
479 HHE reports were found based on your search terms. Reports are listed in order of year published with the most recently published reports listed first.
Year Published and Title
(2013) Zoonotic disease and exposures in persons working with marine mammals. (Click to open report) The HHE Program evaluated potential exposure of employees and volunteers to zoonotic diseases at a marine mammal rescue and rehabilitation center. Zoonotic diseases are those that can be transmitted from animals to humans. Investigators with the HHE Program observed work practices and personal protective equipment use and found that some practices may lead to a higher risk of exposure to zoonotic diseases. Employees and volunteers were given a survey and blood tests to look for evidence of past ... (Click to show more)The HHE Program evaluated potential exposure of employees and volunteers to zoonotic diseases at a marine mammal rescue and rehabilitation center. Zoonotic diseases are those that can be transmitted from animals to humans. Investigators with the HHE Program observed work practices and personal protective equipment use and found that some practices may lead to a higher risk of exposure to zoonotic diseases. Employees and volunteers were given a survey and blood tests to look for evidence of past infection. Among the 213 participants, little evidence was found of past infection with the organisms that cause leptospirosis, brucellosis, or Q fever. Air, surface, and bulk dust samples were collected for C. burnetti, the bacterium that causes Q fever; all but one of 130 samples was negative. A ventilation assessment showed that the biological safety cabinet in the laboratory did not have enough airflow so investigators recommended that the employer have this cabinet certified yearly and ensure that it meets minimum flow requirements. Investigators also found that when the harbor seal area ventilation system was turned on air flowed from the intensive care unit to other areas of the building. Investigators recommended that harbor seal pups not be housed in the intensive care unit if they are suspected of having Q fever. Instead they should be housed outside and isolated from other harbor seal pups. Investigators recommended that the carpet in the triage building be removed and replaced with a nonporous surface. Investigators noted that some employees and volunteers were not wearing the correct personal protective equipment and recommended that the employer provide initial training and refresher training for all employees and volunteers on hand washing, proper personal protective equipment use, and the risk of infection. Employees were encouraged to (1) wash their hands after exposure to animals or animal areas even if they were wearing gloves, (2) not wear personal protective equipment in areas where people eat or drink, (3) report signs of possible zoonotic infection to their supervisor, and (4) to tell their healthcare provider about their duties and exposures to marine mammals. The employer was encouraged to post signs about hand washing.
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(2012) Ergonomic evaluation of surfacing and finishing tasks during eyeglass manufacturing - Minnesota. (Click to open report) In June 2010, NIOSH received an HHE request from managers to evaluate potential ergonomic hazards and MSDs among employees at three eyeglass manufacturing facilities in Minnesota. The request concerned employees working in the surfacing and finishing departments. We visited the three facilities on November 16-19, 2010. We observed work processes and practices and assessed workplace conditions. We videotaped surfacing and finishing tasks. We also measured workstation heights and reach distances. ... (Click to show more)In June 2010, NIOSH received an HHE request from managers to evaluate potential ergonomic hazards and MSDs among employees at three eyeglass manufacturing facilities in Minnesota. The request concerned employees working in the surfacing and finishing departments. We visited the three facilities on November 16-19, 2010. We observed work processes and practices and assessed workplace conditions. We videotaped surfacing and finishing tasks. We also measured workstation heights and reach distances. We talked with employees privately to discuss concerns about the workplace and their health. We also reviewed medical records related to MSDs. We found that employees were exposed to a combination of risk factors for developing WMSDs, including awkward postures, forceful exertions, and repetitive motions. Of 60 interviewed employees, 45 reported having current or past MSD symptoms. Review of 19 employees' medical records found that most medically documented WMSDs involved the wrists, shoulders, hands, and back. Three employees had undergone surgery and three (one of whom had undergone surgery) were put on permanent work restrictions. Comparison of OSHA Form 300 Logs of Work-Related Injuries and Illnesses showed higher rates of injury and illness at this facility than at other eyeglass manufacturing facilities in the United States in 2007-2009, but by 2010, all but one facility's rates had declined to near the national industry average. On the basis of employee interviews and OSHA Logs, the most commonly reported MSDs were wrist, shoulder, hand, and back disorders. We provided the facility with recommendations for reducing the risk of WMSDs. By designing work areas to have a working height of 27"-62" and rotating employees to different job tasks after every break, managers can reduce the risk of WMSDs. Training employees to recognize and avoid risk factors that can lead to musculoskeletal problems and encouraging employees to report work-related musculoskeletal discomfort can also reduce employees' risk of injury.
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(2012) Exposure to radon progeny during closure of inactive uranium mines - Colorado. (Click to open report) In June 2011, NIOSH received an HHE request from managers of a federal agency in Colorado. NIOSH was asked to evaluate employees' exposure to ionizing radiation hazards during construction of various types of closures at abandoned uranium mines. The primary health concern at these sites involved inhalation of naturally occurring short-lived radon progeny (i.e., polonium-218, lead-214, bismuth-214, and polonium-214) at mine entrances (adits). Also of concern, but to a lesser extent, was exposure ... (Click to show more)In June 2011, NIOSH received an HHE request from managers of a federal agency in Colorado. NIOSH was asked to evaluate employees' exposure to ionizing radiation hazards during construction of various types of closures at abandoned uranium mines. The primary health concern at these sites involved inhalation of naturally occurring short-lived radon progeny (i.e., polonium-218, lead-214, bismuth-214, and polonium-214) at mine entrances (adits). Also of concern, but to a lesser extent, was exposure to gamma radiation emitted from mine waste and nearby geological formations. On September 12-15, 2011, we visited several abandoned mines on Wedding Bell Mountain in southwest Colorado and the Vanadium Queen mine in Utah. We observed the construction of a native stone and mortar closure on Wedding Bell Mountain. We also conducted continuous monitoring of radon progeny at several mine openings at Wedding Bell Mountain and at the Vanadium Queen mine. We reviewed the state inactive mine reclamation program's pre-bid radon monitoring protocol. Monitoring results and onsite observations suggest that employee exposures to radon during mine closure activities are generally low. However, radon concentrations at mine openings are greatly affected by changing environmental conditions such as wind velocity, moisture, and barometric pressure. Results of NIOSH exposure monitoring did not exceed the average pre-bid PAEC values obtained during previous monitoring by state inactive mine reclamation program staff. Nevertheless, PAEC results from the CWLMs varied widely over the sampling period because of constant fluctuations in ventilation patterns. Given this variability, it is unlikely that shortterm sampling, as conducted by state inactive mine reclamation program staff, is sufficient to derive long-term average concentrations that form the basis of protective actions. Control measures are needed in some instances to keep exposures as low as reasonably achievable (ALARA). Gamma radiation is likely to be measureable at the surface of waste rock piles near mine adits. Occupancy to these areas should be limited to minimize exposures to radon. The use of simple engineering controls (e.g., barriers, ventilation), along with the use of respiratory protection when needed, are recommended to keep radon exposures ALARA.
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(2011) Electromagnetic field exposures at a research institution's laboratories and atomic time radio stations - Colorado. (Click to open report) In June 2009, NIOSH received a health hazard evaluation request from a research institution in Colorado. The request concerned sub-RF (below 30 kHz) and RF (30 kHz to 300 GHz) EMF exposures at the institution's laboratories and atomic time radio stations. The radio stations were located at a remote site in Colorado separate from the laboratories. In response to this request, we evaluated the facilities on August 31-September 3, 2009, and August 3-5, 2010. During the first evaluation, magnetic fl... (Click to show more)In June 2009, NIOSH received a health hazard evaluation request from a research institution in Colorado. The request concerned sub-RF (below 30 kHz) and RF (30 kHz to 300 GHz) EMF exposures at the institution's laboratories and atomic time radio stations. The radio stations were located at a remote site in Colorado separate from the laboratories. In response to this request, we evaluated the facilities on August 31-September 3, 2009, and August 3-5, 2010. During the first evaluation, magnetic flux density (B) fields near or above OELs were measured in the magnetic annealing laboratory and superconducting magnet laboratory. Electric (E) field strengths above OELs were measured at the interoperability communications laboratory. Measurements taken at the atomic time radio stations demonstrated a potential for overexposure to RF. However, because the RF meter we used did not span all broadcasted frequencies and potentially perturbed fields, we planned another evaluation of the atomic time radio stations using appropriate instrumentation in 2010. During this second evaluation, we measured E and magnetic (H) field strengths at the atomic time radio stations. E-field strengths exceeded the action levels along the access roads leading to the helix houses within 700 feet of the LF north and south antennas. E- and H-field strengths exceeded the action levels at locations along the access road circling the HF antennas. E- and H-field strengths exceeded OELs within 30 feet of the 10- and 15-MHz antennas. Because EMF field strengths exceeded OELs or action levels in some locations at the research institution, we recommended implementing a comprehensive EMF safety program. This program should be managed by an EMF safety officer. The EMF safety officer should maintain an inventory of EMF sources, conduct annual EMF safety awareness training, audit the EMF safety program annually, and install signage and other controls in areas where field strengths are likely to exceed OELs or action levels. In addition, a system should exist for employees to report EMF exposures incidents and provide feedback to the EMF safety officer.
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(2011) Exposure to toluene, ethanol, and isopropanol at an electronics manufacturer - Ohio. (Click to open report) In January 2009, NIOSH received an HHE request from an electronics manufacturer in Ohio. The request concerned the potential for exposure to toluene and ethanol when gluing and oven curing electrical contacts to electrical shells and exposure to isopropanol when placing rubber inserts and electrical contacts into electrical shells. NIOSH investigators made site visits to the electronics manufacturer facility on February 23, 2009, and June 18, 2009. We walked through the facility and observed wor... (Click to show more)In January 2009, NIOSH received an HHE request from an electronics manufacturer in Ohio. The request concerned the potential for exposure to toluene and ethanol when gluing and oven curing electrical contacts to electrical shells and exposure to isopropanol when placing rubber inserts and electrical contacts into electrical shells. NIOSH investigators made site visits to the electronics manufacturer facility on February 23, 2009, and June 18, 2009. We walked through the facility and observed work processes, practices, and conditions. We spoke with employees about health and workplace concerns and collected air samples. We used colorimetric detection tubes on February 23, 2009, to estimate air concentrations of toluene and ethanol in the gluing and oven curing area. On a return site visit on June 18, 2009, we collected full-shift and short-term air samples for toluene and ethanol in the gluing and oven curing area. We also collected task-based and short-term air samples for isopropanol in the shell dipping area. We evaluated the LEV in the gluing and oven curing area using a thermoanemometer and smoke tubes. Finally, we used colorimetric lead swabs to determine if lead was present on the electrical shells. We detected measurable levels of toluene, ethanol, and isopropanol; however, all samples were less than 6% of applicable OELs. Some skin contact to isopropanol was observed during the shell dipping process. Employees did not wear gloves to protect against skin exposure to these chemicals. LEV systems in the gluing and oven curing area were present but were not working optimally. Lead was not detected on the surface of the electrical shells. Several strategies could be used to minimize exposures and improve effectiveness of the LEV systems in the gluing and oven curing area. When the LEV on either the gluing station or oven is not in use, close the damper to increase the capture efficiency. Redesign the hood types and/or place the hoods closer to contaminants for better capture efficiency. Similarly, for the shell dipping area, an LEV unit could be added to reduce nuisance odors. Gloves should be used if dermal exposure to the glue or shell dipping solution is anticipated. Employees who choose to wear respiratory protection voluntarily during work activities should be provided with Appendix D of the OSHA Respiratory Protection Standard (29 CFR 1910.134). NIOSH investigators evaluated the potential for exposure to chemicals at an electrical connector manufacturer. We found that the air concentrations of toluene, ethanol, and isopropanol were very low, less than 6% of OELs. To reduce toluene and ethanol nuisance odors, we recommend changes to the LEV in the gluing and oven curing area. Additionally, installing LEV in the shell dipping area may reduce isopropanol nuisance odors.
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(2011) Lead exposure at an indoor firing range - California. (Click to open report) In August 2008, NIOSH received an HHE request from employees at an indoor small arms firing range concerned about lead exposure and indoor environmental quality. We met with employer and employee representatives and observed work processes, practices, and workplace conditions on January 12-13, 2009. We also evaluated the ventilation systems, measured airflow in the firing range, and spoke with employees. On the basis of this initial visit, we recommended installing a new ventilation system capab... (Click to show more)In August 2008, NIOSH received an HHE request from employees at an indoor small arms firing range concerned about lead exposure and indoor environmental quality. We met with employer and employee representatives and observed work processes, practices, and workplace conditions on January 12-13, 2009. We also evaluated the ventilation systems, measured airflow in the firing range, and spoke with employees. On the basis of this initial visit, we recommended installing a new ventilation system capable of delivering the NIOSH-recommended airflow. The follow-up site visit to collect air and surface lead samples was scheduled for March 2009; however, we delayed this site visit until December 2009 because of plans to install a new ventilation system in the firing range. This renovation was still delayed by the time of the December site visit, so we offered instead to collect air and surface samples to assess lead exposure before and after installation of the new ventilation system. This report only describes conditions before installation of the new ventilation system. On December 8-10, 2009, we collected PBZ air samples on firing range instructors (instructors), shooters, and the hazardous materials technician at the facility. General area air samples, floor vacuum samples, and surface wipe samples were collected in areas around the facility. We also repeated the airflow measurements in the firing range. The lead concentrations from PBZ air sampling on instructors ranged from ND- 96 microg/m3 over the sampling period (calculated 8-hour TWAs were ND- 83 microg/m3); one instructor's calculated TWA exposure (83 microg/m3) exceeded applicable OELs for an 8-hour TWA. For shooters, PBZ lead exposures ranged from 42 - 340 microg/m3 over the sampling periods (calculated 8-hour TWAs were 10 - 99 microg/m3). One shooter who repeated a portion of the qualification had an exposure of 99 microg/m3; this exceeded applicable OELs for an 8-hour TWA. The hazardous materials technician's lead exposure was 3,200 microg/m3 over the sampling period (calculated 8-hour TWA was 670 microg/m3), exceeding the applicable OELs for an 8-hour TWA. The PBZ air sample was collected outside the loose-fitting PAPR that the hazardous materials technician wore while sweeping, vacuuming, and changing exhaust air vent filters in the firing range. Floor vacuum and surface wipe sample results showed the presence of lead on work surfaces. This suggests that workplace contamination was being tracked into these areas by employees' footwear, clothing, or hands. Our review of the instructors' medical monitoring results indicated that BLLs were all below 10 microg/dL of lead. While reviewing medical records, we noted that four instructors had slightly more hearing loss in the left ear than the right ear. Two instructors had threshold shifts that met the NIOSH definition of 15 dB or more at any testing frequency. In addition to our previous recommendation for a new ventilation system, we recommended eliminating dry sweeping, removing carpeting, and improving general housekeeping practices. We also recommended that instructors not use firearms on their workdays and that all personnel working in the firing range wash their hands, arms, and face before eating, drinking, or touching others. Periodic air sampling for lead should be performed whenever changes are made that affect instructor, shooter, or hazardous materials technician exposures. Management should also continue medical monitoring for personnel at the facility.
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(2011) Noise and lead exposures at an outdoor firing range - California. (Click to open report) On February 25, 2011, NIOSH received a technical assistance request from a federal government agency to assess exposures to noise and lead of firing range instructors at an outdoor firing range in California. On April 11-12, 2011, NIOSH investigators evaluated employee exposures to noise and lead during a 3-day basic firearms course. Eight students and five instructors contributed 14 personal noise dosimetry measurements over 2 days. During live fire training, we measured sound levels and octave... (Click to show more)On February 25, 2011, NIOSH received a technical assistance request from a federal government agency to assess exposures to noise and lead of firing range instructors at an outdoor firing range in California. On April 11-12, 2011, NIOSH investigators evaluated employee exposures to noise and lead during a 3-day basic firearms course. Eight students and five instructors contributed 14 personal noise dosimetry measurements over 2 days. During live fire training, we measured sound levels and octave band noise frequency levels with a type 1 SLM. We took 16 PBZ air samples and six surface wipe samples for lead. We also used a colorimetric wipe test to test for lead on hands. Noise monitoring results indicated that all participants' TWA noise exposures exceeded the NIOSH REL, some exceeded the OSHA AL, but none exceeded the OSHA PEL. However, noise dosimeter microphones and electronic circuitry do not adequately capture peak noise levels above the maximum range of the instrument, therefore, personal TWA noise measurements from gunfire noise using dosimeters should be interpreted cautiously. These measurements can underrepresent noise exposure and hearing loss risk from gunfire noise. Sound level meter measurements revealed that peak noise levels during gunfire were greater than 160 dB. None of the lead PBZ air sampling results exceeded applicable OELs. Results varied from Day 1 to Day 2, which was likely due to the meteorological conditions. Under different meteorological conditions and employee proximity to the gun smoke source, exposures may be higher. Lead was found on the outdoor picnic table surface where we observed employees eating lunch. Employees appeared to have good hand hygiene as no lead was found on the hand wipes after washing. Because of the high noise levels in firing ranges, double hearing protection is necessary. The noise levels generated by the firearms warrant a hearing conservation program, which should meet the requirements of the OSHA hearing conservation standard [29 CFR 1910.95]. Firing range instructors should have yearly audiometric evaluations to measure hearing levels and identify hearing loss. Reviewers of audiograms should be aware of potentiating and synergistic effects of ototoxins such as lead and solvents. To reduce lead exposures, use of non-lead bullets and non-lead primers should be considered as it becomes economically feasible. Good personal hygiene should continue to be encouraged to reduce the potential for lead ingestion. Personal noise measurements taken during a basic firearms course at an outdoor firing range exceeded the NIOSH REL. Personal lead air measurements did not exceed applicable OELs, but lead was found in air samples and on a picnic table where employees ate lunch. Employees should wear double hearing protection and participate in a hearing conservation program.
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(2011) Police officers' exposures to chemicals while working inside a drug vault - Kentucky. (Click to open report) In November 2009, NIOSH received an HHE request from a police department in Kentucky. The request concerned possible health effects from working inside a vault used to store drug evidence, including marijuana, cocaine, methamphetamine, and oxycodone. We conducted evaluations in December 2009 and July 2010. We held confidential interviews with 14 employees to learn about their health and workplace concerns. We observed work processes, practices and workplace conditions. We took area and PBZ air s... (Click to show more)In November 2009, NIOSH received an HHE request from a police department in Kentucky. The request concerned possible health effects from working inside a vault used to store drug evidence, including marijuana, cocaine, methamphetamine, and oxycodone. We conducted evaluations in December 2009 and July 2010. We held confidential interviews with 14 employees to learn about their health and workplace concerns. We observed work processes, practices and workplace conditions. We took area and PBZ air samples for inorganic acids, VOCs, and drug particles, and work surface samples for drug particle contamination. We also evaluated the supply and exhaust ventilation systems inside the drug vault and adjacent office area and measured the temperature and RH levels in these areas. The air concentrations of inorganic acids inside the drug vault were well below applicable OELs. The primary VOCs we identified in the drug vault were terpenes. Terpenes are chemicals produced by plants, including marijuana, that contribute to their taste and smell. The low levels we measured are unlikely to cause health effects. However, some individuals are particularly sensitive to strong odors. Only methamphetamine particles were detected in the area air samples, while all the drugs (cocaine, methamphetamine, oxycodone, and THC) were measured in some of the PBZ and surface samples. Of the compounds we measured, drug particles probably present the greatest potential health risk because of their physiological and neurological effects. Employees reported a variety of nonspecific health symptoms, with upper respiratory symptoms, headache, eye irritation, and skin rash most commonly reported. Limited evidence exists linking low levels of indirect drug exposures to acute or chronic health effects. Nevertheless, it is possible that the drug exposures we measured could have contributed to some of the reported symptoms. These symptoms can also be caused by a variety of other occupational (e.g., odors, mold, poor indoor environmental quality, and stress) and nonoccupational factors. The general exhaust ventilation in the drug vault was adequate for gases and vapors based on the recommended minimum exhaust rate for chemical storage rooms. However, the ceiling-mounted exhaust air grills were near the supply air diffusers, leading to short-circuiting (a situation where supply air is immediately exhausted) and reduced ventilation effectiveness. Although temperature and RH levels inside the drug vault and office were acceptable for thermal comfort of employees, RH levels above 50 percent measured during our July visit could promote mold growth. We found visible mold contamination on cardboard boxes used for storing plant-based drugs. We recommend that the employer develop written policies and SOPs to ensure health and safety for employees working inside the drug vault. Employees should be trained on these policies and SOPs, and all training should be documented. All drug vault employees should participate in the medical surveillance program and wear recommended personal protective equipment. If the recommendations provided in this report are implemented, the use of respirators is not necessary inside the drug vault. A drying chamber should be used to remove moisture from plant-based drugs; these drugs should be sealed in plastic bags to prevent off-gassing. Simple modification of the existing supply and exhaust ventilation systems will improve the mixing of air and removal and dilution of the odor-causing compounds. Reducing odors may help reduce the incidence of reported symptoms. In addition, surfaces that are contaminated with drug particles should be thoroughly cleaned. Once cleaned, the recommendations we provide should help control further contamination.
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(2010) 2009 pandemic influenza A (H1N1) virus exposure among internal medicine housestaff and fellows. (Click to open report) In August 2009, NIOSH received an HHE request from the director of the internal medicine residency program at UUSM concerning the exposure of internal medicine housestaff to the pH1N1 virus. A number of internal medicine housestaff were reportedly diagnosed with pH1N1 in June 2009, and more housestaff were reported to have ILI, leading to significant absenteeism in this program. The exact extent of the disease, risk factors leading to infection, and modes of transmission among the internal medic... (Click to show more)In August 2009, NIOSH received an HHE request from the director of the internal medicine residency program at UUSM concerning the exposure of internal medicine housestaff to the pH1N1 virus. A number of internal medicine housestaff were reportedly diagnosed with pH1N1 in June 2009, and more housestaff were reported to have ILI, leading to significant absenteeism in this program. The exact extent of the disease, risk factors leading to infection, and modes of transmission among the internal medicine housestaff were unknown at the time of the request. In August-September 2009, we performed a cross-sectional study to examine pH1N1 exposure; determine the prevalence of pH1N1 infection and ILI; identify modes of transmission; and identify risk factors for infection among the internal medicine housestaff, cardiology fellows, and pulmonary and critical care fellows who were in the program at any time from May 1-June 30, 2009. We also assessed knowledge, attitudes, and practices towards influenza infection control measures. We made a site visit to UUSM and the four associated medical centers in September 2009, to meet with housestaff, fellows, and staff members at each of the four medical centers to learn about their experience during the early 2009 pH1N1 pandemic. We found that most of the 88 responding physicians reported exposure to individuals with pH1N1 or ILI either at work or outside of work. Most respondents reported having contact with a patient with confirmed or probable pH1N1 or ILI but also reported contact with ill coworkers at work and outside of work. Thirteen cases of ILI, with five laboratory-confirmed diagnoses of influenza A, occurred in responding physicians in May-June 2009. Transmission likely occurred at work and outside of work. We concluded that all four medical centers were appropriately using the occupational health hierarchy of controls approach to prevent influenza transmission within their centers and to prevent exposure of healthcare personnel. Comprehensive programs were in place, and innovative methods of infection control had been implemented with respect to engineering and administrative controls. However, our survey results show some gaps in infection control knowledge, incomplete exclusion of ill housestaff and fellows from work, and gaps in adherence to PPE use. We recommend that the residency and fellowship programs have procedures for tracking ill and absent housestaff and fellows. The programs should also develop a written plan for staffing in the event of a pandemic or other emergency. Housestaff and fellows should be encouraged to self assess for symptoms. Housestaff and fellows with febrile respiratory illness should be excluded from work according to the most recent CDC guidance, found at <a href="https://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm"target="_blank">https://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm</a>. They should also be encouraged to avoid social events outside of work. Education and training of housestaff and fellows should be provided at least annually regarding the evaluation, diagnosis, treatment, and complications of patients with symptoms of influenza; the recommended isolation precautions at each of the four medical centers; proper hand hygiene; and the proper donning, use, and removal of recommended PPE. Housestaff, fellows, and all medical center employees should continue to be required to receive the annual seasonal influenza vaccine as part of the comprehensive influenza infection control strategy. The vaccine should be made available to all housestaff and fellows at their assigned medical centers. Signage indicating appropriate isolation precautions should be placed outside of patients' rooms concurrent with placement of patients in rooms. HCP entering the room of a patient in isolation precautions for influenza should be limited to those performing patient care activities. A respiratory protection program should be developed, implemented, and maintained for all housestaff and fellows to protect against airborne infectious agents. All housestaff and fellows should receive training, receive medical clearance, and undergo fit testing as specified in the OSHA Respiratory Protection Standard (29 CFR 1910.134). PPE, including gloves, gowns, surgical masks, N95 filtering facepiece respirators, and eye protection, should be made readily available near patient rooms according to hospital guidelines. PPE use should be emphasized when caring for critically ill and noncritically ill pH1N1 and ILI patients. The medical centers should ensure appropriate stockpiles of N95 respirators and other PPE in preparation for potential outbreaks of airborne infectious agents.
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(2010) Comparison of mold exposures, work-related symptoms, and visual contrast sensitivity between employees at a severely water-damaged school and employees at a school without significant water damage. (Click to open report) On January 18, 2005, NIOSH received a request for an HHE at AFSHS in New Orleans, Louisiana. Employees submitted the request because of concerns about exposure to mold and lead paint in their school building. Employees reported a variety of health effects, including difficulty breathing, chronic sinusitis, immune system problems, nosebleeds, skin rashes, irregular menses, headaches, irritable bowel syndrome, and nausea. We visited AFSHS on April 18-19, 2005. During informal interviews, employees... (Click to show more)On January 18, 2005, NIOSH received a request for an HHE at AFSHS in New Orleans, Louisiana. Employees submitted the request because of concerns about exposure to mold and lead paint in their school building. Employees reported a variety of health effects, including difficulty breathing, chronic sinusitis, immune system problems, nosebleeds, skin rashes, irregular menses, headaches, irritable bowel syndrome, and nausea. We visited AFSHS on April 18-19, 2005. During informal interviews, employees reported possible work-related symptoms, some of which were consistent with symptoms reported by people working in water-damaged buildings. The building had obvious microbial contamination, so we decided that further evaluation was needed. On May 23-24, 2005, we returned to New Orleans for a follow-up evaluation. During this visit we administered a work history and health symptom questionnaire. We also conducted VCS testing using the F.A.C.T. handheld chart. VCS testing measures the subjects' ability to determine changes in alternating light and dark bands of varying intensity. Performance on this test has been adversely associated with exposure to neurotoxins such as solvents and lead among many other conditions and exposures such as aging, certain eye conditions, alcohol and medication use, and depression. We used VCS testing for this evaluation to determine if it could serve as a biomarker of effect for occupants who experience adverse effects from a water-damaged building. We also collected environmental samples for culturable and aerosolized fungal spores and measured IEQ parameters (CO2, temperature, and RH). We performed a similar evaluation at WHHS in Cincinnati, Ohio, on February 27-29, 2006. WHHS had no history of ongoing water intrusion or mold growth. Of 119 employees at AFSHS, 95 (80%) participated in the evaluation. Of 165 employees at WHHS, 110 (67%) participated. Participants at both schools were similar in sex, age, history of psychiatric disease, atopy (the predisposition to allergic disease), smoking history, and having mold or moisture problems in their homes. Employees at AFSHS had higher prevalences of work-related cough, wheezing, or whistling in the chest; chest tightness; unusual shortness of breath; sinus problems; sore or dry throat; frequent sneezing; stuffy nose; runny nose; fever or sweats; aching all over; unusual tiredness or fatigue; headache; difficulty concentrating; confusion or disorientation; trouble remembering things; change in sleep patterns; and rash, dermatitis, or eczema on the face, neck, or arms than employees at WHHS. At each school, 13 employees reported currently having asthma. A significantly higher percent of the asthmatics at AFSHS reported their asthma was worse at work. Monocular and binocular VCS values were significantly lower at all spatial frequencies among AFSHS employees. A significantly higher percentage of employees at AFSHS had scores that fell below the average performance for 90% of the population compared to the results found among employees at WHHS. Actively growing Cladosporium was found on the walls of AFSHS. Mold was found in all three MSQPCR air samples with C. sphaerospermum being the most prevalent. The vacuum dust samples detected 32 of the 35 fungal species tested. The culturable air samples showed that Cladosporium and Pencillium were the most prevalent genera both inside and outside the school. Aspergillus species were detected in inside samples but not in outside air samples. The spore trap samples showed that Cladosporium was the prevalent genera both inside and outside the school with the exception of Room 316. No fungal growth was detected on six of eight sticky tape samples collected at WHHS. One had a trace of hyphae, and the other showed a few Aspergillus/Pencillium-like spores and a trace of hyphae. Both were from the band room. Air samples analyzed with MSQPCR showed low counts for inside samples compared to outside samples. The culturable and spore trap air samples collected inside and outside WHHS were comparable in terms of both counts and genera ranking. CO2 concentrations were elevated in some classrooms. We determined that a health hazard existed at AFSHS. Employees had significantly higher prevalences of rashes and nasal, lower respiratory, and constitutional symptoms than employees at WHHS. The prevalences of several neurobehavioral symptoms were also significantly higher. VCS values across all spatial frequencies were lower in the employees at AFSHS. Further studies are needed to determine what factors could be responsible for the VCS findings and whether they have any clinical significance for affected individuals. The building problems at AFSHS need to be addressed; recommendations to prevent water damage and microbial growth and for remediation in NOPS and WHHS are provided in this report.
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