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HHE Search Results
62 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
(1993) Providence Ambulatory Health Care Foundation, Inc., Allen Berry Health Care Center, Providence, Rhode Island. (Click to open report) In response to a request from the Providence Ambulatory Health Care Foundation (SIC-8011), Providence, Rhode Island, the ventilation system at the Allen Berry Health Care Center was evaluated for suitability for preventing tuberculosis transmission. The system was operated in the automatic mode which meant that, if the temperature setpoints were met, no additional supply air entered the system to the examination rooms and the laboratory. Standing water was found in two of the units. Microbial gr... (Click to show more)In response to a request from the Providence Ambulatory Health Care Foundation (SIC-8011), Providence, Rhode Island, the ventilation system at the Allen Berry Health Care Center was evaluated for suitability for preventing tuberculosis transmission. The system was operated in the automatic mode which meant that, if the temperature setpoints were met, no additional supply air entered the system to the examination rooms and the laboratory. Standing water was found in two of the units. Microbial growth was observed in the condensate pans under the air conditioning coils. Poor maintenance of the low efficiency fiberglass particulate filters was noted. One of the thermostats controlling the units was functioning improperly. Although the clinic had a tuberculin screening program for clients, there was no screening program for employees. The author concludes that there were deficiencies in the ventilation system which could potentially increase the risk of tuberculosis transmission. The author recommends that these deficiencies be corrected, and the tuberculosis control program in place at the clinic be strengthened.
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(1993) Puerto Rico Department of Health, San Juan, Puerto Rico. (Click to open report) In response to a request for technical assistance from the Puerto Rico Department of Health Secretary, NIOSH conducted evaluations of acid fact bacterium isolation rooms for tuberculosis patients at six regional hospitals and a private clinic (SIC-8062). A visual inspection of the systems as well as a review of the original specifications of the air handling units was completed for each facility. Ventilation systems in all hospitals evaluated were either not functioning or varied from the design... (Click to show more)In response to a request for technical assistance from the Puerto Rico Department of Health Secretary, NIOSH conducted evaluations of acid fact bacterium isolation rooms for tuberculosis patients at six regional hospitals and a private clinic (SIC-8062). A visual inspection of the systems as well as a review of the original specifications of the air handling units was completed for each facility. Ventilation systems in all hospitals evaluated were either not functioning or varied from the design airflow. At four of the facilities there was a general flow of air out of the designated isolation rooms into the main corridors. On several occasions isolation room windows and doors were left open. One facility did not have any type of employee tuberculin screening program in place. The ventilation system at the private clinic was set up appropriately. The authors conclude that deficiencies in the ventilation systems of the facilities could potentially contribute to the transmission of tuberculosis from infectious patients to other patients, staff and visitors. The authors recommend that modifications to the ventilation systems be made to meet isolation criteria, and that infection control programs be improved.
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(1993) Warren Correctional Institution, Lebanon, Ohio. (Click to open report) In response to a request from the Service Employees International Union, District 1199, an investigation was begun into potential exposures to Mycobacterium-tuberculosis at the Warren Correctional Institution (SIC-9223), Lebanon, Ohio. The facility housed about 1,300 inmates in 15 structures. An inmate had been diagnosed with active tuberculosis disease in May of 1992. At the time of the NIOSH evaluation, the patient was no longer considered to be infectious. Periodic tuberculosis screening was ... (Click to show more)In response to a request from the Service Employees International Union, District 1199, an investigation was begun into potential exposures to Mycobacterium-tuberculosis at the Warren Correctional Institution (SIC-9223), Lebanon, Ohio. The facility housed about 1,300 inmates in 15 structures. An inmate had been diagnosed with active tuberculosis disease in May of 1992. At the time of the NIOSH evaluation, the patient was no longer considered to be infectious. Periodic tuberculosis screening was not provided for employees or inmates, but all inmates were screened at a reception center before arriving at the facility. Most of the air in the Medical Department was recirculated, allowing the potential for aerosolized M-tuberculosis to be transmitted throughout the department and into administrative offices as well. Other ventilation deficiencies which would increase the potential for spread of infections were also seen. These included incorrect pressure relationships between rooms and adjacent corridors. The authors conclude that the risk of M-tuberculosis transmission to employees was low or nonexistent at the time of the investigation, because the patient was no longer infectious. During a period where an inmate is actually infectious, there did appear to be cause for concern among the staff. The authors recommend that the potential for exposures should be reduced through ventilation system improvements and increased medical screening.
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(1992) A.G. Holley State Hospital, Lantana, Florida. (Click to open report) In response to a request from the Department of Health and Rehabilitative Services of the State of Florida, an investigation was begun into possible hazardous working conditions at the A. G. Holley State Tuberculosis Hospital (SIC-8069), Lantana, Florida. The adequacy of the ventilation system in place at the hospital for control of nosocomial transmission of tuberculosis was evaluated. Measurements were taken of the air flow from supply and exhaust diffusers in patient rooms along with temperat... (Click to show more)In response to a request from the Department of Health and Rehabilitative Services of the State of Florida, an investigation was begun into possible hazardous working conditions at the A. G. Holley State Tuberculosis Hospital (SIC-8069), Lantana, Florida. The adequacy of the ventilation system in place at the hospital for control of nosocomial transmission of tuberculosis was evaluated. Measurements were taken of the air flow from supply and exhaust diffusers in patient rooms along with temperature and humidity readings. Air flow was examined between patient rooms and hallways and between hospital wards. Current employee infection control practices were reviewed. The results indicated that the ventilation systems did not provide adequate fresh air to all of the rooms located on the second and third floors. The authors conclude that deficiencies noted in the ventilation systems could contribute to the transmission of tuberculosis bacilli from infectious patients to other patients and staff. The authors recommend specific measures, including the redesigning of some patient rooms, a restructuring of part of the ventilation system, adequate inspection of the ventilation equipment, institution of a respirator policy, instruction in proper usage of germicidal ultraviolet lamps, consistency in the skin testing protocol, and upgrading of the record keeping system.
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(1992) George Washington University Medical Center, Washington, D.C. (Click to open report) Exposure during aerosolized pentamidine administration was investigated in response to concerns raised by a published report about pulmonary diffusing capacity in a health care worker and diagnosis of idiopathic pulmonary fibrosis in a worker administering pentamidine (100334) at the George Washington University Medical Center (SIC-8069) in Washington, DC. Pentamidine has been used in the treatment of protozoal diseases, particularly Pneumocystis- carinii pneumonia, an opportunistic infection in... (Click to show more)Exposure during aerosolized pentamidine administration was investigated in response to concerns raised by a published report about pulmonary diffusing capacity in a health care worker and diagnosis of idiopathic pulmonary fibrosis in a worker administering pentamidine (100334) at the George Washington University Medical Center (SIC-8069) in Washington, DC. Pentamidine has been used in the treatment of protozoal diseases, particularly Pneumocystis- carinii pneumonia, an opportunistic infection in patients with compromised immune function. Environmental measurements indicated a pentamidine concentration of 0.04 micrograms/cubic meter in a personal breathing zone air sample for a nurse involved in administering the medication, and 0.09 and 0.13 micrograms/cubic meter in area air samples outside the treatment room. Of four employees interviewed, two expressed occasional symptoms of mild chest tightness associated with exposure to the medication. The authors conclude that the recognized irritant effects of pentamidine, its potential to cause bronchospasm, and the risk of tuberculosis transmission in these settings justify continued efforts to minimize worker exposure.
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(1992) John C. Murphy Family Health Center, Berkeley, Missouri. (Click to open report) In response to a request from the Senior Industrial Hygienist, Department of Community Health and Medical Care, St. Louis County, an investigation was made of occupational exposure to ultraviolet radiation emitted by germicidal lamps at the Tuberculosis Clinic of the John C. Murphy Family Health Center (SIC-8099), Berkeley, Missouri. Measurements were taken on all lamps at the tuberculosis (TB) clinic. There were approximately 140 staff at the site and they provided care to about 200 to 400 pati... (Click to show more)In response to a request from the Senior Industrial Hygienist, Department of Community Health and Medical Care, St. Louis County, an investigation was made of occupational exposure to ultraviolet radiation emitted by germicidal lamps at the Tuberculosis Clinic of the John C. Murphy Family Health Center (SIC-8099), Berkeley, Missouri. Measurements were taken on all lamps at the tuberculosis (TB) clinic. There were approximately 140 staff at the site and they provided care to about 200 to 400 patients per day, 5 days/week. The results of the evaluation indicated that levels of occupational exposure to radiation from germicidal lamps in most of the work areas were below the NIOSH Recommended Exposure Limit of were in the levels at very close distances to the lamps. Other findings noted were the presence of older lamps, inappropriate labeling and posting of signs, and ventilation deficiencies in the TB clinic area. The authors conclude that a health hazard could exist from exposure to the lamps at a distance of 10.2 centimeters, if the staff were not wearing protective eyewear. The authors recommend minimizing the ultraviolet exposures as well as improving certain ventilation parameters.
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(1992) Onondaga County medical examiner's office, Syracuse, New York. (Click to open report) In response to a request from the Division of Bacterial and Mycotic Diseases (DBMD), National Center for Infectious Diseases, Centers for Disease Control, an evaluation of environmental conditions and procedures used to prevent tuberculosis transmission was carried out at the Medical Examiner's Office (SIC-9199), Syracuse, New York. About 18 persons were employed at the Office, which conducted 600 to 700 autopsies per year. There was air mixing between the morgue and office areas. Ultraviolet ra... (Click to show more)In response to a request from the Division of Bacterial and Mycotic Diseases (DBMD), National Center for Infectious Diseases, Centers for Disease Control, an evaluation of environmental conditions and procedures used to prevent tuberculosis transmission was carried out at the Medical Examiner's Office (SIC-9199), Syracuse, New York. About 18 persons were employed at the Office, which conducted 600 to 700 autopsies per year. There was air mixing between the morgue and office areas. Ultraviolet radiation levels in the morgue were high due to the use of six ceiling mounted germicidal ultraviolet lamps providing direct irradiation of the area below. Louvers and baffles were not used on these lamps. Measurements taken indicated that the permissible exposure times for working under these lamps was less than 20 minutes for workers with unprotected skin and eyes. The author concludes that a potential hazard existed for workers exposed to aerosols from cadavers which had active tuberculosis at the time of death. The use of aerosol generating procedures presented a high risk situation. The author recommends specific measures to correct existing ventilation deficiencies, including isolation of the morgue ventilation system, use of personal protective equipment, safe use of germicidal ultraviolet lamps, and the provision of separate clean and dirty change areas for morgue personnel.
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(1992) Veterans Administration Medical Center, East Orange, New Jersey. (Click to open report) In response to a request for technical assistance from the National Center for Infectious Diseases and the National Center for Prevention Services, Centers for Disease Control, an investigation was made of ventilation for the isolation of tuberculosis patients at the Veterans Administration Medical Center (SIC-8062), East Orange, New Jersey. Ventilation measurements were on an infectious disease ward (5B) housing acquired immune deficiency patients, to determine the status of the ventilation sys... (Click to show more)In response to a request for technical assistance from the National Center for Infectious Diseases and the National Center for Prevention Services, Centers for Disease Control, an investigation was made of ventilation for the isolation of tuberculosis patients at the Veterans Administration Medical Center (SIC-8062), East Orange, New Jersey. Ventilation measurements were on an infectious disease ward (5B) housing acquired immune deficiency patients, to determine the status of the ventilation systems serving the area. Two single bed patient rooms were being used for isolation of tuberculosis patients at the time of the survey. The average supply airflow varied above and below the designed value. The rooms were all positively pressurized; this is not recommended for the isolation of infectious patients. Smoke tube traces were used to determine room to corridor pressure relationships, and the pressure relationship of this particular ward to the core areas of the hospital. There was found to be a general flow of air out of the ward into the core area. The air flowed through the core area and into an adjacent wing of the hospital, which could result in infectious agents being circulated to other wards and floors of the hospital due to the sharing of the ventilation systems. The authors conclude that there was no isolation of infectious patients on Ward 5B. The authors recommend that a separate isolation facility be constructed to house infectious patients.
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(1990) Technical Assistance to San Francisco General Hospital and Medical Center, San Francisco, California. (Click to open report) In response to a request from the Director of the Environmental Health and Safety Department of the San Francisco General Hospital and Medical Center, located in San Francisco, California, an evaluation was undertaken of possible hazardous working conditions at that site. Concern existed about exposures to hazards while operating the germicidal lamp at this facility. Germicidal lamps were used to disinfect the air in tuberculosis and aerosolized pentamidine clinics. The workers wore no protectiv... (Click to show more)In response to a request from the Director of the Environmental Health and Safety Department of the San Francisco General Hospital and Medical Center, located in San Francisco, California, an evaluation was undertaken of possible hazardous working conditions at that site. Concern existed about exposures to hazards while operating the germicidal lamp at this facility. Germicidal lamps were used to disinfect the air in tuberculosis and aerosolized pentamidine clinics. The workers wore no protective eye wear. All rooms used a 30 watt germicidal lamp. Lower wattage bulbs in the smaller rooms would have reduced occupational ultraviolet (UV) exposure. Reflectance levels of UV radiation were quite high and varied. Worker exposure to germicidal lamp UV levels was dependent on many factors, some of the most important ones being the position of the bulb in the room, age of the bulb, obstruction of the UV radiation by objects near the bulb, and the height of the worker. While there are no consensus guidelines available on ventilation systems designed for areas where germicidal lamps are used, the provision of good room air distribution and mixing is recommended to prevent stagnant air conditions or short circuiting of supply air within the room. Bulb changers need to be aware of the need for protective clothing and gloves for protection from both the UV radiation levels as well as possible glass breakage.
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(1982) Cincinnati Zoo, Cincinnati, Ohio. (Click to open report) In response to a request from the Health Department of Cincinnati, an evaluation was made of exposures to silica (7631869) dust and bird droppings at the Cincinnati Zoo (SIC-8421), Cincinnati, Ohio, occurring among workers involved in cleaning the bird cages. There were six workers assigned to the aviary area. Sand covered floors of the cages were swept with brooms to remove bird droppings and other debris. The materials from the sweepings were then scooped into a screened bottom shaker box and ... (Click to show more)In response to a request from the Health Department of Cincinnati, an evaluation was made of exposures to silica (7631869) dust and bird droppings at the Cincinnati Zoo (SIC-8421), Cincinnati, Ohio, occurring among workers involved in cleaning the bird cages. There were six workers assigned to the aviary area. Sand covered floors of the cages were swept with brooms to remove bird droppings and other debris. The materials from the sweepings were then scooped into a screened bottom shaker box and shaken to separate sand and debris. Treated or cleaned sand was returned to the cages while the waste was dumped into a waste container for removal. Positive tuberculin skin tests had occurred among some workers, causing concern. Air samples were taken and the respirable dust concentrations were found to range from 1.7 to 2.1 milligrams per cubic meter (mg/m3) and free silica concentrations from 0.32 to resulting 8 hour time weighted average free silica concentrations ranged from nondetectable to 0.1mg/m3 with three of four samples exceeding NIOSH recommended levels. However, these exposures were for periods of 45 minutes to an hour, once or twice a month, and for not more than a few years. No excess occurrence of respiratory disease was found at the zoo, but the rate of tuberculin reactivity was higher than expected. Two former employees with active tuberculosis acquired outside the zoo may have been a source for transmission. The authors conclude that it is unlikely that the silica exposures constitute a hazard. The authors recommend that the substitution of other materials for the sand might lower the exposure to crystalline silica. A ventilation system should be established in the individual bird cages, not only for dust control but also for temperature control. Testing for tuberculosis should be expanded to include all the employees.
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