The effect of high-efficiency particulate air respirator design on occupational health: a pilot study balancing risks in the real world.

Abstract:

OBJECTIVES:To quantify specific factors believed to increase healthcare worker (HCW) risk for contaminated sharps injuries (eg, visibility, communication, and range of motion); to quantify the degree to which respirators of various designs impacted those same factors; and to assess HCW opinions about the suitability of selected respirators with respect to patient care and user compliance criteria. DESIGN:Sharps injury data from seven hospitals were analyzed to determine the potential contribution of visibility, communication, and range of motion to reported injuries. Healthcare workers representing various clinical specialties and physical characteristics were examined at baseline and while wearing five different respirators to quantify the impact of respirator design on visibility, communication, and range of motion. Healthcare workers were interviewed and completed a survey assessing each respirator. SETTING:Hospital and ambulatory-care settings. PARTICIPANTS:Population-based and convenience sample. RESULTS:Communication, visibility, and range of motion were found to affect contaminated sharps injuries significantly. Selected high-efficiency particulate air (HEPA) respirators were found to have a negative impact on each of these variables. Healthcare workers involved in the study also reported compliance criteria problems with selected HEPA respirators, which may effect implementation of respiratory precautions adversely. CONCLUSION:Current HEPA respirators, because of their design, potentially increase the risk of bloodborne pathogen exposure through sharps injuries. We conclude that mandating respirators without regard to the potential impact of their design to the sharps injuries may be counterproductive to HCW safety, because they may increase, rather than decrease, overall occupational risk to HCWs.

authors

Eck EK,Vannier A

doi

10.1086/647566

subject

Has Abstract

pub_date

1997-02-01 00:00:00

pages

122-7

issue

2

eissn

0899-823X

issn

1559-6834

journal_volume

18

pub_type

杂志文章
  • Respiratory virus shedding in a cohort of on-duty healthcare workers undergoing prospective surveillance.

    abstract:BACKGROUND:Healthcare-associated transmission of respiratory viruses is a concerning patient safety issue. DESIGN:Surveillance for influenza virus among a cohort of healthcare workers (HCWs) was conducted in a tertiary care children's hospital from November 2009 through April 2010 using biweekly nasal swab specimen co...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/669857

    authors: Esbenshade JC,Edwards KM,Esbenshade AJ,Rodriguez VE,Talbot HK,Joseph MF,Nwosu SK,Chappell JD,Gern JE,Williams JV,Talbot TR

    更新日期:2013-04-01 00:00:00

  • Multidrug Resistant Acinetobacter baumanii: A 15-Year Trend Analysis.

    abstract::From 2000 to 2009, rates of multidrug-resistant Acinetobacter baumanii increased 10-fold to 0.2 per 1,000 patient days. From 2010 to 2015, however, rates markedly declined and have stayed below 0.05 per 1,000 patient days. Herein, we present a 15-year trend analysis and discuss interventions that may have led to the d...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2018.52

    authors: Russell DL,Uslan DZ,Rubin ZA,Grogan TR,Martin EM

    更新日期:2018-05-01 00:00:00

  • Healthcare-Associated Transmission of Plasmodium falciparum in New York City.

    abstract::A patient with no risk factors for malaria was hospitalized in New York City with Plasmodium falciparum infection. After investigating all potential sources of infection, we concluded the patient had been exposed to malaria while hospitalized less than 3 weeks earlier. Molecular genotyping implicated patient-to-patien...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2015.236

    authors: Lee EH,Adams EH,Madison-Antenucci S,Lee L,Barnwell JW,Whitehouse J,Clement E,Bajwa W,Jones LE,Lutterloh E,Weiss D,Ackelsberg J

    更新日期:2016-01-01 00:00:00

  • Ultraviolet powder versus ultraviolet gel for assessing environmental cleaning.

    abstract::We compared cleaning rates associated with use of a white ultraviolet (UV) powder versus a transparent UV gel among units with various degrees of previous experience with UV powder. The study outcome was the presence of discordant cleaning (removal of powder without the removal of gel, or vice versa). We found higher ...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/663713

    authors: Munoz-Price LS,Fajardo-Aquino Y,Arheart KL

    更新日期:2012-02-01 00:00:00

  • Mycobacterium chimaera Outbreak Associated With Heater-Cooler Devices: Piecing the Puzzle Together.

    abstract::An outbreak of invasive Mycobacterium chimaera infections associated with heater-cooler devices (HCDs) has now affected patients in several countries on different continents. Clinical infections are characterized by delayed diagnosis, inadequate treatment response to antimicrobial agents, and poor prognosis. Outbreak ...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章,评审

    doi:10.1017/ice.2016.283

    authors: Sommerstein R,Schreiber PW,Diekema DJ,Edmond MB,Hasse B,Marschall J,Sax H

    更新日期:2017-01-01 00:00:00

  • The influenza vaccination demonstration project: an expanded policy goal.

    abstract::In 1980, the Public Health Service established an objective of immunizing 60% of high-risk persons with influenza vaccine annually by the year 1990. As no more than 32% of high-risk persons currently receive influenza vaccine each year, the Health Care Financing Administration (HCFA) has undertaken an influenza vaccin...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/646187

    authors: Fedson DS

    更新日期:1990-07-01 00:00:00

  • The Risk of Cross Infection in the Emergency Department: A Simulation Study.

    abstract::OBJECTIVESThe risk of cross infection in a busy emergency department (ED) is a serious public health concern, especially in times of pandemic threats. We simulated cross infections due to respiratory diseases spread by large droplets using empirical data on contacts (ie, close-proximity interactions of ≤1m) in an ED t...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2018.61

    authors: Hertzberg VS,Wang YA,Elon LK,Lowery-North DW

    更新日期:2018-06-01 00:00:00

  • Challenges faced by hospital healthcare workers in using a syndrome-based surveillance system during the 2003 outbreak of severe acute respiratory syndrome in Taiwan.

    abstract::Because the severe acute respiratory syndrome (SARS) outbreak in Taiwan in 2003 was worsened by hospital infections, we analyzed 229 questionnaires (84.8% of 270 sent) completed by surveyed healthcare workers who cared for patients with SARS in 3 types of hospitals, to identify surveillance problems. Atypical clinical...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/508835

    authors: Shih FY,Yen MY,Wu JS,Chang FK,Lin LW,Ho MS,Hsiung CA,Su IJ,Marx MA,Sobel H,King CC

    更新日期:2007-03-01 00:00:00

  • How frequently are hospitalized patients colonized with carbapenem-resistant Enterobacteriaceae (CRE) already on contact precautions for other indications?

    abstract::Using samples collected for VRE surveillance, we evaluated unit admission prevalence of carbapenem-resistant Enterobacteriaceae (CRE) perirectal colonization and whether CRE carriers (unknown to staff) were on contact precautions for other indications. CRE colonization at unit admission was infrequent (3.9%). Most CRE...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2018.236

    authors: Goodman KE,Simner PJ,Klein EY,Kazmi AQ,Gadala A,Rock C,Tamma PD,Cosgrove SE,Maragakis LL,Milstone AM,CDC Prevention Epicenters Program.

    更新日期:2018-12-01 00:00:00

  • Additional costs for preventing the spread of methicillin-resistant Staphylococcus aureus and a strategy for reducing these costs on a surgical ward.

    abstract:OBJECTIVE:To determine the added costs of hygienic measures (barrier precautions, isolation, and decontamination) required for MRSA carriers in German hospitals and possible strategies for cost reduction. DESIGN:On a septic surgical ward caring for 35% of all MRSA cases in a university hospital (1,182 beds), additiona...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/502274

    authors: Herr CE,Heckrodt TH,Hofmann FA,Schnettler R,Eikmann TF

    更新日期:2003-09-01 00:00:00

  • Hand washing and physicians: how to get them together.

    abstract:OBJECTIVE:To determine the motivating and behavioral factors responsible for improving compliance with hand washing among physicians. DESIGN:Five unobtrusive, observational studies recording hand washing after direct patient contact, with study results reported to physicians. SETTING:A 450-bed hospital in a health ma...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/501965

    authors: Salemi C,Canola MT,Eck EK

    更新日期:2002-01-01 00:00:00

  • Controlling use of antimicrobials in a community teaching hospital.

    abstract:OBJECTIVE:To test the hypothesis that antibiotic use could be controlled or improved in a community teaching hospital, with improvement defined as reductions in overall use, overall cost, and antimicrobial resistance. DESIGN:Interventional study with historical comparison. SETTING:A not-for-profit, 900-bed community ...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/500419

    authors: Philmon C,Smith T,Williamson S,Goodman E

    更新日期:2006-03-01 00:00:00

  • An outbreak of epidemic keratoconjunctivtis in a pediatric unit due to adenovirus type 8.

    abstract:OBJECTIVES:To investigate and control an outbreak of epidemic keratoconjunctivitis (EKC) occurring in a neonatal intensive care unit (NICU) and to determine signs specific for EKC in newborns. DESIGN:Outbreak investigation and case-control study. SETTING:NICU of a 1,600-bed university hospital in Heidelberg, Germany....

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/502247

    authors: Chaberny IE,Schnitzler P,Geiss HK,Wendt C

    更新日期:2003-07-01 00:00:00

  • Nosocomial transmission of HIV in Africa: what tribute is paid to contaminated blood transfusions and medical injections?

    abstract::We reviewed the published data on the possible impact of medical injections and blood transfusions on the spread of human immunodeficiency virus (HIV) in Africa. We also compared these results to our experience in Rwanda, central Africa. The importance of medical injections in the epidemic of HIV infection seems to di...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/645833

    authors: Lepage P,Van de Perre P

    更新日期:1988-05-01 00:00:00

  • An investigation of potential neurosurgical transmission of Creutzfeldt-Jakob disease: challenges and lessons learned.

    abstract::In 2001, New York State health officials were notified about 2 patients with Creutzfeldt-Jakob disease who had undergone neurosurgical procedures at the same hospital within 43 days of each other. One patient had Creutzfeldt-Jakob disease at the time of surgery; the other patient developed Creutzfeldt-Jakob disease 6....

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/503017

    authors: Stricof RL,Lillquist PP,Thomas N,Belay ED,Schonberger LB,Morse DL

    更新日期:2006-03-01 00:00:00

  • Control of methicillin-resistant Staphylococcus aureus in a neonatal intensive-care unit: use of intensive microbiologic surveillance and mupirocin.

    abstract:OBJECTIVE:To describe the epidemiology and the interventions used to control two methicillin-resistant Staphylococcus aureus (MRSA) epidemics involving 46 infants with two fatalities in a neonatal intensive care unit (NICU). SETTING:A 50-bed, level III NICU in a university hospital. INTERVENTIONS:After traditional in...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/647285

    authors: Back NA,Linnemann CC Jr,Staneck JL,Kotagal UR

    更新日期:1996-04-01 00:00:00

  • Staphylococcus aureus bacteremia in older adults: predictors of 7-day mortality and infection with a methicillin-resistant strain.

    abstract:OBJECTIVES:To determine the predictors of 7-day mortality in older adult patients with Staphylococcus aureus bacteremia after controlling for comorbidity using the Charlson weighted index of comorbidity (WIC) and to identify the risk factors associated with bacteremia due to methicillin-resistant S. aureus (MRSA). DES...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/507924

    authors: Bader MS

    更新日期:2006-11-01 00:00:00

  • Nosocomial infection due to Vibrio cholerae in two referral hospitals in Guatemala.

    abstract::We report nosocomial infection with Vibrio cholerae 01, in four seriously ill individuals and one infant in Guatemala. Nosocomial cholera occurs in developing countries in Latin America and should be suspected in hospitalized patients with diarrhea, especially during community outbreaks, in order to institute appropri...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/647321

    authors: Hernández JE,Mejía CR,Cazali IL,Arathoon EG

    更新日期:1996-06-01 00:00:00

  • Building and Validating a Computerized Algorithm for Surveillance of Ventilator-Associated Events.

    abstract:OBJECTIVE:To develop an automated method for ventilator-associated condition (VAC) surveillance and to compare its accuracy and efficiency with manual VAC surveillance SETTING:The intensive care units (ICUs) of 4 hospitals METHODS:This study was conducted at Detroit Medical Center, a tertiary care center in metropoli...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2015.127

    authors: Mann T,Ellsworth J,Huda N,Neelakanta A,Chevalier T,Sims KL,Dhar S,Robinson ME,Kaye KS

    更新日期:2015-09-01 00:00:00

  • Reduction of Environmental Contamination With Multidrug-Resistant Bacteria by Copper-Alloy Coating of Surfaces in a Highly Endemic Setting.

    abstract::OBJECTIVE To evaluate the efficacy of copper-coating in reducing environmental colonization in an intensive-care unit (ICU) with multidrug-resistant-organism (MDRO) endemicity DESIGN Interventional, comparative crossover trial SETTING The general ICU of Attikon University hospital in Athens, Greece PATIENTS Those admi...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2017.52

    authors: Souli M,Antoniadou A,Katsarolis I,Mavrou I,Paramythiotou E,Papadomichelakis E,Drogari-Apiranthitou M,Panagea T,Giamarellou H,Petrikkos G,Armaganidis A

    更新日期:2017-07-01 00:00:00

  • Evidence of delays in transferring patients with methicillin-resistant Staphylococcus aureus or vancomycin-resistant Enterococcus to long-term-care facilities.

    abstract::This retrospective case-control study examined whether there was a difference in length of time awaiting long-term-care placement for patients identified as having methicillin-resistant Staphylococcus aureus or vancomycin-resistant Enterococcus compared to controls. Thirty-nine patients with methicillin-resistant Stap...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/501757

    authors: Bryce EA,Tiffin SM,Isaac-Renton JL,Wright CJ

    更新日期:2000-04-01 00:00:00

  • Susceptibility of Candida auris and Candida albicans to 21 germicides used in healthcare facilities.

    abstract::Candida auris is an emerging fungal pathogen that is often resistant to major classes of antifungal drugs. It is considered a serious global health threat because it can cause severe infections with frequent mortality in more than a dozen countries. It can survive on healthcare environmental surfaces for at least 7 da...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2019.1

    authors: Rutala WA,Kanamori H,Gergen MF,Sickbert-Bennett EE,Weber DJ

    更新日期:2019-03-01 00:00:00

  • Do intensive hospital antibiotic control programs prevent the spread of antibiotic resistance?

    abstract::The relation between antibiotic control and resistance was assessed by review of selected journal articles from 1988 through 1994. Most studies of control or monitoring do not report susceptibility pattern as an outcome measure. Several aspects of bias and confounding prevent more than analysis of temporal association...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章,评审

    doi:10.1086/646954

    authors: McGowan JE Jr

    更新日期:1994-07-01 00:00:00

  • Water Cultures Are More Sensitive Than Swab Cultures for the Detection of Environmental Legionella.

    abstract::Water cultures were significantly more sensitive than concurrently collected swab cultures (n=2,147 each) in detecting Legionella pneumophila within a Veterans Affairs healthcare system. Sensitivity for water versus swab cultures was 90% versus 30% overall, 83% versus 48% during a nosocomial Legionnaires' disease outb...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2017.235

    authors: Decker BK,Harris PL,Toy DL,Muder RR,Sonel AF,Clancy CJ

    更新日期:2018-01-01 00:00:00

  • Transmission of hepatitis C in a pharmacologic study.

    abstract:OBJECTIVE:To describe an outbreak of hepatitis C in a clinical research study. DESIGN:Observational study. SETTING:Tertiary-care hospital. PATIENTS:Healthcare workers who volunteered to be subjects in a study of the metabolic effects of inhaled and oral corticosteroids who were unwittingly exposed to hepatitis C vir...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/501848

    authors: Saginur R,Nixon J,Devries B,Bruce N,Carruthers C,Scully L,Berger R,Leech J,Nicolle L,Mackenzie A

    更新日期:2001-11-01 00:00:00

  • Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record.

    abstract:OBJECTIVE:To determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. PATIENTS:All patients at least 18 years of age...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2020.1344

    authors: Cabral SM,Goodman KE,Blanco N,Leekha S,Magder LS,Nadimpalli G,Pineles L,Thom KA,Harris AD

    更新日期:2020-12-17 00:00:00

  • Cluster randomized trial of an antibiotic time-out led by a team-based pharmacist.

    abstract:OBJECTIVE:Antibiotic time-outs (ATOs) have been advocated to improve antibiotic use without dedicated stewardship resources, but their utility is poorly defined. We sought to evaluate the effectiveness of an ATO led by a team-based pharmacist. DESIGN:Cluster randomized controlled trial. SETTING:Six medicine teams at ...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2020.347

    authors: Van Schooneveld TC,Rupp ME,Cavaleiri RJ,Lyden E,Rolek K

    更新日期:2020-11-01 00:00:00

  • Vertical transmission of Citrobacter diversus documented by DNA fingerprinting.

    abstract:OBJECTIVE:To confirm the vertical transmission of Citrobacter diversus from a mother to her infant and to evaluate the epidemiologic usefulness of a new automated procedure for analysis of polymerase chain reaction (PCR)-generated DNA fingerprints. DESIGN:Repetitive element-based PCR (rep-PCR) analysis of C diversus i...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/647009

    authors: Harvey BS,Koeuth T,Versalovic J,Woods CR,Lupski JR

    更新日期:1995-10-01 00:00:00

  • COVID-19 infections among HCWs exposed to a patient with a delayed diagnosis of COVID-19.

    abstract::We report on COVID-19 risk among HCWs exposed to a patient diagnosed with COVID-19 on day 13 of hospitalization. There were 44 HCWs exposed to the patient before contact and droplet precautions were implemented: of these, 2 of 44 (5%) developed COVID-19 potentially attributable to the exposure. ...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2020.256

    authors: Baker MA,Rhee C,Fiumara K,Bennett-Rizzo C,Tucker R,Williams SA,Wickner P,Beloff J,McGrath C,Poulton A,Klompas M

    更新日期:2020-09-01 00:00:00

  • Evaluation of two retrospective active surveillance methods for the detection of nosocomial infection in surgical patients.

    abstract:OBJECTIVE:To compare the sensitivity and specificity of two retrospective active surveillance methods based on review of the medical record and review of the discharge form in identfying nosocomial infection, taking the prospective surveillance method as the reference standard. DESIGN:Blind comparison of three active ...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/501692

    authors: Belío-Blasco C,Torres-Fernández-Gil MA,Echeverría-Echarri JL,Gómez-López LI

    更新日期:2000-01-01 00:00:00