Impact of a cleaners’ strike on compensation claims for asthma among teachers in Ontario

BACKGROUND:

A review of Workplace Safety and Insurance Board (WSIB) claims in Ontario from 1998 to 2002 showed an unusual spike in the number of claims accepted for work-exacerbated asthma (WEA) in April 2001.

OBJECTIVE:

To identify the cause for the spike in the number of WSIB claims for WEA in April 2001.

METHODS:

File reviews were performed to identify the occupations of workers with claims accepted for WEA in April 2001 compared with claims during March and May 2001, and during the same months in 2000 and 2002.

RESULTS:

In April 2001, there were 61 accepted WEA claims; the most common occupation was ‘teacher’. In contrast, among educational workers, there was only one WEA claim in the previous month and one in the following month. From March to May in the preceding and following years, there were only four and two claims, respectively. The most frequently implicated causative agents were dust and dirt exposure, which were responsible for 98% of claims; the mean (± SD) number of lost workdays was 6.5±10. The only identified environmental change associated with this spike was a cleaners’ strike at all elementary and high schools in the Toronto District School Board in Ontario, which started on March 31, 2001 and ended on May 1, 2001.

CONCLUSION:

The spike in accepted WEA claims in Ontario in April 2001 was temporally associated with a strike by Toronto District School Board cleaners, suggesting acute symptomatic effects of poor workplace (school) maintenance on asthmatic employees. The WSIB database was sufficiently sensitive to capture this phenomenon.     

Hospital support services and the impacts of outsourcing on occupational health and safety

Background: Outsourcing labor is linked to negative impacts on occupational health and safety (OHS). In British Columbia, Canada, provincial health care service providers outsource support services such as cleaners and food service workers (CFSWs) to external contractors.

Objectives: This study investigates the impact of outsourcing on the occupational health safety of hospital CFSWs through a mixed methods approach.

Methods: Worker’s compensation data for hospital CFSWs were analyzed by negative binomial and multiple linear regressions supplemented by iterative thematic analysis of telephone interviews of the same job groups.

Results: Non-significant decreases in injury rates and days lost per injury were observed in outsourced CFSWs post outsourcing. Significant decreases (P < 0.05) were observed in average costs per injury for cleaners post outsourcing. Outsourced workers interviewed implied instances of underreporting workplace injuries.

Conclusions: This mixed methods study describes the impact of outsourcing on OHS of healthcare workers in British Columbia. Results will be helpful for policy-makers and workplace regulators to assess program effectiveness for outsourced workers.     

手术室保洁员的培训与医院感染控制管理

手术室保洁员的培训是加强医院感染控制的一项重要举措。本院采用言传身教的方法对保洁员进行岗前和岗位培训,使保沽员全面、正确地掌握岗位工作方法和注意事项,从而使手术室环境符合手术要求。     

医院保洁人员职业安全防护的调查分析及对策

目的加强医院保洁人员的职业安全防护意识。方法采用自行设计的问卷对32名保洁人员进行调查。结果所有保洁人员对消毒剂的有效浓度不掌握,医院感染知识欠缺,不规范使用防护用具和洗手流程。结论应进行职业安全防护知识的强化培训,熟练应用防护知识的强化培训,熟练应用防护技术,建立完善的管理制度,配备必要的防护设施,加强安全管理,有效控制医院感染。     

Musculoskeletal symptoms among hospital cleaners

Studies have indicated that cleaners are at risk for musculoskeletal symptoms (MSS). In 2001, the Norwegian Labor Inspectorate suggested improvements in cleaners' work environment to reduce MSS. We estimate prevalence of MSS among cleaners in a Norwegian hospital that had implemented improvements to reduce risk of MSS and calculate relative risk of MSS among cleaners compared to a group of office workers. Data were collected from 255 participants. MSS were investigated using the Nordic Questionnaire for Analysis of Musculoskeletal Symptoms. Cleaners reported a significantly higher prevalence of MSS compared to office workers but a lower prevalence compared to similar studies among cleaners in other countries. This may indicate that working conditions in Norway are better than in other countries; further studies are needed to compare MSS and working conditions in different settings.     

综合干预对保洁人员医院感染知识认知程度的影响

目的了解医院保洁人员对医院感染知识掌握情况,探讨提高保洁人员掌握医院感染知识的有效方法,从而减少医院感染的发生。方法通过自行设计问卷并结合现场观察在保洁人员不知情的情况下进行调查,经过综合干预(实行形式多样、反复强化的培训,建立考核奖惩制度等)1年后用同样的方法再次评价。结果干预前与干预后保洁人员医院感染知识掌握情况合格率分别为13.3%和100%(满分100分,60分以上合格),其中干预前最高65分,最低20分,平均41分;干预后最高100分,最低75分,平均89分,差异有统计学意义(P<0.01)。结论综合干预是提高保洁人员掌握医院感染知识的有效方法。     

Exposure of nickel and the relevance of nickel sensitivity among hospital cleaners

The nickel content of water specimens from consecutive stages during the cleaning process in a Danish hospital was analyzed. Statistically significant increases of the nickel concentrations were found from step to step of the cleaning, eventually exceeding the theoretical sensitizing safety limit. The relevance of the findings in relation to hand eczema is discussed.     

Work load during floor cleaning. The effect of cleaning methods and work technique

Cardiovascular and muscle load levels were evaluated during floor cleaning. A group of 12 experienced female cleaners participated in the study. Of the subjects 6 used a mopping method and 6 a traditional scrub and cloth method. Heart rate, oxygen consumption, rating of perceived exertion, electromyography from the trapezius muscle and video recordings were obtained during floor cleaning. With respect to relative heart rate and oxygen consumption the two groups did not differ. The results revealed a high cardiovascular load corresponding on average to 53% of the individual maximal oxygen uptake. In addition 65% of the observed period was spent with the back in a position forward flexed more than 20°. The time spent in extreme forward back flexion was shorter for the mopping group. Both groups exhibited high static, median and peak shoulder muscle load levels of 10%, 25% and 54% maximal voluntary contraction, respectively. At the same time, however, the mopping group tended to have a higher shoulder load than the group using the scrub and cloth method. Furthermore, electromyographic signs of fatigue in the trapezius muscle indicated a more stereotype activation of the shoulder muscles during mopping than during scrubbing. Based on these results, it was concluded that mopping cannot be recommended as less strenuous than scrubbing.     

Work-related asthma among professional cleaning women

The job of cleaning has developed dynamically as a working service, and women constitute the majority of all professional cleaning workers. Cleaners are at an increased risk of work-related asthma (WRA). This study characterizes work-related respiratory symptoms reported by female cleaners, evaluates any associated factors of WRA, and shows diagnostic management of medical certification. The study group comprised 50 professional cleaning women referred to our Occupational Diseases Department due to suspicion of occupational asthma (OA). A questionnaire, skin prick tests, serum specific IgE antibodies, and specific inhalant challenge were performed in all of the participants. Work-related asthma was recognized in 46% of symptomatic cleaners, of whom 15 were considered as having work-exacerbated asthma (WEA) and 8 as having OA. Sensitization to latex and disinfectants played an important role as a causative agent in OA of cleaners.     

情景模拟培训在塞拉利昂医院保洁人员埃博拉出血热防控中的应用

目的：探讨情景模拟培训法对塞拉利昂医院保洁人员防控技能培训的效果。方法对塞方40名保洁人员进行情景模拟演练培训，即针对需解决的防控问题进行情景设计、演练、培训，最后按评价和考核标准进行考核。结果经过培训后40名塞方保洁人员在焦虑、紧张、害怕、失眠、抑郁等方面均有减轻，培训前后比较差异均有统计学意义（χ2值分别为16．2，39．7，34．3，15．9，5．2；P＜0．05）。培训前40名保洁人员对环境布局改造满意者7名，培训后工作满意度提高，对环境布局改造满意者39名，培训前后比较差异有统计学意义（χ2＝52．4，P＜0．01）；培训后40名保洁人员对培训效果和培训内容满意度均达100％；考试得分最高98分，最低68分，合格39人；工作状态良好，未发生院内感染的不良事件。结论分步骤、全流程情景模拟培训是提高保洁人员防控知识和技能的有效途径。