Safety awareness among New York farmers

BACKGROUND: This study was conducted to assess the health status and safety practices among year-round adult farm workers and residents and included a telephone interview survey of 1,727 persons from 552 farms. METHODS: Logistic regression was used to analyze four safety questions. RESULTS: Among 541 farm owner/operators significant predictors of making substitutions in the use of chemicals and major changes to equipment include younger age, more persons assisting on the farm, and higher gross sales. Having training is associated with having more than a high school education. Among all participants the perception that personal protective equipment are useful is associated with being younger, male, an owner/operator or worker, and having at least a high school education. CONCLUSIONS: These findings suggest that older and less educated farmers should be targeted for health and safety programs.     

Risk of spontaneous abortion among nurses handling antineoplastic drugs

The purpose of the study was to evaluate the frequency of spontaneous abortion in two groups of women. One group consisted of women regularly involved in the preparation of cancer chemotherapy perfusions and therefore considered to be exposed to cytostatic agents; the other consisted of women not occupationally exposed to such agents. The study was carried out in four French hospitals. Four hundred and sixty-six women were involved; 534 pregnancies were described in which 139 were exposed and 357 were unexposed. The results showed that the frequency of spontaneous abortion was 26% for the exposed pregnancies and 15% in the unexposed ones (odds ratio 2.0). These results do not seem to be due either to the classic risk factors of spontaneous abortion (age, cigarette consumption during pregnancy, pregnancy order) (adjusted odds ratio 1.7) or to possible errors concerning the retrospective evaluation of prior gynecologic and obstetric history.     

护士对医院感染控制知识掌握程度的调查分析

目的了解临床医院感染控制护士对医院感染控制知识特别是对近年卫生部新颁布的规范和指南的掌握程度,以确定培训的重点对象及内容。方法采用现场测试的方式进行调查,内容涉及手卫生、职业暴露防护、多药耐药控制、消毒隔离技术、医院感染暴发报告及处置5个方面,各占20分。结果共测试临床医院感染控制护士67人,分数为43～92分,平均74分;内科医院感染控制护士测试及格率为86.48%,高于外科的60.00%,差异有统计学意义(χ2=6.14,P<0.05);重点科室医院感染控制护士的测试及格率为93.33%,高于普通科室的68.00%,差异有统计学意义(P<0.05);不同职称医院感染控制护士测试及格率差异无统计学意义;临床医院感染控制护士掌握新规范的程度依次为:手卫生、职业暴露防护、隔离技术、多药耐药菌株控制及医院感染暴发报告及处置。结论应有针对性地加强医院感染控制护士医院感染控制知识培训,特别要加强对卫生部新规范的培训力度和频率,使之在临床科室的医院感染控制中发挥更积极的作用。     

Leukaemia and reproductive outcome among nurses handling antineoplastic drugs.

During the past decades conclusive evidence has accumulated that alkylating antineoplastic drugs (ADs) can cause cancer, most notably acute non-lymphocytic leukaemia, and that most ADs are reprotoxic. Studies on health workers handling ADs have shown significantly increased risks for miscarriages (two studies) and malformations (two studies). The present study monitored the risk for cancer and adverse reproductive outcome among Danish nurses handling ADs. No increased risks were found for miscarriages, malformations, low birth weight, or preterm birth among the offspring of nurses handling ADs during pregnancy. The sex ratio was normal. The relative risk (RR) for leukaemia was significantly increased (10.65) but based on only two cases, one of acute myeloblastic and one of chronic myeloid leukaemia. From the available exposure data occupational exposures to ADs were apparently higher in the studies that have reported increased risks for miscarriages and malformations than in the present one. Regarding reproductive outcome the study gives some confidence that the safety measures which were implemented in the oncology departments around 1980 can protect the health personnel against adverse effects of ADs on reproduction. As the study is as yet the only negative one in a well protected setting, it should be followed up by other studies of well protected health personnel handling ADs. The findings concerning the leukaemia risk, although based on small numbers, encourage larger studies.     

Leukaemia and reproductive outcome among nurses handling antineoplastic drugs.

During the past decades conclusive evidence has accumulated that alkylating antineoplastic drugs (ADs) can cause cancer, most notably acute non-lymphocytic leukaemia, and that most ADs are reprotoxic. Studies on health workers handling ADs have shown significantly increased risks for miscarriages (two studies) and malformations (two studies). The present study monitored the risk for cancer and adverse reproductive outcome among Danish nurses handling ADs. No increased risks were found for miscarriages, malformations, low birth weight, or preterm birth among the offspring of nurses handling ADs during pregnancy. The sex ratio was normal. The relative risk (RR) for leukaemia was significantly increased (10.65) but based on only two cases, one of acute myeloblastic and one of chronic myeloid leukaemia. From the available exposure data occupational exposures to ADs were apparently higher in the studies that have reported increased risks for miscarriages and malformations than in the present one. Regarding reproductive outcome the study gives some confidence that the safety measures which were implemented in the oncology departments around 1980 can protect the health personnel against adverse effects of ADs on reproduction. As the study is as yet the only negative one in a well protected setting, it should be followed up by other studies of well protected health personnel handling ADs. The findings concerning the leukaemia risk, although based on small numbers, encourage larger studies.     

Urinary biological monitoring markers of anticancer drug exposure in oncology nurses.

People handling anticancer drugs or their wastes may absorb these potent genotoxic agents. The aim of this study was to determine the utility of some general urinary markers among 24 female oncology nurses handling these drugs in comparison with 25 "unexposed" nurses. The markers were the Salmonella typhimurium reverse and forward mutation assays, total thioethers, and D-glucaric acid. The reverse mutation assay was the most specific and sensitive marker for anti-cancer drug exposure. Use of the marker battery was no great advantage as a screening tool relative to use of the reverse mutation assay alone. Better recording of work practices in nurse work logs would have improved interpretation of results.     

Assessment of DNA damage in Japanese nurses handling antineoplastic drugs by the comet assay

To clarify genotoxic effects of occupational exposure to antineoplastic drugs in Japan, we examined DNA damage, assessed by the comet assay, in 121 female nurses and 46 female clerks working at three hospitals in the northeast of Japan. The comet assay is considered to be a sensitive and rapid method for DNA strand break detection in individual cells, and tail length and tail moment are used as the comet parameters. Concerning the basal characteristics, the 46 control subjects had higher rates of smoking and coffee-drinking habits and lower hemoglobin than the 121 nurses (p<0.05). The log-transformed tail length in the nurses was significantly longer than that in the control subjects after adjusting for possible covariates such as age and smoking habit (p<0.05). Also, the log-transformed tail length was significantly longer, in the 57 nurses who had handled antineoplastic drugs in the last six months, than that in the 46 control subjects (p<0.05); but, no significant difference in tail length or tail moment was seen between the two nurse groups with and without experience of handling hazardous drugs (p>0.05). These results suggest that Japanese nurses who have worked at hospitals using antineoplastic drugs may have a potential risk of DNA damage. To minimize this risk in Japan, use of biological safety cabinet and appropriate protective equipment, in addition to staff education and training, should be implemented in the healthcare environment.     

Lifestyle, mental health, and awareness of health among Japanese bus drivers

To examine lifestyle, mental health and awareness of health, a self-administered questionnaire survey was performed among 751 employees of a bus company in a rural city of Japan. From 597 (79.5%) respondents, we analyzed 130 male bus drivers and age-matched 130 male clerks. The questionnaire included eleven questions about lifestyle and mental health, three questions about awareness of health, and questions on personal concern about specific parts of the body or diseases, and health information they needed. Answers for lifestyle and mental health were classified into the categories of "good" or "not good" practices recommended by Breslow and Morimoto. The results were as follows; 1) Over 80 percent of subjects of both groups had good awareness of health, but bus drivers had significantly worse lifestyle with regard to nutritional intake (p < 0.05), daily walking (p < 0.001), sports (p < 0.05), and sleeping hours (p < 0.001). 2) Bus drivers had significantly greater prevalence of concern about their cardiovascular system, esophagus and gastrointestinal system, and joints and bones than clerks (p < 0.05). 3) Bus drivers had a significantly greater need for information about nutritional intake (p < 0.001), and methods for prevention of diseases (p < 0.01). From these results, the discrepancy between awareness of health and lifestyle seen in this study, especially in food intake, walking time, sports participation, and sleep, may have resulted from the bus driver's characteristics of job, for example, long and irregular working hours. Therefore, effective guidance on health and lifestyle changes to restore balance and improve their lifestyle.     

A pilot study testing the dimensions of safety climate among Japanese nurses

To investigate the dimensions of safety climate among Japanese nurses, an anonymous self-administered questionnaire survey was conducted. The subjects involved in the survey included 293 full-time nurses (registered nurses and licensed practical nurses) working in a public hospital, excluding directors of nursing. A total of 221 of the 293 nurses answered the questionnaires. Among 221 questionnaires, the questionnaires, which had missing values in the question items used in this study, were excluded from the analyses. Consequently, a total of 201 questionnaires were analyzed. The average age of the subjects was 34.7 yr. As a result of exploratory factor analysis, 5 factors were extracted as follows: intellectual development regarding medical safety among nurses, accumulated fatigue, nursing conditions, supervisors' attitudes, and communication with physicians. All the values of Cronback's coefficient alpha among these 5 factors were between 0.804 and 0.892. As a result of the confirmatory factor analysis of the 5 factors, the value of the GFI (Goodness of Fit Index) was 0.868. The value of the CFI (Comparative Fit Index) was 0.943. The value of the RMSEA (Root Mean Square Error of Approximation) was 0.062. The results of this study will contribute to the investigation of the dimensions of a nurses' safety climate scale in the future. The associations between the dimensions of the safety climate and the motivation to work toward improving patients' safety among Japanese nurses will need to be examined, as will those between the dimensions of the safety climate and actual clinical mistakes.     

A qualitative study of cervical cancer and cervical cancer screening awareness among nurses in Ghana

Despite the availability of cervical cancer screening tools, including those that are appropriate for low resource settings, the rates of preventive cervical cancer screening remain extremely low among women in LMICS. Nurse-led education interventions have been proven to be effective at increasing participation in healthcare recommendations. However, there is a need to determine nurses' knowledge of cervical cancer and cervical cancer prevention in order to develop effective health education interventions. Our goal was to assess Ghanaian nurses' knowledge of cervical cancer and cervical cancer prevention. Interviews and small focus groups were conducted with 42 nurses at two hospitals in Ghana. Awareness of cervical cancer was very high among the nurses. However, the majority of the participants held negative perceptions about cervical cancer and lacked knowledge about cervical cancer risk factors and prevention. The results can be used to inform the development of culturally-relevant cervical cancer education interventions targeted towards women and healthcare providers in LMICs.     

Prevalence and correlates of hand dermatitis among nurses in a Japanese teaching hospital

BACKGROUND: Although hand dermatitis represents a common occupational disease among hospital nurses, epidemiologic studies of this nature are comparatively rare in Japan. METHODS: We recruited a complete cross-section of nurses from a teaching hospital in central Japan. Data was gathered by means of a self-reported questionnaire, with hand dermatitis symptoms and evaluation criteria drawn from previously validated research. Participants were categorised according to their hospital department during the analysis. RESULTS: A total of 305 questionnaires were successfully completed and returned (response rate: 84%). There were statistically significant differences in hand dermatitis prevalence between the departments (p < 0.05), ranging from 6% in psychiatry to 48% in the surgical unit and averaging 35% across the entire group. A history of allergic disease was shown to increase the risk of hand dermatitis (odds ratio = 3.7, 95% confidence interval: 2.1 - 6.6). Washing their hands more than 15 times per work shift also increased the risk (odds ratio = 2.0, 95% confidence interval: 1.2 - 3.4). CONCLUSION: This study has shown that hand dermatitis prevalence varies among Japanese nurses depending on their hospital department, and is generally quite high when compared to other reports.     

广西居民中药知识认知现状调查

目的了解广西居民对中药的认识及安全使用中药的情况,为开展中药知识健康教育提供依据。方法采用随机抽样的方法,对广西南宁市西乡塘区,北海市,马山的部分居民做现场调查,采用自行设计的问卷,内容包括了居民的基本情况,中药知识认知途径情况,对中药毒性的认识,服药依据等方面;所得数据采用SPSS13.0软件包进行统计分析。结果发放问卷202份,回收有效问卷186份,有效应答率为92.1%。被调查者主要通过宣传册子、电视广告获取中药知识;大多数人认为中药有毒,服用中药应该在中医师的指导下进行,但仍有5.4%的人认为中药是没有毒性的。结论由于各地经济发展水平的不同,影响了当地民众对中药的认识。广西居民安全使用中药的意识需要提高,特别是经济相对落后的农村地区,开展中药知识教育是非常必要的。     

Chromosome aberrations in lymphocytes of nurses handling cytostatic agents

In an evaluation of the possible chromosome damage caused by cytostatic agents 11 nurses with long-term exposure to such agents were studied. Five laboratory workers and 11 hospital clerks served as referents. The number of chromosomally aberrant lymphocytes was significantly higher in the group of nurses than in the group of laboratory workers or hospital clerks. The number of chromosome-type breaks was increased significantly among the nurses as compared to the reference groups. There was no significant difference in the number of chromatid-type breaks between the groups. The observed increase in chromosome-type aberrations may have been due to long-term occupational exposure to cytostatic agents.