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Introduction: The routine use of heat-producing tools in the perioperative setting generates surgical smoke. Surgical smoke poses a known health hazard for perioperative staff working in the operating room. Objective: The objective of this best practice project was to promote evidence-based practices regarding surgical plume management in a pediatric operating room. Methods: This project was guided by the JBI Model of Evidence-Based Healthcare and used the JBI Practical Application of Clinical Evidence System and the Getting Research into Practice audit and feedback strategy to promote evidence-based practices regarding surgical smoke management in a pediatric operating room. Seven audit criteria representing best-practice recommendations were used. A baseline audit was conducted, followed by the implementation of multiple strategies developed by the key stakeholders. The project was finalized with a follow-up audit to determine any changes in compliance with best-practice recommendations. Results: Baseline audit data indicated an average of 41% compliance with best practices across all audit criteria, revealing the need for significant improvement in five of the seven criteria. Three barriers were identified and strategies were implemented, including the development and implementation of an educational module and a surgical smoke exposure risk assessment tool. Follow-up audits showed an overall improvement of 30% among five of the seven audit criteria. Conclusions: This project yielded improvements with best practices for surgical smoke management in the perioperative setting. However, additional work is required to ensure the sustainability of best practices in this setting. [ABSTRACT FROM AUTHOR]

We developed an opioid hazard awareness module for inclusion in required miner safety refresher training. The module was disseminated throughout the United States and post-training surveys showed improved knowledge and positive response to the training. Clinicians can improve care of high-risk worker patients by recommending employer support for such training. Objective: In response to elevated risk factors, an opioid hazard awareness training for the sand, stone, and gravel mining sector was developed and embedded in annual safety training. Methods: After positive results from a prior study among Massachusetts workers, a revised training was disseminated across the United States. Two hundred post-training surveys were obtained and compared with results from the Massachusetts cohort. Results: Participants' knowledge about opioid-based medications, confidence in talking to a doctor about opioids and/or to a coworker about their own use of opioids, and ability to refer struggling coworkers to resources improved. Massachusetts respondents had slightly more favorable responses. Both cohorts had strong positive views of the training. Conclusions: These results highlight the feasibility and effectiveness of opioid hazard prevention training for a high-risk worker population. [ABSTRACT FROM AUTHOR]

All-terrain vehicle (ATV) crashes are one of the leading causes of death and injury in agriculture across the United States. Use of ATVs is highly prevalent in rural areas and has seen an increase in their application for a variety of agricultural work tasks. Empirical research on the use of these vehicles for agricultural tasks and associated injuries is limited, especially in the United States. Moreover, little is known about the risk factors associated with ATV-related injuries while doing farm work. A comprehensive review was conducted to evaluate the current injury burden of ATV use in agriculture, the need for future research, and possible solutions related to agricultural ATV safety. Potential injury prevention approaches are evaluated based on the hierarchy of control, including elimination or substitution (using side-by-side vehicles instead of ATVs or modifying ATV design), engineering control (operator protection devices), administrative authority (regulations and standards in the United States and around the world), training, and use of personal protective equipment. In addition, vehicle nomenclature, risk factors, and crash mechanisms are reviewed. Recommendations to decrease the likelihood of ATV crashes and injuries are provided. [ABSTRACT FROM AUTHOR]

Objectives: Non-fatal injuries in the high risk US Dungeness crab fishery have been under-documented, despite their potential for lost work time and income, long-term disability, and early unwanted retirement. The Fishermen Led Injury Prevention Program (FLIPP) characterized injuries in this fishery, in order to identify work hazards and inform injury control measures. Methods: The FLIPP injury survey was completed by 426 fishermen in 23 Washington, Oregon, and California fishing ports prior to the 2015–2016 Dungeness crab season; 413 (97%) provided injury information for this analysis. Participants indicated whether they had been injured in the previous 12 months, described the injury, any treatments received, and whether the injury limited their ability to work. Results: Participants were mostly male (98%), more than half (56.6%) worked as deckhands, and reported considerable fishing experience (median = 14 years, interquartile range 5–27). Eighty-nine fishermen (21.5%) reported an injury incident in the past year, of which 49 (55.1%) were limiting. The 89 incidents yielded 102 injuries, of which nearly two-thirds were sprains/strains (23, 22.5%), surface wounds/bruises (17, 15.0%), cuts (18, 17.6%), or punctures (11, 10.8%). More severe injuries, including eight fractures, were rare. The majority of injuries received either no treatment (27, 26.5%) or first aid (35, 34.3%); clinical care was less common (22, 21.6%), and emergency care rare (3, 2.9%). Conclusion: One in five Dungeness crab fishermen reported an injury incident in the previous year. Most injuries were not severe and did not result in clinical care, but approximately half were work-limiting. Control measures must account for the remote and resource-limited workplace in commercial fishing. [ABSTRACT FROM AUTHOR]

Background: Modern U.S. dairy farm operations present multiple safety hazards which may result in worker injuries, illnesses and fatalities. The U.S. industry trend towards large-herd milking operations, especially in the Western U.S., necessitates an increased number of workers on each farm. The U.S. dairy workforce is comprised of an increasing percentage of immigrant workers with limited English proficiency which presents a safety training challenge. Our objective was to develop, deliver and evaluate safety awareness training to U.S. dairy farm workers using mobile tablets as a personal learning environment. Methods: A non-random sample of 1,436 dairy workers received safety awareness training on a mobile device platform. Kirkpatrick Levels 1, 2 and 3 training effectiveness evaluations were performed. Results: Approximately 58.7% of training participants received a middle school education, and 22.7% were from Guatemala who reported K’iche’ as their native language. A statistically significant large effect size suggests safety knowledge was gained among training participants when comparing post-test scores to pre-test scores (Level-2). Training participants rated their training experience favorably (Level-1), and applied knowledge gained in their daily work activities three months after training (Level-3). Conclusion: Our findings suggest the utilization of mobile learning techniques is an effective means to deliver safety awareness training content to dairy workers. Dairy worker safety training should be culturally, linguistically, and literacy appropriate and comprehensive in nature to include all applicable dairy safety hazards. Our observations support the use of mobile devices as just one component of a more comprehensive health and safety management program on farms. [ABSTRACT FROM AUTHOR]

The article presents a qualitative analysis of the situational pressures that influence firefighters' decision making with respect to personal protective equipment (PPE), and it mentions how the research reveals that firefighter identity, goal seduction, and situation aversion were the strongest factors of PPE non-compliance among the U.S. firefighters that were studied. A gap between demonstrated safety knowledge and lack of connection to self-reported safety behaviors is also assessed.

Background: Masons have the highest rate of overexertion injuries among all construction trades and rank second for occupational back injuries in the United States. Identified ergonomic solutions are the primary method of reducing exposure to risk factors associated with musculoskeletal disorders. However, many construction workers lack knowledge about these solutions, as well as basic ergonomic principles. Construction apprentices, as they embark on their careers, are greatly in need of ergonomics training to minimize the cumulative exposure that leads to musculoskeletal disorders. Apprentices receive safety training; however, ergonomics training is often limited or non-existent. In addition, apprenticeship programs often lack "soft skills" training on how to appropriately respond to work environments and practices that are unsafe. The SAVE program - SAfety Voice for Ergonomics - strives to integrate evidence-based health and safety training strategies into masonry apprenticeship skills training to teach ergonomics, problem solving, and speaking up to communicate solutions that reduce musculoskeletal injury risk. The central hypothesis is that the combination of ergonomics training and safety voice promotion will be more effective than no training or either ergonomics training alone or safety voice training alone.Methods/design: Following the development and pilot testing of the SAVE intervention, SAVE will be evaluated in a cluster-randomized controlled trial at 12 masonry training centers across the U.S. Clusters of apprentices within centers will be assigned at random to one of four intervention groups (n = 24 per group): (1) ergonomics training only, (2) safety voice training only, (3) combined ergonomics and safety voice training, or (4) control group with no additional training intervention. Outcomes assessed at baseline, at the conclusion of training, and then at six and 12 months post training will include: musculoskeletal symptoms, general health perceptions, knowledge of ergonomic and safety voice principles, and perception and attitudes about ergonomic and safety voice issues.Discussion: Masons continue to have a high rate of musculoskeletal disorders. The trade has an expected increase of 40 % in the number of workers by 2020. Therefore, a vetted intervention for apprentices entering the trade, such as SAVE, could reduce the burden of musculoskeletal disorders currently plaguing the trade.Trial Registration: ClinicalTrials.gov Identifier: NCT02676635 , 2 February 2016. [ABSTRACT FROM AUTHOR]

Introduction: There is a paucity of data available to assess the occupational health and safety risk associated with exposure to monoclonal antibodies. Industry standards and published guidelines are conflicting or outdated. Guidelines offer contrary recommendations based on an array of methodological approaches. This survey aimed to describe current practices, beliefs and attitudes relating to the handling of monoclonal antibodies by Australian medical, nursing and pharmacy clinicians. Methods: An electronic survey was distributed between June and September 2013. Respondents were surveyed on three focus areas: institutional guideline availability and content, current practices and attitudes. Demographic data relating to respondent and primary place of practice were also collected. Results: A total of 222 clinicians completed the survey, with representation from all targeted professional groups and from a variety of geographic locations. 92% of respondents reported that their institution prepared or administered monoclonal antibodies, with 87% specifically handling anti-cancer monoclonal antibodies. Monoclonal antibodies were mostly prepared onsite (84-90%) and mostly within pharmacy clean-rooms (75%) and using cytotoxic cabinets (61%). 43% of respondents reported access to institutional monoclonal antibody handling guidelines with risk reduction strategies including training and education (71%), spill and waste management (71%), procedures for transportation (57%) and restricted handling (50%). Nurses had a stronger preference towards pharmacy manufacturing than both doctors and pharmacists for a range of clinical scenarios. 95% of all respondents identified that professional or regulatory body guidelines are an important resource when considering handling practices. Conclusion: Monoclonal antibodies are most commonly handled according to cytotoxic drug standards and often in the absence of formal guidelines. [ABSTRACT FROM AUTHOR]

Objectives. Using the social-ecological model, we hypothesized that the home residences of injured workers would be clustered predictably and geographically. Methods. We linked health care and publicly available datasets by home zip code fortraumatically injured workers in Illinois from 2000 to 2009. We calculated numbers and rates of injuries, determined the spatial relationships, and developed 3 models. Results. Among the 23 200 occupational injuries, 80% of cases were located in 20% of zip codes and clustered in 10 locations. After component analysis, numbers and clusters of injuries correlated directly with immigrants; injury rates inversely correlated with urban poverty. Conclusions. Traumatic occupational injuries were clustered spatially by home location of the affected workers and in a predictable way. This put an inequitable burden on communities and provided evidence for the possible value of community-based interventions for prevention of occupational injuries. Work should be included in health disparities research. Stakeholders should determine whether and how to intervene at the community level to prevent occupational injuries. [ABSTRACT FROM AUTHOR]

The article discusses the impact of the development of the new toxic tort litigation and exposure limit on respirable crystalline silica in the safety engineering industries in the U.S. Occupational exposure to crystalline silica composed of chemical compound silica dioxide leads to silicosis and other respiratory diseases. This two developments are the primary initiatives of state legislatures, insurance industry and the Congress. It will raise the significance of maintaining and improving credible documentation associated with site-specific exposure evaluation.

This study examines the determinants of health, safety, and environmental (HS&E) incidence and reporting behavior in Gulf of Mexico offshore drilling. One objective is to determine statistically significant variables that influence the probability of HS&E incidence and reporting. Incidence modeling employs standard qualitative response models with binary and ordered dependent variables, and a Poisson specification. A second objective is to examine the impact of imperfect reporting on inferences. Unlike previous studies, models allowing for the possibility of imperfect reporting are specified and estimated. The results of this analysis provide strong evidence to support the hypothesis that aspects of well complexity and site complexity increase the likelihood of HS&E incidents in drilling. Equally important is evidence rejecting the hypothesis that broader oil company attributes influence HS&E incidence. An analysis of reporting behavior provides mixed support for the hypothesis that well-known firms are more likely to report an incident than their more anonymous counterparts. There is weak evidence indicating differential reporting behavior between regulatory districts. Finally, the analysis provides consistent support for the conclusion that a 1996 policy change reduced HS&E incidence and increased HS&E reporting. The results of this research provide guidance to company managers and regulators on the factors driving HS&E incidence and reporting. Results also provide evidence that models of imperfect reporting can alter, in this case reverse, the interpretation of trends in reported incidents. These results can be used to support efficient resource allocation to prevention efforts, and inform regulatory policy. [ABSTRACT FROM AUTHOR]

The article reports that the U.S. Green Building Council has approved a prevention through design (PTD) pilot credit to recognize the value of workplace safety and health. The PTD credit reportedly involves two safety and health reviews of building operations and maintenance and supports industrial safety by early attention to safety and health hazards of a building. Comments from occupational safety expert Michael Behm on the issue are also presented.