Potential for radioactive patient excreta in hospital trash and medical waste

Radioactive excreta from nuclear medicine patients can enter solid waste as common trash and medical biohazardous waste. Many landfills and transfer stations now survey these waste streams with scintillation detectors which may result in rejection of a hospital's waste. Our survey indicated that on the average either or both of Boston University Medical Center Hospital's waste streams can contain detectable radioactive excreta on a weekly basis. To avoid potential problems, radiation detectors were installed in areas where housekeepers carting trash and medical waste must pass through to ensure no radioactivity leaves the institution.

Nonincreased risk of nosocomial infection during a 22-day housekeeping personnel strike in a tertiary hospital

BACKGROUND

From April 2-23, 1992, the housekeeping staff of the University of Granada Hospital was on strike. Measures were implemented to minimize the effects of the strike on patients' health and especially to diminish the risk of hospital infection.

OBJECTIVE

To assess the risk of nosocomial infection during the housekeeping personnel strike.

SETTING

An 800-bed, tertiary care hospital.

METHODS

A case-cohort approach was used. One hundred forty-eight infected patients (with 184 hospital infections) were detected prospectively from March 1, 1992, to May 31, 1992. A sample of 459 of the base population (patients admitted during the same period) was selected. Information on relevant risk factors for hospital infection was abstracted from patients' clinical charts after hospital discharge. Crude odds ratios and adjusted (by proportional hazards model) relative risks (RRs) for the strike period were estimated.

RESULTS

Risk of nosocomial infection did not increase during the strike period (multiple-risk factor adjusted RR = 0.99, 0.96 to 1.01/day of strike). Similar results were observed for major sites of infection (especially surgical wound) and major areas of the hospital (including gynecology, surgery, and intensive care).

CONCLUSION

We concluded that there was no increase in the risk of nosocomial infection during the housekeeping strike.

Impact of regular relaxation training and psychosocial working factors on neck-shoulder tension and absenteeism in hospital cleaners

Occupational stress in hospital cleaners (n = 50), and the effect of relaxation training (n = 25, age matched, randomized), were studied by recording the electrical activity of the upper trapezius muscle at rest and during working conditions at the beginning, middle, and end of a 6-month follow-up period. A short (15-minute) relaxation program was practiced daily at the workplace to provide stress management. The amount of sick leave was counted, and the extent of depression and some psychosocial working factors were screened. Intercorrelations were found between the neck-shoulder tension, psychosocial factors, depression, and the absentee rate. The relaxation training diminished tension in the neck-shoulder region efficiently; nevertheless, the decrease in absenteeism might have been related mainly to the social support offered by the research maneuver itself.

Impact of regular relaxation training on the cardiac autonomic nervous system of hospital cleaners and bank employees

The work-related strain of 50 female hospital cleaners and 48 female bank employees was recorded during a period of rationalization in the workplace, and the effect of daily relaxation to help the workers cope was tested. The subjects were arranged into age-matched pairs and randomly allocated into intervention and reference groups. The intervention period lasted six months. The relaxation method was brief and easily introduced as an alternative break in the workplace. Each training session lasted 15 min. A microcomputer-based system was used to record heart rate variability in response to quiet breathing, the Valsalva maneuver, deep breathing, and active orthostatic tests. Cardiac reflexes indicated that occupational strain (especially of a mental nature) caused the functioning of the autonomic nervous system to deteriorate. Regular deep relaxation normalized the function and improved the ability to cope.

Occupational chemical exposures in an academic medical center

Although the risks of certain chemical agents in the hospital environment are well known, problems associated with the entire spectrum of chemicals are not. To address this issue, we analyzed incident reports generated in response to chemical exposures in an academic medical center. We also reviewed workers' compensation clinic logs and the OSHA 200 log to obtain information on medical follow-up and severity. A total of 253 exposures occurred during the 3 years from 1988 to 1990. The overall incidence rate was 8.0 per 1000 person-years. Exposure rates by job title were highest for housekeepers (60.1 per 1000 person-years), followed by maintenance workers (18.6), and laboratory technicians (13.1). The most frequently involved chemical groups were disinfectants (25.9%), solvents (16.8%), and cleaning compounds (12.1%). Exposure by the dermal route was most common (37.9%). Thirteen percent of the exposures resulted in lost time and a similar percentage was reported on the OSHA log. Medical treatment was obtained by 53%. Implications for hazard communication, recordkeeping, and prevention are discussed.

[Postoperative nosocomial infections in the Cameroon hospital milieu. Epidemiology and prevention]

The paper aims at describing easy steps: asepsis and hygiene to prevent nosocomial infections within surgery unit in Hospitals with limited budget. Essential and compulsory they are: cleansing of the surgery unit before any disinfection, behaviour of the staff in relation to aerobic contamination, maintenance of equipment, prophylaxis applied to patients antibio-prophylaxis is also mentioned complementary to that steps. Possible strategies of fight and control are mentioned, including awareness and full participation of all.

A staffing standard proposal for patient and non-patient areas in hospitals. Philadelphia Chapter of the National Executive Housekeepers Association

The Philadelphia Chapter of N.E.H.A. submits the following proposal for publication. We feel very strongly about the need to formalize some staffing standards for hospitals and all related healthcare facilities. The incentive comes from the current trend in administrative philosophies to "do more with less." The less means less for the support departments whose contribution is viewed most times as less worthy because we do not directly generate revenue. Oddly enough, the revenue generators cannot make money without the non-revenue generators.

The risks of handling cytotoxic drugs. II. Recommendations for working with cytotoxic drugs

Presuming that preparation of antineoplastic drugs without proper protection may lead to mutagenic urine (of which the effects are uncertain), one has to take great care when preparing these drugs. Apart from Norway no other country has national regulations issued by the government for handling cytostatic agents. Many organizations in various countries have made their own guidelines, which may be adapted to the situations in local hospitals. The following recommendations have been compiled after a review of the literature. They reflect a personal set of guidelines for preparation, administration and disposal of cytotoxic drugs. They are probably the minimum precautions that should be taken, and have not been approved by any committee or agency. Further precautions must first have their potential benefit weighed against probable inconvenience and additional costs.

A ticklish problem: pest infestation in hospitals

Pest outbreaks in hospitals can put patients and staff at risk. Monitoring by nursing and other staff means prompt action can be taken to control outbreaks effectively.