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Socias-Morales CM, Haas EJ, Gwilliam M, Yorio PL, Delaney NB, Falcon RG, Stallings HA, Burnham BR, Stuever DM, Stouder SM, Ewing GL, Collins JW, Chaumont Menendez CK. The association between safety climate and noncombat injury events among United States Air Force workers. J Safety Res 2024; 88:16-23. [PMID: 38485358 DOI: 10.1016/j.jsr.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 06/16/2023] [Accepted: 10/16/2023] [Indexed: 03/19/2024]
Abstract
INTRODUCTION Work-related injuries are a common lagging safety indicator whereas safety climate assessments can help identify constructs serving as leading indicators. The National Institute for Occupational Safety and Health (NIOSH) partnered with the U.S. Department of the Air Force (DAF) Safety Center to examine the association between perceptions of safety climate survey constructs and the number of injury events within the DAF workforce. METHODS The DAF administers voluntary, anonymous, occupation-specific safety climate surveys to DAF workers using the internal Air Force Combined Mishap Reduction System (AFCMRS). Survey responses from 2014 to 2018 provided by DAF workers and injury events in maintenance, support, and operations occupations were shared with NIOSH. Exploratory Factor Analysis revealed five constructs: Leadership and Communication; Organizational Safety Priority; Error Management; Resource Adequacy; and Deployment/Official Travel Impact. Squadron-level analysis included bivariate correlations and estimated Rate Ratios (RRs). RESULTS 1,547 squadrons administered the survey, averaging 144 workers and 15.8 reportable injuries per squadron. Higher (more favorable) squadron-level construct scores were consistently correlated with fewer reported injuries (p < 0.001). Controlling for the number of workers, RRs revealed significant reductions in injury rates with each one-unit increase in responses: Leadership and Communication RR = 0.40 (95%CI: 0.32-0.48); Organizational Safety Priority RR = 0.50 (95%CI: 0.40-0.64); Error Management RR = 0.37 (95%CI: 0.30-0.47); Deployment/Official Travel Impact RR = 0.36 (95%CI: 0.29-0.45). Resource Adequacy revealed a non-significant lower injury rate RR = 0.87 (95%CI: 0.73-1.04). CONCLUSIONS This unique study quantified safety climate and the association with injuries across a multi-year period. While safety climate measurements may be limited by frequent turnover and the self-reported, voluntary, anonymous nature of AFCMRS, the strength of this study is in the census of injuries. PRACTICAL APPLICATIONS Future research should include longitudinal analyses to examine the impact on injuries when squadron leaders are provided feedback on safety climate survey results.
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Affiliation(s)
| | - Emily J Haas
- CDC National Institute for Occupational Safety and Health (NIOSH), United States
| | - Melody Gwilliam
- CDC National Institute for Occupational Safety and Health (NIOSH), United States
| | - Patrick L Yorio
- CDC National Institute for Occupational Safety and Health (NIOSH), United States
| | | | | | | | | | | | | | | | - James W Collins
- CDC National Institute for Occupational Safety and Health (NIOSH), United States
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Selcen Kilinc-Balci F, Kahveci Z, Yorio PL. Impact of surface tension on the barrier performance of gowns and coveralls. Am J Infect Control 2023; 51:1392-1400. [PMID: 37121474 PMCID: PMC10680362 DOI: 10.1016/j.ajic.2023.04.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/19/2023] [Accepted: 04/21/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Health care workers and laboratory workers who are routinely exposed to potentially life-threatening infectious diseases should wear protective clothing when anticipating contact with infectious materials. The most critical property of protective clothing is its ability to prevent liquids and viruses from passing through the garment. There are a number of potentially infectious liquids that workers may be exposed to during routine tasks. Each liquid has different physical and chemical properties that affect penetration. However, the current test methods use a limited number of liquids for classifying the barrier performance. The impact of the surface tension of the challenge liquid on the penetration resistance of gowns and coveralls was investigated in this study. METHODS Eight isolation gowns and 2 coveralls were tested in accordance with American Association of Textile Chemists and Colorists 42 and American Association of Textile Chemists and Colorists 127 test methods, which were modified to incorporate the substitute challenge liquids. RESULTS Although current standard test methods only use water to categorize the liquid penetration resistance of minimal to moderate barrier performance gowns, a significant difference in the penetration was found when simulated body fluids were used. CONCLUSIONS The results suggest that safety professionals and wearers should consider the varying barrier performance of personal protective equipment with different liquids and the use limitations when selecting them for the required tasks. Furthermore, standard development organizations should consider multiple challenge liquids when classifying protective clothing for health care settings.
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Affiliation(s)
- F Selcen Kilinc-Balci
- US Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA.
| | - Zafer Kahveci
- US Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA
| | - Patrick L Yorio
- US Centers for Disease Control and Prevention, Office of the Director (OD), Human Resources Office (HRO), Office of the Chief Operating Officer (OCOO), Atlanta, GA
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Kahveci Z, Kilinc-Balci FS, Yorio PL. Evaluation of fluid leakage at the coverall and glove interface in single and double glove conditions. Am J Infect Control 2023; 51:1145-1150. [PMID: 36931507 DOI: 10.1016/j.ajic.2023.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND Fluid leakage through the glove-protective clothing interface is an area of concern for many health care personnel, including emergency medical service providers, who may wear coveralls to protect themselves from multiple types of hazards. There is currently no established standard test method to specifically evaluate the barrier performance of the glove-protective clothing interface region for any personal protective equipment ensemble. OBJECTIVE This study quantifies the fluid leakage at the coverall and glove interface using single and double gloving. METHODS A robotic arm, which can simulate upper extremity movements of health care personnel, was used to test 5 coverall models and an extended examination glove model in single and double glove conditions. RESULTS The results show that there was a significant difference in fluid leakage amounts between some of the coverall models and the number of glove layers studied. Findings also highlight that there is a high correlation between basis weight and stiffness of the coverall fabrics and the fluid leakage amounts. CONCLUSIONS These results underline that coverall constructed from thin and less stiff fabrics can result in lower fluid leakage levels. Also, there was no significant difference in fluid leakage amounts between single and double gloves when tested with each of the coverall models, with the exception of the coveralls with the highest basis weight and stiffness.
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Affiliation(s)
- Zafer Kahveci
- US Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA
| | - F Selcen Kilinc-Balci
- US Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA.
| | - Patrick L Yorio
- US Centers for Disease Control and Prevention, Office of the Director (OD), Human Resources Office (HRO), Office of the Chief Operating Officer (OCOO), Atlanta, GA
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Haas EJ, Yorio PL. Behavioral safety compliance in an interdependent mining environment: supervisor communication, procedural justice and the mediating role of coworker communication. Int J Occup Saf Ergon 2022; 28:1439-1451. [PMID: 33634742 PMCID: PMC11049610 DOI: 10.1080/10803548.2021.1896140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives. Although a focus on safety communication between managers and employees has been prevalent, research around coworker influence in this communication has been fragmented in the literature. Methods. To examine these issues, researchers gathered survey data from 1955 mine employees from surface stone, sand and gravel (SSG) and industrial mineral operations across the USA between 2016 and 2018, and studied the effects of relationships between justice perceptions, supervisor communication and coworker communication on behavioral safety compliance. Results. Using structural equation modeling, coworker communication partially mediated the direct effects of supervisor communication and justice perceptions on behavioral safety compliance - where the indirect effects were greater for justice perceptions. Conclusion. The results demonstrate the value in formal and informal communication paths to facilitate employee safety compliance; and that enhanced perceptions of job fairness and adaptability enhances coworker communication, further improving compliance in an interdependent environment.
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Affiliation(s)
- Emily J Haas
- Pittsburgh Mining Research Division, National Institute for Occupational Safety and Health, USA
| | - Patrick L Yorio
- National Personal Protection Technology Laboratory, National Institute for Occupational Safety and Health, USA
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Kahveci Z, Kilinc-Balci FS, Yorio PL. A simulation study to assess fluid leakage through the glove-gown interface in isolation settings. Am J Infect Control 2021; 49:1481-1487. [PMID: 34428530 PMCID: PMC10124161 DOI: 10.1016/j.ajic.2021.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/06/2021] [Accepted: 08/07/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Isolation gowns are recommended to protect healthcare personnel, patients, and visitors from transfer of microorganisms and body fluids in patient isolation situations. Standards provide limited information about barrier performance of isolation gowns for possible exposure scenarios. One of the most vulnerable areas of the personal protective equipment ensemble is considered the glove-gown interface. However, current isolation gown classification standards do not consider the interface regions of the personal protective equipment system while assessing the level of protection. The purpose of this study was to quantitatively evaluate the fluid leakage through the glove-gown interface by simulating exposures and healthcare personnel arm movements in patient care for isolation settings. METHODS We tested fluid leakage of two examination gloves with different cuff lengths and seven isolation gown models designed with varying levels of barrier resistance and multiple cuff types. RESULTS Our results demonstrated that leakage through the glove-gown interface depends on multiple factors, including glove cuff length and gown cuff design. Gowns with the thumb loop design provided better protection than the elastic cuff design, and the elastic cuff design provided better protection compared to the knit cuff design for a given AAMI PB70 level. More importantly, a substantial penetration through gown fabrics was observed. CONCLUSIONS This research identifies a need to develop a standardized method to evaluate leakage at the glove-gown interface to improve worker protection.
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Affiliation(s)
- Zafer Kahveci
- U.S. Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH), National Personal Protective Technology Laboratory (NPPTL), Pittsburgh, PA
| | - F Selcen Kilinc-Balci
- U.S. Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH), National Personal Protective Technology Laboratory (NPPTL), Washington, DC.
| | - Patrick L Yorio
- U.S. Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH), National Personal Protective Technology Laboratory (NPPTL), Pittsburgh, PA
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Kahveci Z, Kilinc-Balci FS, Yorio PL. Barrier resistance of double layer isolation gowns. Am J Infect Control 2021; 49:430-433. [PMID: 33080362 PMCID: PMC7568468 DOI: 10.1016/j.ajic.2020.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 11/26/2022]
Abstract
Background Isolation gowns are one of the crucial pieces of personal protective equipment (PPE) to prevent the migration of microorganisms and body fluids from patients to health care personnel and vice versa. Underperforming isolation gowns in terms of fluid resistance, could potentially put lives in danger. Wearing multiple layers of isolation gowns could theoretically increase the fluid penetration resistance. This study investigates if 2-layer lower barrier level isolation gowns meet the barrier effectiveness requirements of a single higher barrier level isolation gown. Methods Three commonly used ANSI/AAMI Level 2 isolation gown models were selected and tested in single layer and double layer configurations in accordance with ANSI/AAMI PB70 requirements. Results Total of 240 experiments were conducted to analyze the effects of gown model, fabric region, and the number of gown layers on AATCC 127 and AATCC 42 test results. In regard to AATCC 42, there was a significant difference among the different gown models, and the number of gown layers. Similar to AATCC 42 results, there was a significant difference among the different gown models, and the number of gown layers for AATCC 127; additionally, the gown regions was also significantly different. Conclusion Test results demonstrated that the double layer isolation gown configurations do not always provide equal fluid penetration resistance as required for a single Level 3 isolation gown using the standard test methods specified in ANSI/AAMI PB70.
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Quinn TD, Yorio PL, Smith PM, Seo Y, Whitfield GP, Barone Gibbs B. Occupational physical activity and cardiovascular disease in the United States. Occup Environ Med 2021; 78:724-730. [PMID: 33737330 DOI: 10.1136/oemed-2020-106948] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 01/26/2021] [Accepted: 01/30/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Emerging evidence, predominately from European and Asian countries, describes opposing effects of occupational physical activity (OPA) and leisure-time physical activity (LTPA) on cardiovascular health. This analysis examined cardiovascular disease (CVD) prevalence associated with OPA and LTPA. METHODS This cross-sectional analysis of 2015 National Health Interview Survey data (n=16 974) employed logistic regression to estimate odds (OR) of self-reported CVD (coronary heart disease, heart attack, stroke or angina) with self-reported total occupational activity (TOA), occupational exertion (OE), occupational standing and walking (OSW) and LTPA. OPA was measured using two questions: 'How often does your job involve…' (1) 'repeated lifting, pushing, pulling or bending?' (OE) and (2) 'standing or walking around?' (OSW) with responses on a 5-item Likert scale (0=never, 4=always). TOA was categorised similarly after summing OE and OSW scores. LTPA was defined as 0, 1-149 or ≥150 min/week of moderate-to-vigorous activity. All models adjusted for common socioeconomic variables and additional analyses were stratified by sex, smoking status and LTPA. RESULTS Odds for CVD were higher when 'always' performing TOA (OR 1.99 95% CI 1.12 to 3.53), OE (OR 2.15, 95% CI 1.45 to 3.19) or OSW (OR 1.84, 95% CI 1.07 to 3.17) compared with 'never'. When restricting to never-smokers, odds for CVD were higher when 'always' performing TOA (OR 3.00, 95% CI 1.38 to 6.51) and OE (OR 3.00, 95% CI 1.80 to 5.02) versus 'never'. CONCLUSION Associations of high OPA with CVD were equally apparent across sexes, stronger in lower LTPA levels and stronger in never-smokers. While uncontrolled confounding is still possible, even after extensive adjustment, the seemingly paradoxical adverse associations with OPA and CVD should be investigated further.
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Affiliation(s)
- Tyler D Quinn
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, Pennsylvania, USA .,Health and Human Development, University of Pittsburgh School of Education, Pittsburgh, Pennsylvania, USA
| | - Patrick L Yorio
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, Pennsylvania, USA
| | - Peter M Smith
- Institute for Work & Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Yongsuk Seo
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, Pennsylvania, USA
| | - Geoffrey P Whitfield
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Bethany Barone Gibbs
- Health and Human Development, University of Pittsburgh School of Education, Pittsburgh, Pennsylvania, USA
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Greenawald LA, Moore SM, Wizner K, Yorio PL. Developing a methodology to collect empirical data that informs policy and practices for stockpiling personal protective equipment. Am J Infect Control 2021; 49:166-173. [PMID: 32659415 DOI: 10.1016/j.ajic.2020.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Personal protective equipment (PPE) are stockpiled across the nation to offset supply depletion during public health emergencies. Stockpiled PPE inventories vary across the United States by type, model, quantity, and the conditions in which they are stored. Over the past decade, federal, state, and local stockpile managers have had concerns for the viability of aging PPE. METHODS To understand factors that may affect stockpiled PPE, we explored the breadth of stockpile storage conditions and respirator and surgical gown inventories through collaboration with the national PPE community, qualitative observations collected at 10 different US stockpiles, and by compiling stockpile PPE inventories and climate data from a convenience sample of US stockpiles. RESULTS The aggregated inventory from 20 stockpiles is reported, accounting for approximately 53 million respirators. Most respirators (69% or 35.8 million) have been stored between 5 and 10 years. Upon visiting 10 stockpile facilities, we report on the storage conditions observed and summarize the storage environment data collected. CONCLUSIONS This is the first study to identify common PPE types, inventories, and storage conditions across federal, state, and local government stockpile facilities as well as health care organization-managed caches. These findings will be leveraged to guide the development of sampling protocols for air-purifying respirators and surgical gowns in US stockpiles to understand the performance viability after long-term storage.
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Andrews AS, Powers JR, Cichowicz JK, Coffey CC, Fries ML, Yorio PL, D'Alessandro MM. Respiratory Protection in a Time of Crisis: NIOSH Testing of International Respiratory Protective Devices for Emergency Use. Health Secur 2021; 19:379-385. [PMID: 33434096 PMCID: PMC8906491 DOI: 10.1089/hs.2020.0173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
National Institute for Occupational Safety and Health (NIOSH)-approved
respirators are required by the Occupational Safety and Health Administration
(OSHA) when personal respiratory protection is used in US occupational settings.
During the COVID-19 pandemic, the demand for NIOSH-approved N95 filtering
facepiece respirators overwhelmed the available supply. To supplement the
national inventory of N95 respirators, contingency and crisis capacity
strategies were implemented and incorporated a component that endorsed the use
of non-NIOSH-approved respiratory protective devices that conformed to select
international standards. The development and execution of this strategy required
the collaborative effort of numerous agencies. The Food and Drug Administration
temporarily authorized non-NIOSH-approved international respiratory protective
devices through an emergency use authorization, OSHA relaxed their enforcement
guidance concerning their use in US workplaces, and NIOSH initiated a
supplemental performance assessment process to verify the quality of
international devices. NIOSH testing revealed that many of the
non-NIOSH-approved respiratory protective devices had filtration efficiencies
below 95% and substantial inconsistencies in filtration performance. This
article reports the results of the NIOSH testing to date and discusses how it
has contributed to continuous improvement of the crisis strategy of temporarily
permitting the use of non-NIOSH-approved respirators in US occupational settings
during the COVID-19 pandemic.
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Affiliation(s)
- Angela S Andrews
- Angela S. Andrews, MS, is a Physical Scientist; John R. Powers, Jr. is a Supervisory General Engineer; and Christopher C. Coffey, PhD, is the former Associate Director for Science (retired); all at the National Personal Protective Technology Laboratory (NPPTL), National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV. Jaclyn K. Cichowicz, MA, and Marisa L. Fries are Health Communications Specialists; Patrick L. Yorio, PhD, is a Health Statistician; and Maryann M. D'Alessandro, PhD, is Director; all at the NPPTL, NIOSH, CDC, Pittsburgh, PA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of NIOSH or CDC. Product and company names are provided for identification purposes only and do not imply endorsement by the CDC
| | - John R Powers
- Angela S. Andrews, MS, is a Physical Scientist; John R. Powers, Jr. is a Supervisory General Engineer; and Christopher C. Coffey, PhD, is the former Associate Director for Science (retired); all at the National Personal Protective Technology Laboratory (NPPTL), National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV. Jaclyn K. Cichowicz, MA, and Marisa L. Fries are Health Communications Specialists; Patrick L. Yorio, PhD, is a Health Statistician; and Maryann M. D'Alessandro, PhD, is Director; all at the NPPTL, NIOSH, CDC, Pittsburgh, PA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of NIOSH or CDC. Product and company names are provided for identification purposes only and do not imply endorsement by the CDC
| | - Jaclyn K Cichowicz
- Angela S. Andrews, MS, is a Physical Scientist; John R. Powers, Jr. is a Supervisory General Engineer; and Christopher C. Coffey, PhD, is the former Associate Director for Science (retired); all at the National Personal Protective Technology Laboratory (NPPTL), National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV. Jaclyn K. Cichowicz, MA, and Marisa L. Fries are Health Communications Specialists; Patrick L. Yorio, PhD, is a Health Statistician; and Maryann M. D'Alessandro, PhD, is Director; all at the NPPTL, NIOSH, CDC, Pittsburgh, PA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of NIOSH or CDC. Product and company names are provided for identification purposes only and do not imply endorsement by the CDC
| | - Christopher C Coffey
- Angela S. Andrews, MS, is a Physical Scientist; John R. Powers, Jr. is a Supervisory General Engineer; and Christopher C. Coffey, PhD, is the former Associate Director for Science (retired); all at the National Personal Protective Technology Laboratory (NPPTL), National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV. Jaclyn K. Cichowicz, MA, and Marisa L. Fries are Health Communications Specialists; Patrick L. Yorio, PhD, is a Health Statistician; and Maryann M. D'Alessandro, PhD, is Director; all at the NPPTL, NIOSH, CDC, Pittsburgh, PA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of NIOSH or CDC. Product and company names are provided for identification purposes only and do not imply endorsement by the CDC
| | - Marisa L Fries
- Angela S. Andrews, MS, is a Physical Scientist; John R. Powers, Jr. is a Supervisory General Engineer; and Christopher C. Coffey, PhD, is the former Associate Director for Science (retired); all at the National Personal Protective Technology Laboratory (NPPTL), National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV. Jaclyn K. Cichowicz, MA, and Marisa L. Fries are Health Communications Specialists; Patrick L. Yorio, PhD, is a Health Statistician; and Maryann M. D'Alessandro, PhD, is Director; all at the NPPTL, NIOSH, CDC, Pittsburgh, PA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of NIOSH or CDC. Product and company names are provided for identification purposes only and do not imply endorsement by the CDC
| | - Patrick L Yorio
- Angela S. Andrews, MS, is a Physical Scientist; John R. Powers, Jr. is a Supervisory General Engineer; and Christopher C. Coffey, PhD, is the former Associate Director for Science (retired); all at the National Personal Protective Technology Laboratory (NPPTL), National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV. Jaclyn K. Cichowicz, MA, and Marisa L. Fries are Health Communications Specialists; Patrick L. Yorio, PhD, is a Health Statistician; and Maryann M. D'Alessandro, PhD, is Director; all at the NPPTL, NIOSH, CDC, Pittsburgh, PA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of NIOSH or CDC. Product and company names are provided for identification purposes only and do not imply endorsement by the CDC
| | - Maryann M D'Alessandro
- Angela S. Andrews, MS, is a Physical Scientist; John R. Powers, Jr. is a Supervisory General Engineer; and Christopher C. Coffey, PhD, is the former Associate Director for Science (retired); all at the National Personal Protective Technology Laboratory (NPPTL), National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV. Jaclyn K. Cichowicz, MA, and Marisa L. Fries are Health Communications Specialists; Patrick L. Yorio, PhD, is a Health Statistician; and Maryann M. D'Alessandro, PhD, is Director; all at the NPPTL, NIOSH, CDC, Pittsburgh, PA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of NIOSH or CDC. Product and company names are provided for identification purposes only and do not imply endorsement by the CDC
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Abstract
Currently, the US mining industry is encouraged, but not required to adopt a formal health and safety management system. Previous research has shown that the adoption of such systems has been more difficult in some subsectors of the mining industry than others. Given the interdependencies between management systems and safety climate in addition to their predictive utility of incidents, it is important to assess differences in the perceptions of safety climate among mining subsectors in the USA. If significant differences exist, then mining subsectors may not necessarily be able to adopt a one-size approach to system implementation. To that end, the National Institute for Occupational Safety and Health assessed mineworkers' perceptions of several individual and organizational safety climate constructs. Participants consisted of 2945 mineworkers at coal, industrial mineral, and stone/sand/gravel mine sites throughout 18 states. Linear regressions were used to answer the research question. The results suggest that coal miners, in comparison to those miners in industrial mineral and stone/sand/gravel sectors, had significantly less favorable perceptions on each of the organizational climate constructs measured (i.e., organizational support, supervisor support and communication, coworker communication, engagement/involvement, and training) (p < 0.001 in all cases). Importantly, these results parse out organizational indicators to show that perceptions are not only lower in one area of organizational or supervisor support. Rather, engagement, training, and communication practices were all significantly lower among coal miners, prompting considerations for these significant differences and actions that can be taken to improve system practices.
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Affiliation(s)
- Emily J. Haas
- National Institute for Occupational Safety and Health, Pittsburgh Mining Research Division, 626 Cochrans Mill Rd., Pittsburgh, PA 15236, USA
| | - Patrick L. Yorio
- National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, 626 Cochrans Mill Rd., Pittsburgh, PA 15236, USA
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Yorio PL, Haas EJ, Bell JL, Moore SM, Greenawald LA. Lagging or leading? Exploring the temporal relationship among lagging indicators in mining establishments 2006-2017. J Safety Res 2020; 74:179-185. [PMID: 32951782 PMCID: PMC9877915 DOI: 10.1016/j.jsr.2020.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 02/29/2020] [Accepted: 06/23/2020] [Indexed: 06/11/2023]
Abstract
PROBLEM Safety management literature generally categorizes key performance indicators (KPIs) as either leading or lagging. Traditional lagging indicators are measures related to negative safety incidents, such as injuries, while leading indicators are used to predict (and therefore can be used to prevent) the likelihood of future negative safety incidents. Recent theory suggests that traditional lagging indicators also possess characteristics of leading indicators, and vice versa, however empirical evidence is limited. METHOD The current research investigated the temporal relationships among establishment-level injuries, near misses, and fatal events using injury and employment data from a sample of 24,910 mining establishments over a 12-year period. RESULTS While controlling for employee hours worked, establishment-level reported injuries and near misses were associated with of future fatal events across the sample of mines and over the time period studied. Fatal events were also associated with increases in future reported near misses, providing evidence of a cyclic relationship between them. DISCUSSION These findings challenge the strict categorization of injuries, near misses, and fatal events as lagging indicators. Practical applications: Understanding the KPIs that should be used to manage organizational safety, and how they can be used, is of critical practical importance. The results of the current study suggest that, depending on several considerations, metrics tied to negative safety incidents may be used to anticipate, and possibly prevent, future negative safety events.
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Affiliation(s)
- Patrick L Yorio
- National Personal Protective Technology Laboratory of the National Institute for Occupational Safety and Health, U.S. Centers for Disease Control and Prevention, Pittsburgh, PA, USA.
| | - Emily J Haas
- National Personal Protective Technology Laboratory of the National Institute for Occupational Safety and Health, U.S. Centers for Disease Control and Prevention, Pittsburgh, PA, USA
| | - Jennifer L Bell
- Division of Safety Research of the National Institute for Occupational Safety and Health, U.S. Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Susan M Moore
- National Personal Protective Technology Laboratory of the National Institute for Occupational Safety and Health, U.S. Centers for Disease Control and Prevention, Pittsburgh, PA, USA
| | - Lee A Greenawald
- National Personal Protective Technology Laboratory of the National Institute for Occupational Safety and Health, U.S. Centers for Disease Control and Prevention, Pittsburgh, PA, USA
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Quinn TD, Yorio PL, Smith P, Seo Y, Whitfield G, Gibbs BB. Associations Of Occupational And Leisure-time Physical Activity With Cardiovascular Disease. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000678588.75487.a9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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13
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Dubaniewicz MT, Rottach DR, Yorio PL. Quality Assurance Sampling Plans in US Stockpiles for Personal Protective Equipment: A Computer Simulation to Examine Degradation Rates. Health Secur 2020; 17:324-333. [PMID: 31433277 DOI: 10.1089/hs.2019.0042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Medical countermeasure stockpiles in the United States are designed to support healthcare workers and the public during public health emergencies; they include supplies of personal protective equipment (PPE). As part of typical PPE manufacturing processes, appropriate test methods are used to ensure that the devices provide adequate protective performance. At the time of manufacture, performance is often measured and weighed against an objective standard of quality, resulting in a pass or fail attribute being assigned to individual PPE items and thence to production lots. Incorporating periodic performance testing for stockpiled PPE can ensure that they maintain their protective qualities and integrity over time while in storage. There is an absence of guidance regarding how to design quality assurance programs for stockpiled PPE. The applicability of the Lot Quality Assurance Sampling (LQAS) approach to stockpiled PPE was examined in a previous study that compared and contrasted different sample sizes in recovering the true percentage of defective units in large lots in the LQAS framework. The current study carries this line of inquiry forward by integrating PPE degradation over time and comparing different sampling time intervals in recovering the true underlying degradation rate. The results suggest that product degradation is more easily detected when tested at shorter time intervals and for higher degradation rates. They further suggest that sampling interval groupings can be made based on the proficiency with which they recover the true underlying degradation rate.
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Affiliation(s)
- Mitchell T Dubaniewicz
- Mitchell T. Dubaniewicz is a student researcher, Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, and was on assignment with CDC/NIOSH/NPPTL
| | - Dana R Rottach
- Dana R. Rottach, PhD, is a Physical Scientist, and Patrick L. Yorio, PhD, is a Health Statistician; both at the National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, PA
| | - Patrick L Yorio
- Dana R. Rottach, PhD, is a Physical Scientist, and Patrick L. Yorio, PhD, is a Health Statistician; both at the National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, PA
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Yoon KN, Greenawald LA, Rottach DR, Pollard JP, Yorio PL. A General Framework to Test and Evaluate Filtering Facepiece Respirators Considered for Crisis Capacity Use as a Strategy to Optimize Supply. J Int Soc Respir Prot 2020; 36:36-51. [PMID: 32508389 PMCID: PMC7274519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
During a public health emergency, respirator shortages can have a profound impact on the national response, such as for the current coronavirus disease 2019 (COVID-19) pandemic. Due to a severe shortage of respirators (particularly filtering facepiece respirators [FFRs]), there may be contexts in which understanding the performance of FFRs that are approved for use as part of a crisis capacity strategy is desired. This includes FFRs that are not covered under the National Institute for Occupational Safety and Health (NIOSH) Respirator Approval Program because they have been stored past their designated shelf life, have been decontaminated, or are approved by international certification bodies other than NIOSH. The purpose of this document is to provide a general framework to assess the performance of FFRs that are only being used as a crisis capacity strategy. The intended audience are those who are responsible for managing large amounts of FFRs. This framework includes a four-step process consisting of: 1) defining the population of FFRs to be sampled; 2) providing sampling strategy options; 3) inspecting and testing the sampled units; and 4) evaluating the results. In addition to the four-step process, we provide an example of how NIOSH recently evaluated the quality of FFRs sampled from ten U.S. stockpiles.
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15
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Yorio PL, Fisher EM, Kilinc-Balci FS, Rottach D, Harney J, Seaton M, Dahm MM, Niemeier T. Planning for Epidemics and Pandemics: Assessing the Potential Impact of Extended Use and Reuse Strategies on Respirator Usage Rates to Support Supply-and-Demand Planning Efforts. J Int Soc Respir Prot 2020; 37:52-60. [PMID: 32508390 PMCID: PMC7274506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
During epidemics and pandemics healthcare personnel (HCP) are on the front line of disease containment and mitigation. Personal protective equipment (PPE), such as NIOSH-approved N95 filtering facepiece respirators (FFRs), serve an important role in minimizing HCP risks and are in high demand during public health emergencies. Because PPE demand can exceed supply, various public health strategies have been developed to reduce the rate of PPE consumption as supply dwindles. Extended use and limited reuse of N95 FFRs are strategies advocated by many governmental agencies used to increase the number of times a device can be used. Increased use of respirators designed for reuse-such as powered air-purifying respirators (PAPRs) and elastomeric half-mask and full facepiece air-purifying respirators- is another option designed to reduce the continuous need for new devices as the daily need for respirator use increases. Together, these strategies are designed to reduce the number of PPE units that must be discarded daily and, therefore, extend the longevity of available supply. The purpose of this paper is to theoretically estimate the impact of extended use and limited reuse strategies for N95 FFRs and the increased use of reusable respirator options on PPE consumed. The results suggest that a considerable reduction in PPE consumption would result from extended use and limited reuse of N95 FFRs and the increased use of respirators designed for reuse; however, the practical benefits must be balanced with the risks and economic costs. In addition, extended use and reuse strategies must be accompanied by proper procedures to reduce risk. The study is designed to support epidemic and pandemic PPE supply and demand planning efforts.
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Affiliation(s)
- Patrick L. Yorio
- National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA USA
| | - Edward M. Fisher
- National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA USA
| | - F Selcen Kilinc-Balci
- National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA USA
| | - Dana Rottach
- National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA USA
| | - Joshua Harney
- National Institute for Occupational Safety and Health, Division of Field Studies and Engineering, Cincinnati, OH USA
| | - Melissa Seaton
- National Institute for Occupational Safety and Health, Division of Science Integration, Cincinnati, OH USA
| | - Matthew M. Dahm
- National Institute for Occupational Safety and Health, Division of Field Studies and Engineering, Cincinnati, OH USA
| | - Todd Niemeier
- National Institute for Occupational Safety and Health, Division of Science Integration, Cincinnati, OH USA
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Abstract
National culture colors nearly every aspect of human behavior (Javidan et al., 2006). Despite this truism, the concept has yet to be integrated into organizational safety culture theory. The purpose of this article is to bring awareness as to how national culture can influence organizational safety culture. We do so by theorizing that the shared organizational beliefs, assumptions, and values related to safety (i.e., the anthropologic component of safety culture) are a reflection of the national culture in which the organization's workers are embedded. These organizational values, beliefs, and assumptions directly influence worker perceptions of organizational life and their behavioral choices. Given this prospectively strong direct influence on organizational behavior, we reason that the effectiveness of different organizational structure designs, safety management practices, and leadership characteristics (i.e., safety culture's normative component) can depend on characteristics of the national culture within which the organization resides. We conclude by providing a few key practical suggestions and directions for future research.
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Affiliation(s)
- Patrick L. Yorio
- National Personal Protective Technology Laboratory of the National Institute for Occupational Safety and Health, U.S. Centers for Disease Control and Prevention, Pittsburgh, PA, USA
- Corresponding author at: National Institute for Occupational Safety and Health, Bruceton Research Center, 626 Cochrans Mill Road, Pittsburgh, PA 15236, USA. (P.L. Yorio)
| | - Jason Edwards
- Centre for Accident Research and Road Safety - Queensland, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Dick Hoeneveld
- Delft University of Technology, Faculty of Technology, Policy and Management, TU Delft Safety & Security Institute, Delft, the Netherlands
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17
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Kahveci Z, Selcen Kilinc-Balci F, Yorio PL. Critical investigation of glove-gown interface barrier performance in simulated surgical settings. J Occup Environ Hyg 2019; 16:498-506. [PMID: 31021715 PMCID: PMC10009782 DOI: 10.1080/15459624.2019.1600702] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The barrier properties of personal protective equipment are vital to healthcare personnel to protect themselves from possible infectious body fluids. Intraoperative exposure of healthcare personnel to body fluids can be substantial in both inpatient and outpatient settings. The glove-gown interface is known as one of the weakest points of the whole personal protective equipment system. However, there is a lack of scientific research designed to investigate the problem. This paper reports the results of experiments using a new testing methodology developed to quantify fluid leakage through the glove-gown interface while simulating surgical settings in terms of operating room personnel activities, exposure types, exposure durations, and physical stresses applied on the interface. This study represents one of the first efforts investigating the amount of fluid leakage through the glove-gown interface for a number of surgical gown and glove models while considering glove material differences and single vs. double gloving. The test results showed that there is a significant difference in fluid leakage amounts between three gown models and four glove models studied. The results also demonstrated that double gloving significantly reduced the fluid leakage compared to single glove use. The mean fluid leakage was lower in the double synthetic glove configurations (M = 2.76g) compared with all other configurations (3GLV, M = 8.3g; 4GLV, M = 9.49g; 5GLV, M = 3.08g; 6GLV, M = 20.03g; double latex, M = 5.22g). Findings highlighted a significant interaction between glove and gown designs, which suggests that gown and gloves should be designed together as a system to minimize or eliminate the fluid leakage.
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Affiliation(s)
- Zafer Kahveci
- a Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH) , National Personal Protective Technology Laboratory , Pittsburgh , Pennsylvania
| | - F Selcen Kilinc-Balci
- a Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH) , National Personal Protective Technology Laboratory , Pittsburgh , Pennsylvania
| | - Patrick L Yorio
- a Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH) , National Personal Protective Technology Laboratory , Pittsburgh , Pennsylvania
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Haas EJ, Yorio PL. The role of risk avoidance and locus of control in workers' near miss experiences: Implications for improving safety management systems. J Loss Prev Process Ind 2019; 59:91-99. [PMID: 32913382 DOI: 10.1016/j.jlp.2019.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The process industry has made major advancements and is a leader in near-miss safety management, with several validated models and databases to track close call reports. However, organizational efforts to develop safe work procedures and rules do not guarantee that employees will behaviorally comply with them. Assuming that at some point, every safety management system will need to be examined and realigned to help prevent incidents on the job, it is important to understand how personality traits can impact workers' risk-based decisions. Such work has been done in the mining industry due to its characteristically high risks and the results can be gleaned to help the process industry realign goals and values with their workforce. In the current study, researchers cross-sectionally surveyed 1,334 miners from 20 mine sites across the United States, varying in size and commodity. The survey sought to understand how mineworkers' risk avoidance could impact their near miss incidents on the job - a common precursor to lost-time incidents. Multiple regressions showed that as a miner's level of risk avoidance increased by 1 unit in the 6-point response scale, the probability of experiencing a near miss significantly decreased by 30% when adjusting for relevant control variables. Additionally, a significant interaction between risk avoidance and locus of control suggested that the effect of risk avoidance on near misses is enhanced as a miner's locus of control increases. A one-unit increase in locus of control appends the base effect of risk avoidance on near misses with an additional 8% decrease in the probability. Findings are discussed from a near-miss safety management system perspective in terms of methods to foster both risk avoidance and locus of control in an effort to reduce the probability of near misses and lost time at the organizational level within the process industry and other high-hazard industries.
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Affiliation(s)
- Emily J Haas
- Senior Research Behavioral Scientist, National Institute for Occupational Safety and Health, Pittsburgh Mining Research Division, 626 Cochrans Mill Rd, Pittsburgh, PA, 15236, USA
| | - Patrick L Yorio
- Statistician, National Institute for Occupational Safety and Health, National Personal Protection Technology Laboratory, 626 Cochrans Mill Rd, Pittsburgh, PA, 15236, USA
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19
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Abstract
Personal protective equipment (PPE) stockpiles in the United States were established to facilitate rapid deployment of medical assets to sites affected by public health emergencies. Large quantities of PPE were introduced into US stockpiles because of the need to protect healthcare and other professionals during these events. Because most stockpiled PPE was acquired during, or immediately following, large-scale public health events, such as pandemic influenza planning (2005-20080), SARS (2003), H1N1 (2009-10), and Ebola (2014-15), aging PPE poses a significant problem. PPE such as N95 filtering face piece respirators were not designed to be stored for long periods, and much of the currently stored PPE has exceeded its manufacturer-assigned shelf life. Given the significant investment in the procurement and storage of PPE, along with projections of consumption during public health emergencies, discarding large quantities of potentially viable PPE is not an attractive option. Although shelf-life extension programs exist for other stockpiled medical assets, no such option is currently available for stockpiled PPE. This article posits stockpile quality assurance sampling plans as a mechanism through which shelf-life extension programs for stockpiled PPE may be achieved. We discuss some of the nuances that should be considered when developing a plan tailored to stockpiles and provide basic decision tools that may be used in the context of a quality assurance program tailored to stockpiled PPE. We also explore basic information by comparing and contrasting different sample size options.
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Affiliation(s)
- Patrick L Yorio
- Patrick L. Yorio, PhD, is a Health Statistician, and Dana R. Rottach, PhD, is a Physical Scientist; both at the National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, PA. Mitchell Dubaniewicz is a student researcher, Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, and was on assignment with CDC/NIOSH/NPPTL
| | - Dana R Rottach
- Patrick L. Yorio, PhD, is a Health Statistician, and Dana R. Rottach, PhD, is a Physical Scientist; both at the National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, PA. Mitchell Dubaniewicz is a student researcher, Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, and was on assignment with CDC/NIOSH/NPPTL
| | - Mitchell Dubaniewicz
- Patrick L. Yorio, PhD, is a Health Statistician, and Dana R. Rottach, PhD, is a Physical Scientist; both at the National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, PA. Mitchell Dubaniewicz is a student researcher, Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, and was on assignment with CDC/NIOSH/NPPTL
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20
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Li M, Furlong JL, Yorio PL, Portnoff L. A new approach to measure the resistance of fabric to liquid and viral penetration. PLoS One 2019; 14:e0211827. [PMID: 30735524 PMCID: PMC6368298 DOI: 10.1371/journal.pone.0211827] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 01/22/2019] [Indexed: 11/25/2022] Open
Abstract
Protective clothing manufacturers routinely test their products for resistance to liquid and viral penetration. Several of the test methods specified by the American Society for Testing and Materials (ASTM) and the International Organization for Standardization (ISO) for penetration testing produce binary results (i.e. pass or fail), deliver imprecise pressure regulation, and do not record the location at which penetration events occur. Instead, our approach measures a continuous variable (time of penetration) during a slow and continuous increase of hydrostatic pressure and retains the location of penetration events. Using a fluorescent dye to enhance visual detection, we evaluate temporal and spatial patterns of penetration events. We then compare the time of liquid penetration with the time of penetration of two bacteriophages (Phi-X174 and MS2). For the fabric tested, the mean viral penetration occurred 0.29 minutes earlier than liquid penetration when solved by logistic regression. The breakthrough time of MS2 was not different from the Phi-X174 bacteriophage. The time of liquid penetration was a latent indicator of the time of viral penetration.
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Affiliation(s)
- Min Li
- Department of Chemistry and Physics, California University of Pennsylvania, California, PA, United States of America
| | - Jennifer L. Furlong
- National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory Pittsburgh, PA, United States of America
| | - Patrick L. Yorio
- National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory Pittsburgh, PA, United States of America
| | - Lee Portnoff
- National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory Pittsburgh, PA, United States of America
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21
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Kilinc-Balci FS, Kahveci Z, Yorio PL. Novel Test Method for the Evaluation of Fluid Leakage at the Glove-Gown Interface and Investigation of Test Parameters. J Am Coll Surg 2018; 227:573-586. [PMID: 30268491 PMCID: PMC10686016 DOI: 10.1016/j.jamcollsurg.2018.09.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/13/2018] [Accepted: 09/14/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Exposure to patients' blood/body fluids could be life-affecting, when providing care to patients with infectious diseases. Although the glove-gown interface is considered one of the weakest points of the protective ensemble system, there is a lack of research, and existing standards do not provide much guidance on strategies to minimize gaps between the gowns and gloves. Currently, there is no known standard test method to evaluate fluid leakage or assess performance improvements with new gowns/gloves. STUDY DESIGN A novel test method with a robotic arm, which has the capability to simulate health care personnel's arm movements during fluid exposure, was developed to determine the leakage at the glove-gown interface. This article explains the test method and investigates the effect of movement, exposure type, exposure duration, procedure duration, and existence of pressure on the amount of leaked fluid at the glove-gown interface. RESULTS Test results suggest that, with the exception of procedure duration, all parameters significantly affected the amount of fluid leaked at the glove-gown interface. Leakage was higher for soaking when compared to spraying, increased as the exposure duration increased, and was greater with the application of pressure. CONCLUSIONS The novel method developed in this study could be used by manufacturers of personal protective equipment to evaluate their products. Standard development organizations could adapt this test method in their specifications, testing standards, and guidelines.
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Affiliation(s)
- F Selcen Kilinc-Balci
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH), National Personal Protective Technology Laboratory, Pittsburgh, PA.
| | - Zafer Kahveci
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH), National Personal Protective Technology Laboratory, Pittsburgh, PA
| | - Patrick L Yorio
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH), National Personal Protective Technology Laboratory, Pittsburgh, PA
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22
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Quinn TD, Seo Y, Yorio PL, Aljaroudi A, Coca A, Kim JH, Roberge RJ, Jon Williams W. Using trunk posture to monitor heat strain at work. Ergonomics 2018; 61:1560-1568. [PMID: 30014772 DOI: 10.1080/00140139.2018.1497207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 06/29/2018] [Indexed: 06/08/2023]
Abstract
This study aimed to determine if trunk posture during walking is related to increases in rectal temperature (Tre). 24 males treadmill walked in one of four conditions (1): 30 min at 3.0 mph and 0% grade, 20 °C and 50% relative humidity (RH), wearing healthcare worker (HCW) PPE; (2): 30 min at 3.0 mph and 0% grade, 27.5 °C and 60% RH, HCW PPE; (3): 30 min at 3.0 mph and 0% grade, 32.5 °C and 70% RH, HCW PPE; and (4): 40 min at 40% VO2max, 30 °C and 70% RH, wearing firefighter PPE. Trunk posture (Zephyr BioHarness 3) and Tre were measured continuously. Tre was positively related to trunk posture, controlling for covariates (B = 3.49, p < .001). BMI and age moderated this relationship (Tre×age, B = 0.76, p < .001; Tre*BMI, B = -1.85, p < .001). Trunk posture measurement may be useful in monitoring fall potential and magnitude of heat stress of workers in hot environments. Practitioner Summary: Occupational hyperthermia increases worker risk for heat illness and injury but is difficult to monitor in the field. This investigation shows that trunk posture is independently and positively related to core temperature. Non-invasive measurement or visual inspection of trunk posture could provide novel insight on individual heat strain level.
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Affiliation(s)
- Tyler D Quinn
- a National Institute for Occupational Safety and Health Pittsburgh Research Laboratory , Pittsburgh , PA , USA
| | - Yongsuk Seo
- a National Institute for Occupational Safety and Health Pittsburgh Research Laboratory , Pittsburgh , PA , USA
| | - Patrick L Yorio
- a National Institute for Occupational Safety and Health Pittsburgh Research Laboratory , Pittsburgh , PA , USA
| | - Ali Aljaroudi
- a National Institute for Occupational Safety and Health Pittsburgh Research Laboratory , Pittsburgh , PA , USA
| | - Aitor Coca
- a National Institute for Occupational Safety and Health Pittsburgh Research Laboratory , Pittsburgh , PA , USA
| | - Jung-Hyun Kim
- a National Institute for Occupational Safety and Health Pittsburgh Research Laboratory , Pittsburgh , PA , USA
| | - Raymond J Roberge
- a National Institute for Occupational Safety and Health Pittsburgh Research Laboratory , Pittsburgh , PA , USA
| | - W Jon Williams
- a National Institute for Occupational Safety and Health Pittsburgh Research Laboratory , Pittsburgh , PA , USA
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Yorio PL, Laney AS, Halldin CN, Blackley DJ, Moore SM, Wizner K, Radonovich LJ, Greenawald LA. Interstitial Lung Diseases in the U.S. Mining Industry: Using MSHA Data to Examine Trends and the Prevention Effects of Compliance with Health Regulations, 1996-2015. Risk Anal 2018; 38:1962-1971. [PMID: 29649352 PMCID: PMC6238148 DOI: 10.1111/risa.13000] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/20/2018] [Accepted: 02/23/2018] [Indexed: 05/31/2023]
Abstract
Given the recent increase in dust-induced lung disease among U.S. coal miners and the respiratory hazards encountered across the U.S. mining industry, it is important to enhance an understanding of lung disease trends and the organizational contexts that precede these events. In addition to exploring overall trends reported to the Mine Safety and Health Administration (MSHA), the current study uses MSHA's enforcement database to examine whether or not compliance with health regulations resulted in fewer mine-level counts of these diseases over time. The findings suggest that interstitial lung diseases were more prevalent in coal mines compared to other mining commodities, in Appalachian coal mines compared to the rest of the United States, and in underground compared to surface coal mines. Mines that followed a relevant subset of MSHA's health regulations were less likely to report a lung disease over time. The findings are discussed from a lung disease prevention strategy perspective.
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Affiliation(s)
- Patrick L. Yorio
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Pittsburgh, PA, USA
| | - A. Scott Laney
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Cara N. Halldin
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - David J. Blackley
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Susan M. Moore
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Pittsburgh, PA, USA
| | - Kerri Wizner
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Pittsburgh, PA, USA
| | - Lewis J. Radonovich
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Pittsburgh, PA, USA
| | - Lee A. Greenawald
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Morgantown, WV, USA
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24
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Rule AM, Apau O, Ahrenholz SH, Brueck SE, Lindsley WG, de Perio MA, Noti JD, Shaffer RE, Rothman R, Grigorovitch A, Noorbakhsh B, Beezhold DH, Yorio PL, Perl TM, Fisher EM. Healthcare personnel exposure in an emergency department during influenza season. PLoS One 2018; 13:e0203223. [PMID: 30169507 PMCID: PMC6118374 DOI: 10.1371/journal.pone.0203223] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 08/16/2018] [Indexed: 12/14/2022] Open
Abstract
Introduction Healthcare personnel are at high risk for exposure to influenza by direct and indirect contact, droplets and aerosols, and by aerosol generating procedures. Information on air and surface influenza contamination is needed to assist in developing guidance for proper prevention and control strategies. To understand the vulnerabilities of healthcare personnel, we measured influenza in the breathing zone of healthcare personnel, in air and on surfaces within a healthcare setting, and on filtering facepiece respirators worn by healthcare personnel when conducting patient care. Methods Thirty participants were recruited from an adult emergency department during the 2015 influenza season. Participants wore personal bioaerosol samplers for six hours of their work shift, submitted used filtering facepiece respirators and medical masks and completed questionnaires to assess frequency and types of interactions with potentially infected patients. Room air samples were collected using bioaerosol samplers, and surface swabs were collected from high-contact surfaces within the adult emergency department. Personal and room bioaerosol samples, surface swabs, and filtering facepiece respirators were analyzed for influenza A by polymerase chain reaction. Results Influenza was identified in 42% (53/125) of personal bioaerosol samples, 43% (28/ 96) of room bioaerosol samples, 76% (23/30) of pooled surface samples, and 25% (3/12) of the filtering facepiece respirators analyzed. Influenza copy numbers were greater in personal bioaerosol samples (17 to 631 copies) compared to room bioaerosol samples (16 to 323 copies). Regression analysis suggested that the amount of influenza in personal samples was approximately 2.3 times the amount in room samples (Wald χ2 = 16.21, p<0.001). Conclusions Healthcare personnel may encounter increased concentrations of influenza virus when in close proximity to patients. Occupations that require contact with patients are at an increased risk for influenza exposure, which may occur throughout the influenza season. Filtering facepiece respirators may become contaminated with influenza when used during patient care.
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Affiliation(s)
- Ana M. Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Otis Apau
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Steven H. Ahrenholz
- Division of Surveillance, Hazard Evaluations, and Field Studies (DSHEFS), National Institute for Occupational Safety and Health, Cincinnati, Ohio, United States of America
| | - Scott E. Brueck
- Division of Surveillance, Hazard Evaluations, and Field Studies (DSHEFS), National Institute for Occupational Safety and Health, Cincinnati, Ohio, United States of America
| | - William G. Lindsley
- Health Effects Laboratory Division (HELD, National Institute for Occupational Safety and Health, Morgantown, West Virginia, United States of America
| | - Marie A. de Perio
- Division of Surveillance, Hazard Evaluations, and Field Studies (DSHEFS), National Institute for Occupational Safety and Health, Cincinnati, Ohio, United States of America
| | - John D. Noti
- Health Effects Laboratory Division (HELD, National Institute for Occupational Safety and Health, Morgantown, West Virginia, United States of America
| | - Ronald E. Shaffer
- National Personal Protective Technology Lab (NPPTL), National Institute for Occupational Safety and Health, Pittsburgh, Pennsylvania, United States of America
| | - Richard Rothman
- Johns Hopkins Hospital, Adult Emergency Department, Baltimore, Maryland, United States of America
| | - Alina Grigorovitch
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Bahar Noorbakhsh
- Health Effects Laboratory Division (HELD, National Institute for Occupational Safety and Health, Morgantown, West Virginia, United States of America
| | - Donald H. Beezhold
- Health Effects Laboratory Division (HELD, National Institute for Occupational Safety and Health, Morgantown, West Virginia, United States of America
| | - Patrick L. Yorio
- National Personal Protective Technology Lab (NPPTL), National Institute for Occupational Safety and Health, Pittsburgh, Pennsylvania, United States of America
| | - Trish M. Perl
- Division of Infectious Diseases, UT Southwestern Medical Center, Dallas, Texas, United States of America
| | - Edward M. Fisher
- National Personal Protective Technology Lab (NPPTL), National Institute for Occupational Safety and Health, Pittsburgh, Pennsylvania, United States of America
- * E-mail:
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25
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Yorio PL, Moore SM. Examining Factors that Influence the Existence of Heinrich's Safety Triangle Using Site-Specific H&S Data from More than 25,000 Establishments. Risk Anal 2018; 38:839-852. [PMID: 28768045 PMCID: PMC6238149 DOI: 10.1111/risa.12869] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 06/12/2017] [Accepted: 06/25/2017] [Indexed: 05/28/2023]
Abstract
In the 1930s, Heinrich established one of the most prominent and enduring accident prevention theories when he concluded that high severity occupational safety and health (OSH) incidents are preceded by numerous lower severity incidents and near misses. Seventy-five years of theory expansion/interpretation includes two fundamental tenets: (1) the ratio of lower to higher severity incidents exists in the form of a "safety-triangle" and (2) similar causes underlie both high and low severity events. Although used extensively to inform public policy and establishment-level health and safety priorities, recent research challenges the validity of the two tenets. This study explored the validity of the first tenet, the existence of the safety triangle. The advantage of the current study is the use of a detailed, establishment-specific data set that evaluated over 25,000 establishments over a 13-year time period, allowing three specific questions to be explored: (1) Are an increased number of lower severity incidents at an establishment significantly associated with the probability of a fatal event over time? (2) At the establishment level, do the effects of OSH incidents on the probability of a fatality over time decrease as the degree of severity decreases-thereby taking the form of a triangle? and (3) Do distinct methods for delineating incidents by severity affect the existence of the safety triangle form? The answer to all three questions was yes with the triangle form being dependent upon how severity was delineated. The implications of these findings in regard to Heinrich's theory and OSH policy and management are discussed.
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Affiliation(s)
- Patrick L. Yorio
- Address correspondence to Patrick L. Yorio, National Personal Protective Equipment Laboratory of the National Institute for Occupational Safety and Health, U.S. Centers for Disease Control and Prevention, 626 Cochrans Mill Road, Pittsburgh, PA 15236, USA;412-386-5568;
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26
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Brady TM, Strauch AL, Almaguer CM, Niezgoda G, Shaffer RE, Yorio PL, Fisher EM. Transfer of bacteriophage MS2 and fluorescein from N95 filtering facepiece respirators to hands: Measuring fomite potential. J Occup Environ Hyg 2017; 14:898-906. [PMID: 28650715 PMCID: PMC5705010 DOI: 10.1080/15459624.2017.1346799] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Contact transmission of pathogens from personal protective equipment is a concern within the healthcare industry. During public health emergency outbreaks, resources become constrained and the reuse of personal protective equipment, such as N95 filtering facepiece respirators, may be needed. This study was designed to characterize the transfer of bacteriophage MS2 and fluorescein between filtering facepiece respirators and the wearer's hands during three simulated use scenarios. Filtering facepiece respirators were contaminated with MS2 and fluorescein in droplets or droplet nuclei. Thirteen test subjects performed filtering facepiece respirator use scenarios including improper doffing, proper doffing and reuse, and improper doffing and reuse. Fluorescein and MS2 contamination transfer were quantified. The average MS2 transfer from filtering facepiece respirators to the subjects' hands ranged from 7.6-15.4% and 2.2-2.7% for droplet and droplet nuclei derived contamination, respectively. Handling filtering facepiece respirators contaminated with droplets resulted in higher levels of MS2 transfer compared to droplet nuclei for all use scenarios (p = 0.007). MS2 transfer from droplet contaminated filtering facepiece respirators during improper doffing and reuse was greater than transfer during improper doffing (p = 0.008) and proper doffing and reuse (p = 0.042). Droplet contamination resulted in higher levels of fluorescein transfer compared to droplet nuclei contaminated filtering facepiece respirators for all use scenarios (p = 0.009). Fluorescein transfer was greater for improper doffing and reuse (p = 0.007) from droplet contaminated masks compared to droplet nuclei contaminated filtering facepiece respirators and for improper doffing and reuse when compared improper doffing (p = 0.017) and proper doffing and reuse (p = 0.018) for droplet contaminated filtering facepiece respirators. For droplet nuclei contaminated filtering facepiece respirators, the difference in MS2 and fluorescein transfer did not reach statistical significance when comparing any of the use scenarios. The findings suggest that the results of fluorescein and MS2 transfer were consistent and highly correlated across the conditions of study. The data supports CDC recommendations for using proper doffing techniques and discarding filtering facepiece respirators that are directly contaminated with secretions from a cough or sneeze.
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Affiliation(s)
- Tyler M Brady
- a National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory , Pittsburgh , Pennsylvania
| | - Amanda L Strauch
- a National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory , Pittsburgh , Pennsylvania
| | - Claudia M Almaguer
- a National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory , Pittsburgh , Pennsylvania
| | - George Niezgoda
- a National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory , Pittsburgh , Pennsylvania
| | - Ronald E Shaffer
- a National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory , Pittsburgh , Pennsylvania
| | - Patrick L Yorio
- a National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory , Pittsburgh , Pennsylvania
| | - Edward M Fisher
- a National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory , Pittsburgh , Pennsylvania
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27
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Yorio PL, Willmer DR, Haight JM. Interpreting MSHA citations through the lens of occupational health and safety management systems: investigating their impact on mine injuries and illnesses 2003-2010. Risk Anal 2014; 34:1538-1553. [PMID: 24471699 DOI: 10.1111/risa.12164] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Since the late 1980s, the U.S. Department of Labor has considered regulating a systems approach to occupational health and safety management. Recently, a health and safety management systems (HSMS) standard has returned to the regulatory agenda of both the Occupational Safety and Health Administration (OSHA) and the Mine Safety and Health Administration (MSHA). Because a mandated standard has implications for both industry and regulating bodies alike, it is imperative to gain a greater understanding of the potential effects that an HSMS regulatory approach can have on establishment-level injuries and illnesses. Through the lens of MSHA's regulatory framework, we first explore how current enforcement activities align with HSMS elements. Using MSHA data for the years 2003-2010, we then analyze the relationship between various types of enforcement activities (e.g., total number of citations, total penalty amount, and HSMS-aligned citations) and mine reportable injuries. Our findings show that the reduction in mine reportable injuries predicted by increases in MSHA enforcement ranges from negligible to 18%. The results suggest that the type and focus of the enforcement activity may be more important for accident reduction than the total number of citations issued and the associated penalty amount.
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Affiliation(s)
- Patrick L Yorio
- CDC-NIOSH, Office of Mine Safety and Health Research, Pittsburgh, PA, USA
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28
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Wachter JK, Yorio PL. A system of safety management practices and worker engagement for reducing and preventing accidents: an empirical and theoretical investigation. Accid Anal Prev 2014; 68:117-130. [PMID: 23993683 DOI: 10.1016/j.aap.2013.07.029] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 05/13/2013] [Accepted: 07/26/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE The overall research objective was to theoretically and empirically develop the ideas around a system of safety management practices (ten practices were elaborated), to test their relationship with objective safety statistics (such as accident rates), and to explore how these practices work to achieve positive safety results (accident prevention) through worker engagement. METHOD Data were collected using safety manager, supervisor and employee surveys designed to assess and link safety management system practices, employee perceptions resulting from existing practices, and safety performance outcomes. RESULTS Results indicate the following: there is a significant negative relationship between the presence of ten individual safety management practices, as well as the composite of these practices, with accident rates; there is a significant negative relationship between the level of safety-focused worker emotional and cognitive engagement with accident rates; safety management systems and worker engagement levels can be used individually to predict accident rates; safety management systems can be used to predict worker engagement levels; and worker engagement levels act as mediators between the safety management system and safety performance outcomes (such as accident rates). IMPLICATIONS Even though the presence of safety management system practices is linked with incident reduction and may represent a necessary first-step in accident prevention, safety performance may also depend on mediation by safety-focused cognitive and emotional engagement by workers. Thus, when organizations invest in a safety management system approach to reducing/preventing accidents and improving safety performance, they should also be concerned about winning over the minds and hearts of their workers through human performance-based safety management systems designed to promote and enhance worker engagement.
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Affiliation(s)
- Jan K Wachter
- Indiana University of Pennsylvania, Safety Sciences Department, Johnson Hall Room 137, 1010 Oakland Avenue, 15705-1063, United States.
| | - Patrick L Yorio
- Indiana University of Pennsylvania, Safety Sciences Department, Johnson Hall Room 137, 1010 Oakland Avenue, 15705-1063, United States
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