Category Archives: Health & Safety

Health-Care-Associated Infections in Hospitals: Leadership Needed from HHS to Prioritize Prevention Practices and Improve Data on These Infections

Source: Governmental Accountability Office, March 31, 2008

According to the Centers for Disease Control and Prevention (CDC), health-care-associated infections (HAI) are estimated to be 1 of the top 10 causes of death in the United States. HAIs are infections that patients acquire while receiving treatment for other conditions. GAO was asked to examine (1) CDC’s guidelines for hospitals to reduce or prevent HAIs and what the Department of Health and Human Services (HHS) does to promote their implementation, (2) Centers for Medicare & Medicaid Services’ (CMS) and hospital accrediting organizations’ required standards for hospitals to reduce or prevent HAIs and how compliance is assessed, and (3) HHS programs that collect data related to HAIs and integration of the data across HHS. GAO reviewed documents and interviewed officials from CDC, CMS, the Agency for Healthcare Research and Quality (AHRQ), and accrediting organizations.

Full report
Testimony

Current Treatment Options for Community-Acquired Methicillin-Resistant Staphylococcus aureus Infection

Source: Clinical Infectious Diseases

During the past decade, there has been a marked increase in the prevalence of community-acquired methicillin-resistant Staphylococcus aureus infection in the United States and elsewhere. The most common such infections are those involving the skin and skin structures. Although a number of these lesions (including small furuncles and abscesses) respond well to surgical incision and drainage, oral antimicrobial agents are commonly used to treat these infections in outpatients. Unfortunately, with the exception of linezolid, none of the agents presently being used in this fashion has been subjected to rigorous clinical trial. Thus, current therapy is based largely on anecdotal evidence. For more-serious infections requiring hospitalization, parenteral antimicrobials such as vancomycin, teicoplanin, daptomycin, linezolid, and tigecycline are presently available and have demonstrated effectiveness in randomized, prospective, double-blind trials.

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Perceived Insufficient Rest or Sleep — Four States, 2006

Source: Morbidity and Mortality Weekly Report (CDC), February 29, 2008

From the press release:
About 10 percent of adults report not getting enough rest or sleep every day in the past month, according to a new four-state study released by the Centers for Disease Control and Prevention′s (CDC) Morbidity and Mortality Weekly Report.

The data from the four states-Delaware, Hawaii, New York, and Rhode Island-may not reflect national trends. But an additional study conducted by CDC utilizing data from the National Health Interview Study indicated that across all age groups the percentage of adults who, on average, report sleeping six hours or less has increased from 1985 to 2006.

Nationwide, an estimated 50 to 70 million people suffer from chronic sleep loss and sleep disorders. Sleep loss is associated with health problems, including obesity, depression, and certain risk behaviors, including cigarette smoking, physical inactivity, and heavy drinking.

Healthcare Workers in Non-Hospital Settings at Substantial Risk of Exposure to Bloodborne Pathogens

Source: At the Frontline, Columbia University Mailman School of Public Health, Vol. 3 no. 1, February 2008

In one of the largest studies of its kind, researchers from the Mailman School assessed the risk of exposure to bloodborne pathogens among non-hospital based registered nurses (RNs), and found that nearly one out of ten of the more than 1,100 nurse participants reported at least one needlestick injury in the previous 12 months. Findings of the study are published in the December issue of Industrial Health.

According to Robyn Gershon, DrPH, professor of Sociomedical Sciences and the study’s principal investigator, “These rates of exposure are surprising since they are similar to rates reported for hospital-based nurses, even though hospitalized patients generally have high levels of acuity of patient care (i.e., more procedures, including more invasive procedures), than are typically performed in community healthcare settings.” But, as Dr. Gershon and colleagues point out, these findings are not completely unexpected since patient care, including more complex types of care, is increasingly delivered at non-hospital based healthcare facilities, including out-patient clinics, nursing homes, doctor’s offices, patients’ homes, and public health clinics.

He Says His Agency Is At Fault: Record-Keeping Chief Says OSHA Lets Companies Underreport Injuries

Source: Kerry Hall and Ames Alexander, Charlotte Observer, February 11, 2008

Bob Whitmore is doing what few career government employees dare — publicly criticizing his own agency.

Whitmore, an expert in record-keeping requirements for the U.S. Occupational Safety and Health Administration, said OSHA is allowing employers to vastly underreport the number of injuries and illnesses their workers suffer.

The true rate for some industries — including poultry processors — is likely two to three times higher than government numbers suggest, he said.

Studies Suggest Higher Risk for Contingent Workers Than in Traditional Employment, NIOSH Researchers Report

Source: NOISH Update, February 5, 2008

Studies in the U.S. and Europe suggest that contingent workers such as part-time, temporary, or contract workers are at higher risk for occupational injuries and illnesses than workers in traditional employment situations, researchers from the National Institute for Occupational Safety and Health (NIOSH) report.

Several possible reasons for the higher risk are suggested in the increasing scientific evidence, and warrant further scientific investigation, the researchers stated. The article, “Contingent Workers and Contingent Health: Risks of a Modern Economy,” by Kristin J. Cummings, M.D., M.P.H., and Kathleen Kreiss, M.D., was published in the January 30 issue of the Journal of the American Medical Association.

Mine Fines Routinely Ignored: MSHA Leaders Promise Reforms

Source: Ken Ward Jr., Charleston Gazette, January 27, 2008

Federal regulators have allowed mine operators to avoid fines for thousands of health and safety citations, despite a federal law that requires monetary penalties for such violations, government officials have confirmed.

Over the last six years, the Department of Labor’s Mine Safety and Health Administration did not assess civil penalties for about 4,000 violations, according to preliminary MSHA data.

Preparing and Protecting Security Personnel in Emergencies

Source: Occupational Health and Safety Administration

Security personnel (i.e., guards) potentially risk occupational exposures to hazardous substances including chemical, biological, radiological, and nuclear (CBRN) materials during emergencies. Emergencies involving the release of hazardous chemicals at industrial facilities, including chemical manufacturers and industrial facilities utilizing hazardous substances, are the most likely and predictable incidents that may involve security personnel. Security personnel, however, work at a variety of locations with the potential for emergency incidents. Although general chemical release emergencies may be the most likely, incidents resulting from natural disasters or involving weapons of mass destruction (WMD) are also of concern to both private and public sector employers and the security personnel they employ. Security personnel working at companies for the protection of the facilities, materials, and products, as well as those employed by government agencies, are often called upon to provide support during hazardous substance emergencies and the emergency planning in preparation for such incidents is key to successful implementation of emergency response operations.

This document specifically addresses emergencies involving hazardous substance releases and provides guidance for employers, and their security personnel, who may be involved in the emergency response. It does not address other safety and health hazards (e.g., workplace violence) that security personnel may be exposed to while performing their routine duties.

Full Report (PDF; 662 KB)

Survey Finds U.S. Healthcare Facilities Not Doing Enough to Curb MRSA

Source: Association for Professionals in Infection Control (APIC)

From press release (Consumers Union):
U.S. healthcare facilities aren’t doing enough to protect patients from Methicillin-resistant Staphylococcus aureus (MRSA) infections, according to a new poll of infection control professionals released today.
The online poll conducted by the Association for Professionals in Infection Control (APIC) found that 59 percent of those responding said their healthcare facility has stepped up efforts to curb MRSA in the past six months. But 50 percent said their healthcare facility is “not doing as much as it could or should to stop the transmission of MRSA.”

Poll results (PDF; 92 KB)

Hospitalizations and Deaths Caused by Methicillin-Resistant Staphylococcus aureus, United States, 1999-2005

Source: Emerging Infectious Diseases (via Robert Wood Johnson Foundation)

From press release:
Hospitalizations related to methicillin-resistant Staphylococcus aureus (MRSA) infections more than doubled, from 127,000 to nearly 280,000, between 1999 and 2005, according to a new study in the December issue of the journal Emerging Infectious Diseases. During that same period, hospitalizations of patients with general staph infections increased 62 percent across the country.

Staph, or Staphylococcus aureus, are a kind of bacteria that attack wounds and cause life-threatening infections, such as blood poisoning and pneumonia. Methicillin-resistant S. aureus (MRSA) are “superbugs” that have evolved resistance to most commonly used antibiotics, so they are more difficult and expensive to treat.

The study, which is the first to examine the recent magnitude and trends related to staph and MRSA infections, found that such infections are now “endemic, and in some cases epidemic,” in many U.S. hospitals, long-term care facilities and communities. Study researchers say that control of the infection should be made a “national priority.”

Full Document (PDF; 192 KB)