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Biomedical subjects

A Yassi

Publications and source records attributed to A Yassi.

At least 37 records · Page 2Linked to original sources
PubMed1996

Effect of an early intervention program on the relationship between subjective pain and disability measures in nurses with low back injury.

STUDY DESIGN: The effect of a workplace-based early intervention program on perceptions of pain and disability in nurses with low back injury was studied using a preintervention versus postintervention design with concurrent control group. OBJECTIVES: To examine the relationship and changes over time between pain and disability measures in two groups of back-injured nurses--those who received the early intervention program (study) and those who were not offered the program (control). SUMMARY OF BACKGROUND DATA: The relationship between back pain and disability is not straightforward. The effects of an intervention program on changes in perceptions of pain and disability over time have not been widely reported. METHODS: The Oswestry Low Back Disability Questionnaire and a visual analog pain scale were administered to 46 study nurses and 137 control nurses at time of injury and at 6 months after injury. Correlation and regression analyses were used to explore the relationships between the two measures. Changes over time were compared with analyses of variance. RESULTS: Pain and disability were positively correlated in both groups at time of injury and at follow-up evaluation. Mean scores for pain and disability were lower at follow-up evaluation than at initial injury in both groups; study nurses had significantly (P < 0.01) lower scores at 6 months than nurses in the control group. Disability at time of injury predicted disability at 6 months only for nurses in the control group. CONCLUSIONS: This workplace-based early intervention program decreased levels of pain and disability in back-injured nurses and altered the relationship between these two variables over a 6-month time interval.

Demography↗
PubMed1996

Upper limb repetitive strain injuries in Manitoba.

A review of workers' compensation board (WCB) claims in Manitoba, Canada identified an estimated 382 upper limb repetitive strain injury (RSI) claims or 9.3% of all upper limb WCB claims accepted in 1991. Tendonitis and carpal tunnel syndrome (CTS) were the most frequent diagnoses (27.5% and 19.3%, respectively). Rates of RSI were not significantly different by gender and age. RSI claimants had been experiencing symptoms for an average of 8 months prior to filing a compensation claim. While clerical occupations accounted for 13.6% of all upper limb RSI claims, the rates for RSIs in these occupations were low (0.67/1,000 workers), in contrast to occupations with the highest RSI rates: food, beverage, and related processing occupations (14.68/1,000 workers) and fabricating, assembling, and repairing of metal products (9.32/1,000). The highest risk industries were meat and poultry processing-related (23.48/1,000) and the manufacturing of airplanes (9.06/1,000). RSI claims were significantly more costly (+5,569 vs. +2,480, p < 0.0001) and required more time loss (71.4 vs. 33.6 d, p < 0.0001) than similar musculoskeletal non-RSI claims. Similarly, RSI claimants were less likely to return to the same job (67.3% vs. 81.0%, p < 0.0001) than non-RSI claimants. It was concluded that the cost and severity of RSI claims militate for intensified preventive measures.

Absenteeism↗
PubMed1995

Efficacy and cost-effectiveness of a needleless intravenous access system.

BACKGROUND: Needlestick injury has been identified as a major cause of exposure to blood and body fluids. The heparin-lock intermittent intravenous procedure was implicated in the largest number of needlestick-related exposures (26%) at this 1100-bed tertiary care hospital, and replacement of this system was imperative. Cost concerns, however, necessitated that replacement products not increase overall hospital costs. METHODS: A needleless intravenous access system (Interlink i.v. Access System; Baxter Healthcare Corp., Parenterals Division, Deerfield, Ill.) was introduced. Effectiveness and cost-benefit of this system were analyzed by comparing needlestick injuries and their associated costs, as well as costs of relevant products and procedures, for the year before introduction of the new product with those for 1 year after implementation of the new system. RESULTS: During the study period, the needleless access system was 78.7% effective in reducing intravenous line-related needlestick injuries. There was an overall reduction of 43.4% in total needlestick injuries from all procedures and events. The incremental cost to this hospital ranged from a 5.3% additional cost to a 5.7% savings, without even considering the less quantifiable benefits associated with avoidance of needlestick injury, time saved by using this product, and decreased infection rate. CONCLUSION: When used as intended, this system was extremely effective in reducing intravenous line-related needlestick injuries, and the system does pay for itself.

Cost-Benefit Analysis↗
PubMed1995

Early intervention for back-injured nurses at a large Canadian tertiary care hospital: an evaluation of the effectiveness and cost benefits of a two-year pilot project.

This study evaluated a two-year multidisciplinary early intervention pilot programme for back-injured nurses employed at a large teaching hospital, using a pre- versus post-programme analysis. The purpose was to ascertain whether this programme could reduce the incidence, morbidity, time lost and cost due to back injuries in the 250 nurses employed on ten targeted high-risk wards. Injuries in the remaining 1395 nurses employed on the other 45 wards were monitored concurrently for comparison. The programme consisted of prompt assessment, treatment and rehabilitation through modified work. Evaluative data were gathered by one research nurse on standardized forms at the time of injury, weekly until return to work, and at a six-month follow-up. Time lost and cost data for up to one-year post-injury were derived from workers' compensation statements. Compared to the two years prior to introduction of the programme, the rates of back injuries and lost-time back injuries decreased by 23% and 43%, respectively, on the targeted wards, while these increased on the control wards. Combined expenditure was 32% lower per injury and 34% lower per lost-time injury for those in the targeted group who consented to take part in the programme compared to their counterparts on the control wards, as the increased assessment and treatment costs per case attributable to the programme were more than offset by the savings in lower compensation (wage loss) costs. This programme thus reduced the incidence and time lost due to back injuries and was cost-beneficial.

Back Injuries↗
PubMed1995

The epidemiology of back injuries in nurses at a large Canadian tertiary care hospital: implications for prevention.

Two years of prospective data on 416 back injuries were gathered at a 1100-bed acute and tertiary care hospital to assist target prevention efforts. The rate of injury among 1645 nurses was found to be highest for those working on orthopaedic, medicine, neurology, spinal and surgery wards, indicating priorities for prevention. In fact, 51% of the orthopaedic nurses sustained at least one back injury during the two-year period. Gender did not significantly affect the risk of back injury; however, injuries were slightly more common in nurses with less seniority and younger nurses were found to be at significantly increased risk of back injury. Almost 63% of the back injuries which occurred in nurses working 8 h shifts on the high-risk wards occurred during the first two hours of the shift. Lifting and transferring patients with assistance were the two most common mechanisms for back injury (22.6% and 23.3%, respectively). In total, injured nurses attributed 52.3% of their injuries to inadequate training; inadequate staffing was given as the primary reason for 13.8% of the injuries. The results suggest that training in the indications for and use of mechanical devices for lifting/transferring patients requires intensification, and a 'warm-up' period should also be considered in the face of injuries occurring early in the shift if work activities cannot be evenly planned.

Adult↗
PubMed1994

Assault and abuse of health care workers in a large teaching hospital.

OBJECTIVES: To determine the nature, extent and costs of injuries to health care workers caused by physical abuse. DESIGN: Retrospective study. SETTING: Large acute and tertiary care teaching hospital in Winnipeg. PARTICIPANTS: All health care workers at the hospital who filed reports of abuse-related injuries and of verbal abuse and threatening behaviour from Apr. 1, 1991, to Mar. 31, 1993. OUTCOME MEASURES: Frequency of physical and verbal abuse of hospital personnel according to job category, type of injury, hours of staff time lost and estimates of costs compensated for abuse-related injuries. RESULTS: Of the 242 reported abuse-related injuries 194 (80.2%) occurred among the nursing personnel. The nurses in the medical units filed most (33.1%) of the reports. Although the psychiatric nurses filed fewer reports (35 [14.5%]) they had the highest rate of injuries per 100,000 paid hours among the nursing staff. Not surprisingly, the security officers were at highest risk, 53.5% having reported an abuse-related injury for a rate of 16.8 such injuries per 100,000 paid hours. Male staff members had a higher injury rate than their female counterparts in all occupational groups. Bruising or crushing was the most frequent type of injury (in 126 cases); the next most frequent were cuts and lacerations (in 47) and human bites and exposures to blood or body fluids (in 23). However, the 36 sprains and strains resulted in the largest amount of time lost. In all, over 8000 hours were lost due to abuse-related injuries, and over $76,000 was paid in workers' compensation benefits. Concurrently, 646 incidents of verbal abuse and threatening behaviour were reported. Only three abuse-related injuries and two incidents of verbal abuse were reported by physicians. CONCLUSIONS: Abuse-related injuries to health care workers in an urban hospital are prevalent, serious and can be costly in terms of time off work and compensation. Underreporting is likely, especially among physicians.

Adult↗
PubMed1994

Cancer mortality in workers employed at a transformer manufacturing plant.

This study examined mortality to December 31, 1989 in a cohort of 2,222 males employed between 1947 and 1975 at a transformer manufacturing plant in Canada, where there had been extensive use of transformer fluid, some containing polychlorinated biphenyls (PCBs). A combined cohort list of 2,222 names was independently obtained from plant management and union officials. Mortality of 1,939 workers with known birthdates was ascertained by record linkage with the Canadian Mortality Data-base. Standardized mortality ratios (SMRs) for different criteria for acceptance of the death certificate link and for cohort membership (based on work history) ranged from .71-1.05. There was no significant increase in overall cancer deaths. The only significant site-specific increased mortality was pancreatic cancer (11 deaths), with SMRs ranging from 2.92-7.64 and higher mortality risk in those who entered the cohort prior to 1960. All but one of these deaths had a latency period of at least 10 years, and greatest SMRs were found in departments with the greatest exposure to transformer fluid. Several previous studies have found excess pancreatic cancers in association with oil exposures and electrical equipment manufacturing. The need to further investigate pancreatic cancer in transformer manufacturing and related exposures is evident.

Canada↗
PubMed1994

Using administrative health data to monitor potential adverse health effects in environmental studies.

Following episodes of environmental contamination, health professionals are limited in their ability to detect adverse health effects in surrounding communities due to lack of relevant baseline health data, resources, and appropriate control populations. The objective of this study was to ascertain the feasibility of using administrative health data for these purposes. The Manitoba Health Services Commission's (MHSC) database is comprehensive since universal health care is free in Canada. As part of an evaluation of two proposed hazardous waste treatment sites, the feasibility of using MHSC's data was tested by (a) defining the two study and control sites through use of MHSC's population registry and (b) determining baseline morbidity rates through analysis of MHSC's physician visit payment files; diagnoses were coded using ICD-9-CM. The results indicated that there were some differences between the groups studied in the age- and sex-standardized morbidity rates of diagnoses potentially influenced by exposures to chemicals. Use of administrative data provided by a national health service is an inexpensive and efficient way to create and follow potentially exposed cohorts residing in defined communities. Despite limitations related to small populations in exposed communities and lack of standardized diagnostic criteria by physicians, this method should be explored further in environmental studies.

Adolescent↗
PubMed1994

Evaluation of waste anesthetic gases, monitoring strategies, and correlations between nitrous oxide levels and health symptoms.

The release of waste anesthetic gases (WAG) in hospital operating rooms (ORs) was evaluated to determine if staff exposure to nitrous oxide exceeded the American Conference of Governmental Industrial Hygienists (ACGIH) Threshold Limit Value (TLV) and investigate possible correlations between symptoms and nitrous oxide exposure. The monitoring strategy consisted of nitrous oxide measurements by personal monitoring of the anesthetists and scrub nurses, and area monitoring at the exhaust grills. In addition, room ventilation rates and carbon dioxide concentrations were measured. Self-administered questionnaires were given to both the operating room personnel and staff on control wards. Nitrous oxide levels exceeded the current TLV of 50 ppm in 4 of 12 ORs. Anesthetists typically received the highest nitrous oxide exposure. There was a strong correlation (r2 = 0.90) for nitrous oxide dosimetry results between anesthetists and scrub nurses, and a fair correlation (r2 = 0.35) between area monitoring results and the anesthetists' personal exposures. Carbon dioxide levels commonly exceeded 1000 ppm on control wards. A correlation between reported symptoms and nitrous oxide exposure was not demonstrated. Reported symptoms more closely correlated with carbon dioxide levels. Nitrous oxide dosimetry of the anesthetists appears to be the only accurate strategy for monitoring human exposure to WAG in an operating room.

Air Pollutants, Occupational↗
PubMed1994

Influenza immunization: knowledge, attitude and behaviour of health care workers.

Knowledge, attitude and behaviour regarding influenza immunization were evaluated in 519 health care workers (HCWs) from high risk hospital areas because of this target group's historically poor acceptance rates. The results of this self-administered questionnaire survey indicated that HCWs' knowledge regarding influenza and influenza vaccine was generally satisfactory. However, only approximately one half of the HCWs knew who should receive influenza vaccine and why it is important. HCWs with good knowledge of influenza and the influenza vaccine were more likely to recommend vaccine to their patients and to their co-workers/family, but were not more likely to receive it themselves. Experiencing post-vaccine symptoms for more than one day significantly reduced the willingness of HCWs to accept and to recommend vaccine. HCWs who heard about influenza vaccine from their doctors indicated significantly more willingness to receive vaccine and to recommend vaccine to co-workers and family. Questionnaire survey of willingness to accept influenza vaccine overestimated actual acceptance, as only 35.7% of the HCWs who had positive views regarding the influenza vaccine actually received the vaccine during the following influenza season. While knowledge about the vaccine, previous experience with perceived adverse symptoms and promotion by family doctor significantly influenced questionnaire responses, hearing about the vaccine from the occupational health department, being on a geriatric ward or being a unit assistant were the most significant factors in actually being vaccinated. Thus, occupational health departments must continue their efforts to promote the influenza vaccine actively and to make it as accessible as possible.

Adolescent↗
PubMed1993

Effects of acetaminophen on adverse effects of influenza vaccination in health care workers.

OBJECTIVE: To evaluate the effects of acetaminophen on the incidence of adverse effects to, and the immunogenicity of, whole-virus influenza vaccine in health care workers. DESIGN: Prospective, randomized, double-blind placebo-controlled trial. SETTING: Health Sciences Centre, an acute care teaching hospital in Winnipeg. PARTICIPANTS: Of 474 hospital personnel who agreed to undergo influenza vaccination during the 1990-91 season 262 volunteered to participate in the study. INTERVENTIONS: A dose of 0.5 mL of inactivated trivalent whole-virus influenza vaccine was injected into the deltoid muscle. Volunteers were randomly assigned to ingest two capsules of acetaminophen in a half dose (162.5 mg per capsule) or a full dose (325 mg per capsule) or two identical placebo capsules. Capsules were to be taken at vaccination and at 4, 8 and 12 hours afterward. Subjects were asked to answer questions regarding six symptoms in a diary for the 3 days after vaccination and to record their ingestion of the study medication. MAIN OUTCOME MEASURES: Incidence of local (sore arm) and systemic (headache, fever, muscle ache, nausea and diarrhea) side effects as well as serum titres of hemagglutination inhibition (HAI) antibody to vaccine antigens before vaccination and 2 weeks and 6 months afterward. RESULTS: A total of 87, 87 and 88 subjects received the half dose, full dose and placebo respectively; 96% returned the diaries, 83% ingested all four doses of medication, and 87% volunteered all blood samples. Compared with the placebo group the incidence of sore arm was 25% to 28% lower in the half-dose and full-dose groups respectively at 24 hours after vaccination, and the rate of nausea was 90% lower in the full-dose group. The HAI titres were similar among the groups at the three test times. CONCLUSIONS: The full dose of acetaminophen significantly reduced the incidence of sore arm and nausea without affecting the antibody response. Acetaminophen use may increase the acceptance of influenza vaccine by health care workers in whom concern about side effects is an impediment to vaccination.

Acetaminophen↗
PubMed1993

Modernization of a laundry processing plant: is it really an improvement?

An ergonomics assessment was conducted in a modern, automated hospital-based laundry to investigate workers' complaints of musculoskeletal aches and pains and general fatigue. Numerous job stressors were identified requiring ergonomic solutions, including prolonged standing, excessive manual handling of transport units, non-adjustability of workstations, work pacing, awkward postures, lack of job rotation and excessive repetition of tasks. Associated health and safety issues such as noise, sharps, equipment maintenance and sanitation were also addressed. Potential mechanisms for repetitive strain injuries were substantiated and solutions for problematic areas were presented to management and the union for implementation. It was concluded that human factors must be taken into consideration when designing automated laundry systems to avoid mismatches resulting in potential injury to workers.

Journal Article↗
PubMed1993

Risks to hearing from a rock concert.

We measured noise exposure and temporary threshold shift (TTS) from a rock concert for 22 volunteers, using dosimetry, questionnaires, and audiometry. Most (81%) participants showed TTS of 10 dB or more 5 to 25 minutes after exposure; of these, 76% showed continued TTS at 40 to 60 minutes. Family physicians should counsel patients about the risks of recreational noise.

Adolescent↗
PubMed1992

"Let's Talk Back": a program to empower laundry workers.

Laundry workers have traditionally been offered little input into the ergonomic and health and safety aspects of their jobs. The "Let's Talk Back" program was developed in response to worker demands, in order to empower them to effectively address some of these concerns. The program, endorsed by the union and administered by a hospital ergonomist, provided formal educational sessions, physical demand analyses, and a forum in which to communicate concerns and suggestions for improvements. Language and/or literacy barriers required innovative educational approaches. Management's reluctance to allow the program to interfere with production schedules hindered the efficiency of the program, but probably contributed to the sense of empowerment in the workforce. Through active participation in ergonomic assessments as well as the educational program, workers were able to demonstrate to management that changes were needed.

Community Participation↗
PubMed1992

Implementing right-to-know legislation for health care workers in Manitoba: a bipartite sectoral train-the-trainer approach.

In October 1988, right-to-know legislation was introduced in Canada. This presented a technical and administrative challenge to the health care sector. With over 170 health care facilities in Manitoba to be brought into compliance, some large, some small, some rural, some urban, a cooperative approach was needed. A labor-management steering committee with representatives from a cross-section of facilities as well as the various health care unions was formed to design and implement a train-the-trainer program. A small-group, highly participatory modular program was developed with input from all parties, and delivered across the province by trainers selected jointly by labor and management. The program achieved its goal of assisting member facilities to implement the legislation. Follow-up surveys and discussions with health care workers showed improved understanding of labelling requirements, material safety data sheet interpretation, and requirements for hazard control. This first bipartite program empowered the health care workforce to use its newly acquired right-to-know, and has provided the incentive to implement other cooperative safety and health programs.

Evaluation Studies as Topic↗
PubMed1991

Determinants of blood and body fluid exposure in a large teaching hospital: hazards of the intermittent intravenous procedure.

Determinants of staff exposure to blood and body fluids in a 1100-bed hospital were examined over a 2-year period. Eighty-two percent of the 799 reported accidental exposures were needlestick injuries, and 18% were cutaneous or mucous membrane splashes. Nurses and nursing students incurred 78.8% of the exposures; respiratory technologists and laboratory personnel, 9.2%; medical personnel, 7.5%; and support staff, 4.2%. Rate of exposure per 100,000 hours worked showed nursing students to be at particularly high risk, highlighting the need for specific instruction. Analysis of events leading to needlestick-related exposures revealed that the heparin lock intermittent intravenous procedure was involved in 26%; recapping accounted for 17%; improper disposal, 15%; manipulating equipment, 14%; phlebotomy, 12%; and other needlestick events, 16%. Ocular splashes and spills onto nonintact skin each accounted for 50% of the total number of non-needlestick-related exposures. This study revealed the hazardous nature of the intermittent intravenous procedure, prompting specific revisions in this procedure as well as promoting point-of-use sharps disposal and other preventive measures.

Accident Prevention↗