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HHS circulating regulations finalized on June 17.

On June 17, 1986, the US Department of Health and Human Services (HHS) published its final regulations in the Federal Register governing the hospital Conditions of Participation in Medicare and Medicaid programs. The final regulations state that "In accordance with applicable State laws and approved medical staff policies and procedures, ...surgical technologists may assist in circulatory duties under the supervision of a qualified registered nurse who is immediately available to respond to emergencies". Coming after a dozen years of exhaustive research and debate on the conditions, HHS deleted the work "direct" as it applies to the degree of supervision required for circulating surgical technologists because, HHS states, "it will give hospitals maximum flexibility to manage their internal procedures...and will recognize appropriately the special qualifications of surgical technologists". The following article will provide you with the historical background and development of this regulation, scheduled to take effect on September 15.

Facility Regulation and Control↗
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Latex allergy among operating room personnel in Turkey.

This study was performed to evaluate the prevalence of latex allergy among health care workers in Turkey, as well as to compare the medical histories with the skin test results and investigate the risk factors. Using a 1/100 weight/volume commercial skin prick test (SPT), we investigated latex sensitization in 206 health care workers who regularly use latex products. One hundred atopic and 100 nonatopic patients without occupational latex exposure were also examined as control groups. Latex SPTs were positive in 10 health care workers (9.22%), whereas none of the control patients was found to have positive SPT to latex. Health care workers were divided into two groups based on the latex SPT results. There was no significant difference between the latex SPT-positive and -negative health care worker groups according to age, sex and total exposure time to latex. In the latex SPT positive group, daily exposure time and daily glove use were significantly higher (p <0.05). The symptoms related to latex products were limited to hands and itching was present in all, however, erythema was found in 68.4%, and contact urticaria in 52.6% in the latex SPT positive group. These symptoms in the latex SPT negative health care group were 21.4%, 14.4%, and 1.6%, respectively (p <0.0001). History of allergic rhinitis, bronchial asthma and conjunctivitis were also higher in the SPT-positive group (p <0.05). Additionally, we found sensitivity to house dust mites and/or grass pollens in seven cases of latex allergy. Patch tests with rubber additives were positive in five out of 42 medical care workers. Two surgeons were found to have both type-I hypersensitivity to latex and type-IV hypersensitivity to rubber additives. Our results suggest that the frequency of latex allergy is higher in the atopic health care workers with a high exposure to latex, and that SPT is a sensitive, safe, cheap and easy method of testing the diagnosis of latex hypersensitivity.

Adult↗