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PubMed1999

International standards for the assessment of the risk of thermal strain on clothed workers in hot environments.

The International Standards Organisation (ISO) has produced an integrated series of international standards for the assessment of human responses to thermal environments. They include standards for the assessment of thermal comfort, heat stress and cold stress and many have been adopted as European and British standards. This paper describes the series of standards and in particular those concerned with the assessment of risk in hot environments. A three tier approach is taken which involves a simple thermal index that can be used for monitoring and control of hot environments (ISO 7243), a rational approach which involves an analysis of the heat exchange between a worker and his or her environment (ISO 7933) and a standard that describes the principles of physiological measurement which can be used in the establishment of personal monitoring systems of workers exposed to hot environments (ISO 9886). The standards are self-contained and can be used independently. In any comprehensive assessment however they would be used in conjunction. The simple index provides a first stage analysis and can confirm whether or not there is likely to be unacceptable thermal strain. Where a more detailed analysis is required then ISO 7933 provides an analytical method that can provide a more extensive assessment and interpretation leading to recommendations for improvement to the working environment. Where a method needs to be confirmed, or conditions are beyond the scope of ISO 7243 and ISO 7933, then ISO 9886 provides guidance on physiological measurement and interpretation. This would be used in extreme environments where individual responses are required to ensure health and safety or, in the case where personal protective equipment (PPE) is worn, which is beyond the scope of ISO 7243 and ISO 7933. The ISO system therefore covers almost all exposures to hot environments. It would be useful however to extend the scope of the standards that provide a simple index or analytical approach. This paper describes the current standards and their scope and forms the basis and background for descriptions of proposed extensions to the scope of the standards described in other papers in this special issue.

Acclimatization↗
PubMed1999

The role of protective clothing in infection prevention in patients undergoing autologous bone marrow transplantation.

PURPOSE/OBJECTIVES: To determine the efficacy of cover gowns and shoe covers in the prevention of infection in patients undergoing autologous bone marrow transplantation (BMT). DESIGN: Randomized two-group controlled clinical trial. SETTING: Adult BMT unit of a university teaching hospital in the Southeastern United States. SAMPLE: 40 women and men receiving an autologous BMT for hematologic and solid tumor malignancies. Patients were assigned randomly to control or experimental groups. Thirty-one patients completed the study. Inclusion criteria required that patients be at least 18 years of age and not have received a previous autologous BMT. METHODS: Data were collected from the patients' medical records. Characteristics of the distributions for the main research variables were compared between the control group (caregivers who wore cover gowns and shoe covers) and experimental group (caregivers who wore no covers). MAIN RESEARCH VARIABLES: Time to first antibiotic treatment and length of antibiotic therapy. FINDINGS: Cover gowns and shoe covers worn by caregivers provided no benefit for this group of 31 patients. The differences in time to first antibiotic and length of antibiotic treatment were not statistically significant between the two groups. CONCLUSIONS: The mean and median number of hours to first antibiotic treatment for adult autologous BMT recipients in the control group exceeded the corresponding time for those in the experimental group by only one hour and four hours, respectively. The potential benefits and risks of cover gown and shoe cover usage by caregivers of autologous BMT recipients should be reexamined in larger randomized trials. IMPLICATIONS FOR NURSING PRACTICE: The elimination of cover gowns and shoe covers in caring for patients undergoing autologous BMT will save nursing time and hospital resources as well as eliminate one isolation barrier experienced by patients.

Adult↗