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PubMedDate not supplied

Facility redesign for your future laboratory requirements.

Laboratories must adapt to rapid changes in equipment technology and fundamental changes in the business of health care. A project begins with the creation of a project team representing the laboratory, administration, facilities, architects, and engineers. Each phase of the project works through the various issues affecting the facility, culminating in documents for the actual construction. Review of the codes, the existing physical facility, and the costs associated with the changes are all important in achieving an efficient laboratory.

Building Codes↗
PubMed2000

Using faculty development to solve a problem of evaluation and management coding: a case study.

Compliance with billing and coding rules put forth by the Health Care Finance Administration (HCFA) is a challenge for practicing physicians, including those in academic settings. The authors, members of the academic practice at Wayne State University School of Medicine, Department of Family Medicine, designed and delivered a comprehensive curriculum as part of the practice's faculty development initiative surrounding the coding challenge. The authors defined outcomes expected on the way to achieving 100% compliance with HCFA's guidelines. Their curriculum covered topics of coding theory, chart auditing for coding, team building, effective meetings, and structured problem solving. The curriculum was delivered from January to May 1998. Chart audits of 251 charts (office notes) from before the intervention and 263 charts from after the intervention were performed to evaluate differences in coding accuracy. Errors were significantly reduced. The total error rate dropped from 50.2% to 31.1% (p < .05). Overcoding errors were reduced by one third (29.1% versus 19.7%), while undercoding errors were reduced by half (16.3% versus 8.4%). Other errors fell from 4.7% to 3%. The approach of defining and developing work teams and then using standard quality improvement tools may be an effective way to improve compliance with HCFA billing and coding rules. In addition, faculty development can be incorporated into the process of solving a problem that faces a faculty.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1993

Childhood cancer in relation to a modified residential wire code.

Several studies have found associations between wire configuration codes, a proxy for historical residential magnetic field exposure, and childhood cancer. The Wertheimer-Leeper coding method was modified by eliminating the distinction between thick and thin primaries, distinguishing only between open and spun secondaries, and reducing the number of categories from five to three. The association between the modified code and measured magnetic fields was similar to the association with the original wire code. The modified code was used to reanalyze data from a case-control study of childhood cancer in the Denver metropolitan area. In the original study, cases were diagnosed from 1976 to 1983 among children under age 15 and compared to controls selected through random digit dialing. Wire codes for the residence at diagnosis yielded imprecise elevations of two and above for very high current configuration homes or modest 1.5-fold elevations for a dichotomous wire code. In contrast, the modified Wertheimer-Leeper code generated risk estimates that were both precise and markedly elevated for the high wire code (HWC) compared to low wire code (LWC) classifications, with medium wire code (MWC) showing little or no increase in risk. High wire code yielded odds ratios of 1.9 for total cancers (95% CI: 1.1-3.2), 2.9 for leukemias (95% CI: 1.5-5.5), and 2.5 for brain cancer (95% CI: 1.1-5.5) that were not confounded by measured potential risk factors for childhood cancer. These risk estimates are larger than the dichotomized results and more precise than those from the original five-level wire code, though limitations in the original study remain, particularly potential control selection bias.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

The National Model Fire Prevention Code: who's going to write it?

The user-friendly and vastly improved NFPA 1, Fire Prevention Code, is the best fire prevention code out there. Here's how NFPA worked toward consensus on the document, and why it's getting rave reviews from fire marshals and inspectors nationwide.

Building Codes↗
PubMed1989

Use of wiring configuration and wiring codes for estimating externally generated electric and magnetic fields.

The relative locations and characteristics of the distribution lines feeding 434 residences in the Denver metropolitan area were recorded and classified according to the Wertheimer-Leeper code (WL code) as a part of an epidemiological study of the incidence of childhood cancer. The WL code was found to place the mean values of the fields in rank order. However, the standard deviations were approximately the same size as the means. Theoretical calculations indicate that a significant fraction of the low-power magnetic fields can be generated by the distribution lines, especially in the cases where the distribution lines are within 50 feet of the residence. Thus, the wiring code was shown to be a useful method for making a first-order approximation to predict long-term, low-level magnetic fields in residences.

Building Codes↗
PubMed2002

Housing and health: time again for public health action.

Poor housing conditions are associated with a wide range of health conditions, including respiratory infections, asthma, lead poisoning, injuries, and mental health. Addressing housing issues offers public health practitioners an opportunity to address an important social determinant of health. Public health has long been involved in housing issues. In the 19th century, health officials targeted poor sanitation, crowding, and inadequate ventilation to reduce infectious diseases as well as fire hazards to decrease injuries. Today, public health departments can employ multiple strategies to improve housing, such as developing and enforcing housing guidelines and codes, implementing "Healthy Homes" programs to improve indoor environmental quality, assessing housing conditions, and advocating for healthy, affordable housing. Now is the time for public health to create healthier homes by confronting substandard housing.

Accidents, Home↗
PubMed1988

Medicare/Medicaid programs; fire safety standards for hospitals, skilled nursing facilities, hospices, intermediate care facilities and ambulatory surgical centers--HCFA. Final rule.

This final rule amends the fire safety standards for hospitals, skilled nursing facilities, hospices, intermediate care facilities and ambulatory surgical centers. It incorporates by reference the 1985 edition, rather than the 1981 edition now required, of the Life Safety Code of the National Fire Protection Association. This change primarily affects new applicants to the program. The incorporation of the 1985 edition of the LSC is intended to ensure that patients, personnel, providers and the public have the benefit of the most current fire protection standards.

Accident Prevention↗
PubMed1987

What the codes say on life safety. Room smoke detectors for nursing homes.

The American Health Care Association will continue to monitor proposed new requirements in the code-making process, and will particularly concentrate on establishing a uniformity among the standards and determining the necessity for new requirements based on documentation of need. In so doing, AHCA's primary goal is to ensure a facility environment that enables residents and staff to function effectively in life-threatening situations.

Accident Prevention↗
PubMed1993

Protection against radon-222 at home and at work. A report of a task group of the International Commission on Radiological Protection.

The Commission has used an epidemiological basis for the assessment and control of radon exposure in this report. Since all the available epidemiological studies use the quantity inhaled potential alpha energy, this has been used as the primary quantity in this report. The Commission does not recommend the use of the dosimetric human respiratory model (ICRP, 1994) for the assessment and control of radon exposures. The Commission sees practical advantages in the delineation of radon-prone areas where more buildings than usual have elevated radon levels. For dwellings, it is suggested that areas with more than 1% of buildings with radon concentrations exceeding ten times the national average concentration might be designated as radon-prone, but the choice will depend on local conditions. A similar approach might be adopted in non-residential areas. Action against radon should be focused on such radon-prone areas. The imperatives of intervention against adventitious exposure to radon in buildings are clear. Above appropriate action levels, intervention is practicable and usually more cost-effective than other investments in radiological protection. Two types of building need to be considered, dwellings and workplaces. In both cases, radon concentrations are most likely to be elevated by the ingress of soil gas from the subjacent ground. Preventive and remedial measures to avoid this circumstance are recommended. The action levels adopted should fall within the recommended range of values given in Table 7. Proven measures against radon are readily available. For remedial work, the technical procedure that is most likely to maintain the radon level to a value well below the action level should be adopted from the outset. Intervention should take place soon after the discovery of elevated levels, especially if the concentrations are substantially above the action levels adopted by the competent authority. For preventive work, construction codes and building guides should be devised that will consistently achieve low concentrations of radon in the completed buildings. In workplaces, both in buildings and underground, where the radon concentrations remain above the recommended action level after any appropriate remedial measures have been taken, the Commission's system of protection should be applied and radon should be treated in the same way as any other radioactive material at work. The relevant data on conversion coefficients are given in Table 6 and the main quantitative recommendations are summarised in Table 7. Corresponding values in historical units are given in Table 8.

Air Pollution, Indoor↗
PubMedDate not supplied

Regulating contents and furnishings.

The criteria in the 1991 edition of the Life Safety Code are a first attempt to address the fire hazards associated with upholstered furniture and mattresses. Recognizing that the criteria do not represent a complete hazard analysis, it is anticipated that the subcommittee will continue its efforts and will evaluate the appropriateness of additional criteria. The NFPA Standards Council also has appointed a Technical Committee on Contents and Furnishings, which will meet in August 1991. This committee will have primary responsibility for developing fire hazard calculation procedures and documents that other committees can use to control the fire hazards of contents and furnishings.

Beds↗
PubMed1996

Shielding design of a treatment room for an accelerator-based epithermal neutron irradiation facility for BNCT.

Protecting the facility personnel and the general public from radiation exposure is a primary safety concern of an accelerator-based epithermal neutron irradiation facility. This work makes an attempt at answering the questions "How much?" and "What kind?" of shielding will meet the occupational limits of such a facility. Shielding effectiveness is compared for ordinary and barytes concretes in combination with and without borated polyethylene. A calculational model was developed of a treatment room , patient "scatterer," and the epithermal neutron beam. The Monte Carlo code, MCNP, was used to compute the total effective dose equivalent rates at specific points of interest outside of the treatment room. A conservative occupational effective dose rate limit of 0.01 mSv h-1 was the guideline for this study. Conservative Monte Carlo calculations show that constructing the treatment room walls with 1.5 m of ordinary concrete, 1.2 m of barytes concrete, 1.0 m of ordinary concrete preceded by 10 cm of 5% boron-polyethylene, or 0.8 m of barytes concrete preceded by 10 cm of 5% boron-polyethylene will adequately protect facility personnel.

Boron Neutron Capture Therapy↗
PubMedDate not supplied

Fire fatalities among children: an analysis across Philadelphia's census tracts.

OBJECTIVE: This study investigates the possible causes of high levels of residential fire deaths to children younger than 15 years of age in Philadelphia from 1989 to 2000. METHODS: The authors analyzed 246 deaths from 146 residential fires by census tract in Philadelphia using both individual level data and aggregate level data drawn from the records of the Fire Marshall's Office. Death rates by age and sex were calculated using the 1990 Census. Data on fires from official records were combined with aggregate level data by census tract from the 1990 Census and analyzed using logistic regression. Newspaper articles on the fires analyzed were used to identify residences with possible fire code violations. The authors used data from the Philadelphia Bureau of Licenses and Inspections to provide evidence of code violations. RESULTS: The statistically significant variables that resulted from the logistic regression were census tracts in the highest quartile for low income households, census tracts in the highest quartile for single-parent households with children younger than age 18, census tracts in the highest quartile for houses built before 1939, and the number of children younger than 15 years of age in a census tract. CONCLUSION: Population characteristics by census tract are useful in identifying risk factors for residential fire deaths of children. Census tracts identified as at highest risk can provide fire prevention units with opportunities to take preventative measures such as the distribution of smoke detectors, and the education of residents about the dangers of careless smoking and planning for the rescue of children in the event of a fire.

Adolescent↗
PubMed1986

Respiratory disease in a photographer.

Reversible airways obstruction occurred in a photographer after long-term exposure (over many years) to sulfuric and acetic acid fixers. Air-exchange recommendations for darkrooms by the Building Officials Code Administration [1981] differ markedly from those recommended by the American Society of Heating, Refrigerating, and Airconditioning Engineers [1977] and the fixer manufacturer (Eastman Kodak). Use of fume hoods or rates of air-exchange higher than are required by law may be necessary to prevent symptoms and disease in certain workers.

Adult↗
PubMed1996

Asbestos exposure of building maintenance personnel.

The exposures of building maintenance personnel and occupants to airborne asbestos fibers, and the effects of operations and maintenance programs on those exposures, continue to be an important public health issue. The subject of this investigation was a large metropolitan county with numerous public buildings which routinely conducted air sampling for asbestos. A total of 302 personal air samples in nine task categories collected during maintenance worker activities in proximity to asbestos-containing materials were analyzed; 102 environmental air samples in four task categories were also analyzed. The arithmetic means of the 8-hr time weighted average exposures for personal sampling for each task category were all below the Occupational Safety and Health Administration permissible exposure level of 0.1 fibers (f)/cc > 5 microm. The highest mean 8-hr time weighted average exposure was 0.030 f/cc > 5 microm for ceiling tile replacement. The maximum asbestos concentration during sample collection for environmental samples was 0.027 f/cc > 5 microm. All asbestos-related maintenance work was done within the framework of an Operations and Maintenance Program (OMP) which utilized both personal protective equipment and controls against fiber release/dispersion. Results are presented in association with specific OMP procedures or controls. These results support the effectiveness of using Operations and Maintenance Programs to manage asbestos in buildings without incurring unacceptable risk to maintenance workers performing maintenance tasks.

Air Pollutants↗