Veille documentaire MTPH

Auteur     Lisa M Brosseau
Auteur     Lorraine M Conroy
Auteur     Margaret Sietsema
Auteur     Kari Cline
Auteur     Kara Durski
Publication     Journal of occupational and environmental hygiene
ISSN     1545-9632
Date     Jun 11, 2014
Résumé     ABSTRACT The objective of this study was to assess respiratory protection programs for aerosol-transmissible diseases in acute care hospitals for conformance with regulatory requirements and public health guidelines. Twenty-eight representative hospitals were selected by size, location and ownership in Minnesota and Illinois. Interviews were conducted with 363 healthcare workers and 171 managers from high-risk departments. Written programs from each hospital were reviewed for required elements. Seventy-seven healthcare workers were observed donning and donning a FFR. The most serious deficiency in many written programs was failure to identify a program administrator. Most written programs lacked adequate details about medical evaluation, fit testing and training and did not include a comprehensive risk assessment for aerosol transmissible diseases; tuberculosis was often the only pathogen addressed. Employees with the highest probability of tuberculosis exposure were most likely to pick a respirator for close contact, but higher levels of respiratory protection were rarely selected for aerosol-generating procedures. Surgical masks were most commonly selected for close contact with droplet disease- or influenza-infected patients; better protection (e.g. respirator) was rarely selected for higher risk exposures. Most of the observed healthcare workers had access to a NIOSH-certified N95 FFR, properly positioned the facepiece and formed the nose clip. The most frequent deficiencies were failure to correctly place straps, perform a user seal check and remove the respirator using straps.