AIMS: To determine whether lead-containing gloves present a risk of metal leaching onto the operator's skin, particularly due to the presence of sweat.
METHODS: Artificial sweat of varying acidity was introduced into two types of commercial gloves containing lead. The level of lead in the sweat was then assessed after different exposure times. Electron microscopy was used to observe the morphology of the glove layers.
RESULTS: Lead was detected in artificial sweat during each contact test on two different types of gloves. The concentration of lead increased with the acidity of the sweat, and the contact time. Gloves with a protective lining transferred less lead into sweat, but it was still present at significant levels. (i.e. few milligrams of lead per glove after one hour contact).
CONCLUSIONS: Fluoroscopy operators should be aware of the risk of leaching of lead ions when using lead gloves under intensive conditions, although the potential harmfulness of lead ions leached into the glove remains essentially unknown.
METHODS: A qualitative study design in which 15 healthcare workers from nurses (4), pharmacists (3), medical technologies (4) and medical doctors (4) participated: two focus group of three to four participants each and eight in-depth interviews. The thematic sessions were identified, including occupational health and safety policy implementations, hazards experiences, barriers, and strategies for quality improvement for OSH. Focus groups and interviews using transcript-based analysis were identified relating to emerging themes on the challenges they had experienced while accessing provisions of OSH in their workplace.
RESULTS: Majority of the participants revealed the existence of policy on Occupational Health and Safety (provisions, guidelines and regulations on OHS from the government) and mentioned that there were limited OHS officers to supervise the healthcare workers in their workplace. Some have limited accessibility to the requirements of the implementation of OHS (free facemasks, gloves, disinfectants, machines, OSH staff, etc.) among healthcare workers, while the workload of the staff in the implementation of OHS in the workplace gradually increased. The results indicated that the respondents were knowledgeable in the implementation of OHS in the workplace, and that there was no existing ASEAN framework on the protection and promotion of the rights of healthcare workers in their workplace. Facilities need to improve health assessment, and to ensure constant evaluation of the existing laws for healthcare workers (quality assurance of existing policies) in their working areas. Direct access to OSH officers, occupational hazards education, emergency contact etc. must be improved. Adherence must be strengthened to fully comply with the OHS standards.
CONCLUSION: The researchers inferred that issues and concerns regarding compliance on provisions of occupational health and safety among health care workers must be properly addressed through immediate monitoring and reevaluation of personnel in terms of their knowledge and practices in OHS. Barriers and challenges have been identified in the study that can lead to improved compliance among healthcare workers in regards to OHS.
METHODOLOGY: Staff members were observed during patient contacts, and their hand washing techniques and hand hygiene practices were monitored. Five contact periods were observed for staff members while they cared for their assigned patients. Hand hygiene practices before and after patient contacts were categorized as clean uncontaminated, clean recontaminated, new gloves, and unchanged contaminated gloves. Compliance to hand-washing steps and time taken for hand washing were analyzed. Appropriate use of gloves based on CDC criteria also was assessed.
RESULTS: Compliance to hand hygiene practices was 70% before each patient contact. Staff members did not completely adhere to the hand-washing steps. The average time taken to wash hands was 20 seconds, and the necessary steps (rubbing palm over dorsum; rubbing fingers interlaced, and rotational rubbing of thumbs) were practiced minimally by all staff. Hand washing protocol was generally followed by all staff (100%). Alcohol hand rubs were available but were used moderately (60%); when used, staff members did not wait for the alcohol to dry. Only 4% of staff changed contaminated gloves between patients.
CONCLUSIONS: Hand hygiene compliance by ICU staff members needs to be improved. Improving adherence to correct hand hygiene techniques will require effective education programs and behavioral modification techniques. Moreover, hand hygiene guidelines must be incorporated into new staff orientation programs and the continuing education curriculum in the two hospitals studied.