WHWB Forum

Cutting core samplesWelcome to the Workplace Health Without Borders Forum. This is where we  post news items and discuss WHWB projects and issues of importance to the international occupational hygiene community.

For example, please see our post seeking help with the Ebola crisis in Africa. You can also find a post describing our first crowdfunding campaign to fund a workshop in India in partnership with  Jeevan Rekha Parishad (JRP) to educate employers, workers, government and public health staff about the health hazards associated with exposure to silica.

We continue to look for mentors and people seeking mentors through our Mentor program, matching experienced occupational hygienists with new entrants to the occupational hygiene field. We continue to work on a training module on the hazards of silica exposure and their control. This will be contributed to the collection of modular occupational hygiene training materials produced by OHTA and available at the www.ohlearning.com website.

If you are registered with WHWB, please login using the Login link at upper right to post your ideas and comments on the forum. Comments and new posts will normally appear here within 24 hours of submission. If you are not registered, but wish to do so, just send an email to the webmaster at: webmaster@whwb.org. If you have difficulties with any part of the web site, please contact the webmaster.

CDC Guidance Document on PPE for Healthcare Workers

The US Centers for Disease Control and Prevention (CDC) has released a guidance document on Personal Protective Equipment (PPE) to be used by Healthcare workers in American hospitals during management of Ebola patients. This document includes specific procedures for donning (putting on) and Doffing (taking off) the PPE. This document was current as of October 20, 2014. While following this information may not be practical in parts of the world where resources are not available, it does provide useful guiding principles based on lessons learned from recent experiences in U.S. hospitals caring for Ebola patients. In particular it emphasizes the importance of training, practice, competence, and observation of healthcare workers in correct donning and doffing of PPE selected by the facility. This guidance document is available here.

Ebola is a workplace disease & occupational hygienists can help‏

As the global health response gears up for greater efforts to combat Ebola in Africa, occupational hygienists have an opportunity to offer their expertise in worker protection.

WHWB is in touch with NGOs that are involved in fighting Ebola in Africa and would benefit from occupational hygiene expertise. We are looking for hygienists who are willing to help,  especially those with infection control expertise.  This will not necessarily  entail travel to Africa.

Please contact us  at info@whwb.org if you are interested in helping, and include some information about your experience, especially infection control experience, if any.

Thanks very much — we look forward to hearing from you.

Lessons from Ebola

by Mary O’Reilly, WHWB Board member

The Ebola crisis has focused the world’s attention on how important it is for doctors and nurses to be safe at work.  Hundreds of health care workers in Africa have died and two nurses in the US became infected and seriously ill from their work caring for Ebola patients.   Even National Public Radio (NPR) in the US stated in  its reporting that people should not get sick or die from their work.  The guiding principle of WHWB is that workers should go home at the end of their shift at least as healthy as they came to work.  The Ebola crisis is demonstrating very graphically what happens when this principle is violated.

One of the root causes of occupational illness and injury is lack of effective training.  Dr. Vargas, the head of the Dallas hospital that treated the Ebola patient from West Africa, reported in congressional testimony that infection control protocol had been in place at the Texas hospital but that hospital personnel had received no training, let alone hands on training, on the protocol.

Unfortunately, this scenario is repeated over and over again in workplaces throughout the US and throughout the world.  In 2013 OSHA (Occupational Safety and Health Administration) reports that 4,405 workers in the US died as result of their work.  Investigations indicate that many of these workplaces had written protocols but the protocols were not followed or effectively communicated to employees and employees were not given the necessary training to implement the protocol.  For example, lock-out tag-out programs may exist on paper but, without effective training, one worker may turn on a remote saw blade when another worker is fixing it; there may be respirators at a workplace but unless workers know how to use them correctly they may be exposed to harmful chemicals.

There are many lessons to be learned from the current Ebola crisis.  One of these lessons is the importance of effective worker training.  If employers, workers and anyone who benefits from the fruits of another’s labor*, learn that safety training is not an add-on but an integral part of every workplace,  we will have made some progress to a safer and healthier world.

* examples include municipal water and sewers, fresh vegetables, medicines, consumer products and  everything we use in modern life

PPE for Ebola

Differing opinions are circulating within the occupational health community on appropriate PPE for health care workers potentially exposed to Ebola.  Lisa Brosseau  (on CIDRAP and her blog)  and Raina McIntyre (blog and video)  have made cases for upgrading recommendations for respiratory protection.

In her blog post, Brosseau asks Is it time to declare Ebola an aerosol-transmissible disease requiring a respirator?”  She   discusses  aerosol sources and “the viability of the organism in air at room temperature and humidity, receptors for the organism in epithelial tissues, animal data showing infection via aerosols and scientific reports of aerosol transmission from one non-human primate species to another.   All of these facts  contribute to the evidence that Ebola is an aerosol-transmissible disease.”

Occupational hygienists and occupational health physicians, including WHWB members, may be called on to advise  on prevention of Ebola transmission.  What are we saying?  What are the implications of upgraded respiratory protection, especially in Africa, in relation to the feasibility of fit-testing, proper training,  heat stress, decontamination facilities, etc.?

Respectful discussion is welcome.

Occupational Health and Safety Guide for small employers

The International Commission on Occupational Health (ICOH)   has developed an occupational health and safety guide for small and medium sized enterprises (SMEs) in developing countries.

Dr. Tee Guidotti of ICOH’s Scientific Committee on Occupational Health and Development, who led development of the guide, encourages WHWB members and partners to use the guide in our work and distribute it widely to the target audience. “All we ask,” says Dr. Guidotti, “is that 1) the content of the document not be changed (except for translation), 2)  it be made available free or for very low cost, 3) ICOH be kept informed on how it was used and the outcome, and 4) however it is distributed, full credit be given to ICOH and to the authors as listed in the Guide.”

The OH Guide is designed to be a practical introduction to the basics of worker health protection for SMEs.  It is also intended for multinational employers to use in promoting worker health protection among their vendors and contractors. French, Spanish, Arabic, Turkish, and Chinese versions are in the works.

You can access the Guide, evaluation survey, an Executive Summary and project description at this link.

Health Professionals needed to help with Ebola crisis

AmeriCares is seeking help to staff a team to combat Ebola in Liberia.

Individuals  interested in serving in the fight against, and treatment of, Ebola in Liberia are asked to register to create a profile along with their resume/CV in the AmeriCares online jobs portal.

More information is available in this document.