2015-04-01 12:00 - Messages

Maladie à virus Ebola

Tenues et procédures de déshabillage des soignants en établissement de santé de référence
Ce document a été conçu en collaboration avec la Société de Pathologie Infectieuse de Langue Française (SPILF), à partir du recueil et de la synthèse des procédures des établissements de santé de référence (ESR) français. Il fait des recommandations pour la tenue des soignants lors de la prise en charge d'un patient cas possible secrétant ou cas confirmé de maladie à virus Ebola (MVE). Il propose également un protocole de déshabillage. Ces recommandations pourront être amenées à évoluer en fonction de l'état des connaissances et des retours d'expérience des ESR.

Source: http://www.inrs.fr/media.html?refINRS=ED%206209

Uncertainty, risk analysis and change for Ebola personal protective equipment guidelines

In early September 2014, we were the first to publicly challenge the guidelines of the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC) and those of many countries which suggested that medical masks be used by health care workers (HCWs) treating Ebola virus disease (EVD) (MacIntyre et al., 2014a). We argued in a previous editorial in the International Journal of Nursing Studies that in situations where there is uncertainty around the transmission mode, a risk analysis framework should be used to select personal protective equipment (PPE) and that the safety of HCWs should be a priority ( MacIntyre et al., 2014a). Our editorial attracted considerable attention and comment ( Jackson, 2014, MacIntyre et al., 2014b and Martin-Moreno et al., 2014). The CDC has since changed their guidelines, but the WHO has yet to do so ( CDC, 2014a). In this paper we discuss the events that influenced the modification of EVD guidelines and factors to be considered in developing frameworks for protection of HCWs.

Source: MacIntyre, C. Raina, Chughtai, Abrar Ahmad, Seale, Holly, Richards, Guy A., & Davidson, Patricia M. (2015). International Journal of Nursing Studies, 52 (5), p. 899-903.
http://dx.doi.org/10.1016/j.ijnurstu.2014.12.001

Optimisation de SATURISK, l’outil de calcul du temps de service des cartouches de protection respiratoire contre les vapeurs organiques

L'exposition des travailleurs aux solvants, ou plus largement aux vapeurs organiques, doit être maîtrisée sinon maintenue en deçà des valeurs limites réglementaires. Lorsque l'ensemble des mesures administratives, d'ingénierie et de protection collective ne permet pas d'atteindre des niveaux d'exposition sans danger pour la santé, les travailleurs concernés doivent être équipés d'appareils de protection respiratoire (APR). En l'absence de situations de danger immédiat pour la vie et la santé (DIVS), les APR équipés de cartouches de filtration à base de charbon activé sont utilisés contre les vapeurs organiques. Se pose alors la question du temps de service de ces cartouches. Parmi les options disponibles pour y répondre, celle visant à mettre en œuvre des modèles prédictifs des temps de claquage est la plus utilisée.
Ainsi, l'objectif de ce projet consistait en la mise à jour de Saturisk, l'outil en ligne offert par l'Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST) pour calculer le temps de service des cartouches pour les vapeurs organiques. Cette mise à jour visait notamment à intégrer un éventail plus large de cartouches  et de solvants à Saturisk. En parallèle, le développement d'un système expérimental basé sur la miniaturisation des cartouches a été réalisé pour vérifier, dans des conditions contrôlées, les temps de service prédits par le modèle.

Source: http://www.irsst.qc.ca/-publication-irsst-cartouches-protection-respiratoire-vapeurs-organiques-r-873.html

Prediction methods of skin burn for performance evaluation of thermal protective clothing

Most test methods use skin burn prediction to evaluate the thermal protective performance of clothing. In this paper, we reviewed different burn prediction methods used in clothing evaluation. The empirical criterion and the mathematical model were analyzed in detail as well as their relationship and limitations. Using an empirical criterion, the onset of skin burn is determined by the accumulated skin surface energy in certain periods. On the other hand, the mathematical model, which indicates denatured collagen, is more complex, which involves a heat transfer model and a burn model. Further studies should be conducted to examine the situations where the prediction methods are derived. New technologies may be used in the future to explore precise or suitable prediction methods for both flash fire tests and increasingly lower-intensity tests.

Source: Zhai LN, Li J. Burns, 2015.
http://dx.doi.org/10.1016/j.burns.2015.02.019

Workplace performance of a loose-fitting powered air purifying respirator during nanoparticle synthesis

Nanoparticle (particles with diameter ≤100 nm) exposure is recognized as a potentially harmful size fraction for pulmonary particle exposure. During nanoparticle synthesis, the number concentrations in the process room may exceed 10 × 106 cm−3. During such conditions, it is essential that the occupants in the room wear highly reliable high-performance respirators to prevent inhalation exposure. Here we have studied the in-use program protection factor (PPF) of loose-fitting powered air purifying respirators, while workers were coating components with TiO2 or Cu x O y  nanoparticles under a hood using a liquid flame spray process. The PPF was measured using condensation particle counters, an electrical low pressure impactor, and diffusion chargers. The room particle concentrations varied from 4 × 106 to 40 × 106 cm−3, and the count median aerodynamic diameter ranged from 32 to 180 nm. Concentrations inside the respirator varied from 0.7 to 7.2 cm−3. However, on average, tidal breathing was assumed to increase the respirator concentration by 2.3 cm−3. The derived PPF exceeded 1.1 × 106, which is more than 40 × 103 times the respirator assigned protection factor. We were unable to measure clear differences in the PPF of respirators with old and new filters, among two male and one female user, or assess most penetrating particle size. This study shows that the loose-fitting powered air purifying respirator provides very efficient protection against nanoparticle inhalation exposure if used properly.

Source: Koivisto AJ, Aromaa M, Koponen IK, et al. Journal of Nanoparticle Research, 2015; 17: 177.
http://dx.doi.org/10.1007/s11051-015-2990-9

Reducing heat stress under thermal insulation in protective clothing

Microclimate cooling by a 'physiological' method
Heat stress caused by protective clothing limits work time. Performance improvement of a microclimate cooling method that enhances evaporative and to a minor extent convective heat loss was tested. Ten male volunteers in protective overalls completed a work-rest schedule (130 min; treadmill: 3 x 30 min, 3 km/h, 5% incline) with or without an additional air-diffusing garment (climatic chamber: 25 °C, 50 % RH, 0.2 m/s wind). Heat loss was supported by ventilating the garment with dry air (600 l/min, «5% RH, 25 °C). Ventilation leads (M ±  SD, n = 10, ventilated vs. non-ventilated) to substantial strain reduction (max. HR: 123 ± 12 b/min vs. 149 ± 24 b/min) by thermal relief (max. core temperature: 37.8 ± 0.3 °C vs. 38.4 ± 0.4 °C, max. mean skin temperature: 34.7 ± 0.8 °C vs. 37.1 ± 0.3 °C) and offers essential extensions in performance and work time under thermal insulation.

Source: Glitz KJ, Seibel U, Rohde U, Gorges W, Witzki A, Piekarski C, Leyk D. Ergonomics, 2015.
http://dx.doi.org/10.1080/00140139.2015.1013574

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