Implementation of the Critical Care Pain Observation Tool increases the frequency of pain assessment for noncommunicative ICU patients.

Background: Pain is a common stressor for ICU patients, necessitating routine assessment. For patients who are unable to communicate, self-report tools are unsuitable, and the use of an observational tool is required to assess pain appropriately. The Critical Care Pain Observation Tool (CPOT) is the most reliable tool currently available to assess pain in these patients.

Experimental Evaluation of Respirable Dust and Crystalline Silica Controls During Simulated Performance of Stone Countertop Fabrication Tasks With Powered Hand Tools.

Objectives: Workers who fabricate stone countertops using hand tools are at risk of silicosis from overexposure to respirable crystalline silica. This study explored the efficacy of simple engineering controls that can be used for dust suppression during use of hand tools by stone countertop fabricators.

Methods: Controlled experiments were conducted to measure whether wet methods and on-tool local exhaust ventilation (LEV) reduced respirable dust (RD) exposures during use of various powered hand tools on quartz-rich engineered stone.

Musculoskeletal symptoms and associated risk factors among African hair braiders.

African hair braiders are potentially subject to work-related musculoskeletal disorders (WMSDs) because they perform repetitive hand motions for many hours a day together with prolonged standing and/or prolonged sitting. A complete enumeration of African hair braiders was attempted in Oklahoma City (OKC) and Dallas/Fort Worth (DFW). Braiders were identified through the channels they typically use to offer services to clients.

Respirable silica dust suppression during artificial stone countertop cutting.

Purpose: To assess the relative efficacy of three types of controls in reducing respirable silica exposure during artificial stone countertop cutting with a handheld circular saw.

Approach: A handheld worm drive circular saw equipped with a diamond segmented blade was fitted with water supply to wet the blade as is typical. The normal wetted-blade condition was compared to (i) wetted-blade plus 'water curtain' spray and (ii) wetted-blade plus local exhaust ventilation (LEV).

Determinants of respirable silica exposure in stone countertop fabrication: a preliminary study.

A preliminary study of personal exposure to respirable quartz was conducted in four shops that used a variety of wet and dry methods to fabricate countertops from granite and quartz-containing synthetic stone-like materials. Full-shift time-weighted average (TWA) exposures exceeded the ACGIH threshold limit value of 0.025 mg/m(3) for all workers who used dry fabrication methods, even for very limited time, during any part of the work shift (n = 15 person-days).

Prevalence of dry methods in granite countertop fabrication in Oklahoma.

Granite countertop fabricators are at risk of exposure to respirable crystalline silica, which may cause silicosis and other lung conditions. The purpose of this study was to estimate the prevalence of exposure control methods, especially wet methods, in granite countertop fabrication in Oklahoma to assess how many workers might be at risk of overexposure to crystalline silica in this industry. Granite fabrication shops in the three largest metropolitan areas in Oklahoma were enumerated, and 47 of the 52 shops participated in a survey on fabrication methods.

Chemical process based reconstruction of exposures for an epidemiological study. III. Analysis of industrial hygiene samples.

As part of an historical cohort study to investigate the mortality experience of industrial workers exposed to chloroprene (beta-CD) and other substances, all available industrial hygiene exposure monitoring data were collected and summarized. From discussions with on-site industrial hygiene personnel, it was apparent that these data were not collected for epidemiological purposes and, therefore, their use in characterization of exposures was problematic as the data mostly pertained to samples collected to investigate the performance of specific tasks. These data were, however, informative for validating the exposure modeling process used to estimate historical exposures.

Chemical process based reconstruction of exposures for an epidemiological study. I. Theoretical and methodological issues.

In the occupational hygiene component of occupational epidemiological studies the goal is to assign group average exposure levels that can be used to compute individual cumulative exposures. This task requires the availability of sufficient amounts of proper individual exposure level data. Typically, the required data are either sparse, completely lacking or happenstance data collected for purposes not suitable for the aims of the study.

Mortality patterns among industrial workers exposed to chloroprene and other substances. II. Mortality in relation to exposure.

As part of an historical cohort study to investigate the mortality experience of industrial workers exposed to chloroprene (CD) and other substances, including vinyl chloride monomer (VC), we analyzed mortality from all cancers combined, respiratory system (RSC) and liver cancer in relation to CD and VC exposures. Subjects were 12,430 workers ever employed at one of two U.S.

Mortality patterns among industrial workers exposed to chloroprene and other substances. I. General mortality patterns.

We conducted an historical cohort study to investigate the mortality experience of industrial workers potentially exposed to chloroprene (CD) and other substances, including vinyl chloride (VC), with emphasis on cancer mortality, including respiratory system (RSC) and liver. In 1999, the International Agency for Research on Cancer (IARC) classified CD as a possible carcinogen (Group 2B); VC was classified in 1987 as a known human carcinogen (Group 1). Subjects were 12,430 workers ever employed at one of two U.

Chemical process-based reconstruction of exposures for an epidemiological study. Part II. Estimated exposures to chloroprene and vinyl chloride.

In a four-facility occupational epidemiology study of chloroprene monomer and polymer production workers, the chloroprene (CD) and vinyl chloride monomer (VCM) exposures were modeled for plant specific job title classes. In two facilities an acetylene-based process was used and in the other two plants only a butadiene-based process was used in the monomer synthesis. In the Acetylene process VCM was an undesirable by-product to be removed.

Classification of worker exposures.

The classification of jobs or workers by exposure is an important undertaking in any occupational epidemiological study. Hitherto, the exposure classification designs have been strongly motivated by a desire to generate a sufficient number of exposure classes for the determination of a potential exposure-response relationship. Thus, the partitioning of exposures has been more or less arbitrary.

Recurrent critical violations of the food code in retail food service establishments.

Records of restaurant inspections by public health departments provide sequential "snapshots" of conditions in retail food service establishments that can be used to identify risk factors and evaluate the effectiveness of interventions. Data from a random 10 percent sample of restaurant inspection files from 31 counties in Oklahoma, including 4,044 inspections conducted during 1996-2000 in "medium-risk" and "high-risk" establishments, were analyzed to determine rates of critical violations and recurrent violations for different categories of establishments. Repeat violations accounted for about half of all violations.

Evaluation of an artificial intelligence program for estimating occupational exposures.

Estimation and Assessment of Substance Exposure (EASE) is an artificial intelligence program developed by UK's Health and Safety Executive to assess exposure. EASE computes estimated airborne concentrations based on a substance's vapor pressure and the types of controls in the work area. Though EASE is intended only to make broad predictions of exposure from occupational environments, some occupational hygienists might attempt to use EASE for individual exposure characterizations.

A preliminary evaluation of the effect of glove use by food handlers in fast food restaurants.

A study was conducted to determine whether the levels of selected microorganisms differed on foods handled by gloved and bare hands at fast food restaurants. Three hundred seventy-one plain flour tortillas were purchased from fast food restaurants and analyzed for Staphylococcus aureus, Escherichia coli, Klebsiella sp., coliform bacteria, and heterotrophic plate count bacteria.

Determinants of exposure to volatile organic compounds in four Oklahoma cities.

To begin to develop generalized models for estimating personal exposure to ambient air pollutants within diverse populations, the design of the Oklahoma Urban Air Toxics Study incorporated eight dichotomous macroenvironmental and household factors that were hypothesized to be potential determinants of exposure. Personal, indoor, and outdoor samples of volatile organic compounds (VOCs) were collected over 24-h monitoring periods in 42 households, together with activity diaries and data on the participants' residences. The distributions of the VOC concentrations were moderately to highly left-censored, and were mostly bimodal.

UV disinfection of soluble oil metalworking fluids.

The efficacy of a new high-intensity germicidal ultraviolet (UV) lamp for disinfection of opaque metalworking fluids (MWF) was investigated under laboratory conditions. Three dilutions of "soluble oil" MWF and water controls in a circulating system were inoculated with suspensions of Pseudomonas fluorescens to an initial concentration of about 10(7) colony forming units (CFU) per milliliter and irradiated with a submerged nonglass UV lamp. Aliquots of the circulating fluid were withdrawn before irradiation and at 10-sec intervals in the water control and 10-min intervals in the MWF.