Medical surveillance for ethylene oxide exposure: practices and clinical findings in Massachusetts hospitals.
Medical surveillance for ethylene oxide exposure: practices and clinical findings in Massachusetts hospitals.
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环氧乙烷暴露的医疗监测：马萨诸塞州医院的实践和临床发现。
DOI：
10.1097/00043764-199602000-00012
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发表时间：
1996
影响因子：
3.2
通讯作者：
Kelsey,KT
中科院分区：
文献类型：
--
作者：
LaMontagne,AD;Mangione,TW;Christiani,DC;Kelsey,KT
职业安全与健康管理局 (OSHA) 环氧乙烷 (EtO) 标准的医疗监测要求于 1985 年生效。然而，人们对 EtO 用户对此监管要求的反应性质知之甚少。为了开始了解这一点，我们对马萨诸塞州医院的环氧乙烷健康和安全进行了调查（n = 92）。我们确定了马萨诸塞州医院提供 EtO 医疗监测的累积发生率、所提供监测干预措施的特点以及 EtO 医疗监测工作的临床结果。从1985年到1993年，62%的使用环氧乙烷的医院对环氧乙烷暴露进行了一次或多次医疗监测。 65% 的 EtO 医疗监测提供者报告执行了 OSHA EtO 标准要求的所有五项医疗监测程序。医疗监测提供者在职业医学或护理方面的认证以及书面医疗监测政策的更大覆盖范围与履行 OSHA 要求的程序的可能性更高有关。 27% 的医疗监测提供者报告发现了与环氧乙烷相关的症状或状况，从粘膜刺激到周围神经病变。这些调查结果表明，OSHA 规定的 EtO 医疗监测得到广泛实施，但 OSHA 规定的程序并未完全履行。根据基于提供者的调查，我们估计 19% 使用 EtO 的马萨诸塞州医院中的一名或多名工作人员经历过 EtO 相关的健康影响。
The medical surveillance requirements of the Occupational Safety and Health Administration's (OSHA) ethylene oxide (EtO) standard became effective in 1985. However, little is known about the nature of the response of EtO users to this regulatory requirement. In an effort to begin to understand this, we conducted a survey of EtO health and safety in Massachusetts hospitals (n= 92). We determined the cumulative incidence of provision of EtO medical surveillance, the characteristics of the surveillance interventions provided, and the clinical findings of EtO medical surveillance efforts in Massachusetts hospitals. From 1985 to 1993, medical surveillance for EtO exposure was provided one or more times in 62% of EtO-using hospitals. Sixty-five percent of EtO medical surveillance providers reported performance of all five medical surveillance procedures required by OSHA's EtO standard. Medical surveillance provider certification in occupational medicine or nursing, and a greater extent of coverage of written medical surveillance policies, were related to higher likelihoods of fulfillment of OSHA-required procedures. Twenty-seven percent of medical surveillance providers reported detection of EtO-related symptoms or conditions, ranging from mucous membrane irritation to peripheral neuropathy. These findings reveal widespread implementation of OSHA-mandated EtO medical surveillance, with concomitant incomplete fulfillment of OSHA-specified procedures. From the provider-based survey, we estimate that one or more workers at 19% of EtO-using Massachusetts hospitals have experienced EtO-related health effects.