Determinants of the provision of ethylene oxide medical surveillance in Massachusetts hospitals.
Determinants of the provision of ethylene oxide medical surveillance in Massachusetts hospitals.
复制标题
马萨诸塞州医院提供环氧乙烷医疗监测的决定因素。
DOI：
10.1097/00043764-199602000-00013
复制
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;Rudd,RE;Mangione,TW;Kelsey,KT
在马萨诸塞州医院（n= 92）进行了一项深入的环氧乙烷健康和安全调查，以调查对环氧乙烷暴露提供医疗监测的决定因素。我们已经评估了提供EtO医疗监督与(1)激活osha指定的触发机制以提供EtO医疗监督之间的关系，(2)对EtO健康和安全的工人进行培训，以及(3)各种公共政策、组织、团体和个人特征。在职业安全与健康管理局（OSHA）提供EtO医疗监测的五个指定触发因素中，只有意外工人暴露与提供监测有关（RR= 2.56， P< 0.001）。超过行动水平30天或更长时间，OSHA的EtO触发器之一也用于许多其他标准，与提供监测无关（RR= 0.84， P= 0.714）。工人培训中EtO医疗监测覆盖率的报告也与EtO医疗监测的提供相关（RR= 3.68， P< 0.001），这支持了OSHA关于工人培训在医疗监测实施中发挥重要作用的前提。制定详细的书面EtO医疗监测政策与提供EtO医疗监测呈正相关（RR= 1.81， P< 0.001）。这些潜在的决定因素与提供医疗监测之间的关系也在多变量分析中得到验证。讨论了通过修订触发机制、改进工人培训努力和其他措施改善职业安全与卫生管理局医疗监测实施的影响。研究结果与未来制定特定物质和一般物质的医疗监测和接触监测政策和做法有关。
An in-depth survey of ethylene oxide (EtO) health and safety was conducted in Massachusetts hospitals (n= 92) to investigate the determinants of the provision of medical surveillance for EtO exposure. We have evaluated the relationships between provision of EtO medical surveillance and (1) activating OSHA-specified triggers for providing EtO medical surveillance,(2) worker training on EtO health and safety, and (3) various public policy, organizational, group, and individual characteristics. Among the Occupational Safety and Health Administration's (OSHA) five specified triggers for provision of EtO medical surveillance, only accidental worker exposures were related to provision of surveillance (RR= 2.56, P< 0.001). Exceeding the Action Level for 30 or more days, one of OSHA's EtO triggers that is also used in a number of other standards, was not related to provision of surveillance (RR= 0.84, P= 0.714). Reports of coverage of EtO medical surveillance issues in worker training were also correlated with the provision of EtO medical surveillance (RR= 3.68, P< 0.001), supporting OSHA's premise that worker training plays an important role in medical surveillance implementation. The presence of detailed written EtO medical surveillance policies was positively related to the provision of EtO medical surveillance (RR= 1.81, P< 0.001). The relationships between these potential determinants and provision of medical surveillance were also validated in multivariate analyses. Implications for improvement of OSHA medical surveillance implementation through revised trigger schemes, improved worker training efforts, and other measures are discussed. Findings are relevant to the future development of medical surveillance and exposure monitoring policies and practices in both substance-specific and generic contexts.