TRAINING AND MEDICAL SURVEILLANCE UNDER THE ETO STANDARD

本研究的总体目标是批判性地评估 培训和医疗监督(MS)条款的实施 职业安全与健康管理局(OSHA)1984年 医院环境中的环氧乙烷(ETO)标准。更广泛的目标 这项研究的目的是确定培训和培训的优点和缺点 MS在特定物质的OSHA标准中的实施，以便 提供更有效的实践、执行策略和 这些领域的政策制定。这项研究将从广泛的 关于ETO培训和MS实施模式的描述性数据收集 以及对培训和MS要求的遵守程度。 实施和合规模式将与组织相关 和劳动力特征来确定最重要的决定因素 与理想的培训模式和我们的女士密切相关 对ETO标准培训和MS规定的合规性评估将 与OSHA综合管理信息系统检查相比较 以此数据来判断该数据库的实用性，用于研究 培训和MS实施及合规。 以下三个具体假设直接从 暴露监测驱动的实施策略 将测试特定物质的健康标准：(1)超过 触发暴露水平与实施 ETO训练，以及(2)超过触发暴露水平是正向的 与实施ETO医疗监测有关。两个ETO 指定暴露级别以触发培训和MS要求： 0.5ppm时间加权平均(TWA)的作用水平和漂移 每15个周期不超过5ppm的TWA。我们是在问雇主在多大程度上 是否符合这些要求以及在多大程度上暴露于 监察具体指导雇主执行《经济、社会及文化权利条例》 培训与MS假设(3)：培训的实施是 积极配合实施医疗监护。 正如OSHA现行政策所述，培训的部分目的是 让工人意识到他们在标准下的权利，这反过来又是 被认为是为了让工人更有可能行使这些权利。我们会 测试与这种因果关系相一致的关联性 培训与多发性硬化症之间的关系 培训缺勤，我们也会把培训频次，培训数量， 和类型到MS实现，允许关于Relative的一些推论 培训效果。为了实现具体目标，我们的方法 整合了职业健康、健康 教育学、社会科学和调查研究方法。

The general aim of this study is to critically evaluate the implementation of the training and medical surveillance (MS) provisions of the Occupational Safety and Health Administration's (OSHA) 1984 Ethylene Oxide (EtO) Standard in the hospital setting. The broader goal of this research is to identify strengths and weaknesses of training and MS implementation in substance-specific OSHA standards in order to provide for more effective practice, enforcement strategies, and policy-making in these areas. The study will begin with extensive descriptive data gathering on EtO training and MS implementation patterns as well as levels of compliance with training and MS requirements. Implementation and compliance patterns will be related to organizational and workforce characteristics to identify determinants which are most closely correlated with desirable patterns of training and MS. Our estimates of compliance with EtO standard training and MS provisions will be compared to OSHA Integrated Management Information System inspection data in order to judge the utility of this database for the study of training and MS implementation and compliance. The following three specific hypotheses, derived directly from the implementation strategies of exposure monitoring-driven substance-specific health standards will be tested: (1) Exceedance of trigger exposure levels is positively associated with implementation of EtO training, and (2) exceedance of trigger exposure levels is positively associated with implementation of EtO medical surveillance. Two EtO exposure levels are specified to trigger training and MS requirements: the Action Level of 0.5 ppm Time-weighted Average (TWA) and the Excursion Limit of 5 ppm TWA per 15 period. We are asking to what extent employers are in compliance with these requirements and to what extent exposure monitoring specifically guides employers in the implementation of EtO training and MS. Hypothesis (3): The implementation of training is positively associated with the implementation of medical surveillance. As stated in current OSHA policy, part of the intent of training is to make workers aware of their rights under a standard, which in turn is presumed to make workers more likely to exercise those rights. We will test for an association which would be consistent with a such a causal relationship between training and MS. In addition to the presence or absence of training, we will also relate training frequency, quantity, and type to MS implementation, allowing some inferences about relative training effectiveness. To achieve the specific aims, our approach integrates theory and principles from occupational health, health education, and the social sciences with survey research methodology.