Homecare Work in Social Assistance and Healthcare: Safe Cleaning and Disinfection

描述(由申请人提供)：这是一个职业健康和安全研究的竞争性续签申请，最终目标是提供一支健康、高效的家庭护理(HC)劳动力队伍。人力资源助理是美国增长最快的职业，越来越多的家庭医疗保健的加速趋势增加了识别人力资源助理的工作危险和预防相关伤害和疾病的紧迫性。清洁和消毒(C&D)是HC助手日常工作的主要部分，因为耐甲氧西林金黄色葡萄球菌(MRSA)和艰难梭菌(C Diff)等多重耐药微生物的风险越来越大。然而，与此同时，越来越多的证据表明，许多广泛用于预防感染的C&D化学品与呼吸道疾病有关。清洁用品是职业性哮喘的主要原因之一。目前，职业呼吸道健康和感染预防工作脱节，造成了我们充分保护HC工人的能力的差距。拟议的研究将开发一种综合的、多学科的方法，以优化职业呼吸系统健康和有效的预防感染的C&D，而不是在两者之间进行权衡。这将通过以下方式实现 具体目标：1)确定不同类型的C&D可在多大程度上减少家庭护理环境表面上发现的病原体和其他微生物。2)评估在HC环境中实践的C&D对呼吸暴露和健康的影响。3)综合目标1和目标2的调查结果，翻译并向人力资源利益攸关方传播。拟议的研究涉及NIOSH国家职业研究议程(NORA)保健和社会援助(HCSA)部门，并涉及化学危险和传染病部门优先领域。涉及的人力资源职业受雇于医疗保健和社会援助服务。NORA的跨部门计划涉及：1)暴露评估；2)呼吸系统疾病；3)通过设计进行预防；4)职业健康差距。预期产出将是定量和定性的数据和通信产品，以服务于为指导人力资源中心安全、有效的C&D提供证据基础的预期结果。研究与实践(R2P)方法将与我们成熟、成功的HC行业伙伴网络合作，在拟议研究的所有阶段进行，以确保研究结果具有相关性，并传播给可将其用于预防性工作场所干预的实践社区。拟议研究的预期中期成果是更好地理解控制和发展的OSH风险和收益，以及对控制和发展的OSH维度进行综合评估，这有助于为HC的良好做法指南提供证据基础。预计这项工作的最终结果将是一支更健康、更具生产力的人力资源援助队伍。

DESCRIPTION (provided by applicant): This is a competitive renewal application for occupational health & safety research with the ultimate goal of providing a healthy, productive home care (HC) workforce. HC aides are the fastest growing occupation in the U.S., and the accelerating trend towards more medical care at home increases the urgency to identify HC aides' work hazards and prevent associated injuries and illness. Cleaning and disinfection (C&D) is a major part of the daily work of HC aides because of the growing risks from multi-drug resistant organisms like methicillin resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C diff). Yet at the same time, there is growing evidence that many C&D chemicals widely used for infection prevention are associated with respiratory illnesses. Cleaning products are among the leading causes of occupational asthma. Currently, occupational respiratory health and infection prevention efforts are disconnected, creating a gap in our ability to fully protect HC workers. The proposed research will develop an integrated, multidisciplinary approach that optimizes occupational respiratory health and effective C&D for infection prevention, rather than trading off one for the other. This will be accomplished with the following specific aims: 1) Determine the extent to which pathogens and other micro-organisms found on surfaces in the home care environment can be reduced by different types of C&D. 2) Evaluate respiratory exposures and health effects from C&D as practiced in HC environments. 3) Synthesize the findings from aim 1 and 2, translate and disseminate them for HC stakeholders. The proposed research addresses the NIOSH National Occupational Research Agenda (NORA) sector of Healthcare and Social Assistance (HCSA) and addresses sector priority areas of Chemical Hazards and Infectious Diseases. The HC occupations addressed are employed both in healthcare and social assistance services. The NORA cross-sector programs addressed are: 1) Exposure Assessment; 2) Respiratory Diseases; 3) Prevention through Design; and 4) Occupational Health Disparities. The expected outputs will be quantitative and qualitative data and communication products to serve the expected outcome of providing the evidence base for guidance on safe, effective C&D in HC. Research to Practice (r2p) methods will be engaged at all stages of the proposed research in collaboration with our well-established, successful HC industry partnership network to insure that the findings are relevant and disseminated to the practice communities that can use them for preventive workplace interventions. Expected intermediate outcomes of the proposed research are an improved understanding of the OSH risks and benefits of C&D and an integrated evaluation of the OSH dimensions of C&D that can contribute to the evidence base for good practice guidelines in HC. The end outcome of this work is expected to be a healthier and more productive HC aide workforce.