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

描述（由申请人提供）：这是一份职业健康与安全研究的竞争性更新申请，最终目标是提供健康，高效的家庭护理（HC）劳动力。在美国，HC助手是增长最快的职业，并且越来越多的家庭医疗保健的加速趋势增加了识别HC助手工作危害和预防相关伤害和疾病的紧迫性。清洁和消毒（C&D）是HC助手日常工作的重要组成部分，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。清洁产品是职业性哮喘的主要原因之一。目前，职业呼吸健康和预防感染的工作脱节，造成我们充分保护卫生工作者的能力存在差距。拟议的研究将开发一种综合的、多学科的方法，优化职业呼吸健康和有效的C&D，以预防感染，而不是用一个代替另一个。这将通过以下方式完成

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.