Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milano
Associazione Italia-Cuba
Funding
Objective of the
project
To conduct a study on exposure to anaesthetic gases in health care workers in Cuba and their outcome on workers’ health
To improve technical capability of laboratories in Cuba dealing with environmental and biological monitoring of occupational exposure
To develop training programs for physicians, and nurses, industrial hygienists, and all the subjects 80 involved in prevention
To publish guidelines, booklets to address risk management and scientific articles to report the results of the studies
Project outcome(s)
and deadline(s) for completion of the
project
Improvement of working and health conditions in Cuban health care workers
Improvement of know-how through educational courses for prevention operators
Training packages for operators of prevention (industrial hygienists, occupational physicians, psychologists)
Target group and/or beneficiaries
Health care workers, occupational health physicians, nurses, industrial hygienists, laboratory technicians, psychologists, institutions for safety and prevention at work.
Summary of the project (max 100 words)
Assessment of exposure to anaesthetic gases and risk reductions:
Complete methods development
Apply methods to evaluate exposure and its neurobehavioral effects in health care workers
Study solutions for the reduction of exposure and apply them in the polluted environments
Test the efficacy of the adopted solution.
Education - Organization of specific frontal training packages on industrial hygiene and biological monitoring and psychosocial risks in health care workers
Dissemination
Guidelines for safety and prevention at work, booklets and training packages for workers and operators of prevention, scientific publications
Impact: global/regional
Regional
Progress on Project
The Cuban colleagues are working on assays for measuring:
airborne exposure to anaesthetic gases in health care workers in Cuba
urinary levels of anaesthetic gases in occupationally exposed subjects
Italian experts from the "Clinica del Lavoro” provide Cuban colleagues with useful supplies and advice. ISPESL, Italy, translated into Spanish a booklet, originally edited in Italian, dedicated to health care workers. The booklet is titled: "Stress and burnout - how recognize symptoms and prevent risk". This booklet has been presented to the Cuban colleagues during the 2nd International Congress on Health and Work, Cuba, 2007.
2009-2012 Work Plan Number
GPA1.9i
Formerly AA3:H3
Project title
Assessment of exposure to antineoplastic agents in pharmacy and hospital personnel
GPA Objective 1: To devise and implement policy instruments on workers’ health
Action 1.10
CC or NGO Name
Institute and Outpatient Clinic for Occupational and Environmental Medicine, University Munich
Project leader
Email address
Dr. Rudi Schierl, rudolf.schierl@med.uni-muenchen.de
Partners (of the CC Network)
National Institute for Occupational Safety & Health (NIOSH), USA
Centre for Environmental and Occupational Health, Porto, Portugal
University of Maryland, USA
INRS, France
Other partners
Funding
Initial funding is secured from a German pharmacy network. Funding for the next years has to be applied for.
Objective of the
project
Examination of safe working conditions related to handling of antineoplastic drugs during drug preparation or administration in hospitals
Project outcome(s)
and deadline(s) for completion of the
project
To test the wipe-kit that will be readily usable for different countries (by 2007)
To develop training courses for the wipe-kit (by 2009)
Target group and/or beneficiaries
Pharmacy technicians, pharmacists, nurses, medical doctors
Summary of the project
There is a risk of adverse health effects for personnel with occupational exposure to antineoplastic agents. The study is aimed at identification, quantification and evaluation of potential health hazards of exposed personnel in pharmaceutical and oncological departments. Biological monitoring for important substances had produced evidence for uptake, but sources remained doubtful in many cases.
Therefore we developed an environmental monitoring strategy in order to detect contamination and to improve working procedures. Within this scheme we are sending a wipe-sampling kit with detailed instructions to hospitals and pharmacies, where sampling is done by local staff. Analyses, evaluation and recommendations were carried out from our institution.
Dissemination
Publications, university studies, reports
Impact: global/regional
Global
Progress on Project
“Wipe-Kit” which can be delivered to pharmacies and hospital units. A detailed instruction with photos is included. At present also a CD-ROM with a video (in German) is available. After sampling the parcel is sent back to Institute and Outpatient Clinic for Occupational and Environmental Medicine laboratory and analyses are performed. Finally, the Institute sends the results together with evaluation and recommendations. During the last year the "Wipe-Kit" was sent to about 50 participants in Germany in order to identify contamination in pharmacies and hospitals. There was also cooperation with a big hospital in Paris, where they did monitoring at several sites (publication under preparation).
Publications:
1) Turci R, Sottani C, Schierl R, Minoia C: Validation protocol and analytical quality in biological monitoring of occupational exposure to antineoplastic drugs. Toxicol Lett 162 (2-3), 256-262 (2006)
2) Schierl R, Böhlandt A, Nowak D. Guidance values for surface monitoring of antineoplastic drugs in German pharmacies. Ann Occup Hyg 53, 703-711 (2009).
List of outcomes already achieved by this project
Meanwhile “guidance values” for good work practice are defined (see publication)
List of additional outcomes expected from this project by 2012
Comparison of surface monitoring and biological monitoring (with INRS)
Helping South America to build up lab capacities (organized by University of Maryland)
List of additional outcomes expected by 2016
2009-2012 Work Plan Number
New Project
GPA 1.9cc
PROJECT Title
Developing tools for the safe handling of hazardous drugs
GPA Objective and GPA Action
GPA Objective 1: To devise and implement policy instruments on workers’ health
Action 1.9
Priority Initiative
Priority 4: Conduct studies and develop evidence-based tools and information materials for the comprehensive protection and promotion of health for healthcare workers
Institute of Occupational and Environmental Medicine, University of Munich
Dr. Rudolf Schierl
Rudolf.Schierl@med.uni-muenchen.de
WHO Regions involved in this CONTRIBUTING project
Pan American Health Organization (PAHO)
Marie Claude Lavoie, MSPH lavoiema@paho.org
Country ministries involved in this CONTRIBUTING project
Not applicable.
External partners for this CONTRIBUTING project
Not applicable.
Summary of the project (max 100 words)
The University of Maryland (UMD) will collaborate with other network partners and PAHO to develop tools for identifying and addressing occupational health risks associated with the administration and handling of hazardous drugs in the healthcare sector. Specifically, UMD will focus on expanding the section on chemical hazards in WHO’s Manual for Healthcare Workers and developing a tool that can be used “in the field” to identify and mitigate hazards related to hazardous drugs. UMD will also work with the University of Munich and laboratories in the Americas to provide guidance for interpreting wipe sample results.
Target group and/or beneficiaries
Healthcare workers, especially those who administer or handle hazardous drugs.
Major Milestones (list up to three dates and milestones)
1. Expansion of the WHO’s Manual for Healthcare Workers segment on chemical hazards, specifically hazardous drug handling by 2012.
2. Development of a two-page tool that can be used in the healthcare sector to identify and mitigate hazards related to hazardous drugs by 2010.
3. Identify laboratory partner in the PAHO region to analyze wipe sample results for hazardous drugs using approach of University of Munich and Dr. Rudy Schierl by 2012.
Dissemination plan
Inclusion of material developed in WHO’s Manual for Healthcare Workers.
Integrate hazardous drug information into existing projects and proposals
Funding source(s)
University of Maryland, PAHO, and possibly other network partners.
Deliverables by 2010
The ability to analyze wipe sample results for hazardous drugs will be established in the Americas and at least one hospital in the region will conduct wipe sampling to assess risks associated with the handling of hazardous drugs. Also, the number of hospitals in the Americas that establish and/or update policies and procedures related to identifying and addressing risks associated with the handling of hazardous drugs will increase.
Additional Major outcomes expected by 2012
The ability to analyze wipe sample results for hazardous drugs will be established in the Americas and at least one hospital in the region will conduct wipe sampling to assess risks associated with the handling of hazardous drugs. Also, the number of hospitals in the Americas that establish and/or update policies and procedures related to identifying and addressing risks associated with the handling of hazardous drugs will increase.
Area 5: Comprehensive programmes including Risk Assessment / Risk Management tools and information
2009-2012 Work Plan Number
GPA1.9j
Formerly AA3:H4
Project title
Identification and prevention of occupational risks for Health Care Workers (HCWs)
Keywords
Risk Assessment, Health Care Workers, Prevention of occupational illness, Ergonomics, HIV and other infectious diseases
GPA Objective
GPA Objective 1: To devise and implement policy instruments on workers’ health
CC or NGO Name
National Institute for Occupational Health (NIOH), SA
Project leader
Email address
Prof Mary Ross (mary.ross@debeersgroup.com) assisted by Ms Claudina Nogueira for NIOH claudina.nogueira@nioh.nhls.ac.za
Partners (of the CC Network)
OEHRU CC (University of Cape Town), SA Singapore CC (National University of Singapore) HSL CC (UK)
Other partners
ICOH WGOIA, ICOH SC for HCWs, Health Protection Agency (UK), Center of Ergonomics for Developing Countries, Sweden, National Institute for Communicable Diseases (NICD), South Africa (WHO CC in Communicable Diseases), University of British Columbia (UBC)
Funding
Funding from the National Health Laboratory Service, South Africa to develop surveillance system for laboratory workers (NIOH). Unsuccessful funding proposal for 2009 to CIDA for surveillance system and evaluation of surveillance system for public hospitals – support from SA provincial governments and UBC obtained.
Objective of the
project
Develop and pilot practical tools and methods for risk assessments in health care settings: primary and secondary preventive intervention.
Project outcome(s)
and deadline(s) for completion of the
project
Outcomes and deadlines of the project:
To develop a health care workers’ toolkit comprising: risk assessment tools, case studies and materials for promotion of occupational health for HCWs (2011)
To develop training packages for the toolkit deliverable through e-learning and face-to-face (by 2011)
Collection of data and case studies in South Africa on tuberculosis incidence and HIV infection in HCWs (2011)
To develop a model for implementing the toolkit within a basic occupational health service for HCWs (2012)
Obtain material s/ courses from partners e.g. Singapore, HPA, WGOIA (ongoing)
Training information on dealing with high risk situations (ongoing)
Occupational health surveillance system for health care workers (2012)
Target group and/or beneficiaries
Health Care workers, particularly for developing countries.
Summary of the project (max 100 words)
The project will address the risk assessment and prevention of global occupational illness such as biological exposures (e.g. HIV, TB, HBV, HCV, avian flu), chemical (e.g. latex), physical (e.g. violence) exposures and ergonomics.
Dissemination
Publications, reports
Impact: global/regional
Global
Progress on Project
To develop toolkit for risk assessment, case studies, materials:
Review of incidence of TB in NHLS laboratory workers commenced and other cases to be collated in 2010 for partners to review.
Obtain materials from partners through ICOH WGOIA on best practices for HCWs on infectious diseases.
Occupational health surveillance systems: NIOH implementing HCW surveillance tool with electronic system to interface with personnel data.
List of outcomes already achieved by this project
Fact sheets on avian influenza and respirator fit (NIOH) 2007
Chapter on walk through risk assessment in health care facilities: Ferrie R, Ross MH. Walk-through survey. Chapter 21 in: Gurusamy J, Masilamani R. eds, Occupational health for health care professionals – caring for the carers. Kuala Lumpur: Malaysian Medical Association, 2008 [available on request, from Ms Claudina Nogueira, NIOH]
Piloting and establishment of data collection system for health care workers in the NHLS in South Africa (2009)
Review of training materials for pandemics by WGOIA: identified best practice documentation from FOM in UK available on internet 2009
Handbook for health care workers on pandemic influenza by partner organisation NICD South Africa – available on internet. 2009 updated in 2010
List of additional outcomes expected from this project by 2012
Balance of outcomes as listed in project outcomes.
List of additional outcomes expected by 2016
Suggest terminating project in 2012 and co-ordinate efforts with SC for Health Workers of the ICOH and the ICOH WGOIA and other bodies engaged in the developmental work of toolkits for health care workers.
