Risk mitigation

风险缓解
  • 文章类型: Journal Article
    抗生素在水产养殖中的应用主要旨在预防和治疗鱼类的细菌感染,但是它们的不当使用可能导致人畜共患抗生素抗性细菌的出现,以及随后通过食物消费将抗性菌株传播给人类。水生环境是耐药细菌的潜在蓄水池,为抗菌素耐药性(AMR)的发展提供了理想的温床。集约化鱼类养殖系统与陆地环境的相互联系,食品加工业和人类创造了传播耐药细菌的途径,进一步加剧了这个问题。这项研究的目的是提供最有效和可用的风险缓解策略,以解决水产养殖中的AMR,基于一个健康(OH)的概念。严格的抗菌药物使用指南,推广疾病控制方法,如加强农场生物安全措施和疫苗接种,抗生素替代品(ABs)(益生元,益生菌,免疫刺激剂,精油(EO),肽和噬菌体疗法),喂养实践,遗传学,监测水质,改善废水处理,而不是过度使用抗菌药物,能有效防止AMR的发展和耐药菌释放到环境和食物中。传统上,环境对AMR开发的贡献受到的关注较少,and,因此,环境因素应更突出地包括在OH的预测努力中,检测和预防健康风险。这对于低收入和中等收入国家尤其重要,因为这些国家缺乏将国家AMR行动计划(NAP)与水产养殖生产环境相结合。基于OH方法的渔业中AMR的综合控制可以有助于抗性的大幅降低,亚洲也是如此,在水产养殖中,在过去的二十年中,耐药性超过50%(P50)的抗菌化合物的百分比从52%下降到22%。
    The application of antimicrobials in aquaculture primarily aims to prevent and treat bacterial infections in fish, but their inappropriate use may result in the emergence of zoonotic antibiotic-resistant bacteria and the subsequent transmission of resistant strains to humans via food consumption. The aquatic environment serves as a potential reservoir for resistant bacteria, providing an ideal breeding ground for development of antimicrobial resistance (AMR). The mutual inter-connection of intensive fish-farming systems with terrestrial environments, the food processing industry and human population creates pathways for the transmission of resistant bacteria, exacerbating the problem further. The aim of this study was to provide an overview of the most effective and available risk mitigation strategies to tackle AMR in aquaculture, based on the One Health (OH) concept. The stringent antimicrobial use guidelines, promoting disease control methods like enhanced farm biosecurity measures and vaccinations, alternatives to antibiotics (ABs) (prebiotics, probiotics, immunostimulants, essential oils (EOs), peptides and phage therapy), feeding practices, genetics, monitoring water quality, and improving wastewater treatment, rather than applying excessive use of antimicrobials, can effectively prevent the development of AMR and release of resistant bacteria into the environment and food. The contribution of the environment to AMR development traditionally receives less attention, and, therefore, environmental aspects should be included more prominently in OH efforts to predict, detect and prevent the risks to health. This is of particular importance for low and middle-income countries with a lack of integration of the national AMR action plans (NAPs) with the aquaculture-producing environment. Integrated control of AMR in fisheries based on the OH approach can contribute to substantial decrease in resistance, and such is the case in Asia, where in aquaculture, the percentage of antimicrobial compounds with resistance exceeding 50% (P50) decreased from 52% to 22% within the period of the previous two decades.
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  • 文章类型: Journal Article
    背景:本文旨在描述南澳大利亚州涉及阿片类药物毒性的住院情况,以指导未来实施和评估风险缓解策略。
    方法:国际疾病分类,第10版代码(T40.0-T40.4)用于识别2017年6月1日至2020年8月30日南澳大利亚州公立医院中涉及院前阿片类药物毒性的入院。使用描述性统计数据提取和总结人口统计学和护理数据。入院成本估算是使用独立医院定价机构的数据计算的。
    结果:共2046例符合纳入标准;超过一半(56%)为女性,入院年龄中位数为44岁(四分位距27岁)。阿片类药物毒性是主要诊断,70%的入院没有指定负责任的阿片类药物,23%与海洛因使用有关。五分之一的入学发生在阿德莱德大都市以外。生活在社会经济相对不利地区的个人人数过多。超过一半的入院需要住院>24小时;19%的入院时间≥5天,22%需要重症监护,约10%需要机械通气。在这3年期间,南澳大利亚涉及阿片类药物毒性的总入院估计费用为18,230,546.50美元,相当于每年560万美元。
    结论:这些发现突出了重要的个人,财政,以及南澳大利亚与阿片类药物毒性相关的住院的系统性影响,并为评估减少阿片类药物相关伤害的举措的有效性提供基线,包括实时处方监控和带回家的纳洛酮供应。
    BACKGROUND: This article aims to characterise hospital admissions involving opioid toxicity across South Australia to guide future implementation and evaluation of risk mitigation strategies.
    METHODS: International Classification of Diseases, 10th Edition codes (T40.0-T40.4) were used to identify admissions involving pre-hospital opioid toxicity in public hospitals across South Australia from 1 June 2017 to 30 August 2020. Demographic and episode of care data were extracted and summarised using descriptive statistics. Admission cost estimates were calculated using Independent Hospital Pricing Authority data.
    RESULTS: A total of 2046 cases met the criteria for inclusion; over half (56%) were female and median age on admission was 44 years (interquartile range 27 years). Where opioid toxicity was the primary diagnosis, 70% of admissions did not specify the responsible opioid and 23% were related to heroin use. One-fifth of admissions occurred outside of metropolitan Adelaide. Individuals living in an area of relative socio-economic disadvantage were over-represented. Over half of admissions required a stay >24 h; 19% were admitted for ≥5 days, 22% required intensive care and ~10% required mechanical ventilation. The total estimated cost of admissions involving opioid toxicity in South Australia over the 3-year period was $18,230,546.50, equating to $5.6 million per annum.
    CONCLUSIONS: These findings highlight the significant personal, fiscal, and systemic impacts of opioid toxicity-related hospital admissions in South Australia and provide a baseline to evaluate the effectiveness of initiatives to reduce opioid-related harm, including real-time prescription monitoring and take-home naloxone supply.
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  • 文章类型: Journal Article
    食品制备涉及各种食品成分的混合以制造更方便的加工食品。这是一个长链过程,每个阶段都有在这些食物系统中积累有害污染物的风险。保护公众健康免受污染食品的侵害已成为确保食品安全的一项艰巨任务。这篇综述集中在原因上,类型,以及食品加工过程中污染物或危险化学品的健康风险。烹饪的影响,如油炸,烧烤,烘烤,烘烤,这可能导致形成危险的副产品,包括多环芳烃(PAHs),杂环胺(HCAs),丙烯酰胺,糖基化终产物(AGEs),呋喃,丙烯醛,亚硝胺,5-羟甲基糠醛(HMF)和反式脂肪酸(TFA)。潜在的健康风险,如致癌性,遗传毒性,神经毒性,在现代生活方式时代,由于污染物摄入量的增加,心血管效应正在成为一个主要问题。固化的影响,吸烟,和发酵导致影响肉制品的感官和营养特性。选择合适的烹饪方法包括温度,时间和食物的消耗是应考虑的主要关键因素,以避免过量摄入有害污染物。总的来说,这项研究强调了了解与食品制备方法相关风险的重要性,减少食品加工过程中有害化合物形成的策略,并强调需要选择健康的饮食来减轻潜在的健康危害。
    Food preparation involves the blending of various food ingredients to make more convenient processed food products. It is a long chain process, where each stage posing a risk of accumulating hazardous contaminants in these food systems. Protecting the public health from contaminated foods has become a demanding task in ensuring food safety. This review focused on the causes, types, and health risks of contaminants or hazardous chemicals during food processing. The impact of cooking such as frying, grilling, roasting, and baking, which may lead to the formation of hazardous by-products, including polycyclic aromatic hydrocarbons (PAHs), heterocyclic amines (HCAs), acrylamide, advanced glycation end products (AGEs), furan, acrolein, nitrosamines, 5-hydroxymethylfurfural (HMF) and trans-fatty acids (TFAs). Potential health risks such as carcinogenicity, genotoxicity, neurotoxicity, and cardiovascular effects are emerging as a major problem in the modern lifestyle era due to the increased uptakes of contaminants. Effects of curing, smoking, and fermentation of the meat products led to affect the sensory and nutritional characteristics of meat products. Selecting appropriate cooking methods include temperature, time and the consumption of the food are major key factors that should be considered to avoid the excess level intake of hazardous contaminants. Overall, this study underscores the importance of understanding the risks associated with food preparation methods, strategies for minimizing the formation of harmful compounds during food processing and highlights the need for healthy dietary choices to mitigate potential health hazards.
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    文章类型: Journal Article
    这项研究的目的是报告体重归一化,大学足球和篮球运动员的腿筋和股四头肌等距力量的性别和运动分层标准值,使用低成本手持测力计,并评估“大量”腿筋-股四头肌(H/Q)比率力量失衡的患病率(<0.6)。使用具有标准化和有效协议的手持式等距测功机检查了94名健康的大学男女足球和篮球运动员(年龄范围:18-24岁)的基线等距腿筋和股四头肌力量。对于足球,男性运动员的平均(95CI)体重标准化峰值等距力量值(考虑优势肢体)分别为3.29(2.90~3.64)N/kg(腿筋)和5.48(4.96~6.00)N/kg(股四头肌),女性运动员为2.62(2.39~2.85)N/kg(股四头肌)和4.55(4.14~4.96)N/kg(股)N/kg(股)对于篮球来说,男性运动员平均(95%CI)峰值强度分别为2.97(2.72~3.21)N/kg(腿筋)和4.89(4.44~5.33)N/kg(股四头肌),女性运动员平均峰值强度分别为2.48(2.15~2.80)N/kg(腿筋)和4.21(3.54~4.87)N/kg(股四头肌).在足球运动员中,H/Q力量严重失衡的发生率为37%(95CI:24%至52%),在篮球运动员中为44%(95CI:29%至60%)。这项研究首先是使用低成本手持式测力计提供峰值等距腿筋和股四头肌强度的标准值。本研究的规范数据库对教练员来说是有价值的,运动医学专业人员,锻炼科学家和其他利益相关者,以告知伤害预防,康复进展,回到大学足球和篮球运动员的比赛决定和表现目标。
    The objectives of this study were to report weight-normalized, sex- and sport-stratified normative values for hamstrings and quadriceps isometric strength in collegiate soccer and basketball players using a low-cost hand-held dynamometer and assess the prevalence of \"substantial\" hamstrings-quadriceps (H/Q) ratio strength imbalance (<0.6) among players. Ninety-four healthy collegiate male and female soccer and basketball players (age range: 18-24 years) were examined for baseline isometric hamstrings and quadriceps strength using a handheld isometric dynamometer with standardized and valid protocols. For soccer, the mean (95%CI) weight-normalized peak isometric strength values (considering dominant limbs) were 3.29 (2.90 to 3.64) N/kg (hamstrings) and 5.48 (4.96 to 6.00) N/kg (quadriceps) in male players and 2.62 (2.39 to 2.85) N/kg (hamstrings) and 4.55 (4.14 to 4.96) N/kg (quadriceps) in female players. For basketball, the mean (95% CI) peak strength values were 2.97 (2.72 to 3.21) N/kg (hamstrings) and 4.89 (4.44 to 5.33) N/kg (quadriceps) in male players and 2.48 (2.15 to 2.80) N/kg (hamstrings) and 4.21 (3.54 to 4.87) N/kg (quadriceps) in female players. The prevalence of substantial H/Q strength imbalance was 37% (95%CI: 24% to 52%) in soccer and 44% (95%CI: 29% to 60%) in basketball players. This study is first to provide normative values for peak isometric hamstrings and quadriceps strength using a low-cost hand-held dynamometer. The normative database from this study is valuable to coaches, sports medicine professionals, exercise scientists and other stakeholders to inform injury prevention, rehabilitation progression, return to play decisions and performance goals in collegiate soccer and basketball players.
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  • 文章类型: Journal Article
    这项研究的目的是探索2019年冠状病毒病(COVID-19)大流行期间怀孕的克罗地亚医护人员(HCWs)的职业安全。为此,我们编写了一份匿名问卷,其中包括怀孕数据,风险评估和缓解,和工作场所干预,并通过其团体和协会的社交媒体将其分发给HCWs。该研究共包括173名受访者(71.1%的医生,19.7%的护士,9.2%的其他HCWs)在2020年和2021年被诊断为怀孕。雇主在怀孕的第八周(IQR7.0-11.0)被告知HCWs怀孕,这将工作场所风险评估和缓解延迟到妊娠早期。只有19.6%的参与者进行了风险评估和缓解,主要是主动(76.5%)。在通知雇主怀孕后,37.0%的参与者选择暂时丧失工作能力(TWI)由于“妊娠并发症”,尽管怀孕健康,16.8%的人获得了怀孕工人的带薪假期,费用由雇主承担,而5.8%的人继续在同一工作场所工作。护士比医生更频繁地使用TWI获益(58.8%vs30.1%,P=0.004)。我们的发现表明,克罗地亚怀孕的HCWs的职业安全缺乏明确和透明的策略来保护怀孕的HCWs,迫使他们滥用医疗系统。
    2019年(COVID-19)。Utusmosvrhusastavilianonimniupitnikkojijeuključivaopodatkeotrudnoći,procjeniismanjenjurizikateointerventioncijamanaradnommjestuidistriiraligaZRputemdruštvenihmedijanjihovihgrupaiudruzenja.Istraçivanjejeobuhvatiloukupno173Sudionice(71,1%liječnice,19,7%的medicinskesestre,9,2%OstaleZR)小岛2020年。i2021年。ZRobaviješteniuosmom(IQR7,0-11,0)tjednutrudnoće,tojeodgodiloprocjenuismanjenjerizikanaradnommjestunakonprvogtromjesečja.Postupakprocjeneismanjenjarizikaprovedenjeusamo19,6%sudionica,uglavnomnanjihovuinicijativu(76,5%)。Nakonštosuposlodavcaobavijestleotrudnoći,37,0%subdionicakoristilojeprivremenunesposobnostzarad(PNR)zbog“komplikacijautrudnoći”unatočzdravojtrudnoći,16,8%odobrenjeplaćenidopusttrudneradnicenateretposlodavca,dokje5,8%纳斯塔维洛·拉迪蒂·纳伊托姆·雷德诺姆·梅斯图。MedicinskesestrekoristilesuPNRčenegoliječnice(58,8%prema30,1%,P=0,004)。NaširezultatiupućujunanedostatakjasnihitransparentnihstrategijazaštitetrudnihZRuHrvatskoj,toihprisiljavanazlouporabuzdravstvvenogsustava.
    The aim of this study was to explore occupational safety in pregnant Croatian healthcare workers (HCWs) during the coronavirus disease 2019 (COVID-19) pandemic. To this end we composed an anonymous questionnaire that included pregnancy data, risk assessment and mitigation, and workplace intervention and distributed it to HCWs through social media of their groups and associations. The study includes a total of 173 respondents (71.1 % physicians, 19.7 % nurses, 9.2 % other HCWs) diagnosed with pregnancy in 2020 and 2021. Employers were notified about HCWs\' pregnancy at the eighth (IQR 7.0-11.0) week of pregnancy, which delayed workplace risk assessment and mitigation beyond the first trimester. Only 19.6 % of the participants had the risk assessed and mitigated, mostly on their own initiative (76.5 %). After notifying employers about pregnancy, 37.0 % of participants opted for temporary work incapacity (TWI) due to \"pregnancy complications\" despite healthy pregnancy, 16.8 % were granted a pregnant worker\'s paid leave at the expense of the employer, while 5.8 % continued to work at the same workplace. Nurses used the TWI benefit more frequently than physicians (58.8 % vs 30.1 %, P=0.004). Our findings suggest that occupational safety of pregnant HCWs in Croatia lacks clear-cut and transparent strategies to protect pregnant HCWs, forcing them to misuse the healthcare system.
    Cilj ovog istraživanja bio je istražiti zaštitu na radu trudnih hrvatskih zdravstvenih radnica (ZR) tijekom pandemije koronovirusne bolesti 2019 (COVID-19). U tu smo svrhu sastavili anonimni upitnik koji je uključivao podatke o trudnoći, procjeni i smanjenju rizika te o intervencijama na radnom mjestu i distribuirali ga ZR putem društvenih medija njihovih grupa i udruženja. Istraživanje je obuhvatilo ukupno 173 sudionice (71,1 % liječnice, 19,7 % medicinske sestre, 9,2 % ostale ZR) kojima je dijagnosticirana trudnoća 2020. i 2021. Poslodavci su o trudnoći ZR obaviješteni u osmom (IQR 7,0–11,0) tjednu trudnoće, što je odgodilo procjenu i smanjenje rizika na radnom mjestu nakon prvog tromjesečja. Postupak procjene i smanjenja rizika proveden je u samo 19,6 % sudionica, uglavnom na njihovu inicijativu (76,5 %). Nakon što su poslodavca obavijestile o trudnoći, 37,0 % sudionica koristilo je privremenu nesposobnost za rad (PNR) zbog „komplikacija u trudnoći” unatoč zdravoj trudnoći, 16,8 % odobren je plaćeni dopust trudne radnice na teret poslodavca, dok je 5,8 % nastavilo raditi na istom radnom mjestu. Medicinske sestre koristile su PNR češće nego liječnice (58,8 % prema 30,1 %, P=0,004). Naši rezultati upućuju na nedostatak jasnih i transparentnih strategija zaštite trudnih ZR u Hrvatskoj, što ih prisiljava na zlouporabu zdravstvenog sustava.
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  • 文章类型: Journal Article
    背景和目的本研究调查了比沙市小学教师和教职员工对COVID-19的认识。它旨在通过检查知识来增强安全协议,意识水平,和人口协会。尽管学校重新开放,担忧挥之不去。这项研究促进了明智的决策,营造更安全的学校环境,促进教育界的福祉。方法对毕沙市小学教师和行政人员进行基于机构的横断面研究,我们的研究旨在全面评估对最小化COVID-19风险的具体措施的认识.样本为348名参与者,我们采用了强大的方法,包括解决社会人口统计学特征和有关COVID-19风险的在线问卷。数据收集期从2022年3月到2023年12月,为响应提供了时间背景。试点测试确保了问卷的清晰度,努力提高信度和效度,结合经过验证的量表和基于反馈的迭代调整。无响应或不完整的响应被透明地处理,进行敏感性分析,以评估潜在的影响。使用17个李克特量表问题测量了意识水平,和预定义的类别(差,中度,和良好)促进了结果解释。通过培训和评估者间的可靠性检查,将研究人员的影响降至最低。严格保持保密性和匿名性,坚持道德考虑。统计分析采用频率表,百分比,意思是,标准偏差,和卡方检验。传播包括学术出版物,向教育局报告,和会议上的演讲。这种整体方法有助于我们研究的稳健性和社会影响,提供Bisha市教育工作者对COVID-19意识的见解。结果在这项研究中,评估了毕沙市教师和行政人员对COVID-19风险最小化的认识,来自348名受访者的数据揭示了关键的生物人口统计学特征。大多数人表现出良好的环境知识(83%)和个人卫生风险(84%)。卡方检验表明,生物人口统计学因素与意识水平之间没有显着关联。具体来说,对于年龄组,χ²(4,N=348)=5.46,p=0.707;性别,χ²(1,N=348)=1.95,p=0.744;对于教育水平,χ²(4,N=348)=2.13,p=0.995;对于居留权,χ²(1,N=348)=1.11,p=0.892;对于作业类型,χ²(3,N=348)=8.30,p=0.404。缺乏重要的协会强调了成功的提高认识运动的潜在普遍性,这表明未来的努力可以在不调整信息的情况下保持包容性的方法。这些结果强调了在教育界不同人口群体中持续开展提高认识工作的重要性。结论本研究揭示了毕沙市小学教师和教职员工对COVID-19的强烈认知,没有显著的人口关联。成功,包容性意识运动可以进一步加强安全措施,促进教育界的福祉。
    Background and aims This research investigates COVID-19 awareness among primary school teachers and staff in Bisha City. It aims to enhance safety protocols by examining knowledge, awareness levels, and demographic associations. Despite school reopening, concerns linger. The study promotes informed decision-making, fostering a safer school environment and contributing to the well-being of the educational community. Methods In an institutional-based cross-sectional study among primary school teachers and administrative staff in Bisha City, our research aimed to comprehensively evaluate awareness regarding specific measures for minimizing COVID-19 risks. With a sample size of 348 participants, we employed a robust methodology, including online questionnaires addressing sociodemographic characteristics and knowledge about COVID-19 risks. The data collection period spanned from March 2022 to December 2023, providing a temporal context for responses. A pilot test ensured questionnaire clarity, and efforts were made to enhance reliability and validity, incorporating validated scales and iterative adjustments based on feedback. Non-response or incomplete responses were handled transparently, with sensitivity analyses to assess potential impact. The awareness level was measured using 17 Likert scale questions, and predefined categories (poor, moderate, and good) facilitated result interpretation. Researcher influence was minimized through training and inter-rater reliability checks. Confidentiality and anonymity were rigorously maintained, adhering to ethical considerations. Statistical analyses employed frequency tables, percentages, mean, standard deviations, and the chi-square test. Dissemination included academic publications, reports to the educational directorate, and presentations at conferences. This holistic approach contributes to the robustness and societal impact of our study, offering insights into COVID-19 awareness among educators in Bisha City. Results In this study assessing awareness among teachers and administrative staff in Bisha City regarding COVID-19 risk minimization, data from 348 respondents revealed key bio-demographic characteristics. The majority demonstrated good knowledge of environmental (83%) and personal hygiene risks (84%). The chi-square test indicated no significant associations between bio-demographic factors and awareness levels. Specifically, for age groups, χ²(4, N = 348) = 5.46, p = 0.707; for gender, χ²(1, N = 348) = 1.95, p = 0.744; for educational levels, χ²(4, N = 348) = 2.13, p = 0.995; for residency, χ²(1, N = 348) = 1.11, p = 0.892; and for job types, χ²(3, N = 348) = 8.30, p = 0.404. The absence of significant associations underscores the potential universality of successful awareness campaigns, suggesting that future efforts can maintain an inclusive approach without tailoring messages. These results emphasize the importance of sustained awareness efforts across the diverse demographic spectrum of the educational community. Conclusion This study reveals robust COVID-19 awareness among primary school teachers and staff in Bisha City, with no significant demographic associations. Successful, inclusive awareness campaigns can further enhance safety measures and promote well-being in the educational community.
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  • 文章类型: Journal Article
    背景:由于工作场所的条件,例如医院不安全和不卫生的工作环境,医院环卫工人(SWs)暴露于许多职业危害。因此,知道幅度,职业危害暴露的类型和来源及其决定因素对于进一步缓解非常重要。
    方法:在公立医院进行基于医院的横断面研究设计,埃塞俄比亚东部从5月1日至8月30日,2023年。809名SWs参加。将数据输入到用于分析的Epi数据版本3.1和Stata17MP版本中。描述性分析用于描述数据。同时,探索了多水平逻辑回归,以确定个体水平(模型1)中结局与独立性之间的关联,在医院(模式2)和两者的组合(模式3)。报告了模型2和模型3的粗比值比(COR)和调整后比值比(AOR)。报告了P值<0.05的具有95%置信区间(CI)的AOR的变量。
    结果:在809SWs中,729人(90.11%)回答。SWs中自我报告的职业危害暴露的总体程度为63.65%(95%CI0.60-0.67)。其中,生物,化学,人体工程学危害占82.44%,74.76%,70.92%,分别。多水平Logistic回归显示,具有社会认可度(AOR:0.37,95%CI0.14,0.91),中立态度(AOR:0.48,95%CI0.17,1.41)与消极态度相比。该模型还发现,与非监督的SWs相比,监督的SWs可以将职业危害暴露的可能性降低50%倍(AOR:0.50,95%CI0.18,1.38)。最终模型预测卫生工作者从医院到医院的职业危害暴露变化为26.59%。
    结论:结论是医院卫生工作者正面临生物,化学,符合人体工程学,物理,心理,机械,和电气危险。这项研究的发现预测,对他们的环境不满意,每天工作8小时以上,对工作场所风险的消极态度和监督不足可能是这些群体中职业危害暴露可能性的促成因素。因此,研究表明,如果医院实施风险评估和安全管理(RASM)模型,可以降低这些危险风险,其中包括多模式策略,指标和三方哲学。
    BACKGROUND: Hospital sanitation workers (SWs) are exposed to numerous occupational hazards due to workplace conditions such as unsafe and unhygienic working environment in the hospitals. Therefore, knowing magnitude, types and source of occupational hazard exposures with their determinants are very significant for further mitigations.
    METHODS: Hospital based cross-sectional study design was conducted in public hospitals, eastern Ethiopia from 1st May to August 30th, 2023. 809 SWs participated. Data was entered into Epi Data Version 3.1 and Stata 17MP version used for analysis. Descriptive analysis was applied to describe the data. While, multilevel logistic regression was explored to determine the association between outcome and independents among at individual level (model 1), at hospitals (model 2) and combination of the two (model 3). The crude odds ratio (COR) and adjusted odds ratio (AOR) for models 2 and 3 were reported. Variables with an AOR with a 95% confidence interval (CI) at a p-value < 0.05 were reported.
    RESULTS: Out of 809 SWs, 729 (90.11%) responded. The overall magnitude of self-reported occupational hazard exposures among SWs was 63.65% (95% CI 0.60-0.67). Of this, biological, chemical, and ergonomic hazards accounted for 82.44%, 74.76%, and 70.92%, respectively. The multilevel logistic regression shows that having social recognition (AOR: 0.37, 95% CI 0.14, 0.91), neutral attitude (AOR: 0.48, 95% CI 0.17, 1.41) as compared to negative attitude. The model also found that SWs those supervised could reduce the likelihood of occupational hazard exposures by 50% times (AOR: 0.50, 95% CI 0.18, 1.38) as compared to non-supervised SWs. The final model predicted the variation of occupational hazard exposures among sanitary workers from the hospitals to hospitals was 26.59%.
    CONCLUSIONS: The concluded that hospital sanitary workers are facing biological, chemical, ergonomic, physical, psychological, mechanical, and electrical hazards. This study\'s findings predicted that dissatisfied with their environment, working more than 8 hr per a day,  a negative attitude towards workplace risks and inadequate supervision may serve as contributing factors for the likelihood of occupational hazard exposures among these groups. Thus, the study suggested that hospitals could reduce these hazard risks if they implement the Risk Assessment and Safety Management (RASM) model, which includes multi-modal strategies, indicators and tripartite philosophy.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    海事系统的自主性更高,任务和责任从人类操作员转移到软件,增加了安全可靠功能的复杂性和重要性。软件故障,然而,可能是有意或无意地从早期生命周期阶段引入的,因此,必须通过安全可靠的设计方法来缓解这些问题。一个挑战是现有的方法不是特别适合于分析软件风险。因此,本文的目的是通过使用软件故障分类和系统建模语言(SysML)扩展系统理论过程分析(STPA),提出一种系统有效的软件故障识别方法。这使得STPA中的控制结构能够涵盖软件功能的动态和静态方面。结合实施平台独立问卷,与现有方法相比,这为潜在的软件故障提供了更系统和引导的搜索。为了证明拟议的方法,对在手动控制或半自主模式下运行的渡轮导航系统进行了案例研究。在案例研究中,重点是创建一个回避地图数据结构,包括轮渡要避免的移动和静态障碍物,以及后续的碰撞风险预警计算过程。在渡轮在雾天条件下运行的碰撞场景中,可以识别和评估软件故障。本文表明,所提出的系统方法为识别和分析关键软件故障提供了改进的过程。这有助于增强设计和测试阶段的风险缓解,有助于自主系统的安全性和安全性。
    With higher autonomy in maritime systems, tasks and responsibilities are moved from the human operator to software, increasing the complexity and the importance of safe and reliable functionality. Software failures, however, may be introduced from the early life cycle phases intentionally or unintentionally, and these must therefore be mitigated by safe and secure design approaches. A challenge is that existing methods are not particularly well-suited for analyzing software risks. Thus, the objective of this paper is to propose a systematic and efficient software failure identification approach by extending the Systems-Theoretic Process Analysis (STPA) with a software failure taxonomy and the System Modeling Language (SysML). This enables the control structure in STPA to cover both the dynamic and static aspects of the software functions. Combined with an implementation platform independent questionnaire, this gives a more systematic and guided search for potential software failures than existing approaches. To demonstrate the proposed approach, a case study on a ferry\'s navigation system that operates in manual control or semi-autonomous mode is performed. In the case study, the focus is on creating an avoidance map data structure, including both moving and static obstacles to be avoided by the ferry, and the subsequent process of collision risk warning calculation. Software failures are identified and evaluated in collision scenarios where the ferry operates under foggy conditions. The paper shows that the proposed systematic approach provides an improved process for identifying and analyzing critical software failures. This facilitates enhanced risk mitigation in the design and testing phases contributing to autonomous systems\' safety and security.
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