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HCW protection gets a piece of fed spending
NIOSH to get $ for respiratory PPE research
Health care workers may be among those who benefit from the recent spending boost in Washington, DC. The 2009 Omnibus Appropria-tions Bill includes language that directs $3 million to the National Institute for Occupational Safety and Health (NIOSH) to fund research into the modes of transmission of influenza and respirators and other personal protective equipment (PPE) that protect health care workers.
NIOSH declined to discuss the specific funding, but NIOSH officials noted that they already are moving forward with an action plan to address respiratory protection needs in health care.
Health care workers need respirators that are more effective and more comfortable, says Bill Borwegen, MPH, health and safety director of Service Employees International Union, which pressed for the statement in the U.S. House of Representatives report accompanying the spending bill.
The language reads:
"According to a report issued in 2008 by the Institute of Medicine [IOM] of the National Academies, there is a critical need to better understand the airborne transmissibility of pandemic flu and other pathogenic bioaerosols to protect healthcare workers and to gauge the efficacy of the currently recommended types of respirators. The bill includes $3,000,000 within the total for Personal Protective Technology for NIOSH to research modes of transmission of influenza and to evaluate filtering facepiece respirators, other types of respirators, and other personal protective equipment. Further, NIOSH is urged to design and promote the next generation of personal protective equipment for healthcare workers and first responders to address the unique challenges posed by the healthcare environment."
This specific support for better respiratory protection is a turnabout from controversial House appropriations language that prevailed from 2004 to 2007. The Wicker Amendment, sponsored by Rep. Roger Wicker, R-MS, prohibited the U.S. Occupational Safety and Health Administration from spending federal funds to enforce its rule requiring annual fit-testing of health care workers who use respirators for protection from tuberculosis.
"Hopefully, this will mark a turn in our country whereby federal policy will do more to protect the fastest-growing segment of our work force, who are facing a wide range of hazards," says Borwegen. "It's a positive turn of events for health care workers to provide high-quality care to their patients in a safe manner.
"Without money earmarked to do the research, we didn't think the research would occur to the degree it needed to, to meet the needs identified in the [IOM] report," he says. "NIOSH had been doing some of this research, but this will direct them to do more."
The IOM report, released in September 2007, has been a catalyst for better respiratory protection for health care workers. In the report, "Preparing for an Influenza Pandemic: Personal Protective Equipment for Healthcare Workers," the IOM panel cited "an urgent need to address the lack of preparedness regarding effective PPE for use in an influenza pandemic."
The IOM outlined three broad areas for research: understanding influenza transmission; committing to worker safety and appropriate use of PPE; and innovation and improvement in PPE design, testing, and certification.
Research already has been moving forward, but additional resources would improve NIOSH's capabilities, says Les Boord, director of NIOSH's National Personal Protective Technology Labora-ory in Pittsburgh. The NIOSH budget is a part of the budget for the Centers for Disease Control and Prevention in Atlanta.
"The ultimate goal will be to demonstrate and have effective personal protective equipment," he says. "It's moving the state of knowledge and information on PPE and respiratory protection forward and tailoring it for the health care worker."
Research that is ongoing or planned includes:
Mechanically simulating the exposure of a health care worker to an infectious aerosol. One machine would generate a cough; another breathing machine would provide breathing samples.
Collecting better surveillance data on the emerging issues related to health care worker use of PPE.
Testing methods to decontaminate N95 filtering facepiece respirators, such as microwaving or ultraviolet light. Those products are one-use items, but the research would explore whether they could safely be reused if a shortage occurred during an influenza pandemic. NIOSH also plans to research the risk associated with surface contamination of the respirators.
Studying the efficacy of fit-tests and fit-checks and determining the best frequency for fit-tests.