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CDC recommends smallpox vaccine for monkeypox
The Centers for Disease Control and Prevention (CDC) has issued guidance advising states that hospital workers and others caring for patients infected with the monkeypox virus, and close contacts of people or animals confirmed to have the virus, should receive a smallpox vaccination to protect against the possibility of contracting the illness. They can be vaccinated up to 14 days post-exposure, the agency said.
At a June news briefing, CDC Deputy Director David Fleming said the vaccine is roughly 85% effective in stopping monkeypox. The CDC currently is investigating 54 possible human cases of the virus in four states: Indiana, Wisconsin, Illinois, and New Jersey.
The CDC also has posted a case definition for human cases of monkey pox at www.cdc.gov/ncidod/monkeypox/index.htm, and the Department of Health and Human Services has enacted a ban on the importation of all rodents from Africa. Health officials fear the imported animals could further spread monkeypox throughout the United States.
OSHA proposing revised respiratory standards
The Occupational Safety and Health Administration (OSHA) has published two proposed rules in the Federal Register to enhance worker protections from respiratory hazards on the job. OSHA is seeking comments until Sept. 4, 2003, on its proposals to amend the Respiratory Protection Standard to include a new fit testing procedure and incorporate new Assigned Pro-tection Factors (APFs) for respiratory protection programs, that are expected to prevent approximately 4,000 injuries and illnesses and prevent about 900 deaths annually from cancer and other chronic diseases.
"It’s critical that workers and employers select respirators that will protect users against overexposures and adverse health effects," said OSHA administrator John Henshaw, in making the announcement. "These proposed additions will assist employers and employees in fit testing respirators and properly selecting respirators based on the conditions in their workplaces."
In a notice of proposed rule making, OSHA will propose amending the existing Respiratory Protection Standard to incorporate Assigned Protection Factors (APFs) as part of a complete respiratory protection program to assist workers and employers in the proper selection of respirators.
APFs are numbers that reflect the workplace level of respiratory protection that respirators are expected to provide to employees. The proposal contains OSHA’s preliminary decisions on an APF Table, definitions for APFs and Maximum Use Concentrations, and amendments to replace the existing APF requirements in OSHA’s substance-specific standards.
OSHA also is seeking comment on its proposal to approve a new testing protocol for its Respiratory Protection Standard. The proposed protocol is referred to as controlled negative pressure (CNP), which requires three different test exercises followed by two re-donnings of the respirator. OSHA’s current CNP protocol specifies eight test exercises, including one re-donning of the respirator.
Written comments on both proposed rule makings must be submitted by Sept. 4. Written comments (10 pages or fewer) can be faxed to OSHA’s Docket Office at (202) 693-1648 or sent electronically to http://ecomments.osha.gov. Three copies of written comments and attachments must be submitted to the OSHA Docket Office, Docket H-049C (APF) or H-049D (CNP), Room N-2625, U.S. Department of Labor, 200 Constitution Ave., Washington, DC 20210. Further information on submitting comments can be obtained by calling the Docket Office at (202) 693-2350.
OSHA plans to hold an informal public hearing on the APF proposal in Washington, DC, in late summer or early fall of 2003. Interested parties who intend to present testimony at the hearing must notify OSHA of their intention to do so no later than Sept. 4. The meeting location and date will be announced following the comment period.
For more information, visit www.osha.gov.
Nasal flu vaccine is something to sniff at
Workers soon will be able to receive their influenza vaccines with a couple of sniffs instead of a shot in the arm. FluMist, an intranasal vaccine approved by the Food and Drug Administration (FDA) in June, is being touted as a mechanism to increase vaccination rates nationally.
FluMist uses a live, attenuated virus, and studies show the virus can be detected in the nasopharynx for several days after vaccination. The vaccine is not recommended for those who come into close contact with immunosuppressed individuals.
The FDA approved its use in healthy children and adolescents ages 5-17 and healthy adults ages 18-49. Its efficacy has not been established for adults ages 50-64; and in clinical trials, it was associated with an increase in asthma events for children younger than 5.
People who have asthma or reactive airway disease, an immune deficiency, chronic medical conditions, or women who are pregnant should not use it. Common adverse events included runny nose/nasal congestion, cough, headache, sore throat, muscle aches, and fever. The price of the vaccine is expected to be double or triple the cost of the current vaccine.
Medical society releases contact lens guideline
Contact lenses are not eye protective devices, and wearing them in an industrial environment does not reduce the need for eye and face protection, says the Arlington Heights, IL-based American College of Occupational and Environmental Medicine (ACOEM) in its newest guideline on "The Use of Contact Lenses in an Industrial Environment."
ACOEM’s guideline supports the Occupational Safety and Health Administration’s (OSHA) position that the use of contact lenses does not pose additional hazards to workers, and reiterates the agency’s regulations that require individuals who wear contact lenses in the workplace to combine them with appropriate industrial eye protection.
Many of the more than 34 million Americans who wear contact lenses are employed in the industrial work force. "Individuals who wear contact lenses in the workplace must combine them with appropriate industrial safety eyewear or a respirator as required by the hazard analysis," said Bernard Blais, MD, chair of the ACOEM Eye and Vision Committee that developed the guideline.
ACOEM’s guideline recommends that workers be permitted to wear contact lenses when handling most hazardous chemicals and in other eye-hazardous environments provided that safety guidelines are followed and that the use of contact lenses is not banned by regulation or contraindicated by medical or industrial hygiene recommendations. Workers needing corrective lenses may wear full-face respirators since the lenses do not interfere with the face piece seal. In fact, contact lenses provide the best visual ergonomics for users of full-face respirator masks.
Other recommendations include establishing a written policy documenting general safety requirements for the wearing of contact lenses — taking into account the visual requirements of individual workers wearing contact lenses, as recommended by a qualified ophthalmologist or optometrist — and conducting an eye injury hazard evaluation in the workplace. In addition, employers should provide training on proper contact lens use and on first aid for contact lens wearers experiencing a chemical exposure.
The guideline is posted on the ACOEM web site at www.acoem.org, and also will be published in a future issue of the College’s peer-reviewed Journal of Occupational and Environmental Medicine. The ACOEM Eye and Vision Committee developed it under the auspices of the Council on Scientific Affairs.