Protecting the health and safety of health care workers is vital to the health of each of us. Preparing for and responding to a future influenza pandemic or to a sustained outbreak of an airborne transmissible disease requires a high-level commitment to respiratory protection for health care workers across the wide range of settings in which they work and the jobs that they perform. Keeping health care workers healthy is an ethical commitment both in terms of addressing the occupational risks faced by health care workers and of providing for the continuity of patient care and services needed to maintain the health of individuals and communities. During a public health emergency, challenges will arise concerning the availability of respiratory protective devices (i.e., respirators). Reusable respirators (specifically, reusable half-facepiece elastomeric respirators) are the standard respiratory protection device used in many industries, and they provide an option for use in health care that has to date not been fully explored. The durability and reusability of elastomeric respirators make them desirable for stockpiling for emergencies, where the need for large volumes of respirators can be anticipated. However, they are used infrequently in health care. Reusable Elastomeric Respirators in Health Care explores the potential for the use of elastomeric respirators in the U.S. health care system with a focus on the economic, policy, and implementation challenges and opportunities. This report examines the practicability of elastomeric use in health care on a routine basis and during an influenza pandemic or other large aerosol-transmissible outbreak, when demand for respiratory protective devices by U.S. health care personnel may be larger than domestic supplies. The report also addresses the issues regarding emergency stockpile management of elastomeric respiratory protective devices.

This book reviews evolving areas in infection prevention on topics including contact precautions, technology implementation, specific infections, and care in various settings. The book summarizes the current data oninfection prevention, presents controversies on the various topics, and includes recommendations for patient safety. Addressing hot topics such as MRSA, C. difficile vaccination, mandatory flu vaccines, and CLABSI, this is the only text to include prevention and control overviews across a range of infection issues. Written by experts in thefield, this book contains 32 chapters that educates and presents the most cutting-edge models of care on emerging and evolving topics in infectious diseases. Infection Prevention: New Perspectives and Controversies is a valuable resource for infection prevention professionals, healthcare quality and safety professionals, caring for patients in in- and outpatient settings.

Protecting 18 million United States health care workers from infectious agents - known and unknown - involves a range of occupational safety and health measures that include identifying and using appropriate protective equipment. The 2009 H1N1 influenza pandemic and the 2014 Ebola virus outbreak in West Africa have called raised questions about how best to ensure appropriate and effective use of different kinds of personal protective equipment such as respirators, not only to promote occupational safety but also to reduce disease transmission. The Use and Effectiveness of Powered Air Purifying Respirators in Health Care is the summary of a workshop convened by the Institute of Medicine Standing Committee on Personal Protective Equipment for Workplace Safety and Health to explore the current state of practices and research related to powered air purifying respirator (PAPRs) and potential updates to performance requirements. Presentations and discussions highlighted current health care practices using PAPRs and outlined the research to date on the use and effectiveness of PAPRs in health care settings with a focus on the performance requirements. The Use and Effectiveness of Powered Air Purifying Respirators in Health Care focuses on efficacy, current training, maintenance, supplies, and possible enhancements and barriers to use in inpatient, clinic, nursing home, and community (home) settings. This report also explores the strengths and weaknesses of using various approaches to health care PAPR standards.

Any strategy to cope with an influenza pandemic must be based on the knowledge and tools that are available at the time an epidemic may occur. In the near term, when we lack an adequate supply of vaccine and antiviral medication, strategies that rely on social distancing and physical barriers will be relatively more prominent as means to prevent spread of disease. The use of respirators and facemasks is one key part of a larger strategy to establish barriers and increase distance between infected and uninfected individuals. Respirators and facemasks may have a role in both clinical care and community settings. Reusability of Facemasks During an Influenza Pandemic: Facing the Flu answers a specific question about the role of respirators and facemasks to reduce the spread of flu: Can respirators and facemasks that are designed to be disposable be reused safely and effectively? The committee-assisted by outstanding staff-worked intensively to review the pertinent literature; consult with manufacturers, researchers, and medical specialists; and apply their expert judgment. This report offers findings and recommendations based on the evidence, pointing to actions that are appropriate now and to lines of research that can better inform future decisions.

Before effective treatments were introduced in the 1950s, tuberculosis was a leading cause of death and disability in the United States. Health care workers were at particular risk. Although the occupational risk of tuberculosis has been declining in recent years, this new book from the Institute of Medicine concludes that vigilance in tuberculosis control is still needed in workplaces and communities. Tuberculosis in the Workplace reviews evidence about the effectiveness of control measuresâ€"such as those recommended by the Centers for Disease Control and Preventionâ€"intended to prevent transmission of tuberculosis in health care and other workplaces. It discusses whether proposed regulations from the Occupational Safety and Health Administration would likely increase or sustain compliance with effective control measures and would allow adequate flexibility to adapt measures to the degree of risk facing workers.

The threat of domestic terrorism today looms larger than ever. Bombings at the World Trade Center and Oklahoma City's Federal Building, as well as nerve gas attacks in Japan, have made it tragically obvious that American civilians must be ready for terrorist attacks. What do we need to know to help emergency and medical personnel prepare for these attacks? Chemical and Biological Terrorism identifies the R&D efforts needed to implement recommendations in key areas: pre-incident intelligence, detection and identification of chemical and biological agents, protective clothing and equipment, early recognition that a population has been covertly exposed to a pathogen, mass casualty decontamination and triage, use of vaccines and pharmaceuticals, and the psychological effects of terror. Specific objectives for computer software development are also identified. The book addresses the differences between a biological and chemical attack, the distinct challenges to the military and civilian medical communities, and other broader issues. This book will be of critical interest to anyone involved in civilian preparedness for terrorist attack: planners, administrators, responders, medical professionals, public health and emergency personnel, and technology designers and engineers.

This fourth edition provides guidance on why respiratory protective equipment (RPE) should be used, what the law says and how to select RPE that is adequate and suitable. It also includes a useful dos and don'ts list for the management and supervision of RPE use.The guidance is aimed principally at employers and the self-employed who wear, or are responsible for workers who wear, RPE. It will also be useful for health and safety specialists, manufacturers and suppliers of RPE.It has been prepared in consultation with industry and updates the 2005 edition

The emergence of severe acute respiratory syndrome (SARS) in late 2002 and 2003 challenged the global public health community to confront a novel epidemic that spread rapidly from its origins in southern China until it had reached more than 25 other countries within a matter of months. In addition to the number of patients infected with the SARS virus, the disease had profound economic and political repercussions in many of the affected regions. Recent reports of isolated new SARS cases and a fear that the disease could reemerge and spread have put public health officials on high alert for any indications of possible new outbreaks. This report examines the response to SARS by public health systems in individual countries, the biology of the SARS coronavirus and related coronaviruses in animals, the economic and political fallout of the SARS epidemic, quarantine law and other public health measures that apply to combating infectious diseases, and the role of international organizations and scientific cooperation in halting the spread of SARS. The report provides an illuminating survey of findings from the epidemic, along with an assessment of what might be needed in order to contain any future outbreaks of SARS or other emerging infections.

The main objective of these updated global guidelines is to offer health-based air quality guideline levels, expressed as long-term or short-term concentrations for six key air pollutants: PM2.5, PM10, ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide. In addition, the guidelines provide interim targets to guide reduction efforts of these pollutants, as well as good practice statements for the management of certain types of PM (i.e., black carbon/elemental carbon, ultrafine particles, particles originating from sand and duststorms). These guidelines are not legally binding standards; however, they provide WHO Member States with an evidence-informed tool, which they can use to inform legislation and policy. Ultimately, the goal of these guidelines is to help reduce levels of air pollutants in order to decrease the enormous health burden resulting from the exposure to air pollution worldwide.

Respiratory protection includes devices and management techniques for keeping people safe from hazardous materials. This handbook presents the state-of-the-art in respiratory protection technology as well as best management practices for work centers. Included are topics relevant to industry, government, and healthcare that provide guidance and tools for ensuring the best possible protection for workers. Most books on this topic are at least 20 years old. Research, technology and management techniques have advanced over the past two decades. This new handbook is needed to provide updated information relevant to today's occupational needs for industrial hygiene and safety professionals.