This is a competitive renewal application for occupational health &safety research with the ultimate goal of providing a healthy, productive home care (HC) workforce. HC aides are the fastest growing occupation in the U.S., and the accelerating trend towards more medical care at home increases the urgency to identify HC aides'work hazards and prevent associated injuries and illness. Cleaning and disinfection (C&D) is a major part of the daily work of HC aides because of the growing risks from multi-drug resistant organisms like methicillin resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C diff). Yet at the same time, there is growing evidence that many C&D chemicals widely used for infection prevention are associated with respiratory illnesses. Cleaning products are among the leading causes of occupational asthma. Currently, occupational respiratory health and infection prevention efforts are disconnected, creating a gap in our ability to fully protect HC workers. The proposed research will develop an integrated, multidisciplinary approach that optimizes occupational respiratory health and effective C&D for infection prevention, rather than trading off one for the other. This will be accomplished with the following specific aims: 1) Determine the extent to which pathogens and other micro-organisms found on surfaces in the home care environment can be reduced by different types of C&D. 2) Evaluate respiratory exposures and health effects from C&D as practiced in HC environments. 3) Synthesize the findings from aim 1 and 2, translate and disseminate them for HC stakeholders. The proposed research addresses the NIOSH National Occupational Research Agenda (NORA) sector of Healthcare and Social Assistance (HCSA) and addresses sector priority areas of Chemical Hazards and Infectious Diseases. The HC occupations addressed are employed both in healthcare and social assistance services. The NORA cross-sector programs addressed are: 1) Exposure Assessment;2) Respiratory Diseases;3) Prevention through Design;and 4) Occupational Health Disparities. The expected outputs will be quantitative and qualitative data and communication products to serve the expected outcome of providing the evidence base for guidance on safe, effective C&D in HC. Research to Practice (r2p) methods will be engaged at all stages of the proposed research in collaboration with our well-established, successful HC industry partnership network to insure that the findings are relevant and disseminated to the practice communities that can use them for preventive workplace interventions. Expected intermediate outcomes of the proposed research are an improved understanding of the OSH risks and benefits of C&D and an integrated evaluation of the OSH dimensions of C&D that can contribute to the evidence base for good practice guidelines in HC. The end outcome of this work is expected to be a healthier and more productive HC aide workforce.
The proposed research is relevant to public health because it will enhance the health of home care (HC) aides, a low income, socially diverse population that provides health and social services to elders and other vulnerable groups. It is relevant to the mission of the National Institute for Occupational Safety and Health because it will develop an understanding of the risks and conditions associated with chemical and infectious exposures in HC work and will translate scientific findings into prevention practices and products to reduce work-related illness.
|Brouillette, Natalie M; Quinn, Margaret M; Kriebel, David (2017) Risk of Sharps Injuries to Home Care Nurses and Aides: A Systematic Review and Meta-Analysis. J Occup Environ Med 59:1072-1077|
|Markkanen, Pia; Galligan, Catherine; Quinn, Margaret (2017) Safety Risks Among Home Infusion Nurses and Other Home Health Care Providers. J Infus Nurs 40:215-223|
|Quinn, Margaret M; Markkanen, Pia K; Galligan, Catherine J et al. (2016) Occupational health of home care aides: results of the safe home care survey. Occup Environ Med 73:237-45|
|Markkanen, Pia; Galligan, Catherine; Laramie, Angela et al. (2015) Understanding sharps injuries in home healthcare: The Safe Home Care qualitative methods study to identify pathways for injury prevention. BMC Public Health 15:359|
|Galligan, Catherine J; Markkanen, Pia K; Fantasia, Linda M et al. (2015) A growing fire hazard concern in communities: home oxygen therapy and continued smoking habits. New Solut 24:535-54|
|Markkanen, Pia; Quinn, Margaret; Galligan, Catherine et al. (2014) Characterizing the nature of home care work and occupational hazards: a developmental intervention study. Am J Ind Med 57:445-57|
|Kim, Hyun; Kriebel, David; Quinn, Margaret M et al. (2010) The Snowman: A model of injuries and near-misses for the prevention of sharps injuries. Am J Ind Med 53:1119-27|
|Kim, H; Kriebel, D (2009) Regression models for public health surveillance data: a simulation study. Occup Environ Med 66:733-9|
|Quinn, Margaret M; Markkanen, Pia K; Galligan, Catherine J et al. (2009) Sharps injuries and other blood and body fluid exposures among home health care nurses and aides. Am J Public Health 99 Suppl 3:S710-7|
|Chalupka, Stephanie M; Markkanen, Pia; Galligan, Catherine et al. (2008) Sharps injuries and bloodborne pathogen exposures in home health care. AAOHN J 56:15-29;quiz 31-2|