Saturday, November 05, 2005

Surgical strike from NSC, CDC to WHO

Surgical strike from NSC: Has CDC infected WHO?

From the NSC e-news letter comes the mis-information for workers exposed to chickens quoted below.

[Remember that joke with the punchline, “Chickens…ick!]

So the NSC parrot WHO who parrot CDC on “surgical masks.” Our US formulation “NIOSH approved N95 filtering facepiece respirator following annual fit tests” is maybe not recognized in an international context, but there has to be some formulation about protecting workers.

There’s literature suggesting that a surgical mask is more comfortable than an N95 [not clear if that’s for an N95 with an exhalation valve]. So if the surgical mask is to protect a patient from a health care worker’s aerosol exhalations, and you wouldn’t want an exhalation valve in that application, maybe it’s ok. Is there any science to back that up?

But obviously, the workers aren’t wearing these masks to protect the chickens. OH professionals don’t sufficiently credit the value of keeping mist and dust and big chunks of feathers and excrement from settling in and on the nose and mouth.

BrooklynDodger wonders, is there a literature on chicken workers’ allergy or any special syndrome demonstrating reaction to the organic dust associated with chickens? There’s plenty on laboratory workers exposed to rat dander, but those folks are sitting in a university setting waiting to be studied. There’s stuff on swine confinement workers [what’s the provenance of that, North Carolina, near UNC SPH, or some Scandinavian deal, Danish hams?] There’s Pigeon Breeders Disease [hypersensitivity pneumonitis, probably came to light in England or somewhere there are urban pigeon racers]

International news
WHO: Protective clothing a must for poultry workers
Poultry workers, cullers and veterinarians should wear special clothing and take antiviral drugs to protect them from bird flu, according to the Geneva-based World Health Organization. WHO recommends workers wear coveralls, rubber gloves, surgical masks, goggles and rubber boots

1 comment:

Delia said...

Well, there's plenty of evidence that chicken... crap (for lack of a better PG word) causes histoplasmosis, coccidioidomycosis and other respiratory fungal diseases.

You're absolutely right about the choice of respiratory protection here. I can't understand the practice of wearing simple surgical masks in industries and situations like these. It's pointless and dangerous, and I'm not convinced it's 'better than nothing' because it gives a false sense of security. I've worn both kinds of protection in appropriate situations, and surgical masks don't seal or prevent inhalation of particles. In industry we want to protect the worker from the hazard, while in the hospital the worker is the hazard (except in cases of reverse isolation, for tuberculosis and immune-compromised persons). Two masks for two entirely different purposes.

As an RN (former COHN) who has given more than 2,000 quantitative fit tests, the real reason they're talking about surgical masks instead of respirators is crystal clear to me, and likely to you also - this industry is averse to annual fit testing and its associated costs, just like they're averse to ergonomics. N95 masks and half-face respirators cost a lot more than surgical face masks, but surgical masks appear to give protection, and appearance is important to appease the workforce.

I never have understood why employers won't spend $100 per employee and a half-hour a year for fit testing to give adequate respiratory protection, but will at the same time spend thousands more on insurance costs for treating disease these workers get on the job. It's a conundrum which I doubt will ever be resolved.