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332463
Safe cleaning and disinfecting for home care aide and client health


Tuesday, November 3, 2015 : 4:30 p.m. - 4:46 p.m.

Margaret M. Quinn, ScD, CIH, Department of Work Environment, University of Massachusetts Lowell, Lowell, MA
Pia Markkanen, ScD, Department of Work Environment, University of Massachusetts Lowell, Lowell, MA
Catherine Galligan, MSc, Department of Work Environment, University of Massachusetts Lowell, Lowell, MA
Susan Sama, ScD, Department of Work Environment, University of Massachusetts Lowell, Lowell, MA
Nancy Goodyear, Ph.D., MT(ASCP), CLS(NCA), Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA
David Kriebel, ScD, Department of Work Environment, University of Massachusetts Lowell, Lowell, MA
Rebecca Gore, PhD, Department of Work Environment, University of Massachusetts Lowell, Lowell, MA
Natalie Brouillette, MSc, Department of Work Environment, University of Massachusetts Lowell, Lowell, MA
Daniel Okyere, BSc, MSc, RN, Department of Work Environment, University of Massachusetts Lowell, Lowell, MA
Chuan Sun, MSc, Department of Work Environment, University of Massachusetts Lowell, Lowell, MA
Letitia Davis, ScD, Occupational Health Surveillance Program, Massachusetts Department of Public Health, Boston, MA
Elise Pechter, MPH, CIH, Occupational Health Surveillance Program, Massachusetts Department of Public Health, Boston, MA
Angela Laramie, MPH, Occupational Health Surveillance Program, Massachusetts Department of Public Health, Boston, MA
Audio (mp3) recording Recorded Presentation (mp4)
Objectives. Patients in hospitals or other healthcare facilities have an increased risk of exposure to harmful microorganisms such as MRSA and C. difficile.  When the patient returns home to receive home care (HC), these hospital exposures can present infection hazards for the HC client, their families and HC aides. To control infection hazards, HC aides clean and disinfect home environmental surfaces.  While cleaning and disinfecting (C&D) is important for infection prevention, there is increasing evidence that C&D can also cause respiratory and dermal hazards.  We assessed the frequency of C&D and exposure to body fluids and other infectious agents among HC aides. 

Methods. HC aides, hired both by agencies and directly by clients, completed an occupational safety and health (OSH) questionnaire survey including detailed questions about their most recent home visits, as well as about individual aides’ OSH experiences.

Results. The final population included 1,249 HC aides (634 agency-employed, 615 client-employed) contributing information on 3,484 HC visits.  Aides performed C&D in 80% of their visits.  They cleaned with bleach in nearly 25% of all visits; with ammonia in 8% of visits; and with other strong cleaning chemicals in 15% of all visits.  Contact with feces occurred in 16% of all visits; contact with blood in 5% of all visits.  Client-hired aides reported chemical and infectious agent exposures slightly more frequently than agency-hired aides. 

Conclusions. More detailed assessment of infectious agents and C&D exposures are needed in home care to provide a basis for good practices and policies.   

Learning Areas:

Chronic disease management and prevention
Environmental health sciences
Occupational health and safety
Other professions or practice related to public health
Protection of the public in relation to communicable diseases including prevention or control
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Identify sources of infectious agents in home care. Explain the need for cleaning and disinfecting in home care. List the hazards of cleaning and disinfecting environmental surfaces in the home. Discuss the current policy needs related to cleaning and disinfecting in home care.

Keyword(s): Occupational Health and Safety, Pathogens

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a professor of occupational health and have been the principal investigator on multiple federally funded grants, including the federal grant that funded the study on which the abstract for the APHA presentation is based. I have been the lead author on several peer-reviewed publications describing research relevant to the APHA presentation topic.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4443.0: Protecting healthcare workers from H&S hazards