COIN DE LA DOCUMENTALISTE – JUILLET 2016

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Le Coin de la documentaliste prend des vacances dans les prochaines semaines et vous reviendra avec la page de SEPTEMBRE – OCTOBRE 2016. BON ÉTÉ!

ADMINISTRATION DE LA SANTÉ

  • Améliorer la performance du système de santé demande de faire face à deux défis. D’une part, développer des propositions de réforme dont l’efficacité est démontrée ou plausible – c’est le défi programmatique. D’autre part, créer les conditions nécessaires à leur implantation et en particulier s’assurer du soutien politique d’une coalition large d’acteurs (Jenkins-Smith et al., 2014) – c’est le défi politique.

    Source : Brousselle, Astrid, Contandriopoulos, Damien, Breton, Mylaine, & Champagne, Geneviève. (Printemps 2016). Le point en santé et services sociaux, 12(1), 36-38.

  • Dans les bureaucraties professionnelles, les réformes les plus brillantes sur papier risquent de rester vaines si les cadres intermédiaires ne prennent pas le relais pour les mettre en oeuvre sur le terrain. Les changements de structures sont généralement insuffisants pour réaliser une transformation, car ils affectent peu les pratiques des intervenants dans les prestations à la clientèle, alors que c’est là que se présentent les défis pour des gains significatifs de performance, surtout lorsque des efforts ont déjà été faits dans la rationalisation des services administratifs. La contribution des gestionnaires intermédiaires est donc indispensable pour réussir une transformation organisationnelle, mais c’est loin d’être une tâche facile pour eux, bien qu’elle soit réalisable.

    Source : Collerette, Pierre. (Printemps 2016). Le point en santé et services sociaux, 12(1), 26-33.

  • Le 14 mai 2013, la Commission de la santé et des services sociaux de la 40e législature se saisissait d’un mandat d’initiative intitulé Les conditions de vie des adultes hébergés en centre d’hébergement et de soins de longue durée. Au cours des mois de janvier et de février 2014, la Commission a entendu 36 organismes, agences de la santé et des services sociaux, centres d’hébergement, associations et fédérations ainsi que des ordres professionnels touchés par la situation des personnes hébergées en centre d’hébergement et de soins de longue durée (CHSLD). Aussi, 38 mémoires ont été déposés dans le cadre de la consultation publique et 160 citoyens ont répondu au questionnaire en ligne. Ce rapport présente une synthèse des propos issus des consultations et des visites ainsi que les observations, conclusions et recommandations de la Commission.

    Source : Commission de la santé et des services sociaux. (2016). Les conditions de vie des adultes hébergés en centre d’hébergement et de soins de longue durée : observations, conclusions et recommandations. Québec : Direction des travaux parlementaires de l’Assemblée nationale du Québec, 13 p. Repéré à http://www.assnat.qc.ca/fr/travaux-parlementaires/commissions/csss/mandats/Mandat-32725/index.html?platform=hootsuite

AGRESSIONS ET VIOLENCE

AMÉNAGEMENT – ARCHITECTURE

  • Evidence is growing that resident-to-resident aggression (RRA) is widespread in dementia units and that environmental factors can be manipulated to mitigate this aggression. Failure to address the issues involved in RRA raises the question of liability for health authorities and care facilities, particularly where a resident is forced to room with a resident known to be aggressive.

    Source : Benbow, Bill. (2016, June/July). Canadian Nursing Home, 27(2), 4-11. Repéré à http://wabenbow.com/wp-content/uploads/2014/02/RRA-condensed.pdf

  • Avec l’allongement de la durée de vie et le vieillissement de la population, se pose la question de la prise en charge des personnes âgées, notamment celles devenues dépendantes. De nombreux Ehpad (établissements d’hébergement pour personnes âgées dépendantes) existent déjà et il s’en construit régulièrement en France. Que ce soit lors de la rénovation de l’existant ou à l’occasion de la conception des nouveaux, le sujet de la prévention des risques professionnels pour les personnels qui y travaillent est essentiel. Autant que le bien-être des résidents.

    Source : Dossier : EHPAD : Conception et rénovation. (2016, Juin). Travail & Sécurité, 773, 14-25. Repéré à http://www.travail-et-securite.fr/ts/dossier/Penser%20les%20espaces%20de%20travail%20en%20fonction%20de%20l%E2%80%99activit%C3%A9%20r%C3%A9elle%20.html

  • The authors investigated how the design of instructions can affect performance in preparing emergency stair travel devices for the evacuation of disabled individuals. They had three hypotheses: 1) Design of instructions would account for a significant portion of explained performance variance, 2) Improvements in design of instructions would reduce time on task across device type and age group, and 3) There would be a performance decrement for older adults compared to younger adults based on the slowing of older adult information processing abilities. Results showed that design of instructions does indeed account for a large portion of explained variance in the operation of emergency stair travel devices, and that improvements in design of instructions can reduce time on task across device type and age group. However, encouragingly for real-world operations, results did not indicate any significant differences between older versus younger adults. We look to explore ways that individuals with disabilities can exploit these insights to enhance the performance of emergency stair travel devices for use.

    Source : Boyce, Michael W., Smither, Janan Al-Awar, Fisher, Daniel O., & Hancock, P.A. (2017). Applied Ergonomics. 58(1), 48-58. doi:10.1016/j.apergo.2016.05.010

  • Le réaménagement de la buanderie et de ses processus à l’hôpital de Chicoutimi s’est mérité le Lauréat Argent dans la Catégorie Innovation – Organismes publics au gala Innovation de la CSST. Cette vidéo vous présente leur projet gagnant et ses impacts sur la santé et sécurité au travail du personnel de la buanderie.

    Source : Commission de la santé et de la sécurité du travail. (2016). Les Grands prix Santé et sécurité du travail : Lauréat régional 2015 : CIUSSS-SLSJ Hôpital de Chicoutimi. [Vidéo en ligne]. Repéré à https://www.youtube.com/embed/Tqe_inQVCAo?rel=0&autoplay=1&utm_source=All&utm_campaign=ASSTSAS+INFOS+8-2+Mars+2016&utm_medium=email

AMIANTE

  • Roofing products are generally considered non-friable and are not expected to release appreciable amounts of airborne asbestos fibers; however, despite the variety of roofing products that have contained asbestos over time, there are no comprehensive analyses of the exposure data associated with these products in the published literature. The objective of this study was to analyze the available data and characterize asbestos exposures associated with the installation, removal, and replacement of built-up roofing (BUR), felts, flashings, shingles, coatings, cements, and mastics under a variety of work practices.

    Source : Lotter, Jason T., Roberts, Ben, Henshaw, John L., & Pierce, S. (2016). Journal of Occupational and Environmental Hygiene, 13(8), D121-D131. DOI:10.1080/15459624.2016.1183010

  • Cette brochure est destiné aux fabricants, distributeurs et utilisateurs de vêtements de type 5 à usage unique, utilisés dans le cadre de la protection contre les fibres d’amiante. Il dresse les critères de performance renforcés de ces vêtements, dans le contexte de travaux ou d’interventions comportant un risque d’exposition à l’amiante.

    Source : Guilleux, Annabelle, Romero-Hariot, Anita, Fehervari, Nicolas, & Garbowski, Carole. (2016). [S.l.] : Institut National de Recherche et de Sécurité, 7 p. Repéré à http://www.inrs.fr/dms/inrs/CataloguePapier/ED/TI-ED-6247/ed6247.pdf

BLOC OPÉRATOIRE – CHIRURGIE

    • A study in press for publication by the National Institute of Occupational Safety and Health (NIOSH) will report that, despite longstanding hazard warnings, healthcare workers are still frequently exposed to toxic smoke and plumes created by burning tissue during laser surgery and electrosurgery, Hospital Employee Health has learned. In a particularly disturbing finding, almost half of those surveyed said they never received any training about the potent mix of chemicals and biologicals found in the smoke created from burning tissue. The NIOSH study had not been published as this issue went to press, but one of the authors previewed some of the findings in Chicago at the November 3, 2015 meeting of the American Public Health Association (APHA).

      Source : Evans, Gary. (2016, July 1). NIOSH: Healthcare Workers Still Face Surgical Smoke Hazards : Twenty years of toxic plume warnings yield little progress. Hospital Employee Health, 35(7), 73-77. Repéré à http://www.ahcmedia.com/articles/138062-niosh-healthcare-workers-still-face-surgical-smoke-hazards

    • Electrosurgery is a method based on a high frequency current used to cut tissue and coagulate small blood vessels during surgery. Surgical smoke is generated due to the heat created by electrosurgery. The carcinogenic potential of this smoke was assumed already in the 1980’s and there has been a growing interest in the potential adverse health effects of exposure to the particles in surgical smoke. Surgical smoke is known to contain ultrafine particles (UFPs) but the knowledge about the exposure to UFPs produced by electrosurgery is however sparse. The aims of the study were therefore to characterise the exposure to UFPs in surgical smoke during different types of surgical procedures and on different job groups in the operating room, and to characterise the particle size distribution.

      Source : Ragde, Siri Fenstad, Jørgensen, Rikke Bramming, & Føreland, Solveig. (2016). The Annals of Occupational Hygiene. Prépublication.10.1093/annhyg/mew033

    • Consensus organizations, government bodies, and healthcare organization guidelines recommend that surgical smoke be evacuated at the source by local exhaust ventilation (LEV) (i.e., smoke evacuators or wall suctions with inline filters). Data are from NIOSH’s Health and Safety Practices Survey of Healthcare Workers module on precautionary practices for surgical smoke. Four thousand five hundred thirty-three survey respondents reported exposure to surgical smoke: 4,500 during electrosurgery; 1,392 during laser surgery procedures. Respondents were mainly nurses (56%) and anesthesiologists (21%). Only 14% of those exposed during electrosurgery reported LEV was always used during these procedures, while 47% reported use during laser surgery. Those reporting LEV was always used were also more likely to report training and employer standard procedures addressing the hazards of surgical smoke. Few respondents reported use of respiratory protection.

      Source : Steege, Andrea L., Boiano, James M., & Sweeney, Marie H. (2016). American Journal of Industrial Medicine. Prépublication. DOI: 10.1002/ajim.22614

BUANDERIE

CANNABIS

    • In just about one year, marijuana will be legalized in Canada. When Health Minister Jane Philpott made this announcement on April 20, she promised this change would happen with support from the justice and public safety departments. However, there are no details on what this means and what tools will be made available to employers. So far, there has been no indication this will include explicit legislation allowing employers to carry out post-incident, reasonable cause, random or other testing. The effect of this change is that employers will no longer be challenged just with the legal use of prescribed medical marijuana; they will also be confronted with the myriad of issues associated with legal recreational use — use that may be carried over into workplaces.

      Source : Bouwmeester, Loretta. (2016, 21 June). Canadian Occupational Safety. Legal Columns. Repéré à http://www.cos-mag.com/legal/legal-columns/5123-get-ready-for-marijuana-legalization.html

CLINIQUES DENTAIRES

    • Whereas in the past dental stools typically facilitated a 90° hip angle, a number of currently available alternative designs allow for a more extended hip posture. The present study investigated the influence of different stool types on muscle activity and lumbar posture. Twenty five participants completed a simulated dental procedure on a standard stool, a saddle and the Ghopec. The authors concluded that to maintain neutral posture during dental screening, the Ghopec is considered the most suitable design for the tasks undertaken.

      Source : De Bruyne, Mieke A.A, Van Renterghemb, Benedikt, Baird, Andrew, Palmans, Tanneke, Danneels, Lieven, & Dolphens, Mieke. (2016). Applied Ergonomics, 56(9), 220-226.

CONSTRUCTION

      • Roofing products are generally considered non-friable and are not expected to release appreciable amounts of airborne asbestos fibers; however, despite the variety of roofing products that have contained asbestos over time, there are no comprehensive analyses of the exposure data associated with these products in the published literature. The objective of this study was to analyze the available data and characterize asbestos exposures associated with the installation, removal, and replacement of built-up roofing (BUR), felts, flashings, shingles, coatings, cements, and mastics under a variety of work practices.

        Source : Lotter, Jason T., Roberts, Ben, Henshaw, John L., & Pierce, S. (2016). Journal of Occupational and Environmental Hygiene, 13(8), D121-D131. DOI:10.1080/15459624.2016.1183010

CPE – SERVICES DE GARDE

    • Vous étudiez la possibilité de choisir une cuisine centralisée pour vos installations? Pour déterminer si cette avenue est optimale pour votre CPE, il est primordial de procéder à une analyse rigoureuse de vos besoins, mais aussi de vos ressources. Ce guide de réflexion vous aidera à évaluer les coûts, mais aussi les impacts sur l’organisation du travail (aménagement des lieux, horaire de préparation, effectifs ainsi qu’équipement et matériel nécessaires, transport des repas et des collations, préservation de la qualité et de l’innocuité des aliments, etc.) et les risques qui y sont liés dans une perspective santé et sécurité du travail (SST).

      Source : Association québecoise des CPE & Mutuelle de prévention des CPE. (2016). [Montréal] : AQCPE et Mutuelle de prévention des CPE, 14 p. Repéré à https://gallery.mailchimp.com/1b509e9135330861690a6359e/files/Guide_de_reflexion_cuisine_VERSION_FINALE.pdf

    • DÉPLACEMENTS DES BÉNÉFICIAIRES

    • Nurses continue to sustain musculoskeletal injuries even with increased emphasis on safe patient handling and mobility (SPHM) and organizational cultures of safety to protect health care workers. Analysis of data from 2011-2014 registered nurse graduates explored hospital safety culture, SPHM education/training, and incidence of new-nurse musculoskeletal injury. Results indicated hospitals provided some type of SPHM education and training, but 46% of study participants were not informed or aware of national SPHM standards or guidelines. Merely 13.9% of participants stated a written « no manual lifting policy » had been implemented; only 32.9% indicated staffing was adequate for SPHM tasks; and only 39.4% stated the hospital had all of the equipment needed to perform SPHM safely. Thirty-nine percent of participants had already sustained a musculoskeletal injury with an additional 35% sustaining but not reporting an injury. More actions are needed to ensure a decrease in musculoskeletal injuries for new nurses.

      Source : Vendittelli, D., Penprase, Barbara, & Pittiglio, Laura. (2016). Workplace Health & Safety. Prépublication. doi: 10.1177/2165079916654928

    • DERMATOSES PROFESSIONNELLES

    • Health Care Workers (HCWs) often cite irritant contact dermatitis (ICD) as a barrier to Hand Hygiene (HH) compliance. Literature supports the cause of ICD on hands, but little data exists on steps HCWs follow to address ICD. The objective of this survey was to quantify knowledge, perception and actions of HCWs to ICD.

      Source : McGuckin, Maryanne, & Govednik, John. (2016). AJIC : American Journal of Infection Control, 44(6 suppl.), S22. DOI: http://dx.doi.org/10.1016/j.ajic.2016.04.196

    • ÉQUIPEMENTS DE PROTECTION

    • Cette brochure est destiné aux fabricants, distributeurs et utilisateurs de vêtements de type 5 à usage unique, utilisés dans le cadre de la protection contre les fibres d’amiante. Il dresse les critères de performance renforcés de ces vêtements, dans le contexte de travaux ou d’interventions comportant un risque d’exposition à l’amiante.

      Source : Guilleux, Annabelle, Romero-Hariot, Anita, Fehervari, Nicolas, & Garbowski, Carole. (2016). [S.l.] : Institut National de Recherche et de Sécurité, 7 p. Repéré à http://www.inrs.fr/dms/inrs/CataloguePapier/ED/TI-ED-6247/ed6247.pdf

ÉQUIPEMENTS INNOVATEURS EN SST

ÉTABLISSEMENTS D’HÉBERGEMENT

    • Evidence is growing that resident-to-resident aggression (RRA) is widespread in dementia units and that environmental factors can be manipulated to mitigate this aggression. Failure to address the issues involved in RRA raises the question of liability for health authorities and care facilities, particularly where a resident is forced to room with a resident known to be aggressive.

      Source : Benbow, Bill. (2016, June/July). Canadian Nursing Home, 27(2), 4-11. Repéré à http://wabenbow.com/wp-content/uploads/2014/02/RRA-condensed.pdf

    • Ce dépliant propose une démarche de prévention pour préserver la santé des personnels travaillant en EHPAD tout en optimisant la qualité des soins prodigués. Tout en présentant les ressources de l’INRS disponibles, il propose, dans un premier temps, de faire un état des lieux des risques encourus et, dans un second temps, les actions à remettre en oeuvre et leur évaluation.

      Source : Institut national de recherche et de sécurité (2016). Paris : INRS, 3 p. Repéré à http://www.inrs.fr/dms/inrs/CataloguePapier/ED/TI-ED-6242/ed6242.pdf

    • Avec l’allongement de la durée de vie et le vieillissement de la population, se pose la question de la prise en charge des personnes âgées, notamment celles devenues dépendantes. De nombreux Ehpad (établissements d’hébergement pour personnes âgées dépendantes) existent déjà et il s’en construit régulièrement en France. Que ce soit lors de la rénovation de l’existant ou à l’occasion de la conception des nouveaux, le sujet de la prévention des risques professionnels pour les personnels qui y travaillent est essentiel. Autant que le bien-être des résidents.

      Source : Dossier : EHPAD : Conception et rénovation. (2016, Juin). Travail & Sécurité, 773, 14-25. Repéré à http://www.travail-et-securite.fr/ts/dossier/Penser%20les%20espaces%20de%20travail%20en%20fonction%20de%20l%E2%80%99activit%C3%A9%20r%C3%A9elle%20.html

    • The authors investigated how the design of instructions can affect performance in preparing emergency stair travel devices for the evacuation of disabled individuals. They had three hypotheses: 1) Design of instructions would account for a significant portion of explained performance variance, 2) Improvements in design of instructions would reduce time on task across device type and age group, and 3) There would be a performance decrement for older adults compared to younger adults based on the slowing of older adult information processing abilities. Results showed that design of instructions does indeed account for a large portion of explained variance in the operation of emergency stair travel devices, and that improvements in design of instructions can reduce time on task across device type and age group. However, encouragingly for real-world operations, results did not indicate any significant differences between older versus younger adults. We look to explore ways that individuals with disabilities can exploit these insights to enhance the performance of emergency stair travel devices for use.

      Source : Boyce, Michael W., Smither, Janan Al-Awar, Fisher, Daniel O., & Hancock, P.A. (2017). Applied Ergonomics. 58(1), 48-58. doi:10.1016/j.apergo.2016.05.010

    • Le 14 mai 2013, la Commission de la santé et des services sociaux de la 40e législature se saisissait d’un mandat d’initiative intitulé Les conditions de vie des adultes hébergés en centre d’hébergement et de soins de longue durée. Au cours des mois de janvier et de février 2014, la Commission a entendu 36 organismes, agences de la santé et des services sociaux, centres d’hébergement, associations et fédérations ainsi que des ordres professionnels touchés par la situation des personnes hébergées en centre d’hébergement et de soins de longue durée (CHSLD). Aussi, 38 mémoires ont été déposés dans le cadre de la consultation publique et 160 citoyens ont répondu au questionnaire en ligne. Ce rapport présente une synthèse des propos issus des consultations et des visites ainsi que les observations, conclusions et recommandations de la Commission.

      Source : Commission de la santé et des services sociaux. (2016). Les conditions de vie des adultes hébergés en centre d’hébergement et de soins de longue durée : observations, conclusions et recommandations. Québec : Direction des travaux parlementaires de l’Assemblée nationale du Québec, 13 p. Repéré à http://www.assnat.qc.ca/fr/travaux-parlementaires/commissions/csss/mandats/Mandat-32725/index.html?platform=hootsuite

    • ÉVACUATION D’URGENCE EN SST

    • The authors investigated how the design of instructions can affect performance in preparing emergency stair travel devices for the evacuation of disabled individuals. They had three hypotheses: 1) Design of instructions would account for a significant portion of explained performance variance, 2) Improvements in design of instructions would reduce time on task across device type and age group, and 3) There would be a performance decrement for older adults compared to younger adults based on the slowing of older adult information processing abilities. Results showed that design of instructions does indeed account for a large portion of explained variance in the operation of emergency stair travel devices, and that improvements in design of instructions can reduce time on task across device type and age group. However, encouragingly for real-world operations, results did not indicate any significant differences between older versus younger adults. We look to explore ways that individuals with disabilities can exploit these insights to enhance the performance of emergency stair travel devices for use.

      Source : Boyce, Michael W., Smither, Janan Al-Awar, Fisher, Daniel O., & Hancock, P.A. (2017). Applied Ergonomics. 58(1), 48-58. doi:10.1016/j.apergo.2016.05.010

FUMÉES CHIRURGICALES

    • A study in press for publication by the National Institute of Occupational Safety and Health (NIOSH) will report that, despite longstanding hazard warnings, healthcare workers are still frequently exposed to toxic smoke and plumes created by burning tissue during laser surgery and electrosurgery, Hospital Employee Health has learned. In a particularly disturbing finding, almost half of those surveyed said they never received any training about the potent mix of chemicals and biologicals found in the smoke created from burning tissue. The NIOSH study had not been published as this issue went to press, but one of the authors previewed some of the findings in Chicago at the November 3, 2015 meeting of the American Public Health Association (APHA).

      Source : Evans, Gary. (2016, July 1). NIOSH: Healthcare Workers Still Face Surgical Smoke Hazards : Twenty years of toxic plume warnings yield little progress. Hospital Employee Health, 35(7), 73-77. Repéré à http://www.ahcmedia.com/articles/138062-niosh-healthcare-workers-still-face-surgical-smoke-hazards

    • Electrosurgery is a method based on a high frequency current used to cut tissue and coagulate small blood vessels during surgery. Surgical smoke is generated due to the heat created by electrosurgery. The carcinogenic potential of this smoke was assumed already in the 1980’s and there has been a growing interest in the potential adverse health effects of exposure to the particles in surgical smoke. Surgical smoke is known to contain ultrafine particles (UFPs) but the knowledge about the exposure to UFPs produced by electrosurgery is however sparse. The aims of the study were therefore to characterise the exposure to UFPs in surgical smoke during different types of surgical procedures and on different job groups in the operating room, and to characterise the particle size distribution.

      Source : Ragde, Siri Fenstad, Jørgensen, Rikke Bramming, & Føreland, Solveig. (2016). The Annals of Occupational Hygiene. Prépublication.10.1093/annhyg/mew033

    • Consensus organizations, government bodies, and healthcare organization guidelines recommend that surgical smoke be evacuated at the source by local exhaust ventilation (LEV) (i.e., smoke evacuators or wall suctions with inline filters). Data are from NIOSH’s Health and Safety Practices Survey of Healthcare Workers module on precautionary practices for surgical smoke. Four thousand five hundred thirty-three survey respondents reported exposure to surgical smoke: 4,500 during electrosurgery; 1,392 during laser surgery procedures. Respondents were mainly nurses (56%) and anesthesiologists (21%). Only 14% of those exposed during electrosurgery reported LEV was always used during these procedures, while 47% reported use during laser surgery. Those reporting LEV was always used were also more likely to report training and employer standard procedures addressing the hazards of surgical smoke. Few respondents reported use of respiratory protection.

      Source : Steege, Andrea L., Boiano, James M., & Sweeney, Marie H. (2016). American Journal of Industrial Medicine. Prépublication. DOI: 10.1002/ajim.22614

GESTION – LEADERSHIP

    • Nurses’ job satisfaction is a critical factor in health-care organisations because of its association with nurse turnover and quality of patient care. Nurses continue to report high levels of job dissatisfaction. The primary aim of this study was to examine the relationships between structural empowerment, psychological empowerment and job satisfaction among staff nurses, after controlling for their leaders’ use of empowering behaviours. Cross-sectional data for 1007 Canadian staff nurses were analysed using hierarchical multiple regression. The results showed that nurses’ job satisfaction is most influenced by their access to organisational empowerment structures. Leader empowering behaviours, structural empowerment, and psychological empowerment, operating together, enhance nurses’ job satisfaction.

      Source : Dahinten, V.S., Lee, S.N., MacPhee, M. (2016). Journal of Nursing Management. Prépublication. DOI: 10.1111/jonm.12407

    • Améliorer la performance du système de santé demande de faire face à deux défis. D’une part, développer des propositions de réforme dont l’efficacité est démontrée ou plausible – c’est le défi programmatique. D’autre part, créer les conditions nécessaires à leur implantation et en particulier s’assurer du soutien politique d’une coalition large d’acteurs (Jenkins-Smith et al., 2014) – c’est le défi politique.

      Source : Brousselle, Astrid, Contandriopoulos, Damien, Breton, Mylaine, & Champagne, Geneviève. (Printemps 2016). Le point en santé et services sociaux, 12(1), 36-38.

    • Dans les bureaucraties professionnelles, les réformes les plus brillantes sur papier risquent de rester vaines si les cadres intermédiaires ne prennent pas le relais pour les mettre en oeuvre sur le terrain. Les changements de structures sont généralement insuffisants pour réaliser une transformation, car ils affectent peu les pratiques des intervenants dans les prestations à la clientèle, alors que c’est là que se présentent les défis pour des gains significatifs de performance, surtout lorsque des efforts ont déjà été faits dans la rationalisation des services administratifs. La contribution des gestionnaires intermédiaires est donc indispensable pour réussir une transformation organisationnelle, mais c’est loin d’être une tâche facile pour eux, bien qu’elle soit réalisable.

      Source : Collerette, Pierre. (Printemps 2016). Le point en santé et services sociaux, 12(1), 26-33.

GESTION DE LA SST

    • In just about one year, marijuana will be legalized in Canada. When Health Minister Jane Philpott made this announcement on April 20, she promised this change would happen with support from the justice and public safety departments. However, there are no details on what this means and what tools will be made available to employers. So far, there has been no indication this will include explicit legislation allowing employers to carry out post-incident, reasonable cause, random or other testing. The effect of this change is that employers will no longer be challenged just with the legal use of prescribed medical marijuana; they will also be confronted with the myriad of issues associated with legal recreational use — use that may be carried over into workplaces.

      Source : Bouwmeester, Loretta. (2016, 21 June). Canadian Occupational Safety. Legal Columns. Repéré à http://www.cos-mag.com/legal/legal-columns/5123-get-ready-for-marijuana-legalization.html

    • The authors aimed to determine the strength of evidence on the effectiveness of legislative and regulatory policy levers in creating incentives for organizations to improve occupational health and safety processes and outcomes. A systematic review was undertaken to assess the strength of evidence on the effectiveness of specific policy levers using a “best-evidence” synthesis approach.

      Source : Tompa, Emile, Kalcevich, Christina, Foley, Michael, McLeod, Chris, Hogg-Johnson, Sheilah, Cullen, Kim, MacEachen, Ellen, Mahood, Quenby, & Irvin, Emma. (2016). American Journal of Industrial Medicine. Prépublication. DOI: 10.1002/ajim.22605

    • Jusqu’à maintenant, l’Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST) a produit des indicateurs statistiques de santé et sécurité du travail tous les cinq ans. Le besoin d’obtenir de l’information sur l’évolution annuelle depuis la dernière série d’indicateurs quinquennaux devenait cependant de plus en plus nécessaire. Ces données serviront à mieux connaître les changements récents concernant les indicateurs de lésions professionnelles et à identifier les types de lésions et les industries-catégories professionnelles pour lesquels l’évolution des indicateurs a été la moins favorable.

      Source : Duguay, Patrice, Busque, Marc-Antoine, Boucher, Alexandre, Lebeau, Martin, & Prud’homme, Pascale. (2016). Montréal : IRSST, xix, 87 p. (Études et recherches, Rapport R-922). Repéré à http://www.irsst.qc.ca/media/documents/PubIRSST/R-922.pdf

HARCÈLEMENT AU TRAVAIL

    • Both work- and person-related factors may trigger workplace bullying. Work-related factors, such as role stressors, can create a stressful work environment leading to bullying. Additionally, person-related factors, such as emotion-focused coping, could make employees more vulnerable to bullying. In this study, the searchers aimed to develop a comprehensive model integrating these factors. Studies published between 1984 and 2014 were reviewed. Results suggested a model in which reappraisal coping, confrontive coping, practical coping, direct coping, active coping, social support (problem-focused coping) and self-care (emotion-focused coping) decrease the association between work stressors and bullying (i.e. buffer-effect). Wishful thinking, emotional coping, avoidance, recreation, social support and suppression (emotion-focused coping) increase this association (i.e. boost-effect). Coping resources (locus of control, self-efficacy, optimism, co-workers support, supervisor support, task complexity, participation in decision-making, autonomy and continuance commitment) related positively to problem-focused coping strategies and negatively to emotion-focused coping strategies.

      Source : Van den Brande, Whitney, aillien, Elfi, De Witte, Hans, Vander Elst, Tinne, & Godderis, Lode. (2016). Agression and Violent Behavior. Prépublication. doi:10.1016/j.avb.2016.06.004

    • Health care bullying is a pervasive, underestimated, and underreported problem that results in poor outcomes for staff, patients, and health care organizations. The most common form of health care bullying occurs between nurses. Nurse managers hold an important role in the prevention and elimination of frontline nurse-to-nurse bullying. An anonymous Web-based survey was conducted to uncover what behaviors nurse managers perceive as bullying and how they respond to bullying acts. Respondents who had witnessed or been victimized by bullying were more apt to identify bullying and those who had been victimized or supervised nurses for more than 20 years were more prone to act upon bullying behaviors. There was only a moderate correlation between the identification of and response to bullying behaviors. Finally, overt bullying elicited a stronger response for intervention than covert bullying. Although nurse managers are well positioned to prevent and eliminate nurse-to-nurse bullying, they may not recognize it and often lack the skills and support necessary to address it. Decreases in nurse-to-nurse bullying reduce health care costs, improve nurse and patient satisfaction, and enhance patient outcomes. Therefore, nurse managers at all levels need education and support to ensure proper identification of bullying and, furthermore, to prevent and eliminate the behaviors.

      Source : Gilbert, Rebecca T., Hudson, John S., & Strider, David. (2016). Nursing Administration Quaterly, 40(3), E1-E11. doi: 10.1097/NAQ.0000000000000175

HORAIRE DE TRAVAIL

    • Pour mieux comprendre les effets du travail en horaires postés, ont été étudiées les variations des perceptions de l’environnement de travail selon le poste travaillé et la phase du poste. Le questionnaire mesure les perceptions de demandes, contrôle et soutien social et deux dimensions supplémentaires : les ressources techniques et humaines et les interférences travail-hors travail. Les résultats montrent des demandes psychologiques globalement plus élevées en début et milieu de poste et des demandes physiques plus élevées en fin de poste. Lors du poste de nuit, les personnels perçoivent davantage d’autonomie et moins de soutien des collègues.

      Source : Cascino, Nadine, Mélan, Claudine, & Galy, Édith. (2016). Étude des perceptions de l’environnement de travail au cours du poste chez des travailleurs postés : intérêt d’une évaluation subjective et temporellement située de la charge de travail. Le Travail humain, 79(2), 97-124. Repéré à http://www.cairn.info/resume.php?ID_ARTICLE=TH_792_0097

    • This study aims at evaluating the chronic disease risk related to prolonged work in long-hour schedules for eight major chronic diseases: heart disease, non-skin cancer, arthritis, diabetes, chronic lung disease, asthma, chronic depression, and hypertension. The study used data from the National Longitudinal Survey of Youth, 1979 covering 32 years of job history (1978 to 2009) for 7492 respondents. The results showed that regularly working long hours over 32 years was significantly associated with elevated risks of heart disease, non-skin cancer, arthritis, and diabetes. The observed risk was much larger among women than among men.

      Source : Dembe, Allard E., & Xiaoxi, Yao. (2016). JOEM : Journal of Occupational & Environmental Medicine. Prépublication. doi: 10.1097/JOM.0000000000000810

    • L’Anses a été saisie pour évaluer les risques sanitaires pour les professionnels exposés à des horaires atypiques, en particulier au travail de nuit, régulier ou non. Cette expertise met en évidence des risques avérés de troubles du sommeil, de troubles métaboliques, et des risques probables cancérogènes, de troubles cardiovasculaires et de troubles psychiques chez les travailleurs concernés. Les enquêtes sur les conditions de travail réalisées auprès de salariés en horaires de nuit indiquent généralement des facteurs de pénibilité physique et des contraintes de travail plus présents.

      Source : Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail. (2016, 22 juin). Anses. Toutes les actualités. Repéré à https://www.anses.fr/fr/content/l%E2%80%99anses-confirme-les-risques-pour-la-sant%C3%A9-li%C3%A9s-au-travail-de-nuit.

      Pour lire le rapport : https://www.anses.fr/fr/system/files/AP2011SA0088Ra.pdf

    • En France, plus de 20 % (soit quatre à cinq millions des travailleurs salariés) sont en rythme posté ou de nuit. Afin d’étudier la pénibilité du travail en horaires décalés, les chercheurs ont entrepris une étude rétrospective concernant des personnes en activité professionnelle, adressées à l’unité du sommeil et de la vigilance du CHU d’Amiens pour un premier enregistrement polysomnographique. Leur objectif est d’explorer l’influence des horaires de travail décalés sur les troubles du sommeil et de la vigilance chez des personnes en activités professionnelle lors d’un premier enregistrement polysomnographique.

      Source : Gay, Otelia Szabo, Doutrellot-Philippon, Catherine, Boulet, Bernard, Rose, Dominique, & Jounieaux, Vincent. (2016). La pénibilité du travail en horaires décalés : évaluation des troubles du sommeil à l’aide de l’enregistrement polysomnographique chez des salariés en horaires décalés. Archives des Maladies Professionnelles et de l’Environnement, 77(3), 372. doi:10.1016/j.admp.2016.03.027

    • Sleep deprivation and an abnormal sleep cycle may increase the risk of heart disease, especially for shift workers, a small study suggests. « In humans, as in all mammals, almost all physiological and behavioral processes, in particular the sleep-wake cycle, follow a circadian rhythm that is regulated by an internal clock located in the brain, » said study lead author Dr. Daniela Grimaldi.

      Source : Preidt, Robert. (2016, June 6). Shift Workers at Greater Risk of Heart Ills, Study Says : Abnormal sleep patterns may disrupt body’s natural rhythm. MedlinePlus. HealthDay. Repéré à https://www.nlm.nih.gov/medlineplus/news/fullstory_159220.html

HYGIÈNE ET SALUBRITÉ

MÉDICAMENTS DANGEREUX

    • The United States Pharmacopeial Convention published a new standard on hazardous drugs in healthcare this year, establishing a more than two-year moratorium to allow time for adoption by healthcare facilities. The standard or « chapter » will become part of healthcare quality standards included in the United States Pharamcopeia-National Formulary (USP-NF). The USP posted the following frequently asked questions on the new chapter.

      Source : USP Issues New Hazardous Drug Standard. (2016, July 1). Hospital Employee Health, 35(7), 79. Repéré à http://www.ahcmedia.com/articles/138065-usp-issues-new-hazardous-drug-standard

      Pour accéder aux FAQ de la United States Pharmacopeial Convention (USP) : http://www.usp.org/frequently-asked-questions/hazardous-drugs-handling-healthcare-settings

    • Despite longstanding guidelines on the hazards of antineoplastic drugs (ADs) used primarily in chemotherapy, public health officials are concerned that healthcare workers are still inadequately protected from these known or suspected carcinogens for which no safe exposure level exists. “Chemotherapy drugs are wonder drugs, but they also pose a tremendous risk to healthcare workers,” says Jim Boiano, MS, CIH, an industrial hygienist at the NIOSH division of surveillance, hazard evaluations, and field studies. “They are highly toxic, they can cause cancer — they are just really nasty drugs that are used in healthcare.”

      Source : NIOSH Emphasizing Hazards of Oncology Drugs. (2016, July 1). Hospital Employee Health, 35(7), 78-80. Repéré à http://www.ahcmedia.com/articles/138064-niosh-emphasizing-hazards-of-oncology-drugs

MANUTENTION DE CHARGES

    • Large spinal compressive force combined with axial torsional shear force during asymmetric lifting tasks is highly associated with lower back injury (LBI). The aim of this study was to estimate lumbar spinal loading and muscle forces during symmetric lifting (SL) and asymmetric lifting (AL) tasks using a whole-body musculoskeletal modelling approach. Thirteen healthy males lifted loads of 7 and 12 kg under two lifting conditions (SL and AL). The results show that certain muscle groups are fundamentally responsible for asymmetric movement, thereby producing high lumbar spinal loading and muscle forces, which may increase risks of LBI during asymmetric lifting tasks.

      Source : Kim, Hyun-Kyung, & Zhang, Yanxin. (2016). Ergonomics. Prépublication. DOI:10.1080/00140139.2016.1191679

    • Powered drives designed to assist with moving hospital beds are commercially available but no studies have evaluated whether they reduce the push and pull forces likely contributing to injury in caregivers. This study measured hand forces of 10 caregivers maneuvering a manual and powered bariatric bed through simulated hospital environments (hallway, elevator, and ramp).

      Source : Wiggermann, Neal. (2017). Applied Ergonomics, 58(1), 59-65. Doi:10.1016/j.apergo.2016.05.015

    • La station de levage aux services alimentaires de l’hôpital de Granby s’est mérité le Lauréat Bronze dans la Catégorie Innovation – Organismes publics au gala Innovation de la CSST. Cette vidéo vous présente leur projet gagnant et ses impacts sur la santé et sécurité au travail du personnel des services alimentaires.

      Source : Commission de la santé et de la sécurité du travail. (2016). Les Grands prix Santé et sécurité du travail : Lauréat régional 2015 : Hôpital de Granby (CIUSSS) – Lauréat régional 2015 – Yamaska. [Vidéo en ligne]. Repéré à https://www.youtube.com/embed/vCV2856g4aA?rel=0&autoplay=1&utm_source=All&utm_campaign=ASSTSAS+INFOS+8-2+Mars+2016&utm_medium=email

    • MILIEU DE VIE

    • Le 14 mai 2013, la Commission de la santé et des services sociaux de la 40e législature se saisissait d’un mandat d’initiative intitulé Les conditions de vie des adultes hébergés en centre d’hébergement et de soins de longue durée. Au cours des mois de janvier et de février 2014, la Commission a entendu 36 organismes, agences de la santé et des services sociaux, centres d’hébergement, associations et fédérations ainsi que des ordres professionnels touchés par la situation des personnes hébergées en centre d’hébergement et de soins de longue durée (CHSLD). Aussi, 38 mémoires ont été déposés dans le cadre de la consultation publique et 160 citoyens ont répondu au questionnaire en ligne. Ce rapport présente une synthèse des propos issus des consultations et des visites ainsi que les observations, conclusions et recommandations de la Commission.

      Source : Commission de la santé et des services sociaux. (2016). Les conditions de vie des adultes hébergés en centre d’hébergement et de soins de longue durée : observations, conclusions et recommandations. Québec : Direction des travaux parlementaires de l’Assemblée nationale du Québec, 13 p. Repéré à http://www.assnat.qc.ca/fr/travaux-parlementaires/commissions/csss/mandats/Mandat-32725/index.html?platform=hootsuite

NORMES ET LÉGISLATION EN SST

    • The United States Pharmacopeial Convention published a new standard on hazardous drugs in healthcare this year, establishing a more than two-year moratorium to allow time for adoption by healthcare facilities. The standard or « chapter » will become part of healthcare quality standards included in the United States Pharamcopeia-National Formulary (USP-NF). The USP posted the following frequently asked questions on the new chapter.

      Source : USP Issues New Hazardous Drug Standard. (2016, July 1). Hospital Employee Health, 35(7), 79. Repéré à http://www.ahcmedia.com/articles/138065-usp-issues-new-hazardous-drug-standardLes modifications que vous avez apportées ne seront peut-être pas enregistrées.

      Pour accéder aux FAQ de la United States Pharmacopeial Convention (USP) : http://www.usp.org/frequently-asked-questions/hazardous-drugs-handling-healthcare-settings

    • The authors aimed to determine the strength of evidence on the effectiveness of legislative and regulatory policy levers in creating incentives for organizations to improve occupational health and safety processes and outcomes. A systematic review was undertaken to assess the strength of evidence on the effectiveness of specific policy levers using a “best-evidence” synthesis approach.

      Source : Tompa, Emile, Kalcevich, Christina, Foley, Michael, McLeod, Chris, Hogg-Johnson, Sheilah, Cullen, Kim, MacEachen, Ellen, Mahood, Quenby, & Irvin, Emma. (2016). American Journal of Industrial Medicine. Prépublication. DOI: 10.1002/ajim.22605

ORGANISATION DU TRAVAIL

    • Ward organization is a major determinant for nurses’ well-being on the job. The majority of previous research on this relationship is based on single source methods, which have been criticized as skewed estimations mainly due to subjectivity of the ratings and due to common source bias. The objective of this study was to investigate the association of ward organization characteristics and nurses’ exhaustion by combining observation-based assessments with nurses’ self-reports.

      Source : Stab, Nicole, Hacker, Winfried, & Weigl, Matthias. (2016). International Journal of Nursing Studies, 61(9), 52-62. doi:10.1016/j.ijnurstu.2016.05.012

PATIENTS OBÈSES

    • Powered drives designed to assist with moving hospital beds are commercially available but no studies have evaluated whether they reduce the push and pull forces likely contributing to injury in caregivers. This study measured hand forces of 10 caregivers maneuvering a manual and powered bariatric bed through simulated hospital environments (hallway, elevator, and ramp).

      Source : Wiggermann, Neal. (2017). Applied Ergonomics, 58(1), 59-65. Doi:10.1016/j.apergo.2016.05.015

PRÉVENTION DES INFECTIONS

    • The authors evaluated the clinical impact of implementing hydrogen peroxide vapour (HPV) for disinfecting rooms vacated by Clostridium difficile infection (CDI) patients. Breakpoint time series analysis indicated a significant reduction in the rate of CDI that occurred at the time when HPV was implemented, resulting in a reduction in the rate of CDI from 1.0 to 0.4 cases per 1000 patient days in the 2 years before vs. the first 2 years of HPV usage. HPV should be considered to augment the terminal disinfection of rooms vacated by patients with CDI.

      Source : McCord, Julie, Prewitt, Malinda, Dyakova, Eleonora, Mookerjee, Siddharth, & Otter, Jonathan A. (2016). Journal of Hospital Infection. Prépublication. doi:10.1016/j.jhin.2016.05.014

    • Tout professionnel impliqué dans les soins aux patients est concerné par l’hygiène des mains. L’hygiène des mains est un élément essentiel dans la lutte contre les infections. Ce dépliant explique dans quels cas il est recommandé de faire une friction hydroalcoolique ou un lavage des mains à l’eau et au savon, et quand il faut pratiquer l’hygiène des mains.

      Source : Institut national de recherche et de sécurité (2016). Paris : INRS, 4 p. (ED 6257). Repéré à http://www.inrs.fr/dms/inrs/CataloguePapier/ED/TI-ED-6257/ed6257.pdf

    • Les travailleurs de la santé sont souvent exposés au sang à la suite de piqûres d’aiguilles accidentelles. Ces événements, qui semblent banals, ont parfois de lourdes conséquences. Plusieurs règles de sécurité simples peuvent pourtant aider à les prévenir. Cette fiche technique vous les présente brièvement.

      Source : ASSTSAS. (2016). Prévention des infections : Mesures pour éviter les piqûres d’aiguilles. Montréal : ASSTSAS, 2 p. (Fiche technique ; 1). Repéré à http://www.asstsas.qc.ca/sites/default/files/publications/documents/Fiches/FT01-piqures-WEB.PDF

    • Ce guide, révisé en 2016, présente l’ensemble des composantes à mettre en place pour un programme complet de prévention des expositions au sang chez les travailleurs de la santé. Il aide à cibler les priorités d’action et il offre de nombreux outils pour agir en prévention.

      Source :Bouchard, Françoise. (2016). Programme de prévention : expositions au sang chez les travailleurs de la santé (Éd. rev.). Montréal : ASSTSAS, 102 p. (Guide de prévention ; 68). Repéré à http://www.asstsas.qc.ca/sites/default/files/publications/documents/Guides_Broch_Depl/gp68_guide_pes_2016_web.pdf

    • IHP disinfectants effectively reduce contamination of hospital surfaces, but there are few data on their impact on healthcare-associated infections (HAIs). We compared the impact on surface contamination and HAI rates of two disinfectants containing IHP or Quat.

      Source : Boyce, John M., Guercia, Kerri A., Havill, Nancy L., & Sullivan, Linda K. (2016). AJIC : American Journal of Infection Control, 44(6 suppl.), S28. DOI: http://dx.doi.org/10.1016/j.ajic.2016.04.191

    • Health Care Workers (HCWs) often cite irritant contact dermatitis (ICD) as a barrier to Hand Hygiene (HH) compliance. Literature supports the cause of ICD on hands, but little data exists on steps HCWs follow to address ICD. The objective of this survey was to quantify knowledge, perception and actions of HCWs to ICD.

      Source : McGuckin, Maryanne, & Govednik, John. (2016). AJIC : American Journal of Infection Control, 44(6 suppl.), S22. DOI: http://dx.doi.org/10.1016/j.ajic.2016.04.196

    • The purpose of this quality improvement project was to identify differences in cleaning practices between isolation rooms and standard precaution rooms in the hospital setting. An ultravoilet marking system was used to evaluate high-touch surfaces throughout the patient environment. Results reveal the importance of refining training systems to reflect staff perceptions and improve evaluation processes across systems in an effort to reduce health care–associated infections.

      Source : Zelikoff, Allison, Dellit, Timothy H., Lynch, John, McNamara, Elizabeth A., & Makarewicz, Vanessa A. (2016). AJIC : American Journal of Infection Control. Prépublication. DOI: http://dx.doi.org/10.1016/j.ajic.2016.04.220

    • Standard precautions (SPs) are designed to limit bloodborne pathogen exposures among health care workers (HCWs) and health care–associated infections. SP adherence is globally suboptimal; however, reasons are underexplored. This study aim was to explore the relationships among safety climate factors and SP adherence by HCWs in hospitals using newly developed survey and observational tools.

      Source : Hessels, Amanda, J., Genovese-Schek, Vinni, Agarwal, Mansi, Wurmser, teri, & Larson, Elaine L. (2016). AJIC : American Journal of Infection Control. Prépublication. DOI: http://dx.doi.org/10.1016/j.ajic.2016.03.060

    • Influenza is a significant problem within hospitals, leading to extended hospital stays, excess morbidity and mortality, and economic loss. Prevention and control strategies are generally “bundled”; therefore, the individual effects of particular strategies and the value of combined strategies cannot be determined directly, making it difficult to discern the optimal strategy. To quantify the individual and joint effectiveness of several known influenza infection control measures used in general hospitals, the authors simulated influenza transmission at a hypothetical hospital during a 1-yeat seasonal epidemic, using a susceptible-exposed-infected-recovered compartmental model.

      Source : Blanco, Natalia, Eisenberg, Marisa C., Stillwell, Terri, & Foxman, Betsy. (2016). American Journal of Epidemiology, 183(11), 1045-1054. doi: 10.1093/aje/kwv293

    • Ce guide national porte sur la manipulation ou l’entreposage des agents pathogènes touchant les humains, des agents pathogènes touchant les animaux terrestres et des toxines au Canada. La NCB énonce les exigences physiques en matière de confinement, les exigences opérationnelles et les exigences relatives aux essais de vérification et de performance nécessaires pour qu’il soit possible de manipuler ou d’entreposer en toute sécurité les agents pathogènes humains, les agents pathogènes d’animaux terrestres et les toxines. La NCB met à jour plusieurs exigences afin qu’ils soient plus axés sur les risques, les éléments probants et le rendement, et de nouveaux éléments d’information du domaine de l’ingénierie du bioconfinement ont été intégrés.

      Source : Gouvernement du Canada. Norme canadienne sur la biosécurité. 2e édition. Ottawa : Agence de la santé publique du Canada, xxxvi, 168 p. Repéré à http://canadianbiosafetystandards.collaboration.gc.ca/cbs-ncb/assets/pdf/cbsg-nldcb-fra.pdf

    • PRODUITS TOXIQUES

    • A study in press for publication by the National Institute of Occupational Safety and Health (NIOSH) will report that, despite longstanding hazard warnings, healthcare workers are still frequently exposed to toxic smoke and plumes created by burning tissue during laser surgery and electrosurgery, Hospital Employee Health has learned. In a particularly disturbing finding, almost half of those surveyed said they never received any training about the potent mix of chemicals and biologicals found in the smoke created from burning tissue. The NIOSH study had not been published as this issue went to press, but one of the authors previewed some of the findings in Chicago at the November 3, 2015 meeting of the American Public Health Association (APHA).

      Source : Evans, Gary. (2016, July 1). NIOSH: Healthcare Workers Still Face Surgical Smoke Hazards : Twenty years of toxic plume warnings yield little progress. Hospital Employee Health, 35(7), 73-77. Repéré à http://www.ahcmedia.com/articles/138062-niosh-healthcare-workers-still-face-surgical-smoke-hazards

    • PROTECTION RESPIRATOIRE

    • This article compares hospital managers’ (HM), unit managers’ (UM), and health care workers’ (HCW) perceptions of respiratory protection safety climate in acute care hospitals. The article is based on survey responses from 215 HMs, 245 UMs, and 1,105 HCWs employed by 98 acute care hospitals in six states. Ten survey questions assessed five of the key dimensions of safety climate commonly identified in the literature: managerial commitment to safety, management feedback on safety procedures, coworkers’ safety norms, worker involvement, and worker safety training.

      Source : Peterson, Kristina, Rogers, Bonnie M. E., Brosseau, Lisa M., Payne, Julianne, Cooney, Jennifer, Joe, Lauren, & Novak, Debra. (2016). Workplace Health & Safety. 64(7), 326-336. doi: 10.1177/2165079916640550

    • Influenza is a significant problem within hospitals, leading to extended hospital stays, excess morbidity and mortality, and economic loss. Prevention and control strategies are generally “bundled”; therefore, the individual effects of particular strategies and the value of combined strategies cannot be determined directly, making it difficult to discern the optimal strategy. To quantify the individual and joint effectiveness of several known influenza infection control measures used in general hospitals, the authors simulated influenza transmission at a hypothetical hospital during a 1-yeat seasonal epidemic, using a susceptible-exposed-infected-recovered compartmental model.

      Source : Blanco, Natalia, Eisenberg, Marisa C., Stillwell, Terri, & Foxman, Betsy. (2016). American Journal of Epidemiology, 183(11), 1045-1054. doi: 10.1093/aje/kwv293

    • Consensus organizations, government bodies, and healthcare organization guidelines recommend that surgical smoke be evacuated at the source by local exhaust ventilation (LEV) (i.e., smoke evacuators or wall suctions with inline filters). Data are from NIOSH’s Health and Safety Practices Survey of Healthcare Workers module on precautionary practices for surgical smoke. Four thousand five hundred thirty-three survey respondents reported exposure to surgical smoke: 4,500 during electrosurgery; 1,392 during laser surgery procedures. Respondents were mainly nurses (56%) and anesthesiologists (21%). Only 14% of those exposed during electrosurgery reported LEV was always used during these procedures, while 47% reported use during laser surgery. Those reporting LEV was always used were also more likely to report training and employer standard procedures addressing the hazards of surgical smoke. Few respondents reported use of respiratory protection.

      Source : Steege, Andrea L., Boiano, James M., & Sweeney, Marie H. (2016). American Journal of Industrial Medicine. Prépublication. DOI: 10.1002/ajim.22614

SANTÉ – BIEN-ÊTRE AU TRAVAIL

    • Nurses’ job satisfaction is a critical factor in health-care organisations because of its association with nurse turnover and quality of patient care. Nurses continue to report high levels of job dissatisfaction. The primary aim of this study was to examine the relationships between structural empowerment, psychological empowerment and job satisfaction among staff nurses, after controlling for their leaders’ use of empowering behaviours. Cross-sectional data for 1007 Canadian staff nurses were analysed using hierarchical multiple regression. The results showed that nurses’ job satisfaction is most influenced by their access to organisational empowerment structures. Leader empowering behaviours, structural empowerment, and psychological empowerment, operating together, enhance nurses’ job satisfaction.

      Source : Dahinten, V.S., Lee, S.N., MacPhee, M. (2016). Journal of Nursing Management. Prépublication. DOI: 10.1111/jonm.12407

    • The aim of this study was to conduct a cost-effectiveness and return-on-investment analysis comparing a mindfulness-based worksite intervention to usual practice. Two hundred fifty-seven governmental research institute employees were randomized to the intervention or control group. Intervention group participants received an eight-week mindfulness training, e-coaching, and supporting elements. Outcomes included work engagement, general vitality, job satisfaction, work ability, and costs. Cost-effectiveness analyses were conducted from the societal and employer’s perspective, and a return-on-investment analysis from the employer’s perspective.

      Source : van Dongen, Johanna, van Berkel, Jantien, Boot, Cécile R.L., Bosmans, Judith E., Proper, Karin I., Bongers, Paulien,… van Wier, Marieke F. (2016). Long-Term Cost-Effectiveness and Return-on-Investment of a Mindfulness-Based Worksite Intervention: Results of a Randomized Controlled Trial. JOEM : Journal of Occupational & Environmental Medicine, 58(6), 550-560. doi: 10.1097/JOM.0000000000000736

    • Après avoir tant entendu parler de souffrance au travail (stress, épuisement professionnel, etc.), voici que le bonheur au travail est aujourd’hui à l’honneur. En débarrassant notamment les employés des lourdeurs bureaucratiques, des entreprises dites libérées souhaitent réconcilier bonheur et travail. Certaines d’entre elles, par exemple Harley-Davidson ou Zappos, ont tenté l’expérience et en ont tiré trois grands principes dont vous pouvez vous inspirer.

      Source : Barel, Yvan, & Frémeaux, Sandrine.(été 2016), Gestion, 41(2), 82-84. Repéré à http://www.revuegestion.ca/catalog/revue-gestion/articles/volume-50/bonheur-au-travail-les-trois-conditions-de-la-reussite.html

SANTÉ PSYCHOLOGIQUE

    • Nurses’ job satisfaction is a critical factor in health-care organisations because of its association with nurse turnover and quality of patient care. Nurses continue to report high levels of job dissatisfaction. The primary aim of this study was to examine the relationships between structural empowerment, psychological empowerment and job satisfaction among staff nurses, after controlling for their leaders’ use of empowering behaviours. Cross-sectional data for 1007 Canadian staff nurses were analysed using hierarchical multiple regression. The results showed that nurses’ job satisfaction is most influenced by their access to organisational empowerment structures. Leader empowering behaviours, structural empowerment, and psychological empowerment, operating together, enhance nurses’ job satisfaction.

      Source : Dahinten, V.S., Lee, S.N., MacPhee, M. (2016). Journal of Nursing Management. Prépublication. DOI: 10.1111/jonm.12407

    • This study’s purpose was twofold: first, to examine the relative importance of job demands and resources as predictors of burnout and engagement, and second, the relative importance of engagement and burnout related to health, depressive symptoms, work ability, organizational commitment, and turnover intentions in two samples of health care workers. In both samples, job demands predicted burnout more strongly than job resources, and job resources predicted engagement more strongly than job demands. Engagement held more weight than burnout for predicting commitment, and burnout held more weight for predicting health outcomes, depressive symptoms, and work ability. Results have implications for the design, evaluation, and effectiveness of workplace interventions to reduce burnout and improve engagement among health care workers. Actionable recommendations for increasing engagement and decreasing burnout in health care organizations are provided.

      Source : Fragoso, Zachary L., Holcombe, Kyla J., McCluney, Courtney, Fisher, Gwenith G., McGonagle, Alyssa K., & Friebe, Susan J. (2016). Workplace Health & Safety. Prépublication. doi: 10.1177/2165079916653414

    • A better knowledge of the job aspects that may predict home healthcare nurses’ burnout and work engagement is important in view of stress prevention and health promotion. The Job Demands-Resources model predicts that job demands and resources relate to burnout and work engagement, but has not previously been tested in the specific context of home healthcare nursing. The current study offers a comprehensive test of the Job-Demands Resources model in home healthcare nursing. We investigate the main and interaction effects of distinctive job demands (workload, emotional demands and aggression) and resources (autonomy, social support and learning opportunities) on burnout and work engagement.

      Source : Vander Elst, Tinne, Cavents, Carolien, Daneels, Katrien, Johannik, Kristien, Baillien, Elfi, Van des Broeck, Anja, & Godderis, Lode. (2016). Job demands resources predicting burnout and work engagement among Belgian home healthcare nurses: A cross-sectional study. Nursing Outlook. Prépublication. DOI: http://dx.doi.org/10.1016/j.outlook.2016.06.004

    • Both work- and person-related factors may trigger workplace bullying. Work-related factors, such as role stressors, can create a stressful work environment leading to bullying. Additionally, person-related factors, such as emotion-focused coping, could make employees more vulnerable to bullying. In this study, the searchers aimed to develop a comprehensive model integrating these factors. Studies published between 1984 and 2014 were reviewed. Results suggested a model in which reappraisal coping, confrontive coping, practical coping, direct coping, active coping, social support (problem-focused coping) and self-care (emotion-focused coping) decrease the association between work stressors and bullying (i.e. buffer-effect). Wishful thinking, emotional coping, avoidance, recreation, social support and suppression (emotion-focused coping) increase this association (i.e. boost-effect). Coping resources (locus of control, self-efficacy, optimism, co-workers support, supervisor support, task complexity, participation in decision-making, autonomy and continuance commitment) related positively to problem-focused coping strategies and negatively to emotion-focused coping strategies.

      Source : Van den Brande, Whitney, aillien, Elfi, De Witte, Hans, Vander Elst, Tinne, & Godderis, Lode. (2016). Agression and Violent Behavior. Prépublication. doi:10.1016/j.avb.2016.06.004

    • Pour mieux comprendre les effets du travail en horaires postés, ont été étudiées les variations des perceptions de l’environnement de travail selon le poste travaillé et la phase du poste. Le questionnaire mesure les perceptions de demandes, contrôle et soutien social et deux dimensions supplémentaires : les ressources techniques et humaines et les interférences travail-hors travail. Les résultats montrent des demandes psychologiques globalement plus élevées en début et milieu de poste et des demandes physiques plus élevées en fin de poste. Lors du poste de nuit, les personnels perçoivent davantage d’autonomie et moins de soutien des collègues.

      Source : Cascino, Nadine, Mélan, Claudine, & Galy, Édith. (2016). Étude des perceptions de l’environnement de travail au cours du poste chez des travailleurs postés : intérêt d’une évaluation subjective et temporellement située de la charge de travail. Le Travail humain, 79(2), 97-124. Repéré à http://www.cairn.info/resume.php?ID_ARTICLE=TH_792_0097

    • Health care bullying is a pervasive, underestimated, and underreported problem that results in poor outcomes for staff, patients, and health care organizations. The most common form of health care bullying occurs between nurses. Nurse managers hold an important role in the prevention and elimination of frontline nurse-to-nurse bullying. An anonymous Web-based survey was conducted to uncover what behaviors nurse managers perceive as bullying and how they respond to bullying acts. Respondents who had witnessed or been victimized by bullying were more apt to identify bullying and those who had been victimized or supervised nurses for more than 20 years were more prone to act upon bullying behaviors. There was only a moderate correlation between the identification of and response to bullying behaviors. Finally, overt bullying elicited a stronger response for intervention than covert bullying. Although nurse managers are well positioned to prevent and eliminate nurse-to-nurse bullying, they may not recognize it and often lack the skills and support necessary to address it. Decreases in nurse-to-nurse bullying reduce health care costs, improve nurse and patient satisfaction, and enhance patient outcomes. Therefore, nurse managers at all levels need education and support to ensure proper identification of bullying and, furthermore, to prevent and eliminate the behaviors.

      Source : Gilbert, Rebecca T., Hudson, John S., & Strider, David. (2016). Nursing Administration Quaterly, 40(3), E1-E11. doi: 10.1097/NAQ.0000000000000175

    • The aim of this study was to conduct a cost-effectiveness and return-on-investment analysis comparing a mindfulness-based worksite intervention to usual practice. Two hundred fifty-seven governmental research institute employees were randomized to the intervention or control group. Intervention group participants received an eight-week mindfulness training, e-coaching, and supporting elements. Outcomes included work engagement, general vitality, job satisfaction, work ability, and costs. Cost-effectiveness analyses were conducted from the societal and employer’s perspective, and a return-on-investment analysis from the employer’s perspective.

      Source : van Dongen, Johanna, van Berkel, Jantien, Boot, Cécile R.L., Bosmans, Judith E., Proper, Karin I., Bongers, Paulien,… van Wier, Marieke F. (2016). Long-Term Cost-Effectiveness and Return-on-Investment of a Mindfulness-Based Worksite Intervention: Results of a Randomized Controlled Trial. JOEM : Journal of Occupational & Environmental Medicine, 58(6), 550-560. doi: 10.1097/JOM.0000000000000736

    • Ward organization is a major determinant for nurses’ well-being on the job. The majority of previous research on this relationship is based on single source methods, which have been criticized as skewed estimations mainly due to subjectivity of the ratings and due to common source bias. The objective of this study was to investigate the association of ward organization characteristics and nurses’ exhaustion by combining observation-based assessments with nurses’ self-reports.

      Source : Stab, Nicole, Hacker, Winfried, & Weigl, Matthias. (2016). International Journal of Nursing Studies, 61(9), 52-62. doi:10.1016/j.ijnurstu.2016.05.012

    • Après avoir tant entendu parler de souffrance au travail (stress, épuisement professionnel, etc.), voici que le bonheur au travail est aujourd’hui à l’honneur. En débarrassant notamment les employés des lourdeurs bureaucratiques, des entreprises dites libérées souhaitent réconcilier bonheur et travail. Certaines d’entre elles, par exemple Harley-Davidson ou Zappos, ont tenté l’expérience et en ont tiré trois grands principes dont vous pouvez vous inspirer.

      Source : Barel, Yvan, & Frémeaux, Sandrine.(été 2016), Gestion, 41(2), 82-84. Repéré à http://www.revuegestion.ca/catalog/revue-gestion/articles/volume-50/bonheur-au-travail-les-trois-conditions-de-la-reussite.html

    • Une étude longitudinale en deux volets permet de mieux comprendre le processus d’implantation d’interventions en prévention des risques psychosociaux (RPS) en milieu de travail. Quatre organisations engagées dans une telle démarche ont participé à l’étude. Une séance d’information a aussi permis aux participants de se familiariser avec 25 outils de gestion des RPS.

      Source : Biron, Caroline, St-Hilaire, France, Baril-Gingras, Geneviève, Paradis, Marie-Esther, Chabot, Shrirley, Lefebvre, Rébecca,… Brisson, Chantal. (2016). Conditions facilitant l’appropriation de démarches préventives en santé psychologique au travail par les gestionnaires. Montréal : IRSST, ix,90 p. (Études et recherches, rapport R-921). Repéré à http://www.irsst.qc.ca/media/documents/PubIRSST/R-921.pdf

SERVICES À DOMICILE

    • A better knowledge of the job aspects that may predict home healthcare nurses’ burnout and work engagement is important in view of stress prevention and health promotion. The Job Demands-Resources model predicts that job demands and resources relate to burnout and work engagement, but has not previously been tested in the specific context of home healthcare nursing. The current study offers a comprehensive test of the Job-Demands Resources model in home healthcare nursing. We investigate the main and interaction effects of distinctive job demands (workload, emotional demands and aggression) and resources (autonomy, social support and learning opportunities) on burnout and work engagement.

      Source : Vander Elst, Tinne, Cavents, Carolien, Daneels, Katrien, Johannik, Kristien, Baillien, Elfi, Van des Broeck, Anja, & Godderis, Lode. (2016). Job demands resources predicting burnout and work engagement among Belgian home healthcare nurses: A cross-sectional study. Nursing Outlook. Prépublication. DOI: http://dx.doi.org/10.1016/j.outlook.2016.06.004

    • This handbook is an easy-to-read overview of some of the topics covered in this course as well as topics that are not covered. It is a useful resource that contains practical tips for homecare worker safety.

      Source : NIOSH (2014). Caring for yourself while caring for others. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH), 77 p. (Publication No. 2015–103). Repéré à http://www.cdc.gov/niosh/docs/2015-103/pdf/2015-103.pdf

SERVICES ALIMENTAIRES

SERVICES AMBULANCIERS – PRÉHOSPITALIERS

    • The purpose of this investigation was to examine if paramedics’ frequency of being exposed to highly physically demanding activities, or their perception of physical, clinical, and emotional demands were altered by patients’ acuity level, operationalized using the Canadian Triage and Acuity Scale (CTAS).

      Source : Morales, Laura, McEachern, Brittany M., MacPhee, Renée S., & Fischer, Steven L.(2016). Applied Ergonomics, 56(9), 187-193. doi:10.1016/j.apergo.2016.04.003

STATISTIQUES EN SST

    • Jusqu’à maintenant, l’Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST) a produit des indicateurs statistiques de santé et sécurité du travail tous les cinq ans. Le besoin d’obtenir de l’information sur l’évolution annuelle depuis la dernière série d’indicateurs quinquennaux devenait cependant de plus en plus nécessaire. Ces données serviront à mieux connaître les changements récents concernant les indicateurs de lésions professionnelles et à identifier les types de lésions et les industries-catégories professionnelles pour lesquels l’évolution des indicateurs a été la moins favorable.

      Source : Duguay, Patrice, Busque, Marc-Antoine, Boucher, Alexandre, Lebeau, Martin, & Prud’homme, Pascale. (2016). Montréal : IRSST, xix, 87 p. (Études et recherches, Rapport R-922). Repéré à http://www.irsst.qc.ca/media/documents/PubIRSST/R-922.pdf

TRAVAIL DE BUREAU

    • The purpose of this study was to evaluate the participatory ergonomic method on the development of upper extremity musculoskeletal disorders and disability in office employees. Methods: This study is a randomized controlled intervention study. It comprised 116 office workers using computers. Those in the intervention group were taught office ergonomics and the risk assessment method. The results suggest that participatory ergonomic intervention decreases the possibility of musculoskeletal complaints and disability/symptom level in office workers.

      Source : Baydur, Hakan, Ergör, Alp, Demiral, & Yücel, Akalin, Elif. (2016). Journal of Occupational Health. 58(3), 297-309. http://doi.org/10.1539/joh.16-0003-OA

    • The objective of this study was to evaluate how different workstations may influence physical behavior in office work through motion and how that may affect spinal loads and discomfort. Twenty subjects performed a typing task in three different workstations (seated, standing, and perching) for one hour each. Measures of postural transitions, spinal loads, discomfort, and task performance were assessed in order to understand the effects of workstation interaction over time. Results indicated that standing had the most amount of motion (6–8 shifts/min), followed by perching (3–7 shifts/min), and then seating (<1 shift/min). Standing had the highest reports of discomfort and seating the least. However, spinal loads were highest in A/P shear during standing, compared to perching and seating. Perching may induce motion through supported mobility in the perching stool, whereas standing motion may be due to postural discomfort. Office workstation designs incorporating supported movement may represent a reasonable trade-off in the costs-benefits between seating and standing.

      Source : Le, Peter, & Marras, William S. (2016). Applied Ergonomics, 56(9), 170-178. doi:10.1016/j.apergo.2016.04.001

    • TRAVAIL EN HAUTEUR

    • Avant de monter sur cette échelle portable, apprenez quelles précautions vous devez prendre pour l’immobiliser et éviter de faire grimper les statistiques sur les accidents. Les chutes en bas des échelles portatives constituent une cause courante de blessures professionnelles et sont souvent attribuables à une mauvaise utilisation de l’échelle. Suivez ces 10 conseils sur la façon d’utiliser votre échelle et grimpez en toute sécurité.

      Source : Centre canadien d’hygiène et de sécurité au travail. (2016). Le rapport sur la santé et la sécurité, 14(5). Repéré à http://cchst.ca/newsletters/hsreport/issues/current.html

    • TRAVAIL EN LABORATOIRE

    • Ce guide national porte sur la manipulation ou l’entreposage des agents pathogènes touchant les humains, des agents pathogènes touchant les animaux terrestres et des toxines au Canada. La NCB énonce les exigences physiques en matière de confinement, les exigences opérationnelles et les exigences relatives aux essais de vérification et de performance nécessaires pour qu’il soit possible de manipuler ou d’entreposer en toute sécurité les agents pathogènes humains, les agents pathogènes d’animaux terrestres et les toxines. La NCB met à jour plusieurs exigences afin qu’ils soient plus axés sur les risques, les éléments probants et le rendement, et de nouveaux éléments d’information du domaine de l’ingénierie du bioconfinement ont été intégrés.

      Source : Gouvernement du Canada. Norme canadienne sur la biosécurité. 2e édition. Ottawa : Agence de la santé publique du Canada, xxxvi, 168 p. Repéré à http://canadianbiosafetystandards.collaboration.gc.ca/cbs-ncb/assets/pdf/cbsg-nldcb-fra.pdf

    • TRAVAILLEURS JEUNES/ÂGÉS

    • Nurses continue to sustain musculoskeletal injuries even with increased emphasis on safe patient handling and mobility (SPHM) and organizational cultures of safety to protect health care workers. Analysis of data from 2011-2014 registered nurse graduates explored hospital safety culture, SPHM education/training, and incidence of new-nurse musculoskeletal injury. Results indicated hospitals provided some type of SPHM education and training, but 46% of study participants were not informed or aware of national SPHM standards or guidelines. Merely 13.9% of participants stated a written « no manual lifting policy » had been implemented; only 32.9% indicated staffing was adequate for SPHM tasks; and only 39.4% stated the hospital had all of the equipment needed to perform SPHM safely. Thirty-nine percent of participants had already sustained a musculoskeletal injury with an additional 35% sustaining but not reporting an injury. More actions are needed to ensure a decrease in musculoskeletal injuries for new nurses.

      Source : Vendittelli, D., Penprase, Barbara, & Pittiglio, Laura. (2016). Workplace Health & Safety. Prépublication. doi: 10.1177/2165079916654928

TROUBLES MUSCULOSQUELETTIQUES (TMS)

    • Nurses continue to sustain musculoskeletal injuries even with increased emphasis on safe patient handling and mobility (SPHM) and organizational cultures of safety to protect health care workers. Analysis of data from 2011-2014 registered nurse graduates explored hospital safety culture, SPHM education/training, and incidence of new-nurse musculoskeletal injury. Results indicated hospitals provided some type of SPHM education and training, but 46% of study participants were not informed or aware of national SPHM standards or guidelines. Merely 13.9% of participants stated a written « no manual lifting policy » had been implemented; only 32.9% indicated staffing was adequate for SPHM tasks; and only 39.4% stated the hospital had all of the equipment needed to perform SPHM safely. Thirty-nine percent of participants had already sustained a musculoskeletal injury with an additional 35% sustaining but not reporting an injury. More actions are needed to ensure a decrease in musculoskeletal injuries for new nurses.

      Source : Vendittelli, D., Penprase, Barbara, & Pittiglio, Laura. (2016). Workplace Health & Safety. Prépublication. doi: 10.1177/2165079916654928

    • The purpose of this study was to evaluate the participatory ergonomic method on the development of upper extremity musculoskeletal disorders and disability in office employees. Methods: This study is a randomized controlled intervention study. It comprised 116 office workers using computers. Those in the intervention group were taught office ergonomics and the risk assessment method. The results suggest that participatory ergonomic intervention decreases the possibility of musculoskeletal complaints and disability/symptom level in office workers.

      Source : Baydur, Hakan, Ergör, Alp, Demiral, & Yücel, Akalin, Elif. (2016). Journal of Occupational Health. 58(3), 297-309. http://doi.org/10.1539/joh.16-0003-OA

    • The objective of this study was to evaluate how different workstations may influence physical behavior in office work through motion and how that may affect spinal loads and discomfort. Twenty subjects performed a typing task in three different workstations (seated, standing, and perching) for one hour each. Measures of postural transitions, spinal loads, discomfort, and task performance were assessed in order to understand the effects of workstation interaction over time. Results indicated that standing had the most amount of motion (6–8 shifts/min), followed by perching (3–7 shifts/min), and then seating (<1 shift/min). Standing had the highest reports of discomfort and seating the least. However, spinal loads were highest in A/P shear during standing, compared to perching and seating. Perching may induce motion through supported mobility in the perching stool, whereas standing motion may be due to postural discomfort. Office workstation designs incorporating supported movement may represent a reasonable trade-off in the costs-benefits between seating and standing.

      Source : Le, Peter, & Marras, William S. (2016). Applied Ergonomics, 56(9), 170-178. doi:10.1016/j.apergo.2016.04.001

    • The effect of physical activity on risk and prognosis for neck pain has been studied earlier with inconclusive results. There is a need for large prospective studies on the subject. The aim of this study was to investigate if work related physical activity and physical activity during leisure time are of importance for the risk and prognosis of neck pain in men and women.

      Source : Palmlöf, Lina, Holm, Lena W., Alfredsson, Lars, Magnusson, Cecilia, Vingård, Eva & Eva Skillgat, Eva. (2016). The impact of work related physical activity and leisure physical activity on the risk and prognosis of neck pain : a population based cohort study on workers. BMC Musculoskeletal Disorders, 17:219. DOI: 10.1186/s12891-016-1080-1

VACCINATION DU PERSONNEL

  • Influenza is a significant problem within hospitals, leading to extended hospital stays, excess morbidity and mortality, and economic loss. Prevention and control strategies are generally “bundled”; therefore, the individual effects of particular strategies and the value of combined strategies cannot be determined directly, making it difficult to discern the optimal strategy. To quantify the individual and joint effectiveness of several known influenza infection control measures used in general hospitals, the authors simulated influenza transmission at a hypothetical hospital during a 1-yeat seasonal epidemic, using a susceptible-exposed-infected-recovered compartmental model.

    Source : Blanco, Natalia, Eisenberg, Marisa C., Stillwell, Terri, & Foxman, Betsy. (2016). American Journal of Epidemiology, 183(11), 1045-1054. doi: 10.1093/aje/kwv293

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