Economic evaluation of occupational safety preventive measures in a hospital

BACKGROUND: When an organization performs an integrated analysis of risks through its Occupational Health and Safety Management System, several steps are suggested to address the implications of the identified risks. Namely, the organization should make a detailed analysis of the monetary impact for the organization of each of the preventive measures considered. However, it is also important to perform an analysis of the impact of each measure on society (externalities). OBJECTIVE: The aim of this paper is to present a case study related to the application of the proposed economic evaluation methodology. METHODS: An analysis of the work accidents in a hospital has been made. Three of the major types of accidents have been selected: needle stings, falls and excessive strain. Following the risk assessment, some preventive measures have been designed. Subsequently, the Benefit/Cost ratio (B/C) of these measures has been calculated, both in financial terms (from the organization’s perspective) and in economic terms (including the benefits for the worker and for the Society). RESULTS: While the financial ratio is only advantageous in some cases, when the externalities are taken into account, the B/C ratio increases significantly. CONCLUSIONS: It is important to consider external benefits to make decisions concerning the implementation of preventive measures in Occupational Health and Safety projects

The main benefits associated with health and safety management systems certification in Portuguese small and medium enterprises post quality management system certification

The purpose of this study is to characterize how Portuguese Small and Medium Enterprises (SMEs) view the Occupational Health and Safety Management Systems (OHSMSs) certification process, after receiving the Quality Management System (QMS) certification. References were based on the ISO 9001 standard for a QMS and OHSAS 18001 for OHSMS. The method used to evaluate the implemented systems, was by form of questionnaire. Those questioned had to have a certified quality management system, an implemented OHSMS and be a SME. The questionnaire was sent to 300 SMEs; 46 responses were received and validated. Of them, only 12 SMEs had the OHSMS certificate according to OHSAS 18001. Within those 12 companies that participated: 7 SMEs are from the industrial sector; 3 belong to the electricity/telecommunications sector and 2 SMEs are from the trade/services activity sector. The size of the sample was small, but corresponds to Portuguese reality. Moreover, 34 SMEs did not have the OHSMS certificate. The questionnaire requested the main reasons for SMEs to opt for non-certification and it was related with high costs, while the main reasons to certificate were, among others, needed to eliminate or minimize risks to workers. The main benefits that Portuguese SMEs have gained from the referred certifications have been, improved working conditions, ensuring compliance with legislation and better internal communication about risks and hazards. Also presented are the main difficulties in achieving an OHSMS certification including high certification costs, difficulties motivating personnel, difficulties in changing the company’s culture and increased bureaucracy.

A-scan ultrasound system for real-time puncture safety assessment during percutaneous nephrolithotomy

Background: Kidney stone is a major universal health problem, affecting 10% of the population worldwide. Percutaneous nephrolithotomy is a first-line and established procedure for disintegration and removal of renal stones. Its surgical success depends on the precise needle puncture of renal calyces, which remains the most challenging task for surgeons. This work describes and tests a new ultrasound based system to alert the surgeon when undesirable anatomical structures are in between the puncture path defined through a tracked needle. Methods: Two circular ultrasound transducers were built with a single 3.3-MHz piezoelectric ceramic PZT SN8, 25.4 mm of radius and resin-epoxy matching and backing layers. One matching layer was designed with a concave curvature to work as an acoustic lens with long focusing. The A-scan signals were filtered and processed to automatically detect reflected echoes. Results: The transducers were mapped in water tank and tested in a study involving 45 phantoms. Each phantom mimics different needle insertion trajectories with a percutaneous path length between 80 and 150 mm. Results showed that the beam cross-sectional area oscillates around the ceramics radius and it was possible to automatically detect echo signals in phantoms with length higher than 80 mm. Conclusions: This new solution may alert the surgeon about anatomical tissues changes during needle insertion, which may decrease the need of X-Ray radiation exposure and ultrasound image evaluation during percutaneous puncture.