The safety and effectiveness of different methods of ear wax removal: a systematic review and economic evaluation

Build-up of earwax is a common reason for attendance in primary care. Current practice for earwax removal generally involves the use of a softening agent, followed by irrigation of the ear if required. However, the safety and benefits of the different methods of removal are not known for certain.

Quality evaluation and safety assessment of different cooking oils available in Pakistan

The present study was conducted to evaluate the quality of cooking oils available in Pakistani market. The physicochemical qualities of 35 commercially available cooking oil brands were investigated for free fatty acid, peroxide value, smell, weight, color, rancidity, foreign matter, appearance and cold point. Analysis showed that free fatty acid, peroxide, smell, weight and rancidity value significantly deviate from standards set by Pakistan standard quality control authority (PSQCA). However, color, foreign matter, appearance and cloud point values were in limits set by PSQCA. In terms of vitamin only 71.43±2.32% brands contain vitamins. These results confirm the presence of adulteration and deviation of product development from quality limits sets by Pakistan standard quality control authority.

Traffic safety education and health promoting school : a metropolitan and rural pilot study

Traffic Safety Education (TSE) is an important part of a school's program; however, it competes with many other components of schooling such as literacy, numeracy and a number of health areas. Hence TSE provision in Victorian schools has been somewhat fragmented and haphazard in its delivery. This small pilot study involved two metropolitan and two rural schools which attempted to link TSE into mainstream school activities through the new Victorian Essential Learning Standards (VELS) utilising the internationally accepted Health Promoting Schools (HPS) framework.
The findings of the pilot study showed that though schools face many demands, understanding and ownership of TSE is possible when administrative support, professional development and adequate planning time are made available. The report outlines several key recommendations to improve the delivery of Traffic Safety Education in Victorian schools.

Pharmaceutical ecomonics and politics vs. patient safety : Lumiracoxib in Australia

Lumiracoxib (Prexige©) 200 mg was listed in Australia’s Pharmaceutical Benefits Scheme (PBS) schedules on 01 August 2006. The listing was intended as a cost-minimisation strategy, as lumiracoxib 200 mg was deemed equivalent in therapeutic effect to celecoxib (Celebrex©) 200 mg, and was available at a lower cost. By the time of listing on the PBS, a safety re-evaluation of the recommended daily dose of lumiracoxib was being considered in other national regulatory jurisdictions. Within 3 months of listing, the manufacturer revised the recommended dosage to half that of the PBS-listed dosage. However, the PBS listing was neither revoked nor modified. At the time of listing on the PBS, lumiracoxib was known to be 17 times as biochemically selective in inhibiting the COX-2 isoform as celecoxib, and twice as selective as rofecoxib, already withdrawn for safety reasons. Safety concerns had already been raised about adverse hepatic outcomes on daily doses of lumiracoxib 200 mg. Communication of information about the risk potential of lumiracoxib was inadequate. Economic and political considerations were prioritised over patient safety, and lumiracoxib 200 mg remained available via the PBS until 10 August 2007, when it was withdrawn for safety reasons following cases of hepatic morbidity and mortality.

Experimental and numerical evaluation of forming and fracture behaviour of high strength steel

Car manufacturers are under pressure to reduce vehicle mass while maintaining comfort and passenger safety for current and future vehicles. To meet this demand the steel industry has developed Advanced High Strength Steels (AHSS) that promise higher strength and improved formability compared to conventional steel grades. Even though significant research has already been performed to evaluate the material properties and forming behaviour of most AHSS types, only a limited literature is available on their necking and fracture behaviour and the effect on formability. This paper examines and compares the thinning, necking and fracture behaviour of two AHSS and one conventional steel type, namely TRIP, DP and HSLA. Uniaxial, plane and biaxial strain conditions are investigated by tensile, cup drawing and stretch forming tests and by using numerical methods. The test results indicate that significant differences exist in necking and fracture behaviour between all three steel types.

Evaluation of heat stress indices using physiological comparisons in an alumina refinery in a sub-tropical climate

The production of alumina involves the use of a process known as the Bayer process. This method involves the digestion of raw bauxite in sodium hydroxide at temperatures around 250°C. The resultant pregnant liquor then goes through a number of filtering and precipitation processes to obtain the aluminium oxide crystals which are then calcined to obtain the final product. The plant is situated in a sub tropical climate in Northern Australia and this combined with the hot nature of the process results in a potential for heat related illnesses to develop. When assessing a work environment for heat stress a heat stress index is often employed as a guideline and to date the Wet Bulb Globe Temperature (WBGT) has been the recommended index. There have been concerns over the past that the WBGT is not suited to the Northern Australian climate and in fact studies in other countries have suggested this is the case. This study was undertaken in the alumina plant situated in Gladstone Queensland to assess if WBGT was in fact the most suitable index for use or if another was more applicable. To this end three indices, Wet Bulb Globe Temperature (WBGT), Heat Stress Index (HSI) and Required Sweat Rate (SWreq) were compared and assessed using physiological monitoring of heart rate and surrogate core temperature. A number of different jobs and locations around the plant were investigated utilising personal and environmental monitoring equipment. These results were then collated and analysed using a computer program written as part of the study for the manipulation of the environmental data . Physiological assessment was carried out using methods approved by international bodies such as National Institute for Occupational Safety & Health (NIOSH) and International Standards Organisation (ISO) and incorporated the use of a ‘Physiological Factor’ developed to enable the comparison of predicted allowable exposure times and strain on the individual. Results indicated that of the three indices tested, Required Sweat Rate was found to be the most suitable for the climate and in the environment of interest. The WBGT system was suitable in areas in the moderate temperature range (ie 28 to 32°C) but had some deficiencies above this temperature or where the relative humidity exceeded approximately 80%. It was however suitable as a first estimate or first line indicator. HSI over-estimated the physiological strain in situations of high temperatures, low air flows and exaggerated the benefit of artificial air flows on the worker in certain environments ie. fans.

Occupational health and safety management systems : system types and effectiveness

The aim of this thesis is to develop a framework to evaluate the relative performance of different types of health and safety management system. This objective is an analytical one, but it stems from a policy issue of public importance. Over the past decade Australia, like other countries, has seen the emergence and growth of interest in developing health and safety management systems. But are they all the same, and if not, do they differ in their effectiveness? The thesis does not seek to give a definitive answer to these questions. Given the novelty of the phenomenon and the lack of research on this subject, the research is exploratory. An hypothesis about the effectiveness of different health and safety management systems is developed rather than tested. The thesis proceeds by first defining health and safety management systems as a combination of the planning and review, the management arrangements, the consultative arrangements and the specific program elements that work together in an integrated way to improve health and safety performance. A research procedure is described involving twenty exploratory case studies. The thesis then - develops - from the literature and the case study research - an analytical framework to evaluate the performance of different health and safety management systems. That framework has two parts. First is a typology of health and safety management systems. This is constructed from two distinctions - between 'safe place' and 'safe person' approaches to health and safety; and between 'innovative' and traditional' management methods and structures. These distinctions yield four types of system. The typology was applied to the case studies which yielded a reasonable fit in most instances. The second part of the framework is a 'process evaluation' technique akin to Quality standards. Derived from the Victorian SafetyMAP audit criteria, the "e;process evaluation tool "e; is preferred to traditional outcome measures such as incident or claim rates. Using this measure, the twenty case study enterprises were classified as above average, average or below average in performance. These results correlated poorly with traditional incident trend and benchmark measures. The two elements of the framework are then combined to explore the relationship between the different types of system and their performance. Evidence from the twenty case studies showed a tendency for innovative/safe place firms to perform better than traditional/safe person firms. This finding can form the basis for a hypothesis that may be subject to statistical testing on a generalisable sample. In addition five 'best practice' cases were selected and subjected to a cross case analysis to search for common characteristics that might explain their performance. This analysis suggests the importance of a number of factors: senior managers who drive health and safety change and mobilise all possible resources in the pursuit of change; health and safety representatives who work with managers in a 'joint regulatory relationship' across system activities; the involvement of employees more generally, but not as a substitute for action by managers and health and safety representatives; a comprehensive approach to elimination of all hazards; and the introduction of innovative programs to continually improve systems and facilitate employee involvement in health and safety.

Performance evaluation and improved risk control philosophies for drinking water systems

World-wide, water is the single most used substance by humans every day. Water is also the major cause of illness and death in many countries including the affluent nations. Through this research, new risk control philosophies from catchment to consumers are highlighted. This thesis is about identifying the hazards, evaluating the risks and implementing controls to protect public health from drinking water.

Nurses' role in medication safety

Aim To explore the nurses role in the process of medication management and identify the challenges associated with safe medication management in contemporary clinical practice.
Background Medication errors have been a long-standing factor affecting consumer safety. The nursing profession has been identified as essential to the promotion of patient safety.
Evaluation A review of literature on medication errors and the use of electronic prescribing in medication errors.
Key issues Medication management requires a multidisciplinary approach and interdisciplinary communication is essential to reduce medication errors. Information technologies can help to reduce some medication errors through eradication of transcription and dosing errors. Nurses must play a major role in the design of computerized medication systems to ensure a smooth transition to such as system.
Conclusion The nurses roles in medication management cannot be over-emphasized. This is particularly true when designing a computerized medication system.
Implication for nursing management The adoption of safety measures during decision making that parallel those of the aviation industry safety procedures can provide some strategies to prevent medication error. Innovations in information technology offer potential mechanisms to avert adverse events in medication management for nurses.

Synthetic evaluation method for bridge priority ranking

In order to maintain the transportation operation, proper monitoring systems should be established on road structures, especially bridges. Since these systems need enormous investments, only a part of bridges should be equipped. Thus, the priorities of the bridges should be ranked. In this paper, a method based on two-level synthetic evaluation is proposed. First, the importance of each bridge is analyzed through the economic analysis. Six factors are considered for the bridges in a network, including construction cost, service duration, length, location importance coefficient, traffic volume, and reconstruction time. Second, the safety condition of the bridge is evaluated by using improved entropy method (IEM) which combines subjective weight with objective entropy weight. Five indices are incorporated in this step, i.e., design and construction condition, technical condition, level of overloading, hazard of wind and earthquake and environmental factors. Finally, the priorities of all the bridge in one network can be ranked and classified through a judge matrix. To demonstrate the effectiveness of the proposed method, a main highway including 16 bridges is taken as an illustrative example. The results show that the bridges can be ranked and classified quickly by using the proposed method.

Programs to improve interpersonal safety in Indigenous communities: evidence and issues

There is now a substantial amount of published literature describing the range of programs and interventions that have been implemented in an attempt to improve aspects of community safety. Only a small body of this work, however, has examined the outcomes of those programs delivered to Indigenous Australians or, indeed, the communities in which they live. This Issues paper provides an overview of those programs that were identified in a systematic search of relevant research databases. 

A participatory workplace health and safety training program for ethylene oxide

The Occupational Safety and Health Administration (OSHA) has regulated ethylene oxide (EtO) on the basis of its acute toxicity and its potential carcinogenic and reproductive effects since 1971. OSHA's 1984 EtO standard and its 1988 revisions focused new attention on health and safety training and other preventive measures. An EtO health and safety training program for hospital sterilization workers was developed by the staff of an independent occupational and environmental health clinic. Participatory and empowerment training methods were central to the approach. Also included were hands-on, demonstration, interactive presentation, and other methods. An EtO Health and Safety Training Manual was developed based on the training experiences. This paper presents the challenges, benefits, and limitations of incorporating participatory and empowerment approaches in the design, implementation, and evaluation of EtO health and safety training.

Assessing and intervening on OSH programmes : effectiveness evaluation of the Wellworks-2 intervention in 15 manufacturing worksites

To develop a transparent and broadly applicable method for assessing occupational safety and health (OSH) programmes or management systems; (2) to assess OSH programmes in a sample of manufacturing worksites; and (3) to determine whether a management focused occupational health intervention results in greater improvement in OSH programmes compared to minimal intervention controls. OSH programmes were assessed using an adaptation of the US Occupational Safety & Health Administration's 1995 Program Evaluation Profile. Scores were generated from 91 binary indicator variables grouped under four "Essential Elements". Essential Element scores were weighted to contribute to an overall programme score on a 100 point scale. Seventeen large manufacturing worksites were assessed at baseline; 15 sites completed the 16 month intervention and follow up assessments. There was considerable variation in Essential Element scores across sites at baseline as judged by our instrument, particularly in "management commitment and employee participation" and "workplace analysis". Most sites scored highly on "hazard prevention and control" and "training and education". For overall OSH programme scores, most sites scored in the 60-80% range at baseline, with four sites scoring below 60%, suggesting weak programmes. Intervention sites showed greater improvements than controls in the four programme elements and in overall programme scores, with significantly greater improvements in "management commitment and employee participation". The OSH programme assessment method used is broadly applicable to manufacturing work settings, and baseline profiles suggest needs for improvement in OSH programmes in most such worksites. Despite a small sample size, results showed that sustained management focused intervention can result in improvement in these OSH programme measures.