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Morbidity and Mortality Weekly Report (MMWR): Recommendations and Reports
No full textChronic hepatitis B virus (HBV) infection can lead to substantial morbidity and mortality. Although treatment is not considered curative, antiviral treatment, monitoring, and liver cancer surveillance can reduce morbidity and mortality. Effective vaccines to prevent hepatitis B are available. This report updates and expands CDC's previously published Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection (MMWR Recomm Rep 2008;57[No. RR-8]) regarding screening for HBV infection in the United States. New recommendations include hepatitis B screening using three laboratory tests at least once during a lifetime for adults aged 6518 years. The report also expands risk-based testing recommendations to include the following populations, activities, exposures, or conditions associated with increased risk for HBV infection: persons incarcerated or formerly incarcerated in a jail, prison, or other detention setting; persons with a history of sexually transmitted infections or multiple sex partners; and persons with a history of hepatitis C virus infection. In addition, to provide increased access to testing, anyone who requests HBV testing should receive it, regardless of disclosure of risk, because many persons might be reluctant to disclose stigmatizing risks
Morbidity and Mortality Weekly Report (MMWR): Recommendations and Reports
Get PDFHepatitis C virus (HCV) infection is a major source of morbidity and mortality in the United States. HCV is transmitted primarily through parenteral exposures to infectious blood or body fluids that contain blood, most commonly through injection drug use. No vaccine against hepatitis C exists and no effective pre- or postexposure prophylaxis is available. More than half of persons who become infected with HCV will develop chronic infection. Direct-acting antiviral treatment can result in a virologic cure in most persons with 8-12 weeks of all-oral medication regimens. This report augments (i.e., updates and summarizes) previously published recommendations from CDC regarding testing for HCV infection in the United States (Smith BD, Morgan RL, Beckett GA, et al. Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945-1965. MMWR Recomm Rec 2012;61[No. RR-4]). CDC is augmenting previous guidance with two new recommendations: 1) hepatitis C screening at least once in a lifetime for all adults aged 6518 years, except in settings where the prevalence of HCV infection is <0.1% and 2) hepatitis C screening for all pregnant women during each pregnancy, except in settings where the prevalence of HCV infection is <0.1%. The recommendation for HCV testing that remains unchanged is regardless of age or setting prevalence, all persons with risk factors should be tested for hepatitis C, with periodic testing while risk factors persist. Any person who requests hepatitis C testing should receive it, regardless of disclosure of risk, because many persons might be reluctant to disclose stigmatizing risks
Owner/Foreman of Construction Company Dies in 15 Foot-Deep Manhole in California
No full textThe owner of a construction company was discovered face down at the bottom of a 15 foot deep manhole which had about 3 feet of muddy water at the bottom. The company employed about 13 individuals and was subcontracted to install a sewage collection system in a park. Extensive damage to a section of the concrete cylinder produced by efforts to straighten the manhole allowed mud and water to seep into the hole. The manhole was not connected to a sewer line. The victim was operating a backhoe, and requested a worker to remove the manhole cover so he could check the grade. The victim was observed walking toward the manhole; 15 minutes later he was found in the manhole, face down. One worker who entered the manhole felt breathless and nauseated. Other workers removed the victim, and did not suffer any ill effects from entering the manhole. The autopsy report suggested that the man slipped and fell on entering the manhole, was knocked unconscious, and drowned in the water at the bottom. The day after the accident, normal levels of oxygen were found in the manhole, and tests for noxious gases indicated they were below the level of danger. Recommendations arising from this accident include the training of a standby person when workers enter a confined space, the development of a comprehensive safety program that documents procedures for safe entry to confined spaces, and a requirement by property owners who contract construction projects that all safety requirements are enforced during the job.Publication date provided by the authoring office. There is no publication date indicated on the resource
Carpenter Dies in 90-Foot Fall from Top of Parking Garage
No full textA 49 year old male carpenter fell 90 feet to his death from the top of a parking garage which was under construction. He was employed by a construction company that has been in business for 14 years. The principal business of the firm was the erection of concrete structures. The company employs 800 workers including 530 carpenters. The employer has a safety officer and written safety rules and procedures. The victim had been a carpenter for about 30 years and worked for this employer for about 7 months. The victim and a coworker were preparing a form for pouring a prestressed concrete column at the eleventh floor level of a parking garage. The victim was tied off to a 1.5 inch diameter rebar. He had secured one end of a 6 foot lanyard to one D-ring on his safety belt, fed the other end of the lanyard through a second D-ring on the belt and then secured it to the first D-ring. This created a loop with the lanyard. He took an 8 foot lanyard and, at its midpoint, wrapped it several times around the 1.5 inch rebar. He took one end of the 8 foot lanyard, passed it through the loop of the 6 foot lanyard and fastened the snap hook to the snap hook at the other end. His coworker witnessed the fall and reported seeing the lanyard unwrapping from the rebar. It was recommended that the employer train the employees in the proper use of safety equipment and that the employer evaluate potential tie off points and determine if the available safety equipment can work as designed.Publication date provided by the authoring office. There is no publication date indicated on the resource
Farmer Dies After Becoming Caught In Barn Cleaning System
Get PDFA 60-year-old male farmer (victim) died after he became caught in a gutter cleaner inside a dairy barn. On the day of the incident, he was cleaning the barn that was used for approximately 25-30 young cows. The barn's gutter was equipped with a mechanical cleaner that consisted of a large continuous chain with metal bars fastened to it. At the ends of the barn, steel panels were used to cover the gutter so tractors or other vehicles could be driven into and out of the barn. The panels were not secured to the concrete barn floor but instead laid loosely over the gutter openings. While the victim worked inside the barn he used a shovel to push manure into the gutter while the gutter cleaner was operating. He apparently slipped and struck his head as he fell. He became caught in the cleaner at one end of the steel plate that covered the gutter on one end of the barn. The victim was discovered by his wife later in the afternoon on the day of the incident. She stopped the cleaner and placed a call to emergency personnel. They arrived at the scene shortly after being notified, removed the victim and pronounced him dead at the scene. MN FACE investigators concluded that, in order to reduce the likelihood of similar occurrences, the following guidelines should be followed: 1. workers should always wear footwear that is appropriate for the work environment; and 2. safety panels should be securely fastened in place to prevent accidental displacement.Cooperative Agreemen
School Crossing Guard Struck and Killed by a Sport Utility Vehicle
Get PDFOn October 25, 2005, an 81-year-old female school crossing guard was struck by a large sport utility vehicle (SUV) after stepping into the street to stop traffic. The incident occurred on a wide, two-lane road near a suburban high school. It was a few minutes after sunrise when she walked into the southbound lane crosswalk and raised her hand-held stop sign towards the northbound traffic to cross three children waiting at the curb. It was cloudy and raining, and visibility was poor. As her back was turned to the traffic, a crossing guard for a neighboring town was driving his SUV to work. He reportedly saw the victim step off the curb, but was not able to stop in time to avoid hitting the victim, who became trapped underneath the vehicle. Witnesses called 911, and an immediate rescue effort was launched to extricate the victim. She was transported to the local hospital where she died of her injuries a few hours later. NJ FACE investigators recommend following these safety guidelines to prevent similar incidents: 1. School crossing guards should be fully equipped with safety gear including retroreflective vests, raincoats, and stop signs; 2. Municipalities should be aware of and follow the national Manual on Uniform Traffic Control Devices (MUTCD) standards and NJ State laws regarding school crossing guards and traffic control at schools; 3. Municipalities should consider additional measures to increase visibility or slow traffic at intersections during school crossing periods.Cooperative Agreemen
A carpenter died after falling 20 feet from a roof.
Get PDFA 40-year-old Hispanic carpenter working for a general contracting company fell from a roof on January 20, 2006. The victim was part of a three-person crew that was installing plywood roof decking to a structural steel frame. The victim and his two coworkers were not using fall protection while working at an elevation of approximately 20 feet. One worker cut sheets of plywood on an adjacent flat structure, while the victim and the other coworker attached the decking to an arched roof using screw guns. The fall was not witnessed because the victim's coworkers were involved in their own tasks and the job superintendent was inside the structure. Coworkers noticed the fall and immediately called 911. Emergency medical service (EMS) arrived in less than 15 minutes and transported the victim to a local hospital where he was pronounced dead approximately one hour after the incident occurred. Oklahoma Fatality Assessment and Control Evaluation (OKFACE) investigators concluded that to help prevent similar occurrences, employers should: 1. Ensure that employees working from surfaces elevated more than six feet above a lower surface or the ground are provided with and use fall restraints, such as a personal fall arrest system, guardrail, or safety net. 2. Develop, implement, and enforce a comprehensive written safety program, which includes a fall protection program that addresses required regulatory standards, company policies, and task-specific safety requirements. 3. Train employees on the company's written fall protection program and all procedures for working in areas where fall hazards exist or are likely to develop during work operations. 4. Routinely have a competent person conduct a hazard analysis of the worksite and of employees' tasks, and should revise their safety and health programs and trainings as needed to address identified hazards.Publication Date provided by FACE program; not printed on the report.Cooperative Agreemen
Fatal Incident Summary Report: Electrocution of an Electrician
No full textOn July 12, 1983, an electrician was electrocuted while replacing a switch on a coal sampler at a coal fired powerplant. The victim was a class-A electrician with about 10 years of experience. The victim, who was working alone replacing a coal sampler limit switch, was found by other employees laying on the ground next to a pack of cigarettes. Based on physical evidence and the patterns of burns on the victim's hands it was theorized that after connecting two of the three wires in the limit switch the victim may have tried to pull the third wire, which was carrying about 220 volts, further out of the conduit and the bottom of his hand contacted the limit switch completing the circuit. The amount of voltage was not considered enough to kill the victim instantly; however, it was considered that a cardiac arrhythmia resulted making the victim uncomfortable and he decided to sit down and smoke a cigarette when he died. The cause of death was determined to be electrocution. It was concluded that the major etiologic factor for this fatal incident was the failure of the victim to follow standard procedure for lockout of electrical power. It was recommended that the importance of lockout procedures be emphasized and enforced
Child Abuse Negl
Get PDFBackground:Family-centered substance use treatment (FCSUT) may have benefits for parents, children, and their families, and have the potential to decrease adverse childhood experiences (ACEs). Few treatment programs use FCSUT, even those that aim to serve pregnant and postpartum people.Objectives:To understand how families are integrated into FCSUT services for pregnant and postpartum people, explore the perceived benefits of FCSUT for families and parents, and identify challenges to implementing FCSUT.Participants and settings:Interviews with 26 administrators and providers working at FCSUT facilities and 27 pregnant and postpartum people who were currently receiving or had previously received services in the last two years from FCSUT facilities.Methods:A qualitative thematic analysis was conducted using data from semi-structured in-depth interviews.Results:The analysis revealed four themes: (1) the importance of families in treatment and recovery; (2) benefits of FCSUT for parents; (3) benefits of FCSUT for families; and (4) additional areas for FCSUT program growth. Despite reported benefits (e.g., improving parenting and communication skills; promoting healthy relationships with children, partners, and other family members; and facilitating a support system for long-term recovery), facilities and families face challenges integrating whole family units into treatment.Conclusions:FCSUT may offer a range of benefits to pregnant and postpartum people and their families. Addressing challenges, such as fully integrating all family members into treatment, may improve FCSUT programs. Meeting the needs of all family members during treatment supports safe, stable, and nurturing relationships and environments for children that may decrease ACEs.CC999999/ImCDC/Intramural CDC HHSUnited States
Hispanic laborer entangled in auger at pork processing plant
Get PDFA 36-year-old, Hispanic man died at a pork processing plant in central Iowa mid-winter of 2004. The victim had his feet entangled in an inclined, auger conveyor when it started. He was retrieving hardware or pieces of metal that had fallen into the auger during dismantling of conveying equipment and metal decking above the auger earlier that day and the day before. In an adjacent room the supervisor, who did not believe anyone was in or above the auger but was not able to see it, removed his lockout and turned on the main circuit breaker. The auger's on/off electric switch was mounted to the wall near the auger. The switch was in the "on" position so when the main circuit breaker was turned on the auger started immediately. A co-worker, who was also tasked with picking up metal debris from the work area, did not know how to turn the auger off so he ran outside the room calling for help. Another employee came into the rendering room where the auger was running and turned off the switch for the auger. The victim's legs were caught in the auger and he was face down, head down the incline, with his feet up the inclined auger. Rescue personnel arrived 10 minutes after the incident. Despite resuscitative efforts, the victim was pronounced dead at the scene 35 minutes later. RECOMMENDATIONS: 1. Equipment lockout/tagout procedures must be fully implemented, including checking the work area to ensure that all employees have been safely positioned or removed before removing lockout and notifying employees that lockout devices have been removed from energy sources. 2. Training should be provided to employees to ensure that the purpose and function of hazardous energy control of machines is understood and that they have the knowledge and skills required for safe application, usage, and removal of hazardous energy controls. 3. All employees should strive for clear communication with each other, and be aware that in hazardous situations language differences may result in misunderstanding of instructions.Cooperative Agreemen