Lessons Learned: Solutions for Workplace Safety and Health

Provides case studies of workplace health hazards, regulatory actions taken, and solutions, including product and design alternatives; a synthesis of findings and lessons learned; and federal- and state-level recommendations

Work-up of globus : assessing the benefits of neck ultrasound and videofluorography

Globus patients with normal ear, nose, and throat ( ENT) status are a diagnostic challenge. The symptom may be long lasting and cause concern about malignancy, leading to possibly unnecessary further investigation. The aim of the study was to assess whether radiological examinations are useful in globus diagnostics, how often patients suffer from persistent globus, and whether globus patients with normal ENT status develop a malignancy during a follow-up. We reviewed medical records of all 76 globus patients referred to Helsinki University Hospital, Department of Otorhinolaryngology-Head and Neck Surgery in 2009. Patient history and findings in physical and radiological examinations were registered. A questionnaire concerning patients' present pharyngeal symptoms was sent 3 and 6 years after their initial visit. Data from the Finnish Cancer Registry revealed whether patients developed malignancies within a 3-year follow-up. Based on medical records, neck ultrasound was performed for 37 (49 %) and videofluorography for 22 patients (29 %), with nonsignificant findings. After a 3- and 6-year follow-up, half patients indicated that they were asymptomatic or had fewer symptoms, whereas the rest had persistent symptoms. The Finnish Cancer Registry data confirmed that globus patients developed no head and neck malignancies during a 3-year follow-up. In the present study, neck ultrasound and videofluorography showed no additional benefit to evaluate the globus etiology in patients whose ENT status was normal. Half the globus patients suffered from persistent symptoms after a 3- and 6-year follow-up, indicating that globus may cause discomfort chronically. However, no patients developed malignancies during a 3-year follow-up.Peer reviewe

Finnish Version of the Eating Assessment Tool (F-EAT-10) : A Valid and Reliable Patient-reported Outcome Measure for Dysphagia Evaluation

Our aim was to validate a Finnish version of the Eating Assessment Tool (F-EAT-10) for clinical use and to test its reliability and validity in a multicenter nationwide study. Normative data were acquired from 180 non-dysphagic participants (median age 57.0 years, 62.2% female). Dysphagia patients (n = 117, median age 69.7 years, 53.0% female) referred to fiberoptic endoscopic evaluation of swallowing (FEES) completed F-EAT-10 before the examination and after 2 weeks. Patients underwent the 100-ml water swallow test (WST) and FEES was evaluated using the following three scales: the Yale Pharyngeal Residue Severity Rating Scale, Penetration-Aspiration Scale, and the Dysphagia Outcome Severity Scale. An operative cohort of 19 patients (median age 75.8 years, 57.9% female) underwent an endoscopic operation on Zenker's diverticulum, tight cricopharyngeal muscle diagnosed in videofluorography, or both. Patients completed the F-EAT-10 preoperatively and 3 months postoperatively. The cut-off score for controls was = 3 is abnormal. Re-questionnaires for test-retest reliability analysis were available from 92 FEES patients and 123 controls. The intraclass correlation coefficient was excellent for the total F-EAT-10 score (0.93, 95% confidence interval 0.91-0.95). Pearson correlation coefficients were strong (p < 0.001) for each of the questions and the total score. Internal consistency as assessed by Cronbach's alpha was excellent (0.95). Some correlations between findings in FEES and 100-ml WST with F-EAT-10 were observed. The change in subjective symptoms of operative patients paralleled the change in F-EAT-10. F-EAT-10 is a reliable, valid, and symptom-specific patient-reported outcome measure for assessing dysphagia among Finnish speakers.Peer reviewe

National action plan for identifying existing exposure situations (KAVATTU)

Article 100 of the Directive laying down basic safety standards for protection against the dangers arising from exposure to ionizing radiation 2013/59/Euratom requires Member States to identify existing exposure situations. In this regard, Article 100 has been implemented in Finland in section 142 of the Radiation Act. This national action plan sets out procedures and proposes respon-sible parties to identify the above-mentioned situations. When an existing exposure situation has been identified, it is managed in accordance with the procedures laid down in chapter 17 (Existing exposure situations) of the Radiation Act

Kansallinen toimintasuunnitelma vallitsevien altistustilanteiden tunnistamiseksi (KAVATTU)

Säteilyturvallisuusdirektiivin 2013/59/Euratom artiklassa 100 vaaditaan jäsenmaita tunnistamaan vallitsevia altistustilanteita. Tältä osin artikla 100 on Suomessa toimeenpantu säteilylain 142 §:ssä. Tässä kansallisessa toimintasuunnitelmassa esitetään menettelyjä ja ehdotetaan vastuutahoja edellä mainittujen tilanteiden tunnistamiseksi. Kun vallitseva altistustilanne on tunnistettu, sitä hallinnoidaan säteilylain 17 luvussa (Vallitsevat altistustilanteet) säädetyin menettelyin

Nationell handlingsplan för identifiering av befintliga exponeringssituationer (KAVATTU)

Artikel 100 i strålskyddsdirektivet 2013/59/Euratom kräver att medlemsländerna identifie-rar befintliga exponeringssituationer. Denna del av artikel 100 har genomförts i Finland genom 142 § i strålsäkerhetslagen. Denna nationella handlingsplan presenterar förfaran-den och föreslår ansvariga för identifiering av de ovannämnda situationerna. När en befint-lig expneringssituation har identifierats hanteras den i enlighet med de förfaranden som föreskrivs i 17 kap. i strålsäkerhetslagen (Befintliga exponeringssituationer)

Finnish Version of the Eating Assessment Tool (F-EAT-10): A Valid and Reliable Patient-reported Outcome Measure for Dysphagia Evaluation

Our aim was to validate a Finnish version of the Eating Assessment Tool (F-EAT-10) for clinical use and to test its reliability and validity in a multicenter nationwide study. Normative data were acquired from 180 non-dysphagic participants (median age 57.0 years, 62.2% female). Dysphagia patients (n = 117, median age 69.7 years, 53.0% female) referred to fiberoptic endoscopic evaluation of swallowing (FEES) completed F-EAT-10 before the examination and after 2 weeks. Patients underwent the 100-ml water swallow test (WST) and FEES was evaluated using the following three scales: the Yale Pharyngeal Residue Severity Rating Scale, Penetration-Aspiration Scale, and the Dysphagia Outcome Severity Scale. An operative cohort of 19 patients (median age 75.8 years, 57.9% female) underwent an endoscopic operation on Zenker's diverticulum, tight cricopharyngeal muscle diagnosed in videofluorography, or both. Patients completed the F-EAT-10 preoperatively and 3 months postoperatively. The cut-off score for controls was = 3 is abnormal. Re-questionnaires for test-retest reliability analysis were available from 92 FEES patients and 123 controls. The intraclass correlation coefficient was excellent for the total F-EAT-10 score (0.93, 95% confidence interval 0.91-0.95). Pearson correlation coefficients were strong (p < 0.001) for each of the questions and the total score. Internal consistency as assessed by Cronbach's alpha was excellent (0.95). Some correlations between findings in FEES and 100-ml WST with F-EAT-10 were observed. The change in subjective symptoms of operative patients paralleled the change in F-EAT-10. F-EAT-10 is a reliable, valid, and symptom-specific patient-reported outcome measure for assessing dysphagia among Finnish speakers

Nationell handlingsplan för identifiering av befintliga exponeringssituationer (KAVATTU)

Artikel 100 i strålskyddsdirektivet 2013/59/Euratom kräver att medlemsländerna identifierar befintliga exponeringssituationer. Denna del av artikel 100 har genomförts i Finland genom 142 § i strålsäkerhetslagen. Denna nationella handlingsplan presenterar förfaranden och föreslår ansvariga för identifiering av de ovannämnda situationerna. När en befintlig expneringssituation har identifierats hanteras den i enlighet med de förfaranden som föreskrivs i 17 kap. i strålsäkerhetslagen (Befintliga exponeringssituationer)

National action plan for identifying existing exposure situations (KAVATTU)

Article 100 of the Directive laying down basic safety standards for protection against the dangers arising from exposure to ionizing radiation 2013/59/Euratom requires Member States to identify existing exposure situations. In this regard, Article 100 has been implemented in Finland in section 142 of the Radiation Act. This national action plan sets out procedures and proposes respon-sible parties to identify the above-mentioned situations. When an existing exposure situation has been identified, it is managed in accordance with the procedures laid down in chapter 17 (Existing exposure situations) of the Radiation Act

Kansallinen toimintasuunnitelma vallitsevien altistustilanteiden tunnistamiseksi (KAVATTU)

Säteilyturvallisuusdirektiivin 2013/59/Euratom artiklassa 100 vaaditaan jäsenmaita tunnistamaan vallitsevia altistustilanteita. Tältä osin artikla 100 on Suomessa toimeenpantu säteilylain 142 §:ssä. Tässä kansallisessa toimintasuunnitelmassa esitetään menettelyjä ja ehdotetaan vastuutahoja edellä mainittujen tilanteiden tunnistamiseksi. Kun vallitseva altistustilanne on tunnistettu, sitä hallinnoidaan säteilylain 17 luvussa (Vallitsevat altistustilanteet) säädetyin menettelyi