[MCOH-EH] group question re: odors

[Swift, Melanie]

I find that usually these people are triggered everywhere - movie theaters when someone sits nearby with a strong perfume, in traffic when there is a smelly exhaust in front of them, etc. This is often because they have poorly controlled asthma, don't measure their peak flows, aren't on a steroid inhaler, don't have a self-management plan, etc. We have had a lot of these and I always get them to work with their pulmonologist or PCP to start doing good asthma self-management. I estimate that 95% of the time, getting them into real asthma management resolves the problem for them, not only at work but in the community. For those rare exceptions that are really well controlled outside a strong odor trigger, then yes, knowing the schedule allows them to avoid the area. But that is a highly burdensome proposition in a hospital because often the activity generating the smell is a room cleaning or a floor stripping that could be based on patient discharges or the census that night, and isn't always planned in advance.

Melanie Swift, MD
Director, Vanderbilt Occupational Health Clinic
http://occupationalhealth.vanderbilt.edu

-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Paulson, Jennifer A., R.N.
Sent: Wednesday, December 03, 2014 9:30 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] group question re: odors

I agree with Mark.  The N95 is not good for fumes, but the charcoal mask has worked for us in the past.

Sent from my iPhone

> On Dec 3, 2014, at 20:37, Upfal, Mark <mupfal at dmc.org> wrote:
> 
> Agree.  However if avoidance is not always feasible, a mask can be helpful in the short term, but an N95 won't help for odors.  N95s are only good for particulates.  A lightweight charcoal impregnated mask may help to trap organic vapors.  
> 
> Mark Upfal, MD, MPH
> 
> Sent from my iPhone
> 
>> On Dec 3, 2014, at 8:23 PM, "Delclos, George" <George.Delclos at uth.tmc.edu> wrote:
>> 
>> Avoidance of exposure is preferable to use of personal protective equipment, in persons who have bona fide reactions to strong chemical odors/cleaners/bleach. These are usually, but not limited to, known asthmatics. What I generally recommend to employers (since most, but not all, of these cleaning operations are planned ahead of time) is to find a way to let the affected employee know when they are scheduled. In concert with a reasonable employer, they should be able to find a way to continue their usual duties away from the area until the odor dissipates.
>> 
>> 
>> 
>> George L. Delclos, MD, MPH, PhD
>> Professor
>> Division of Epidemiology, Human Genetics and Environmental Sciences 
>> The University of Texas School of Public Health P.O. Box 20186 
>> Houston, Texas 77225-0186
>> Phone:  +1 713 500 9459
>> FAX:     +1 713 500 9442
>> Email:   George.Delclos at uth.tmc.edu<mailto:George.Delclos at uth.tmc.edu>
>> ________________________________
>> From: MCOH-EH [mcoh-eh-bounces at mylist.net] on behalf of alukasek via 
>> MCOH-EH [mcoh-eh at mylist.net]
>> Sent: Wednesday, December 03, 2014 7:14 PM
>> To: MCOH/EH
>> Subject: Re: [MCOH-EH] group question re: odors
>> 
>> N95
>> 
>> 
>> Sent from my iPhone
>> 
>> On Dec 3, 2014, at 4:35 PM, <Kim.Thompson at hcahealthcare.com<mailto:Kim.Thompson at hcahealthcare.com>> <Kim.Thompson at hcahealthcare.com<mailto:Kim.Thompson at hcahealthcare.com>> wrote:
>> 
>> I'm sure this has come up before.....what you do with an employee who is affected by (asthma triggered) odors such as cleaning fluids, waxing, deodorizers, etc.
>> 
>> I know that a reasonable accommodation might be to schedule cleaning 
>> at a time/shift other than when that employee works but if that is 
>> not feasible and she cannot transfer to another dept, what are some 
>> possible solutions? Thank you
>> 
>> 
>> Kim Thompson RN, BSN
>> Employee Health Nurse Manager
>> Medical Center of McKinney
>> 4500 Medical Center Drive - MOB, Suite 105
>> McKinney, TX     75069
>> 
>> 972- 540- 4218 (phone)
>> 469 - 713- 8660 (fax)
>> 
>> <image001.jpg>
>> 
>> 
>> 
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The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   http://www.mcoh-eh.net
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
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List archives (public): http://mylist.net/archives/mcoh-eh/
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Send administrative requests to: drjoe at meditrax.com
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