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The public health and medical response to a radiological or nuclear incident requires the capability to sort, assess, treat, triage and to ultimately discharge, refer or transport people to their next step in medical care. The size of the incident and scarcity of resources at the location of each medical decision point will determine how patients are triaged and treated. This will be a rapidly evolving situation impacting medical responders at regional, national and international levels. As capabilities, diagnostics and medical countermeasures improve, a dynamic system-based approach is needed to plan for and manage the incident, and to adapt effectively in real time. In that the concepts and terms can be unfamiliar and possibly confusing, resources and a concept of operations must be considered well in advance. An essential underlying tenet is that medical evaluation and care will be managed by healthcare professionals with biodosimetry assays providing critical supporting data.

Accidental events in manufacturing industries can be caused by many factors, including work methods, lack of training, equipment design, maintenance and reliability. This study is aimed at determining the contribution of failures of commonly used industrial equipment, such as machines, tools and material handling equipment, to the chain of causality of industrial accidents and incidents. Based on a case study which aimed at the analysis of an existing pulp and paper company's accident database, this paper examines the number, type and gravity of the failures involved in these events and their causes. Results from this study show that equipment failures had a major effect on the number and severity of accidents accounted for in the database: 272 out of 773 accidental events were related to equipment failure, where 13 of them had direct human consequences. Failures that contributed directly or indirectly to these events are analyzed.

Investigations of accidents in a number of hazardous domains suggest that a cluster of organisational pathologies—the "vulnerable system syndrome" (VSS)—render some systems more liable to adverse events. This syndrome has three interacting and self-perpetuating elements: blaming front line individuals, denying the existence of systemic error provoking weaknesses, and the blinkered pursuit of productive and financial indicators. VSS is present to some degree in all organisations, and the ability to recognise its symptoms is an essential skill in the progress towards improved patient safety. Two kinds of organisational learning are discussed: "single loop" learning that fuels and sustains VSS and "double loop" learning that is necessary to start breaking free from it.

High temperature alkaline chemical liquids have caused injuries and hazardous situations in Finnish pulp manufacturing mills. There are no requirements and/or test method standards concerning protection against high temperature alkaline chemical splashes. This paper describes the test method development process to test and identify materials appropriate for hot liquid chemical hazard protection. In the first phase, the liquid was spilled through a stainless steel funnel and the protection performance was evaluated using a polyvinyl chloride (PVC) film under the test material. After several tentative improvements, a graphite crucible was used for heating and spilling the chemical, and a copper-coated K-type thermometer with 4 independent measuring areas was designed to measure the temperature under the material samples. The thermometer was designed to respond quickly so that peak temperatures could be measured. The main problem was to keep the spilled amount of chemical constant, which unfortunately resulted in significant variability in data.

Improvements in patient safety result primarily from organisational and individual learning. This paper discusses the learning that can take place within organisations and the cultural change necessary to encourage it. It focuses on teams and team leaders as potentially powerful forces for bringing about the management of patient safety and better quality of care.

Time trends in employee exposures to the air contaminants measured by the Occupational Safety and Health Administration (OSHA) during compliance inspections of pulp and paper manufacturing facilities conducted between 1979 and 1997 were evaluated based on the measurement results stored in the OSHA Integrated Management Information System (IMIS) database. The IMIS database is among the largest sources of occupational exposure measurements available for occupational health research in the United States. The IMIS database contains the results of 3,568 personal time-weighted average (TWA) measurements for 171 air contaminants made at 524 establishments in Standard Industrial Classification (SIC) 26. An analysis of these measurements revealed an overall decrease in the total number of measurements made per year since 1991, and a decrease in the percentage of measurements by year that exceeded the OSHA permissible exposure limits (PELs). Linear regression analyses detected decreasing trends in the geometric mean concentrations by year for 33 of the 36 agents analyzed.

The Canadian Pulp and Paper Association has developed eight "Guiding Principles for Management of Occupational Health and Safety" (OH&S) for its member companies. As part of a study to assess member companies' OH&S activities, an on-site audit was performed for 11 sites. The audit assessed five key components of a management system for a number of OH&S activities. Management-system components more likely to be in place included system ownership and goals and procedures, whereas measures of performance, a review of measures, and corrective action were less likely to be present. Environmental surveillance and injury reduction were most actively monitored, as indicated by the number of measures of performance relating to these activities. The auditing process demonstrated leadership and communicated the OH&S priorities of the Canadian Pulp and Paper Association to the sites.

Elintarvikepakkausmateriaalien turvallisuus ja mikrobiologinen puhtaus ovat erittäin ajankohtaisia aiheita. Suomen lainsäädäntö ja elintarviketeollisuus vaativat mm. elintarvikepakkausmateriaaleja ja elintarvikepakkauksia maahantuovilta, valmistavilta ja käsitteleviltä yrityksiltä toimivaa laatujärjestelmää elintarvikkeiden kanssa kosketukseen tarkoitettujen materiaalien turvallisuuden ja hygienian varmistamiseksi. Tässä julkaisussa käsitellään paperi- ja pakkausteollisuuden tuotteiden laatua ja laatujärjestelmiä sekä elintarvikkeiden kanssa kosketukseen tarkoitettujen pakkausmateriaalien lainsäädäntöä Suomessa. Julkaisussa keskitytään erityisesti omavalvonnan ja HACCP-järjestelmän (Hazard Analysis Critical Control Point) sisältöön ja toteutukseen sekä kyseisten järjestelmien aiheuttamiin muutoksiin eri yrityksissä. Julkaisun loppuosassa selvitetään elintarvikepakkausten hygieniariskejä, prosessihygienian hallintaa sekä käytännön kokemuksia ja tuloksia liittyen paperi- ja pakkausteollisuudessa tehtyihin HACCP-vaara-analyyseihin ja mikrobiologisiin hygieniakartoituksiin. Taustalla on laaja yhteistyö yritysten kanssa. Kaikkiaan kymmenelle tehtaalle on laadittu omavalvontasuunnitelma tai sen keskeisin kohta HACCP-vaara-analyysi. Laajoja mikrobiologisia hygieniakartoituksia on tehty useampaan otteeseen viidelle eri tehtaalle.

Elintarvikepakkausmateriaalien turvallisuus ja mikrobiologinen puhtaus ovat erittäin ajankohtaisia aiheita. Suomen lainsäädäntö ja elintarviketeollisuus vaativat mm. elintarvikepakkausmateriaaleja ja elintarvikepakkauksia maahantuovilta, valmistavilta ja käsitteleviltä yrityksiltä toimivaa laatujärjestelmää elintarvikkeiden kanssa kosketukseen tarkoitettujen materiaalien turvallisuuden ja hygienian varmistamiseksi. Tässä julkaisussa käsitellään paperi- ja pakkausteollisuuden tuotteiden laatua ja laatujärjestelmiä sekä elintarvikkeiden kanssa kosketukseen tarkoitettujen pakkausmateriaalien lainsäädäntöä Suomessa. Julkaisussa keskitytään erityisesti omavalvonnan ja HACCP-järjestelmän (Hazard Analysis Critical Control Point) sisältöön ja toteutukseen sekä kyseisten järjestelmien aiheuttamiin muutoksiin eri yrityksissä. Julkaisun loppuosassa selvitetään elintarvikepakkausten hygieniariskejä, prosessihygienian hallintaa sekä käytännön kokemuksia ja tuloksia liittyen paperi- ja pakkausteollisuudessa tehtyihin HACCP-vaara-analyyseihin ja mikrobiologisiin hygieniakartoituksiin. Taustalla on laaja yhteistyö yritysten kanssa. Kaikkiaan kymmenelle tehtaalle on laadittu omavalvontasuunnitelma tai sen keskeisin kohta HACCP-vaara-analyysi. Laajoja mikrobiologisia hygieniakartoituksia on tehty useampaan otteeseen viidelle eri tehtaalle.

An international data base of exposure measurements in the pulp, paper and paper product industries was constructed to be used in exposure assessment for epidemiology studies and hazard control. Industrial hygiene and biological monitoring data were collected from countries participating in the multicentric study of the International Agency for Research on Cancer. Each measurement was characterized by country, mill type and number, department, job, agent measured, sampling method, measurement result in the standard unit, duration and date of sampling, assessment of representativeness, measurer, purpose of measurements, and remarks (e.g. on measurement sites and biases). Over 31,000 measurement results on 246 different chemical agents from 13 countries were available from pulp (45% of measurements), paper/paperboard/recycling (12%) and paper product (11%) mills or from their non-production departments (23%). Most measurements (82%) were carried out after 1980. The most frequently measured group of agents was inorganic gases (35%), followed by organic compounds (25%), solvents (18%), mineral dusts (12%), metals (6%) and bioaerosols (3%). Over 90% of the measurements were without an obvious bias, but their true representativeness is difficult to assess. Concentrations of various agents, including sulfur dioxide, chlorine dioxide, carbon monoxide, nitrogen dioxide, ozone, ammonia, formaldehyde and some solvents, often exceeded current occupational exposure limits. This data base summarizes a great deal of previously unpublished exposure data, provides a unique opportunity to study exposure patterns at the international level and identifies exposure situations that require further attention and investigation.

Since parathion and other cholinesterase insecticides are being used extensively, safety precautions are important, and the need for prompt and adequate therapy if poisoning does occur must be emphasized. This paper stresses the acute nature of the poisoning and attempts to outline the basic principles of therapy so that practicing physicians may handle cases with more confidence, which should help prevent prolonged periods of functional disturbances due to anxiety following poisoning.