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COHN-S Exam Review Questions and
Answers
Healthy People 2030 - ANS-Us Department of Health and human services promotion object , bench mark , justified programs like smoking cessation & Tabaco and HIV programs Leading Health Indicators, key health problems in the country to help develop health education - ANS-divided into Health Promotion behaviors motivated by life choices for active healthy living and Health protection behaviors motivated by avoiding sickness Total Worker Health TWH - ANS-policies, programs, and practices that integrate protection from work-related safety and health hazards with the promotion of injury and illness prevention efforts to advance worker well-being the 6 T W H total worker health theory's are - ANS-1) opioid & other substance in workplace
- mental health in the workplace
- measurements on worker well being
- out reach Education training
- health work design and well being
- future of work Social Ecological Model (SEM) - ANS-a health behavior theory that is shaped by physical and social environment including ones individual, interpersonal, organizational, community, public policy transtheoretical model of behavioral change (TMM) - ANS-Ones Behavior changes occur in stages. Stage 1 Precontemplation , No interest in change Stage 2 Contemplation, possible intent to change stage 3 Preparation, the intent to change in 30 days Stage 4 Action, change behaviors in less than 6 months stage 5 Maintain changes, for more than 6 months Social Cognitive Theory (SCT) - ANS-Self-Efficacy • Task • Barrier Persuasion from authority Observation of others, Successful performance of the behavior, Physiological feedback Outcome Expectation
Health Belief Model - ANS-A theory of health behaviors; the individuals perception of the disease determines the susceptibility of the disease. Health risk assessment (HRA) - ANS-A screening tool used to evaluate the benefits and the risks associated with starting any type of exercise that is strenuous in nature. Employers can use HRA data to determine priority health needs. Workplace Integrated Safety & Health Assessment (WISH) - ANS-WISH is a tool to assess the understanding of current policies and procedures & programs currently in place. It consists of 6 guided outlines. The six guided outlines for workplace Integrated safety & health Assessment (WISH) - ANS-1) leadership commitment
- participation
- supportive policies and procedures environmental working conditions
- comprehensive & collaboration in different departments /working together
- adherence
- data drive changes The three different levels of Prevention Activities are primary, secondary, tertiary - ANS- Primary Prevention activities = eliminating or reducing the risk by taking specific action via Health promotion or Risk reduction secondary prevention activities= Early detection of a disease while treatable - ANS- tertiary prevention activities = maintaining the health of individuals and providing rehabilitation to obtain optimal health Health Promotion Program Model phases = the frame work that is used in developing health programs - ANS-This contains 4 steps step 1) Assess & analyze for the need step 2) Plan and develop specific details about program step 3) implementation when the plan goes into action step 4) evaluation to assess if the goals have been met Ethical principles that OHNs need to follow. Found in AEOEM , ANA, AAOHN, - ANS- Nonmaleficence = ethical principle of the employer should prevent intentional harm to employee Autonomy = ethical principle of the employee has the right to make their own decisions and owns work Beneficence= ethical principle of performing actions that benefit others justice= ethical principle that relates to the distribution of limited resources Federal regulations that OHN must follow = OSHA, HIPPA, FMLA, ADA, GINA - ANS- OSHA = Occupational safety & health administration who requires employees to have a safe workplace and have access to relevant medical records at no cost to them
HITACH Act 2009 - ANS-the penalties from transmitting electronic medical records w/ out adequate privacy protection to a third part vendor like immune re registration cancer registries or public health General Duty Clause - ANS-Statement in U.S. Occupational Safety and Health Act that requires employers subject to OSHA to provide employees with a safe and healthy work environment. Privacy Act of 1974 - ANS-a law that gives citizens access to the government's files on them. It also allows them to Amend their records The Right-to-Know Standard requires employers to have the following 4 requirements on chemicals - ANS-1) a chemical inventory & hazard classification
- labels & information identifying hazards w/ in the GHS
- access to all SDS on each chemical
- employee training identifying, handling of hazard GHS Globally Harmonized System of Classification and Labeling of Chemicals - ANS- Internationally agreed system created by the united nations to classify & label & inform all chemical hazards Quantitative - ANS-relating to, measuring, or measuring by the quantity of something rather than its quality. independent Variable X = predictable or presumed cause Dependable Variable Y = outcome or presumed effect Qualitative - ANS-Data in the form of words, objective, groups onions Incident rate = number of new cases - ANS-Number of injuries or illness X 200,000/ Number of hours worked based on the number of recordable cases per 200,000 work hours prevalence rate formula - ANS-number of ALL cases in a time period / divided by size of at-risk populations at midpoint of time period x 100, mortality rate (death rate) - ANS-the number of deaths per thousand people Permissible Exposure Limits PEL = The maximum amount or concentration of a chemical that a worker may be exposed to under OSHA regulations. - ANS-Biological Exposure Indicates = general values to analyze biological monitoring or concentration of chemicals in body fluids like blood or urine
Threshold Limit Value (TLV) = the concentration of a given toxic material that generally may be tolerated without ill - ANS-T L V - T W A = threshold limit value in time weight average of 8 hrs T L V - STEL = threshold limit value short term exposure = less than 15 min - ANS-T L V -C = threshold limit value "absolute" defined by the shortest interval that can be samples Action levels = the concentration of about 1/2 of PEL which triggers environmental & biological monitoring and some controls in OSHA - ANS-Immediately Danger to Life Health level I D L H= maximum concentration for which escaped w/ in 30 min that caouses dangerous health effect L D 50 = dose which when obtained directly kills half of the tested subjects and or animals - ANS-L C 50 = the concentration of the chemical in a test atmosphere that kills 1/2 of the subjected being tested in 1 hour The OSHA confined space standard requirements/criteria - ANS-large enough for an employee to fully enter and perform task, rule out hazardus atmospheric testing, have a configuration/emergency plan if an employee is trapped or asphyxiated. PPE SCUBA and emergency tank. EE must have Walk-through survey - ANS-a survey in which a safety professional walks through a worksite and notes hazards. OSHA blood-borne pathogens B B P standard =Guidelines designed to protect employees against occupational exposure to blood-borne pathogens or OPIM Other potential infectious material like ebola, zika, HIV - ANS-BBP OSHA requires employer to establish written exposure control plan including PPE universal precaution, training on controlling, safe use practice, cleaning, exposure plan , medical surveillance Burns = Tissue damage cause by extreme heat, cold, electrical. 1st degree surface of the skin, 2nd dermal layer blister pain erthema and 3rd degree burns down to muscle and bone. Stop the source of burn - ANS-Stains is an overstretching of a part of the muscle or tendon. Strains refer to damage to the ligaments. each have 3 degrees with 1 being the least and 3 most severe BBP Hep B HPV Medical surveillance = OSHA requirement that all Employees in the initial 10 days & annually be educated on BBP and complete mandatory Hep B Vaccine acceptance or declination form Post-exposure OHN should evaluate and refer for testing and offer to counsel - ANS-Water borne pathogens found in drinking water examples are Giardia, Shigella, Salmonella, legionella, Cryptosporidium Prevention is eating raw or tap water wile traveling Respirator Protection Program OSHA requirement 29 CFR 191.134 consist of OHN reviewing questionnaire form and conducting medical eval for correct respirator for
chemical irritants are substances that irritate the air passage = airway constriction Resulting in SOB, difficulty breathing and asthma - ANS-Chemical irrants are Chlorine , Hydrogen Fluoride, ammonia, Florine, Sulfur Dioxide Ozone fibrosis "scarring" Products are substance that cause Pulmonary fibrosis and pneumoconiosis aka scaring of the lungs - ANS-fibrosis substances are asbestos, coal dust " Monday Moring Fever", silica, beryllium Allergens are substances that trigger allergic response by broncho spasming and creating Reactive airway diffusions RADS - ANS-Isocyanates , Fungal spoors, formaldehydes, animal dander carcinogenic substances that cause or lead to cancer - ANS-carcinogenic substances inhaled are Asbestos, cigarettes smoke, Chromium, Uranium, Arenic Chemical Burns from Powder metals & Dry Lime or Calcium Oxide, Sodium, Potassium, magnesium, phosphorus, lithium, and titanium. Will react to water so do not wet! Brush off first - ANS-Alkaline substances will cause more damage the Acid substance to the eye. May take 3-4 hours to flush out with a morgan lens, PH paper is helpful to use to test if the substance is out. Phenol Exposures will cause hypotension, cardiac arrhythmias, seizure, coma .. Antidote treatment is 50% Polyethylene glycol - ANS-Arsenic & Mercury antidote treatment = Dimercaprol B A L Cyanide antidote treatment = Cyanokit hydrogen cantalanin Ethylene Glycol antifreeze antidote treatments = Fomepizole alcohol Lead antidote treatment = B A L, EDTA , Succimer - ANS-Methemoglobin from water with pesticides antidote treatment is Methylene Blue Organophosphates pesticides toxicity will inhibit acetylchorites and will have prolonged SLUGE m, salvation, lacrimation, urination, G I aggravation, emesis and muscle twitching's - ANS-Organophosphates pesticides antidote treatment is atropine & Oxygen then Pralidoxime 2 pam. Duo Date IM (atropine & Pralidoxime auto injectable) Nitro Dioxide / Silo Farmer Disease = result of Nirto dioxide gas build up in silo causing pulmonary edema, bronchitis fibrosis obliterans 10 -15 days post exposure - ANS- Treatment for Nitro Dioxide / Silo Farmer Disease is Oxygen at 100% and steroids treatment for 8 weeks Hydrogen Sulfide (H2S) from sewerage sells like rotten eggs. SEVERE Toxicity that Causes Drop effect or CNS depression, death, Pulmonary edema. PPE SCBA air respirator & H2s monitor - ANS-O D T S = Organic Dust Toxic Syndrome from fungus, bacteria, endotoxins from trapped gasses from molding wood chips compost, grain fever, can cause death.
H P Hypersensitivity Pneumonitis cause extrinsic allergic alveolitis wheezing SOB restrictive PFTs with employees working on farms, cheese workers, animals birds. - ANS-Farmer Lung = Molding Hay Sugar lung = Bagassossis both cause fluid in the alveoli Beryllium chronic beryllium disease fibrosis irritant / foresent lights should be tested for LPF - ANS-Pneumoconiosis = inert Dust Diseases fibrosis scaring of the lungs seen with iron workers, Fibro genic Dust, Asbestos coal workers Cadmium chemical found in batteries, pigments, colorants will cause prostate & lung cancer& COPD. Cadmium has a 1/2 life of 24 years. Diagnoses with urine test and blood test also known as the Ouch Ouch disease in Japan WWII - ANS-Phenol has a rapid absorption though skin and EYEs phenolic resins. Can cause blindness Severe, & damage to liver and kidneys causing dark urine and increase phenol on urine treatments Flush's water and give polyethylene glycol Cyanide Toxicity r/t burring plastics, foam, rubber seen fire fighters causes severe CNS issues confusion, dilated pupils, coma & Death GIVE Cyanokit. PPE SCBA respirator - ANS-Physical Hazards are factors in the environment that cause harm = Radiation, Heat & Cold Burns, Electrical Burns, Noise Hazards, Ergonomic OHN should identify and eliminate/control Physical Hazards early as possible to help prevent harm. Via first aid or Medical surveillance programs. - ANS-Job Hazard Analysis = is a technique to identify hazards before the occur in the workplace, identified during safety inspection, Safety walk through incident inspection. OSHA requirement to determine PPE Vibration Hazards cause damage to the nerves muscles and bones. It also increases the risk of hearing loss. W B V whole body vibration can result in muskleskelital pain in back .Cause Hand-arm vibration syndrome H A V S. Stockholm work shop. - ANS- Vibration Hazards engendering controls are mechanical fixes. Administrative control would be to limit the amount via schedule medical surveillance hearing conservation Radiation Hazard can harm someone with out touching and found in wide range of Occ Health setting. Two main types are - ANS-Ionizing Radiation = Very high energy form if electromagnetic radiation PEL standard is 1.25 rem per colander year PPE All EE must wear their responders and must not exceed 5 Rem annual whole body.
- ANS-Health Surveillances OHN may conduct Hearing Conservation, Respirator Protection, Laser Protection, Hazardous Material, Chemical Protection Hearing Conservation Program OHN oversees hearing conservation/hearing loss prevention programs for noisy workplaces. NIOSH recommended exposure limit is 85 db average over 8 hrs TWA - ANS-OSHA PEL requirement is 90 db for 8 hrs; 95db in 4hrs; 100db in 2 hrs 105db in 30 min as the time decreases the number of db sounds increases by 5. OSHA also requires annual audiogram testing.
