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OliverWallace  
#1 Posted : 14 January 2021 09:12:10(UTC)
Rank: Forum user
OliverWallace

I was wondering on what side of the fence people sit in regards to the efficacy and competency for performing workplace rapid antigen testing on behalf of an employer if pushed. Obviously any testing kit acquired and utilised would need to be approved by the relevent body however a lot of these testing kit providers talk about how simple they are to perform that safety practitioners and first aiders can perform them. I missed the "infection control" unit in my diploma.

From a personal perspective I don't feel comfortable baring the responsibility for performing workplace testing, the potential for incorrectly performing the test and consequence of missing a positive case that then transmits Covid in the workplace. I would worry about results giving an incorrect reading, and also my personal exposure to Covid-19. It also raises questions around the frequency and quantity of tests to perform. Do you test everyone or just a random sample?. Then the additional controls around contaminated media and subsequent need for PPE. 

We are a simple assembly and distribution facility with plenty of site space to social distance, have a reduced workforce and have introduce all the government guidance and then some (one way systems, sanitizer stations, clean downs & temperature checking (pointless for asymptomatic). Until now we have had 6 known positive cases, no known workplace transmission and have a workforce of 70 that typically work quite far apart within "production". Smoking shelters and canteens are hard to police and a lot of staff car share. We have introduced policies for the canteens and smoking areas. 

I ask as I get the impression that top management want to be seen to be doing something more in the near future but I really don't see the need if everyone simply follows the guidance. Top managment will only be hoping to capture the asymptomatic cases. 

HSSnail  
#2 Posted : 14 January 2021 09:29:16(UTC)
Rank: Super forum user
HSSnail

Oliver, I’m with you; no way I would undertake these tests on someone – and I am reasonably sure it’s not in the 1st Aid Course! If you have a nurse on-site, maybe! I was under the impression that most of these kits are DIY – well, having seen my wife swabbed twice before being allowed to attend hospital appointments, I know what I would be saying if someone wanted me to do that twice a weak! (yes, I’m a wimp!)

 

As discussed on this site, there is the question of accuracy – with both false positives and negatives. So you may be excluding people who could work – and allowing people in who are carriers.

I have already had issues in my workplace when reminding people to socially distance that they say, “O, it’s OK, I have had the virus. “  I can just see it with these kits – “O, it’s OK. I tested negative, so I don’t need to follow the rules.” But of course, testing negative at 9.00 in the morning does not mean that you have not contracted the virus by 10.00 in the morning.

I’m still to be convinced of the value of these kinds of tests – does it show?

thanks 1 user thanked HSSnail for this useful post.
OliverWallace on 14/01/2021(UTC)
A Kurdziel  
#3 Posted : 14 January 2021 10:17:02(UTC)
Rank: Super forum user
A Kurdziel

I have had the Lateral Flow Device test, and it’s not pleasant  but it is quick: you get the result in about 45 minutes. The staff managing the test  do not need to be medically qualified  and interpretation is straight forward if you follow the protocol.  The actual sampling has to be self- administered. Non-medically qualified people can’t  be taking swabs from the back of your throat or up your nostril. It is also voluntary. Just as some people can’t stand to have their face covered ( for genuine reasons) so many people can’t cope with the back of their throat being touched or things travelling couple of inches up their nose.  

There are also things like confidentiality rules which need to be applied but the biggy is what the test means. A positive result means that you are  most likely (90% certainty) have the virus, but a negative result might be a false negative ( about 30% false negatives compared to the gold standard  RT-PCR lab based test)  so its only on the balance of probabilities that you are negative- what I got back for the last test was “It’s likely you were not infectious when the test was done.”

That brings us to the fact that you can get infected any time  after the test, so how often do you test,: once a week, once a day, hourly?

thanks 2 users thanked A Kurdziel for this useful post.
Kate on 14/01/2021(UTC), OliverWallace on 14/01/2021(UTC)
Roundtuit  
#4 Posted : 14 January 2021 10:33:35(UTC)
Rank: Super forum user
Roundtuit

I must admit I am one of those with a very strong gag reflex for anything nearing the back of my throat.

Having seen reports of "accidents" with the swab breaking and getting stuck I will not be rushing to any location where admittance is based upon being tested particularly given the reports of horrendous waiting times for the Ambulance Service at present.

Roundtuit  
#5 Posted : 14 January 2021 10:33:35(UTC)
Rank: Super forum user
Roundtuit

I must admit I am one of those with a very strong gag reflex for anything nearing the back of my throat.

Having seen reports of "accidents" with the swab breaking and getting stuck I will not be rushing to any location where admittance is based upon being tested particularly given the reports of horrendous waiting times for the Ambulance Service at present.

FHS  
#6 Posted : 14 January 2021 11:14:24(UTC)
Rank: Forum user
FHS

Roundit - Do you have any links to report of swaps breaking please? I am involved in the delivery of LFTs  and this would be of interest.

Thanks

A Kurdziel  
#7 Posted : 14 January 2021 11:28:38(UTC)
Rank: Super forum user
A Kurdziel

PS

People have been describing the Lateral Flow Devices as LFT, but  I have been told by a former NHS laboratory manager( of  one the biggest labs in Yorkshire)  that we should not do this as in the NHS testing service, LFT stands for Liver Function Test. So, Tracy is now happy !

Roundtuit  
#8 Posted : 14 January 2021 11:42:41(UTC)
Rank: Super forum user
Roundtuit

https://www.bbc.co.uk/news/uk-england-leicestershire-54561788

Admit it is not the "typical" testing point but with my reflex and the fact these things can break.

Other items:

June 2020 a US 64 year old had an endoscopic recovery of a brken swab from their stomach

July 2020 a Saudi child underwent surgery to remove a broken swab

Roundtuit  
#9 Posted : 14 January 2021 11:42:41(UTC)
Rank: Super forum user
Roundtuit

https://www.bbc.co.uk/news/uk-england-leicestershire-54561788

Admit it is not the "typical" testing point but with my reflex and the fact these things can break.

Other items:

June 2020 a US 64 year old had an endoscopic recovery of a brken swab from their stomach

July 2020 a Saudi child underwent surgery to remove a broken swab

Kate  
#10 Posted : 14 January 2021 11:54:34(UTC)
Rank: Super forum user
Kate

As to non-qualified people taking the swabs from others:

When you do a standard home test, you get a leaflet which after telling you how to swab yourself, also tells you how swab an adult or a child who is unable to do this themselves. 

johnc  
#11 Posted : 14 January 2021 12:28:57(UTC)
Rank: Super forum user
johnc

If a person has a Lateral Flow Test and the result comes back positive they are then asked to go to another testing centre where they will do the same self swabbing but this time the swab is placed in a tube with a liquid in and sealed. This is then sent to a laboratory for testing and the result comes back in between one and three days. Whilst waiting for the result the person must self isolate. At some of the second test centres staff may take the swab although this is not the norm now. The second test has to be booked as it is done on an appointed time basis. Are you going to allow,staff time to visit a second centre if their first test comes back positive. The swab stick is designed to snap in two so it fits into the tube sent to the laboratory. It didn't seem that easy to break when I did it.
OliverWallace  
#12 Posted : 14 January 2021 13:41:10(UTC)
Rank: Forum user
OliverWallace

I appreciate the replies and it will certainly help me to strengthen my recommendation. I personally do not see the urgent need on site to resort to introducing testing but I feel I can better articulate that now given som eof the additional advice you have given. Much appreciated by all. 

Acorns  
#13 Posted : 14 January 2021 17:10:07(UTC)
Rank: Super forum user
Acorns

Oliver, I think you have answered your own question really. If the result has no probative help in showing if a person does/n't have covid then you really have to ask what is the value of the test?  Pretty much a varioation and extension on your view, and of many others, on the limited value of a temperature check.  

chris.packham  
#14 Posted : 15 January 2021 07:25:47(UTC)
Rank: Super forum user
chris.packham

The number and variety of routes by which a person can be exposed to SARS-Cov-2 and become colonised, possibly then infected, make me question the real benefits of the test. It only tests what is in (not on) the body and may thus return a negative result whereas at the time of testing that person's hands (or clothing) might be contaminated (colonised). Following the test the person transfers the virus to where it can gain access to the respiratory system with subsequent infection, albeit probably initially asymptomatic. Even without that they may actually transfer the virus to objects which others handle. There is increasing evidence that what I call the 'indirect' route, i.e. via fomites, is somthing the significance of which has not been properly reconised. They could be completely clear but during the day handle one or more objects that are fomites and thus become colonised/infected. These fomites could then be a source of transmission of the virus to others who handle them.

Unfortunately there does not yet appear to be a simple, quick test to establish whether a surface has become contaminated with the virus, so for me testing the person could well be considered highly selective and the interpretation questionable, potentially misleading

Essentially we are faced with a working environment where the hazard (SARS-Cov-2) could be present without our knowing if, or where, or when. Instead of spending time on testing perhaps more attention to how it might spread within our workplace and how we can minimise this would be more productive. How we achieve minimisation of spread will vary from working environment to working environment. There are no 'silver bullets' here!

Roundtuit  
#15 Posted : 15 January 2021 08:41:55(UTC)
Rank: Super forum user
Roundtuit

https://www.constructionenquirer.com/2021/01/15/colas-rolls-out-weekly-covid-rapid-testing-for-staff/

Weekly

Site operational staff

Hope this ones a miss-print "£25m a test"

Fogging the cabs of vehicles

Edited by user 15 January 2021 12:34:35(UTC)  | Reason: it was a miss-print now says £25 a test

Roundtuit  
#16 Posted : 15 January 2021 08:41:55(UTC)
Rank: Super forum user
Roundtuit

https://www.constructionenquirer.com/2021/01/15/colas-rolls-out-weekly-covid-rapid-testing-for-staff/

Weekly

Site operational staff

Hope this ones a miss-print "£25m a test"

Fogging the cabs of vehicles

Edited by user 15 January 2021 12:34:35(UTC)  | Reason: it was a miss-print now says £25 a test

HSSnail  
#17 Posted : 15 January 2021 09:14:21(UTC)
Rank: Super forum user
HSSnail

https://www.theguardian.com/world/2021/jan/14/regulator-refuses-to-approve-mass-covid-testing-schools-in-england

Looks like the regulator agrees with all of us about the potential negative inpact of such tests.

http://www.msn.com/en-gb/news/coronavirus/fears-of-return-to-pre-christmas-channel-chaos-as-france-bans-rapid-coronavirus-tests/ar-BB1cMaZ0?ocid=ientp

And now the French have banned it for clearance to enter France.

Edited by user 15 January 2021 09:20:17(UTC)  | Reason: adding france link

stevedm  
#18 Posted : 17 January 2021 11:09:32(UTC)
Rank: Super forum user
stevedm

You can train people to give the test however the Clinical Governance structure needs to be in place i.e. your are supervised ultimately by a qualified Doctor...you can be trained to undertake any test such as this as a 'Technician' some people call it different things...but to expect somone untrained to take that on and to administer it can be prelude to simple assault charges if they don't follow the procedures for (and understand) the types and acknowledgement of simple things like consent...the test is and confidentiality rears its head again...my advice...'run forest run'..far away from this....

if you are doing it in your work place today...I hope you professional indenity cover extends to medical procedures..  :)

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A Kurdziel on 18/01/2021(UTC)
John Murray  
#19 Posted : 18 January 2021 07:24:17(UTC)
Rank: Forum user
John Murray

Good luck. Most of the vaguely-medical people doing the nasopharyngeal test do it wrong. There's a reason the swab is at the end of a long stick....it has to sample the back of your throat via the nose! Hint: the swab will be almost horizontal if done correctly......hopefully the person being tested won't have nasal polyps, a deviated septum or have had surgery for either, otherwise the procedure won't be fun.

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A Kurdziel on 18/01/2021(UTC)
johnc  
#20 Posted : 18 January 2021 15:15:54(UTC)
Rank: Super forum user
johnc

Post #18. The test is not classed as a clinical procedure and the sampling is done by the person who is being tested. I have undergone these tests several times now and for both the quick test and the lab test. Consent is said to have been given when the person being tested hands over the sample or if an NHS test when the form giving personal details is completed. There is no need for a doctor to supervise - look at all the testing stations being run by the army, the NHS or local councils, no doctors anywhere. Post #19. Not sure who advised you on the test but the nasal part of the test is carried out by reaching up the nasal passagel until you feel a slight obstruction. This is when the top of the nasal passage is reached. It is not the back of the throat. I have a deviated septum and haven't had a problem by using the nostril on the clearer side as only one sample is required from the nose and two from the tonsil area of the throat.

Edited by user 18 January 2021 15:20:26(UTC)  | Reason: Formatting

thanks 1 user thanked johnc for this useful post.
Martin Fieldingt on 18/01/2021(UTC)
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