Archive for: General Safety and Health

This week: OSHA emphasizes fall prevention

By: May 8th, 2017 Email This Post Print This Post

A failure to provide workers with adequate fall protection is the violation cited most frequently by OSHA inspectors. Each year, hundreds of construction workers are killed in falls, which is why OSHA and its partners set aside this week, May 8-12, as a “National Fall Prevention Safety Stand-Down” to encourage employers to pause during the workday and revisit safety topics.

Given the high number of fall-related fatalities among construction workers, that industry serves as the natural focus of this week’s events, but the stand-down carries worthwhile reminders for those overseeing safety in healthcare settings as well.

Late last year, OSHA cited Jersey City Medical Center RWJ Barnabas Health with one willful and four serious safety violations, proposing a penalty of nearly $175,000 after a maintenance worker was electrocuted while working on a 6-foot A-frame ladder. The worker, who fractured multiple bones and sustained a subdural hematoma, died from the injuries more than two weeks after the fall. Kris Hoffman, director of OSHA’s Parsippany Area Office, called the death “tragic” and “preventable.”

Employers who hope to prevent fall-related injuries and deaths are encouraged this week to have conversations with their workers about hazards and protection. To that end, OSHA assembled a website, www.osha.gov/StopFallsStandDown/. The free resources available on the site include fall-prevention training guides in English and Spanish and a downloadable version of Falling Off Ladders Can Kill: Use Them Safely, a document that details proper ladder usage.

Will you pause this week for a fall prevention stand-down? If not, you should consider working these resources into your future training sessions. The emphasis may be only a week long, but the hazards exist year-round.

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When does workplace violence violate OSHA’s General Duty Clause?

By: May 5th, 2017 Email This Post Print This Post

It remains unclear whether the feds will follow California’s lead in implementing an occupational health and safety standard on workplace violence prevention in healthcare settings, despite a largely positive response from those who commented on OSHA’s recent request for input on the idea.

The federal standard could specify which steps employers must take to protect healthcare workers and impose fines for noncompliance. Even without the nationwide standard, however, it’s already possible for OSHA to penalize healthcare employers anywhere in the country for failing to prevent violence against doctors, nurses, and other healthcare professionals.

That possibility comes, of course, from the OSH Act’s General Duty Clause, which requires that an employer keep its workplaces “free from recognized hazards that are causing or likely to cause death or serious physical harm to [its] employees.” But what exactly does it take to support an allegation that an employer whose workers have been victimized by violence should be held accountable, to some degree?

Clarence Webster III, JD, with the firm Bradley Arant Boult Cummings LLP, addressed that question this week in a blog post, citing a directive that took effect in January. The directive guides OSHA officials on when and how to issue citations in response to workplace violence, Webster explained.

“In determining whether to initiate an inspection, the Directive sets forth a list of known risk factors, none of which would individually trigger an inspection,” Webster wrote.

These risk factors include employment in healthcare, working alone or in small numbers, late-night or early-morning shifts, working in high-crime areas, and others. If your workplace has some of these factors, there are four questions OSHA must answer in the wake of a violent incident to determine if you violated the General Duty clause:

  1. Did the employer fail to keep its workplace free of a foreseeable workplace violence hazard?
  2. Was the hazard explicitly recognized or recognized in a high-risk industry?
  3. Was the hazard causing or likely to cause death or serious physical harm?
  4. Was there a feasible and useful means by which to correct the hazard?

Answering “yes” to all four questions above–which align loosely with the four-pronged test articulated last year in a Government Accountability Office report on workplace violence prevention—would tend to support an alleged violation of the General Duty Clause. (An affirmative response to fewer than four of the above questions could still warrant a “hazard alert letter” with recommendations to improve safety.)

For any employers looking for practical steps to minimize risks, there is an 11-page list in Appendix A of the directive. It outlines engineering and administrative controls, and it provides a table with recommended applications in various healthcare settings.

Webster said one of the keys to preventing workplace violence is making sure that your employees understand that they should report potentially violent behavior, not tolerate it.

“However, when you get to the suggested engineering and administrative controls,” Webster added, “be sure to balance them against other laws governing your workplace, including state, local, and federal privacy laws and safety and building codes and standards.”

For more on the prospect of a federal OSHA standard on workplace violence prevention in healthcare, see the June edition of HCPro’s Briefings on Hospital Safety newsletter.

Workers’ Memorial Day: A somber reminder of progress made, work left to do

By: April 28th, 2017 Email This Post Print This Post

Carrie Rouzer was caring for a patient last July at Parrish Medical Center in Titusville, Fla., when a stranger barged in and gunned down both Rouzer, 36, and her 88-year-old patient before being subdued by security guards.

The shocking case, which drew attention to workplace violence as a real threat to healthcare workers, was certainly on the minds of groups who gathered Friday in Jacksonville and Miami in observance of Workers’ Memorial Day. The two sites were among hundreds nationwide holding local ceremonies commemorating the lives of those killed on the job, whether by violence or accidents.

The annual event is held on April 28, the day OSHA was established in 1971, as a reminder of the progress made in workplace safety in recent decades and the work yet to be done. Rouzer’s story, sadly, is among many others collected over the years.

Among the thousands of occupational fatalities recorded across all industries, between 100 and 150 occur in the healthcare and social assistance sectors each year, according to the Bureau of Labor Statistics. In 2015, there were 109. (Finalized numbers for 2016 will be released this December.)

When you consider how many hours workers put in, those 109 fatalities translate to a fatal injury rate of 0.6 per 100,000 full-time equivalent workers. That’s much less than the overall rate across all industries, which was 3.4 in 2015, according to BLS data. Workers in transportation and warehousing, by contrast, suffered a fatal injury rate of 13.8—which is 23 times higher than the rate in healthcare.

Within the healthcare sector, the numbers are broken down into three categories. Ambulatory healthcare services, which saw 47 fatalities in 2015, had a rate of 0.7. Nursing and residential care facilities, which saw 24 fatalities, had a rate of 1.1. And hospitals, which saw 21 fatalities, had a rate of 0.4. All of these numbers are down slightly from rates reported for 2006.

Although the fatal injury rate in healthcare remains low compared to other industries and has declined slightly in recent years, OSHA continues to look for ways to improve safety. Those improvements should be balanced against other considerations. But let’s take Workers’ Memorial Day as an opportunity to reflect on Rouzer’s story and others like it. Are we doing all we can reasonably do to protect workers? Is there more?

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A summary report on the number and rate of workplace fatalities by industry and sector published by the U.S. Bureau of Labor Statistics groups healthcare with educational services. Full report: https://www.bls.gov/iif/oshwc/cfoi/cfch0014.pdf

 

Seeking input on lab safety training book

By: December 15th, 2015 Email This Post Print This Post

Hi folks –

We are working on a rewrite of a popular book with our lab folks, Lab Safety Made Simple, that was done in 2006 by Terry Jo Gile.

If you know the book, you know that it helps laboratory directors facing increasing pressure from OSHA, the Joint Commission, COLA,  and CAP to train frontline staff on safety compliance every year. Safety compliance training not only fulfills annual regulatory requirements, but also helps to maintain a safe work environment, protect your facility’s bottom line, and avoid fines or fees from major regulators.

http://hcmarketplace.com/lab-safety-training-made-simple

The book is packed with tips, tools, games, activities, and case studies, Lab Safety Training Made Simple features training methods culled from lab experts in the field. It provides guidance on how to design successful training for employees of various ages, learning styles, levels of education, and job experience.

We also are planning to take the book electronic, and provide a lot of the tools in e-reader format for those of you who like to take your information mobile on a tablet or phone.

A lot has changed in 9 years, including GHS and a bunch of things related to waste management and other things.

What I’d like to know is what you want to see in the book? Is there a need for it? What would help you do your job better?

Please drop me a line at jpalmer@hcpro.com with any feedback. Thank you!

John Palmer

October is time to review fire safety

By: October 6th, 2015 Email This Post Print This Post

Dan Scungio, MT(ASCP), SLS, is a laboratory safety officer for Sentara Healthcare, a multihospital system in the Tidewater region of Virginia and otherwise known as “Dan, the Lab Safety Man.”

Every year I love to use autumn as the time to discuss fire safety. After all, many other organizations promote fire safety ever since October was designated as National Fire Prevention Month in 1922. This year, as always, I do want lab safety professionals to be “fired up” about safety, but there have been some questions about regulations in this area that need special discussion.

The College of American Pathologists (CAP) is the accrediting agency for many labs in the United States, and they have specific regulations about fire safety on their General Checklist.

One regulation states: “If the fire safety plan includes laboratory staff use of fire extinguishers, personnel are instructed in the use of portable fire extinguishers.”

If fire extinguishers are present in your laboratory, their purpose is to be used by the staff in the department, whether or not the safety plan includes staff using them or not. OSHA has something to say about this as well:

“If fire extinguishers are available for employee use, it is the employer’s responsibility to educate employees on the principles and practices of using a fire extinguisher and the hazards associated with fighting small or developing fires.”

The CAP checklist strongly recommends that staff have hands-on fire extinguisher operation that includes the actual use of the device (or a simulator). They do not indicate how often this training should occur. Many labs I have inspected only provide the training once, but OSHA states that it must be provided upon hire and annually thereafter. That makes sense, and lab staff should be ever-ready and able to extinguish a small fire should that become necessary.

Some facilities offer fire extinguisher training as they need to empty out their refillable extinguishers (typically CO2 extinguishers). However, if that does not happen where you are, you have other options. One is to contact your local fire authority. They may happily provide fire extinguisher training for your staff. Another option is to provide the training yourself. You may be able to obtain a test extinguisher or you may simply have to use a full extinguisher without actually discharging it. The important thing is to go through all of the steps of PASS (Pull, Aim, Squeeze, and Sweep) and to let the staff actually handle the fire extinguisher.

If you are providing the training, make sure you give some information about fires that people may not know. Describe the different classes of fires (A, B, and C) and the types of fire extinguishers used to fight them. Remind them not to use more than one extinguisher at a time so they do not blow a small fire onto another person. Tell them to always keep themselves between the fire and the exit. If the fire gets too big or out of control, make sure they leave the firefighting to the professionals.

Inspect your lab for fire risks. Are electrical cords frayed? This is a major cause of fires in the laboratory. Are items stored too close to the ceiling? This may block the action of your sprinkler system. Are ceiling tiles missing or out of place? This disrupts an important fire and smoke barrier. Who performs these inspections? You can, or your local fire authority can as well.

Autumn is a great time to raise fire safety awareness in your laboratory, but this is something that must be done all year. Drill your staff, make sure they know how to react to a real fire. Train them in the use of fire-fighting equipment. Walk your evacuation routes annually. Your staff truly cannot be too prepared.

Have you performed fire drills this year? Have your staff had hands-on fire extinguisher training? If not, it’s a great time to perform these tasks. Many people in history have lost their lives to fires, and laboratory fires are more common than you may think. Be aware, be ready, and ensure your staff remains safe if a fire situation does occur in your workplace.

 

 

 

MGH settlement underscores drug diversion problems

By: September 30th, 2015 Email This Post Print This Post

If you’ve been paying attention to the news, Massachusetts General Hospital (MGH) just got hit with the largest fine ever involving allegations of drug diversion at a hospital. In the settlement, MGH agreed to pay the United States $2.3 million to resolve allegations that lax controls enabled MGH employees to steal controlled substances for personal use. MGH has also agreed to implement a comprehensive corrective action plan to prevent, identify, and address future diversions.

The settlement stems from a 2013 investigation following an MGH disclosure to the Drug Enforcement Administration (DEA) that two of its nurses had stolen large volumes of prescription medications from the hospital. Altogether, the two nurses stole nearly 16,000 pills, mostly oxycodone, an addictive painkiller, from automated dispensing machines that MGH used to store and dispense prescription medications.

Read the rest of the story here.

The settlement drives home the idea that drug diversion is a huge problem in America’s healthcare facilities, and we’d like to help you prevent such problems in your facility.

We’d like to know what precautions your clinic or hospital has in place to monitor and control prescription medication. We are considering producing a book that would help healthcare facilities in their fight against drug thefts.

Please drop me a line at jpalmer@hcpro.com with your comments, and a few words about what you would like to see in such a book. What information would help you out in a book about drug diversion prevention?

Have a great day!

John Palmer

Is OSHA being sneaky?

By: June 4th, 2015 Email This Post Print This Post

Hi folks –

Boy, it’s fun to watch how sneaky OSHA can be. If you’ve been paying attention, you know that the agency has quietly passed changes to a few pretty important rules in the healthcare industry.

First, there was an upgrade to the Workplace Violence Prevention rule (3148), which basically is a rule that requires employers to have a plan in place. There was also a very well-done manual that went with it to help you out.

Then, in May, OSHA and NIOSH teamed up to provide a Respiratory Protection Toolkit for employers, which essentially is a warning that if you don’t already use respirators to help protect your workers against infections, you better start. And here’s the handy toolkit published to help you out:

https://www.osha.gov/Publications/OSHA3767.pdf

I don’t doubt that these are great things. We all want a safer work environment. But what’s going on here? Well, in the opinion of one lawyer who I read in an online blog:

“The bottom line is that OSHA is coming. Accordingly, employers in the health care industry should act now to ensure that their employees are working in the safest possible conditions and that, when OSHA appears at their door, they can demonstrate their commitment to employee health and safety.”

Interestingly, the Joint Commission is taking note of these changes, and has issued their own recommendations right about the same time that OSHA is doing so.

I’d like to know what you think. Is OSHA about to get tough on the healthcare industry? Good luck getting them to say so.

The feeling out there is that OSHA doesn’t have enough inspectors, so they probably won’t inspect. Will that change? And will you do anything different in your job because of it?

Please drop me a line and let me know your opinions.

Thanks!

John Palmer

Summer Safety in Healthcare

By: June 3rd, 2015 Email This Post Print This Post

Hi folks – ​

We are compiling a story of the most common safety and security concerns and dangers to hospitals and medical clinics during the summer months.

Please take a minute to share what you think is one of the biggest concerns, why it’s such a big deal, and what you suggest as a way to help mitigate the problem. It could be anything from making sure your employees are hydrated to keeping the doors shut so intruders don’t get in.

Thank you for all your help!

Have a great day.

John Palmer

Try our workplace violence prevention tools!

By: May 28th, 2015 Email This Post Print This Post

We’ve been telling you for some time now that you need to get a workplace violence prevention plan in place in your facility, and now it’s time for us to help you get started.

If you’re looking for a place to start, we have lots of downloadable tools and resources for you to use in your own facility. For instance, try the workplace violence assessment checklist as a place to start to determine the weak spots in your facility’s security. Next, give our safety tips poster to your employees during your next in-service training meeting.

According to Bureau of Labor Statistics, in 2013 more than 23,000 significant injuries were caused due to assaults at work. More than 70 percent of these assaults were in healthcare and social service settings. Health care and social service workers are almost four times more likely to be injured as a result of violence than the average private sector worker, OSHA says.

Further statistics show that about 27 out of the 100, or about 30% of the fatalities in healthcare and social service settings that occurred in 2013 were due to assaults and violent acts.

As a result, OSHA issued the update to OSHA 3148 in April, encouraging healthcare workplaces to develop a workplace violence prevention plan. It’s not so much an “encouragement” as it is a warning that inspectors will be checking to make sure you have a plan in place.

We’re here to help you do your job better and safer. Look to HCPro for all of your healthcare safety and security resources!

June 1 GHS deadline: Your compliance checklist

By: May 11th, 2015 Email This Post Print This Post


June 1, 2015 is the deadline that OSHA set for all employers to be in compliance with the new GHS chemical labeling regulations, which have been phased in over a three-year period to make the transition to the new system easier, especially for manufacturers, many of whom still have large stocks of inventory with old labels.

But for employers—and that means you as the laboratory or medical clinic—it’s a different story. By now you should have your books in order and your employees should know what an SDS is, and why it’s so different than what it used to be. If not, you’ve got a lot of work to do. We’ve put together a quick answer sheet for you to review, and to make sure you’ve made the right moves to be in compliance with the new GHS system.

What is GHS? Unless you really haven’t been doing your job as a safety officer (and you have, right?), this is a review for you. But the new GHS requirements were introduced by OSHA in 2012 that will require manufacturers of chemicals to switch from the traditional Material Safety Data Sheets (MSDS) to the new SDS system. The idea is to make identification of hazardous chemicals universally easier around the world, in any language, which at least theoretically, makes it safer for workers to handle and work with.

A major component of the new system is the updated Safety Data Sheets, or SDS, which replaces the older Material Safety Data Sheets (MSDS) that OSHA requires employers to have on record at job sites.

The sheets, which identify the chemicals and hazards associated with them, are divided into 16 sections, each dedicated to information about firefighting and first aid, storage, hazards, and what to do in the event of exposure to the substance. In addition, eight visual guides to workplace hazards called “pictograms” consist of a black hazard symbol on a white background with a red background, and are designed to be identified at a glimpse. They clearly identify hazards such as flames, carcinogens, corrosives, explosives, and environmental hazards.

What do my employees need to know?  OSHA gave employers until December 1, 2013 to complete training with their employees on the new SDS system and pictograms. To be safe, employees need to recognize both sheets, and how to find information about handling chemicals safely as well as first aid information should there be an exposure in the workplace.

What are some training ideas I can use?  Even if you did the proper training with your employees two years ago, if you don’t make the training an ongoing part of your safety program, your employees can forget the information.

Most safety experts suggest hosting a series of in-service trainings, to start. Get some donuts and coffee and introduce the new information such as pictograms to your employees. Make a fun quiz, or have your employees team to complete a scavenger hunt that requires them to identify pictograms on the new SDS. This also gives you a written record of their training you can then use to show to OSHA inspectors as proof of training.

Why are my chemical suppliers still sending old labels? In this case, chemical manufacturers had large stores of product that still had the old labels on them, along with original MSDS sheets corresponding to those products. If manufacturers had to change everything immediately, it would cost them a lot of money and waste a lot of chemicals, so OSHA gave them an extra two years to make the transition. That’s why your employees need to be trained to recognize both systems. Manufacturers have until June 2016 to complete their own transitions.

I can’t find SDS labels for the chemicals we use on the manufacturer’s web site. What’s next? Many manufacturers have been forward thinking enough to make sure they are providing the updated documentation for their products, even making them available on their website for easy download. But some safety managers who have been trying to update safety records have complained that they can’t find the proper SDS information for the chemicals they have in the workplace. In this case, you can wait for your suppliers to provide the updated documentation, but many safety folks have decided to take matters into their own hands and call vendors and suppliers to get the right information.

What if I don’t comply? OSHA’s GHS requirements are a law, so you really don’t have a choice. At best, you are opening your facility open to a major OSHA citation and fines. You also open yourself and your employees to injuries caused by not being up to date on information about the hazards associated with chemicals they are working with, as well as the first aid necessary to help out in an emergency.

For more information about the GHS requirements and ideas to help your facility comply, check out the following link on the OSHA website: https://www.osha.gov/Publications/OSHA3695.pdf

OSHA updates violence prevention guidelines

By: April 21st, 2015 Email This Post Print This Post

OSHA likes to tout itself as a governmental agency that looks out for workers in all industries. But they aren’t doing a very good job of announcing a huge change to guidelines that could help protect healthcare workers from the rising problem of workplace violence.

It took a couple of well-connected readers to let me know that OSHA earlier in April released an update to its Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers, known to many in the safety field as OSHA Rule 3148. Good luck finding any of this on the OSHA web site, by the way.

After an inquiry to OSHA public relations, I was sent the updated guidelines, which you should pay attention to if you are in charge of safety at your facility.

According to its own statistics, OSHA says in 2013 more than 23,000 significant injuries were caused due to assaults at work. More than 70 percent of these assaults were in healthcare and social service settings. Health care and social service workers are almost four times more likely to be injured as a result of violence than the average private sector worker, OSHA says. Further statistics show that about 27 out of the 100, or about 30% of the fatalities in healthcare and social service settings that occurred in 2013 were due to assaults and violent acts.

Under pressure to do something about this, the updated OSHA 3148 recommends that all healthcare facilities develop an effective workplace violence prevention program. Pay attention, because the word is that the Joint Commission is also following these changes closely.

The new OSHA guidelines are very specific in the types of workplace controls that employers should consider, especially when it comes to facility security and keeping track of employers. Examples include:

  • The use of silent alarms and panic buttons in hospitals and medical clinics
  • Providing safe rooms and arranging furniture to make sure there are clear exit routes for workers and patients
  • Installing permanent or hand-held metal detectors to detect weapons, and providing staff training on the use of these devices
  • Ensuring nurse stations have a clear view of all treatment areas, including the use of curved mirrors and installing glass panels in doors for better viewing, as well as closed circuit cameras to help monitor areas
  • Using GPS, cell phones, and other location technology to help keep track of staff working with patients in off-site locations
  • Protection front-end and triage staff using facility design elements such as deep counters, secure bathrooms for staff separate from patient treatment areas, and using bulletproof glass and lockable doors with keyless entry systems

In addition, the recommendations include employing administrative controls designed to track patients and visitors who have a history of violence, to better educate workers on the dangers and signs of impending violence, and to ensure better reporting procedures. Some of these recommendations include:

  • Providing clear signage in the facility that violence will not be tolerated
  • Instituting procedures that require off-site staff to log in and log out, as well as checking in with office managers periodically
  • Keeping a behavioral history of patients, including identifying triggers and patterns
  • If necessary, establish staggered work times and exit routes for workers who may be subjects of stalkers
  • Keep a “restricted visitor” list for suspected violent people, such as gang members, and make sure all staff are made aware

Also, OSHA recommends that employers provide updated training for employees, including:

  • Risk factors that cause or contribute to violent incidents
  • Early recognition of escalating behavior or recognition of warning signs
  • Ways to recognize, prevent or diffuse volatile situations or aggressive behavior, manage anger and appropriately use medications
  • Proper use of safe rooms—areas where staff can find shelter from a violent incident;
  • Self-defense procedures where appropriate
  • How to apply restraints properly and safety when necessary
  • Ways to protect oneself and coworkers, including use of the “buddy system”

For more information, the Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers can be found at https://www.osha.gov/Publications/osha3148.pdf

 

Take a lesson about chemicals from janitor’s death

By: July 9th, 2014 Email This Post Print This Post

We hear it every day like a broken record – wear your PPE and know what you are doing when you are working with hazardous chemicals in the workplace. Unfortunately, too many people don’t listen and they end up paying the ultimate price.

I’m reminded of this today as I read more about the janitor in an elementary school in Plymouth, Massachusetts who was apparently overcome and died from exposure from an as-yet unknown chemical on Monday morning.

If you’re just learning about this, 53-year-old Chester Flattery, the head custodian at Manomet Elementary School, was found dead by the school secretary at about 8 a.m.  That employee and 12 other people – many of them police officers, firefighters and other first responders who were exposed – had to also be taken to the hospital for treatment.

The investigation is still ongoing, but reports say Flattery had been at work for an hour before anyone else and that he may have been applying a floor sealant at the time of his death. School is not in session and there is a lot of maintenance work that goes into getting the building ready for next year.

Now, we all in workplace safety world know he was supposed to be wearing a respirator, eye protection, and other protective equipment. I have been a teacher in an elementary school, and I have seen these guys hard at work getting the school ready, even as I was getting my own classroom ready for students.

Most of the time, they are in regular street clothes as they go about their duties and I am willing to bet Flattery was no exception. As someone who had been working there since 2007, he was probably just doing what he always did – this time the fumes were too much for him and no one was there to help him until it was too late.

It almost happened to me. Back in college, I worked as a pool director at a country club in Connecticut, responsible for maintaining the proper chemical levels. One morning, I went into the supply closet looking for chlorine pellets, not knowing that one of my lifeguards hadn’t tightened the cover of the bucket properly the night before, allowing rain water to seep in. When I took the cover off, I got hit with a cloud of chlorine gas that knocked me off my feet and burned my throat. Happily, I was able to get to fresh air quickly and was fine. But no one was around and I was not wearing any kind of protection. I was lucky, and I never made the same mistake twice.

In the healthcare field, you can take a lesson from this tragedy. Don’t assume that just because you have done a job for a long time, you can ignore the rules. OSHA has bloodborne pathogens and hazardous chemical standards for a reason. If you are working with patients, wear your gloves, use your safety sharps, and lift safely.

If you are in a lab and work with chemicals, make sure you know the hazards of what you are working with and how to handle it properly, as well as any first aid information – it’s why OSHA says you must have SDS safety sheets on site. And always be sure someone is around, because it may save your life.

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