1064:
from grocery stores to hardware stores, consumers are deluged with warnings that they are being exposed to unnamed carcinogens and reproductive toxins. They are not told either the degree of exposure or the likelihood that they may actually be impacted by it. Moreover, because the risks to business of not providing a warning, many provide a warning even though they don't actually know whether an exposure is occurring, or even if the exposure is trivial, further diluting the meaning of warnings to consumers."
25:
1044:"Unfortunately, the 'safe harbor' warning-sign language specified under Proposition 65 is designed to be so all-encompassing that it is vague and typically doesn't provide much useful information," said Jim Abrams, president and CEO of CH&LA. "People see Prop. 65 warning signs nearly every place they go – grocery and hardware stores, restaurants, commercial buildings, car show rooms, hotels and inns, pretty much everywhere...
1118: (Cal. Ct. App. 4th Dist. Div. 3 March 24, 2006) ("Given the ease with which it was brought, and the absolute lack of any real public benefit from telling people that things like dried paint may be slowly emitting lead molecules or that parking lots are places where there might be auto exhaust, instead of $ 540,000, this legal work merited an award closer to a dollar ninety-eight."), archived from
329:
Prop 65 warning labels to any product of theirs that they think might possibly contain one of the 900 listed chemicals without testing to see whether the chemical is really present in their product and without reformulating their product, because it is cheaper to do so than to run the risk of being sued by Prop 65 enforcers.
1182:
customers. That profusion of warnings has subverted
Proposition 65 and left Californians, and increasingly anyone who shops online, overwarned, underinformed and potentially unprotected, a Times investigation has found. And it has funneled hundreds of millions of dollars to a handful of attorneys and their repeat clients.
328:
has been criticized for causing "over-warning" due to encouraging "meaningless warnings." There is no penalty for posting an unnecessary warning sign, and to the extent that warnings are vague or overused, they may not communicate much information to the end user. Many companies now routinely attach
154:
alert that highlighted the widespread problem of alarm fatigue in hospitals. Their recommendations included establishing guidelines to tailor alarm settings, training all members of the clinical team on safe use of alarms, and sharing information about alarm-related incidents. This alert resulted in
1063:
While the intent of Prop 65 was to 'inform' consumers, the impact of warnings under the Act has been a proliferation of meaningless warnings. Virtually every business has some sort of Prop 65 warning sign posted, and innumerable products are labeled with the warning. From gas stations to hotels,
141:
The constant sounds of alarms and noises from blood pressure machines, ventilators and heart monitors causes a "tuning out" of the sounds due to the brain adjusting to stimulation. This issue is present in hospitals, in home care providers, nursing homes and other medical facilities alike. The US
1181:
Companies in every sector of the consumer economy now routinely attach warnings for any of the more than 900 chemicals and elements covered by
Proposition 65, without testing for them or attempting to reformulate products. They fear citizen-enforcer lawsuits more than they fear freaking out
155:
designation in 2014 of clinical alarm system safety as a
National Patient Safety Goal and it remains a goal in 2017. This Goal will force hospitals to establish alarm safety as a priority, identify the most important alarms, and establish policies to manage alarms by January 2016.
250:, some 15 hours' drive from Thunder Bay, followed one hour later by a second alert which notified individuals that the first alert had been resolved. A similar double alert occurred on a single night in February 2019, leading to concerns over alert fatigue.
802:
Cantillon DJ, Loy M, Burkle A, Pengel S, Brosovich D, Hamilton A, Khot UN, Lindsay BD (2016). "Association
Between Off-site Central Monitoring Using Standardized Cardiac Telemetry and Clinical Outcomes Among Non-Critically Ill Patients".
206:. In this approach, alarms do not fire at the bedside, but fire at a central monitoring station where a trained healthcare provider evaluates each alarm and alerts the bedside clinician if they should intervene or evaluate the patient.
1098:
This is to be contrasted with Prop. 65 warning experience where the public received meaningless warnings filled with disclaimers, information that trivializes risk, and fails to put it into context.
183:. Some additional outcomes include workload increase, interference with communication, wasted time, patient dissatisfaction, and unnecessary investigations, referrals, or treatments.
971:"July 27, 2010 Railroad Accident Report – Collision of Two Washington Metropolitan Area Transit Authority Metrorail Trains Near Fort Totten Station Washington, D.C. June 22, 2009"
167:
The large number of alarms, especially of false alarms, has led to several unintended outcomes. Some consequences are disruption in patient care, desensitization to alarms,
289:
system generated alerts notifying train dispatchers to the presence of such faulty circuits, the rate of such alerts was about 8,000 per week. An investigation by the US
150:
sentinel event reports 80 alarm-related deaths and 13 alarm-related serious injuries over the course of a few years. On April 18, 2013, the Joint
Commission issued a
195:
Change alarm sounds to be softer and friendlier in order to improve identification of alarms by sound alone. Another recommendation is for clinicians to adjust the
838:
Blum, JM; Tremper, KK (February 2010). "Alarms in the intensive care unit: too much of a good thing is dangerous: is it time to add some intelligence to alarms?".
93:) become desensitized to safety alerts, and as a result ignore or fail to respond appropriately to such warnings. Alarm fatigue occurs in many fields, including
581:
217:. The algorithms used can be adjusted to balance between sensitivity and specificity to limit the number of false alarms and still detect true deterioration.
1028:"California Hotel & Lodging Association Helps Lodging Guests Understand Proposition 65; Court Approval Obtained for Comprehensive Compliance Procedure"
203:
35:
1158:
899:
684:
524:
748:
Graham, KC; Cvach, M (January 2010). "Monitor alarm fatigue: standardizing use of physiological monitors and decreasing nuisance alarms".
456:
Bliss, JP; Gilson, RD; Deaton, JE (November 1995). "Human probability matching behaviour in response to alarms of varying reliability".
278:
953:
496:
179:, misuse of monitor equipment including "work-arounds" such as turning down alarm volumes or adjusting device settings, and missed
421:
Blackmon, R.B.; A. K. Gramopadhye (1 June 1995). "Improving
Construction Safety by Providing Positive Feedback on Backup Alarms".
1027:
317:, but in 2020, federal officials set up a three-tier system so people would get this warning for the most serious situations.
263:
607:
571:
Monegain, Bernie. "'Alarm
Fatigue' Endangers Patients." Healthcare IT News. HIMSS Media, 9 April 2013. Web. 24 January 2014
290:
1075:
199:
and delays to alarms to match the patient's traits and status. However, this directly trades sensitivity for specificity.
1115:
993:
882:
784:
585:
69:
159:
has listed alarms on its "Top Ten
Hazards List" since 2007; in 2014, alarms were listed as the number one hazard.
913:
1159:"Title 27, California Code of Regulations - Article 6 Clear & Reasonable Warnings: Side-by-Side Comparison"
325:
1200:
548:
293:
concluded that "the extremely high incidence of track-circuit alarms would have thoroughly desensitized ".
143:
434:
970:
933:
640:
Borowski, M; Görges, M; Fried, R; Such, O; Wrede, C; Imhoff, M (April 2011). "Medical device alarms".
380:
1125:
213:. Currently, the alarm systems are very sensitive but not specific. This leads to a large amount of
1210:
729:
Joint
Commission. (2013). Medical device alarm safety in hospitals. Sentinel Event Alert, 50, 1–3.
51:
1165:
535:
1059:
In the United States House of
Representatives, Committee on Small Business. October 28, 1999. "
368:
286:
313:
may have been the result of too many warnings. Since 2012, weather alerts have been sent out to
146:
cataloged 566 deaths from ignored alarms in the period 2005 to 2008. The United States-based
121:
sound alarms so frequently, and often for such minor reasons, that they lose the urgency and
374:
259:
274:; the sirens had little effect other than irritating passengers and were removed in 2015.
8:
1136:
1030:(Press release). California Hotel & Lodging Association. July 7, 2004. Archived from
785:"National Patient Safety Goals: Reducing the Harm Associated with Clinical Alarm Systems"
1076:"Equity and Environmental Justice Considerations in Electromagnetic Field (EMF) Policy"
712:
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Alarm fatigue has sometimes contributed to public transport disasters such as the
191:
There are many solutions proposed to reduce alarm fatigue in healthcare settings:
1215:
1205:
851:
239:
180:
1082:
914:"Mobile users warn of 'apathy' after alerts ring out for Thunder Bay abduction"
685:"Air-in-Line Alarms: Decreasing Alarms Through Antisiphon Valve Implementation"
306:
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156:
151:
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has been theorized as being susceptible to alarm fatigue. A 2018 abduction in
1194:
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129:, such false alarms rob the critical alarms of the importance they deserve.
816:
700:
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271:
214:
94:
582:"ECRI Institute Releases Top 10 Health Technology Hazards Report for 2014"
477:
683:
Meade, Karen; Catania, Kimberly; Lopez, Ben; Connell, Ryan (2019-04-01).
653:
362:
356:
243:
227:
118:
114:
761:
934:"More research needed to determine if alert fatigue is true, says prof"
314:
310:
210:
196:
110:
1133:"Proposition 65 Safe Drinking Water and Toxic Enforcement Act of 1986"
900:"Amber alert fatigue? Alerts on cell phones set Californians buzzing"
122:
90:
875:
Child Abduction: Prevention, Investigation, and Recovery: Prevention
353: – Condition characterized by emotional and physical exhaustion
246:
resulted in an amber alert being sent to cell phones as far away as
938:
918:
285:
which failed to detect the presence of a stopped train. Though the
1073:
549:"The Joint Commission Announces 2014 National Patient Safety Goal"
998:
168:
113:(where electronic monitors tracking clinical information such as
639:
365: – Decrease in a behavioral response to a repeated stimulus
266:
installed sirens in 2006 to discourage subway users from using
247:
235:
98:
994:"As flood alerts lit up phones, did 'warning fatigue' set in?"
605:
525:
Medical devices that are music to our ears could save lives
371: – Condition of failing to see something in plain view
1111:
Consumer Defense Group v. Rental Housing Industry Members
455:
420:
801:
682:
89:
describes how busy workers (in the case of health care,
954:
Exit Alarms in the Subways Are Silenced by the M.T.A.
359: – Deceptive or erroneous report of an emergency
105:
sound so frequently that they often become senseless
423:Journal of Construction Engineering and Management
301:Some people think the large number of deaths from
133:and policy are critical to prevent alarm fatigue.
377: – Decision making with too much information
1192:
546:
162:
837:
747:
642:Biomedizinische Technik/Biomedical Engineering
347: – Tendency to ignore banner-size notices
16:Psychological consequence of overuse of alarms
906:
32:The examples and perspective in this article
1057:Proposition 65's Effect on Small Businesses.
1055:Written Testimony of Jeffrey B. Margulies.
795:
497:"The Joint Commission Sentinel Event Alert"
992:Calvan, Bobby Caina (September 5, 2021).
926:
891:
866:
341: – Usability factor in alarm systems
70:Learn how and when to remove this message
1074:Indira Nair and Detlof von Winterfeldt.
782:
504:Medical device alarm safety in hospitals
1022:
1020:
946:
435:10.1061/(asce)0733-9364(1995)121:2(166)
1193:
1103:
991:
608:"2011 National Clinical Alarms Survey"
279:2009 train collision in Washington, DC
1049:
743:
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264:Metropolitan Transportation Authority
230:system used in countries such as the
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689:Clinical Journal of Oncology Nursing
491:
489:
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291:National Transportation Safety Board
18:
506:. The Patient Safety Advisory Group
253:
13:
732:
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606:Healthcare Technology Foundation.
221:
14:
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750:American Journal of Critical Care
484:
320:
783:Copeland, CS (5 February 2019).
389: – Psychological phenomenon
171:in hospital staff and patients,
23:
1164:. December 2017. Archived from
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1067:
985:
963:
831:
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383: – Sociological phenomenon
898:Wood, Daniel B. (2017-08-07).
877:. Greenwood Publishing Group.
574:
565:
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1:
393:
163:Unintended outcomes of alarms
136:
852:10.1097/ccm.0b013e3181bfe97f
186:
144:Food and Drug Administration
7:
1061:Implications for consumers.
332:
46:, discuss the issue on the
10:
1232:
1116:40 Cal Rptr 3d 832
296:
238:to notify the public of a
470:10.1080/00140139508925269
381:Normalization of deviance
326:California Proposition 65
873:Snow, Robert L. (2008).
1122: on April 11, 2019.
817:10.1001/jama.2016.10258
701:10.1188/19.CJON.209-211
369:Inattentional blindness
287:automatic train control
840:Critical Care Medicine
547:The Joint Commission.
103:vehicle back-up alarms
973:. NTSB. July 27, 2010
756:(1): 28–34, quiz 35.
281:, caused by a faulty
654:10.1515/bmt.2011.005
410:. September 7, 2019.
375:Information overload
260:New York City Subway
52:create a new article
44:improve this article
34:may not represent a
1201:Security technology
1137:State of California
952:Matt Flegenheimer,
762:10.4037/ajcc2010651
1034:on August 24, 2005
960:(January 1, 2015).
387:Semantic satiation
351:Compassion fatigue
204:centralized alarms
148:Joint Commission's
173:sleep deprivation
80:
79:
72:
54:, as appropriate.
1223:
1185:
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1178:
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1171:on July 24, 2019
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1088:on July 26, 2011
1087:
1081:. Archived from
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345:Banner blindness
339:Alarm management
254:Public transport
131:Alarm management
107:background noise
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464:(11): 2300–12.
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408:"Alert Fatigue"
406:
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268:emergency exits
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240:child abduction
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222:Child abduction
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181:critical events
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177:immune systems
175:and depressed
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157:ECRI Institute
152:sentinel event
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38:of the subject
36:worldwide view
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942:. 2019-02-16.
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922:. 2018-05-14.
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884:9780313347870
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811:(5): 519–24.
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588:on 2016-03-05
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87:alert fatigue
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83:Alarm fatigue
74:
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645:
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586:the original
576:
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508:. Retrieved
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215:false alarms
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95:construction
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363:Habituation
357:False alarm
315:cell phones
272:evade fares
244:Thunder Bay
228:amber alert
127:crying wolf
115:vital signs
60:August 2023
1195:Categories
616:21 October
592:2015-09-10
557:21 October
510:21 October
458:Ergonomics
394:References
311:New Jersey
211:algorithms
197:parameters
137:Healthcare
111:healthcare
91:clinicians
977:April 10,
443:1943-7862
187:Solutions
123:attention
48:talk page
1175:July 24,
1143:July 22,
1092:July 22,
1038:July 22,
939:CBC News
919:CBC News
860:20083933
825:27483066
789:Vitalacy
770:20045845
717:81977608
709:30880809
670:17511189
662:21366502
333:See also
307:New York
42:You may
478:7498189
297:Weather
258:In the
169:anxiety
101:(where
1216:Safety
1206:Alarms
1139:. 1986
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248:Ottawa
236:Canada
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713:S2CID
666:S2CID
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500:(PDF)
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1177:2019
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1007:2021
999:WHYY
979:2012
879:ISBN
856:PMID
821:PMID
805:JAMA
766:PMID
705:PMID
658:PMID
618:2013
559:2013
512:2013
474:PMID
439:ISSN
309:and
234:and
226:The
202:Use
117:and
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