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1
Occupational Health Nursing
Christina Barrick
2
Objectives
• Describe legislation impacting on OHN
• Utilize an occupational health history.
• Identify prevalent occupational health disorders.
• Describe the profile of a worker population.
• Apply epidemiology to OHN.
• Describe the roles of the OHN.
3
Scope of Occupational Health Problems
• Every 5 seconds a worker is injured
• 10,000,000 injuries a year
• 100,000 deaths a year
• Every 10 seconds a worker is disabled
• Incidence of work-related injuries increasing
4
Trends
• 1/3 of life at work
• Lost time from illness and injury
• Primary care in occupational setting
• Increase the proportion of worksites that have health services (Healthy People, 2010).
5
Evolution of Occupational Health
• “Part of job”
• Horrible accidents
• Occupational, safety, and health administration (OSHA, l970)
– set and enforce standards
– demand for OHN’s
• National Institute for Occupational Safety and Health (NIOSH).
– Identifies, monitors, educates, & researches
• Super fund Amendment & Reauthorization Act
– Nurse key role
6
Role of OHN
• Beyond emergency and band aid care• Goal of OHN
– Removing health hazards from the environment• Largest group of occupational workers• Diverse levels of preparation• Multiple roles
– clinician, case manager, educator, consultant, researcher, corporate manager, program planner
– skills: provision of emergency care, health assessment, worker’s compensation management
7
Characteristics of the Workplace
• High tech
• Health and computer-related occupations
• Increase in part-time and temporary work
• Increase in contractual workers
• Reduced job security
• Increase in shift work
• Development of new chemicals
8
Characteristics of Worker Population
• Characteristics of workplace• Older worker (65 and over)
– Will double by 2050– Mean age of nurses?
• More racially diverse– Fastest growing group?
• Women with children and aging parents. Implications?• Workers with chronic physical or mental health problems• High job demand, low supply
– Increase health status, employment longevity, and satisfaction of workers
• Fastest growing occupations– Computer-related, Nursing and Home Health, Personal care aid
9
Application of the Epidemiological Model
• Host factors: – age, gender, work practices, health status,
lifestyle– hyper susceptible– greatest risks for accidents?
10
Application of the Epidemiological Model
• Types of Agent Factors:– Biological– Chemical
• *.1% of millions known chemical have been tested
– Ergonomic or mechanical– Physical – Psychosocial
11
Application of the Epidemiological Model
• Environment: all external conditions that influence host and agent interaction
Examples?
12
Issues with Occupational Health Programs
• Widely vary
• Organization exemption
• OSHA sanctions
• Limited # of inspectors
13
Worker Assessment
• Overall health assessment
• Occupational health assessment
– list current and past jobs
– exposure history
– job titles and responsibilities
– host factors (smoking)
– masked risk: retiree or housewife
– family members
• Assessment Guide: page 1084.
14
Workplace Assessment
• Walk-through, plant survey– What are you looking for?
• Review the Standard Industrial Classification (SIC) code
• Describe demographic info. of workers• Review policies and procedures• Epi. data collection about injuries and
illnesses
15
Hazard Communication Standard
• Cannot eliminate all toxins
• Report known toxins
• Provide safety education on identification, toxicity, and protective measures
16
Workers Compensation
• Financial compensation
• State laws
• Varies by state
• Prevention is less costly
17
Nursing Interventions at the Worksite
• Primary prevention– Health promotion – Prenatal care– Risk reduction– Immunizations– Injury prevention– Use of personal protective gear
18
Nursing Interventions at the Worksite
• Secondary
– Pre-employment screening
– Periodic screening
– Environmental screening
19
Nursing Interventions at the Worksite
• Tertiary– Prevent the spread of communicable diseases– Prevent complications of acute and chronic
illnesses– Assess fitness to return to work.
20
Indicators of Psychological Health Problems
• Increased absenteeism• Mood changes• Increase in minor accidents• Fatigue or general decrease in energy• Sudden weight loss or gain• Increased blood pressure• Frequent stress-related illnesses• Bloodshot or bleary eyes
21
Psychological Stress
• “Job strain”
• Tenth leading cause of occupational disease
• Health care and service workers
• Sources of stress
22
In-Class Activity
• Identify occupational health hazards for Towson University nursing students. Identify all possible factors that might influence health, then take one factor and analyze its potential health effects . (Can be psychosocial as well as biologic.