Health Care Workers Occupational DiseasesDr. Alireza Safaeian

Occupational Medicine Specialist

What is healthcare?

Healthcare is involved, directly or indirectly, with the provision of health services to individuals.

These services can occur in a variety of work settings, including hospitals, clinics, dental offices, out-patient surgery centers, birthing centers, emergency medical care, home healthcare, and nursing homes.

Other than doctors and nurses, what workers are exposed?

physicians, nurses, technicians, clinical laboratory workers, first responders, building maintenance, security and administrative personnel, social workers, food service, housekeeping, and mortuary personnel

What types of hazards do workers face?

bloodborne pathogens and biological hazards

potential chemical and drug exposures (formaldehyde, ethylene oxide, glutaraldehyde )

waste anesthetic gas exposures

respiratory hazards

ergonomic hazards from lifting and repetitive tasks

laser hazards

workplace violence

hazards associated with laboratories

radioactive material and x-ray hazards.

Hazards in hospital

HCWs: Clinical areas

• Bloodborne pathogens

• Airborne pathogens

• Ergonomic

• Slips, trips, falls

• Sharps

Surgical Suite

• Anesthetic gases

• Bloodborne pathogens

• Compressed gases

• Lasers

• Ergonomic

• Latex

HCWs: Lab Workers

• Infectious diseases

• Chemical agents(formaldehyde, toluene, xylene)

• Ergonomic

• Slips, trips, falls

• Sharps

HCWs: Radiology• Radiation

• Ergonomics

• Airborne pathogens

• Bloodborne pathogens

• Slips, trips, falls

HCWs: Physical Therapy

• Ergonomics

• Trips, falls

• Equipment hazards

• Bloodborne pathogens

HCWs: Pharmacy

• Drug absorption

• Ergonomic

• Slips, trips, falls

• Latex

HCWs: Central Supply

• Compressed gases

• Anesthetic gases

• Chemical agents (sterilizers, cleaners)

• Ergonomic

• Burns, cuts

HCWs: Laundry Workers

• Contaminated laundry

• Noise

• Heat

• Lifting

• Sharps

• Slips, trips, falls

• Fire hazard

HCWs: Housekeepers

• Chemical agents

• Contaminated objects

(infectious agents)

• Latex

• Sharps

• Lifting hazard

• Slips, trips, falls

HCWs: Dietary

• Foodborne diseases

• Heat

• Moving machinery

• Fire hazards

• Slips, trips, falls

• Electrical equipment

Stress

• Life threatening illnesses and injuries

• Understaffing

• Malfunctioning equipment

• Patient death

• Hierachy of authority

• Demanding patients

• Excessive paperwork• Health Effects: loss of appetite, ulcers, mental disorder, migraines, difficulty in sleeping emotional instability, disruption of social and family life, and the increased use of cigarettes, alcohol, and drugs. Stress can also affect worker attitudes and behavior.

Reduce Stress

• Define aggravating factors

• Establish discussion/support groups

• Change work design

• Involve Employee Assistance personnel

How to Prevent Musculoskeletal Disorders (NIOSH)

Prevent Ergonomic Injuries

• Use proper lifting techniques

• Have more than one HCW assist on lifts

• Use lifting assist devices

• Change positioning

Lifting guidelines for health care workers

Never transfer patients/residents when off balance. 

Lift loads close to the body. 

Never lift alone, particularly fallen patients/residents, use team lifts or use mechanical assistance. 

Limit the number of allowed lifts per worker per day. 

Avoid heavy lifting especially with spine rotated. 

Training in when and how to use mechanical assistance.

Patient handling tasks pose increased ergonomic risk if they are: repetitive  

done in awkward postures  

done using a great deal of force

lifting heavy objects  

combining these factors.

Safe Patient Handling

Equipment, which can range from ceiling-mounted lifts to simple slide sheets that facilitate lateral transfer

Minimal-lift policies and patient assessment tools

Training for all caregivers or for dedicated lifting teams on proper use of the equipment

Mechanical Lift Equipment - Patient Transfer SystemsSling-Type Full Lift

A Safety and Health Management System

also known as an injury and illness prevention program

is a proactive, collaborative process to find and fix workplace hazards before employees are injured or become ill.

Almost all successful systems include six core elements:

Management leadership

Employee participation

Hazard identification and assessment

Hazard prevention and control

Education and training

Program evaluation and improvement

Workplace violence

The National Institute for Occupational Safety and Health (NIOSH) defines workplace violence as "violent acts (including physical assaults and threats of assaults) directed toward persons at work or on duty.“

Workplace violence is any physical assault, threatening behavior, or verbal abuse occurring in the work setting

The risk factors The increasing number of acute and chronic mentally ill patients

The availability of drugs or money at hospitals, clinics and pharmacies

Unrestricted movement of the public in clinics and hospitals and long waits in emergency or clinic areas that lead to client frustration over an inability to obtain needed services promptly;

The increasing presence of drug or alcohol abusers, trauma patients or distraught family members;

Low staffing levels during times of increased activity such as mealtimes, visiting times and when staff are transporting patients;

Isolated work with clients during examinations or treatment;

Solo work, often in remote locations with no backup or way to get assistance, such as communication devices or alarm systems (this is particularly true in high-crime settings);

Lack of staff training in recognizing and managing escalating hostile and assaultive behavior;

Poorly lit parking areas.

Hazardous Drugs

Preparation, administration, manufacturing, and disposal of hazardous medications

Healthcare facilities and the pharmaceutical industry,

Antineoplastic cytotoxic medications, anesthetic agents, anti-viral agents, and others

These hazardous medications are capable of causing serious effects including cancer, organ toxicity, fertility problems, genetic damage, and birth defects.

Hazards control and prevention

engineering and work practice controls

administrative controls

ensure the use of personal protective clothing and equipment

provide training

medical surveillance

hepatitis B vaccinations

signs and labels

Engineering controls are the primary means of eliminating or minimizing employee exposure and include the use of safer medical devices, such as needleless devices, shielded needle devices, and plastic capillary tubes.

Personal Protective Equipment

Healthcare Workers

Why You Need to Wear Assigned PPE

You could face a variety of workplace hazards

Safety controls don’t always eliminate hazards

When hazards can’t be eliminated, PPE serves as a barrier between you and the hazards

Common Healthcare Hazards Requiring PPE

Skin penetration by sharps

Chemicals Antineoplastic and

other potentially harmful drugs

Blood and other potentially infected materials

TB or other airborne bacteria

Common Healthcare Hazards Requiring PPE (cont.)

Mechanical hazards Heat X rays Light radiation (e.g., lasers or UV) Any other identified hazard

PPE Is Your Personal Defense Against Hazards

Eyes and face Skin Respiratory

system Feet Hearing Head

Eye and Face Protection

Shatterproof safety glasses

Goggles Filtered lenses Face shields Eye protection with

prescription glasses

Skin Protection

Gloves Disposable

Cotton

Leather

Rubber, neoprene, or vinyl

Heat resistant

Protective clothing

Respiratory Protection

Respirators Respirator fit

testing and training

Foot Protection

Sensible, sturdy shoes with nonslip soles

Safety shoes Boots Shoe covers

Hearing Protection

Earmuffs Earplugs Canal caps Homemade

hearing protection IS NOT effective and should NOT be used

Head Protection

Hard hats protect your head in two ways: Hard outer shell

resists blows and penetration

Shock-absorbing suspensions act as a barrier between the outer shell and your head to absorb impact

Inspect PPE Before Use

Inspect before each use

Look for holes, tears, cracks, wear, or other problems

Don’t use defective, worn, or damaged PPE. Turn it in and get an effective replacement.

Get a Good Fit

PPE fits well when it: Provides you with

the protection you need

Is comfortable enough to allow you to move and perform your job well

Remember to check fit before each use

Remove and Dispose of PPE Correctly

Remove PPE when it’s contaminated

Remove PPE from the top down, wearing gloves to protect your skin

Grasp contaminated gloves on the inside and peel down without touching the outside

Place contaminated PPE in assigned containers

Wash thoroughly after removing PPE

Maintain PPE Properly

Clean PPE before you put it away

Store PPE in a safe place where it won’t be damaged or lost

Thanks for your attention

Any questions ?