Workplace May Be Unsafe for Healthcare Professionals

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Healthcare workers -- particularly nurses, nurses' aides, orderlies, and attendants -- suffer more musculoskeletal injuries than those working in any other field, a Public Citizen report found.

Those injuries cost the U.S. about $7 billion each year, according to the , which was written by Keith Wrightson and Taylor Lincoln, both of the organization's Congress Watch division.

The increased number of on-the-job injuries may be the result of comparatively sparse rates of safety inspections at healthcare facilities, according to 2010 data from the Occupational Safety and Health Administration (OSHA).

The report compared OSHA-reported data between physical labor-intensive industries to draw comparisons for rates of inspection, injury, and employment. For example, the construction sector included 9.1 million workers in its ranks in 2010; they suffered a total of 74,950 injuries. Construction sites were subject to 52,179 OSHA inspections in that year.

In comparison, the healthcare and social assistance sector employed 18.9 million workers in 2010, who reported 176,380 injuries that year. OSHA conducted 2,504 inspections of healthcare and social assistance facilities in that same year.

"A partial explanation for the greater number of inspections in construction and manufacturing likely has to do with the severity of the injuries those employees tend to suffer," the report noted, adding that in 2010, 774 construction workers died, while 141 workers in the healthcare and social assistance field died that year.

They cautioned that although the proportion of deaths may explain the lower volume of inspections, "healthcare inspections would need to be increased by about a factor of four to bring them into parity with construction sector inspections."

Additional explanations for the lower number of inspections include limited resources -- OSHA had a budget of $535.2 million budget for fiscal 2013 to monitor 7 million work sites and implement other programs -- and limited regulations aimed improving healthcare worker safety.

For the latter, the report noted that a 2000 ergonomics standard that "required employers to implement ergonomics programs in response to employee complaints about work-related musculoskeletal disorders" never took effect, and was repealed in early 2001 through a joint House and Senate effort.

However, the authors noted that prior implementation of OSHA standards has been successful in protecting healthcare workers and has also resulted in unexpected innovation and financial benefits for workers. One example is the Bloodborne Pathogens Standard, which requires exposure control, storage, and disposal of sharp devices and needles.

In addition, the Needlestick Safety and Prevention Act requires employers to "implement new developments in safety technology" and to "solicit employees' input in the selection of sharp devices."

They also noted that state laws and mandates from employers on safe practices and safe patient handling have helped protect employees at healthcare sites.

To address current deficits in employee safety, the report listed several recommendations for OSHA and also suggested prospective future regulations.

For safe patient handling, they recommended, the use of lifting and transfer aids or similar devices should be a requirement while caring for residents and patients, and this device assistance should be required during all shifts and units.

To address workplace violence, employers should take a zero-tolerance policy for workplace violence, verbal threats, and nonverbal threats, the report suggested. Additionally, facilities should require employees to report instances of workplace violence and offer suggestions on methods to minimize risk, as well as protection for those who report workplace violence.

The authors also suggested an amendment to current bloodborne pathogen regulations which included requirements for a comprehensive log of sharp device injuries that would be reviewed by management, use of the best-available technologies for sharp devices, and consultation with employees before the purchase of new sharp devices.

Finally, the report warned that the OSHA requires additional funding to "dramatically increase its number of inspections" and enforce new legislation, adding that the burdens placed on the healthcare industry will only increase as the number of baby boomers requiring nursing and living assistance grows over time.

Primary Source

Public Citizen

Wrightson K, Lincoln T "Health care workers unprotected: insufficient inspections and standards leave safety risks unaddressed" Public Citizen 2013.