Health Care Workers Occupational Diseases Dr. Alireza Safaeian Occupational Medicine Specialist.
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Transcript of Health Care Workers Occupational Diseases Dr. 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.
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: 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
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
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.
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
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