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Report: Healthcare worker safety needs closer monitoring

Thursday July 18, 2013
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Healthcare workers suffer more injuries and illnesses on the job each year than workers in any other industry, but the Occupational Safety and Health Administration conducts relatively few inspections of healthcare facilities, according to a report by the citizens-interest group Public Citizen.

In addition, OSHA is hamstrung in its ability to take action to resolve unsafe conditions by an absence of needed safety standards, according to the report.

"OSHA is required by law to ensure safe conditions for every employee in the United States," Keith Wrightson, worker safety and health advocate for Public Citizen and co-author of the report, said in a news release. "The record is clear that the government has broken its promise to healthcare workers."

Nurses, nursing aides, orderlies and attendants suffer more musculoskeletal injuries than workers in any other field, according to the report. Costs associated with back injuries in the healthcare industry are estimated to be more than $7 billion annually.

"This is an issue that affects so many frontline workers and their patients — nurses, CNAs, radiologists, physical therapists — women and men who are trying to meet the needs of their patients safely and effectively," L. Toni Lewis, MD, chair of the healthcare division of the Service Employees International Union, which advised Public Citizen on the report, said in the news release. "The current patchwork approach is not enough."

In 2010, healthcare employers reported 653,900 workplace injuries and illnesses, about 152,000 more than the next most afflicted industry sector, manufacturing. Although healthcare workers outnumber construction workers more than two-to-one, according to the report, OSHA conducts only about 5% as many inspections of healthcare facilities as of construction sites.

"It’s alarming that healthcare workers rank right alongside laborers, truck drivers and other physical, labor-intensive jobs in terms of musculoskeletal injuries," Suzy Harrington, director of the American Nurses Association’s Department for Health, Safety and Wellness, said in the news release.

"This is a primary reason healthcare workers leave direct patient care. We can’t afford to lose healthcare workers to injury and still meet rising demand for healthcare services."

In response to questions posed by Public Citizen for the report, OSHA stated it "does not have resources to move forward on all rulemaking necessary to address all the pressing workplace health and safety hazards." (OSHA's full response is presented in the report’s appendix.)

The fault for OSHA’s failure to protect healthcare workers does not rest entirely with the agency, according to Public Citizen, which stated that Congress has limited OSHA’s ability to carry out its mission.

The agency’s $535 million budget is "woefully inadequate," to oversee the 7 million job sites in its purview, according to the news release. Meanwhile, the agency’s rulemaking efforts have been obstructed. In 2000, the agency published a final standard to protect workers in all industries from ergonomic stressors, but Congress repealed the rule before it took effect.

At the outset of the Obama administration, the agency proposed a rule to add a column on employers’ incident reporting logs to designate whether workplace injuries were musculoskeletal disorders. But the administration delayed the proposed rule, and Congress subsequently blocked it.

OSHA is attempting to partially address the frequency of injuries among nursing home employees with a "national emphasis program," which aims to address ergonomic stressors, bloodborne pathogens, tuberculosis, workplace violence and slips, trips and falls.

But the program does not cover hospitals or other healthcare settings, where high injury rates also have been reported, according to Public Citizen. In the absence of a specific standard for ergonomic safety, the agency must rely on its catch-all "general duty clause" to issue citations for unsafe ergonomic conditions. General duty clause cases require a high evidentiary threshold, and only seven citations regarding ergonomics have been issued to nursing homes over the past two fiscal years.

Public Citizen recommends that OSHA increase the number of inspections of the healthcare industry facilities by several-fold and pursue binding standards to ensure that workers are protected from the risks posed by musculoskeletal disorders, workplace violence and other threats. The report also recommends that Congress significantly increase funding of OSHA.

Read the report (available as a PDF): www.citizen.org/documents/health-care-workers-unprotected-2013-report.pdf.

Read about the ANA’s recently issued interprofessional standards for safe patient handling and mobility: http://www.nursingworld.org/SPHM-Standards.


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