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Occupational Hazard Recognition  & Control: for nurses & other health care workers

Introduction

Working in a health care environment can present hazards to your health. Health care workers have suffered from back, neck and shoulder injuries, skin, respiratory, cardiac and infectious diseases. Many of these ailments have beer caused or aggravated, directly or indirectly, by the places and conditions under which they work.

This pamphlet presents information that will assist you, the worker to:

  • recognize the hazards present in the health care work environment.
  • locate sources of information to control or eliminate hazards.
  • recognize, report and record occupational illnesses and injuries.
     

Keys to Controlling Workplace Hazards

  • Commitment on the part of workers and managers to identify and control hazards.
  • Education to recognize hazards and understand the control process.
  • Assessment of the work environment for Hazards.
  • Worker health surveillance programs.
     

Personal Responsibility

  • Become safety conscious for yourself and others.
  • Know your work environment/recognize hazards.
  • Attend occupational safety and health educational programs.
  • Follow protocols to control hazards.
  • Report unsafe conditions.
     

Recording and Reporting

Recognition 
An injury or illness occurs that is attributable to an event or process within the work environment may be an occupational illness or injury.

Reporting 
Report exposure to workplace hazards or injury immediately to the supervisor and the person responsible for employee health and safety.

Recording 
A permanent written record of the date, event and symptoms should be made. The recording form should be the OSHA 101 form or a Massachusetts Department of Industrial Accident injury form. (Always keep a copy of any written report for your records.)

OSHA Recordable Incidents 
Incidents that result in medical treatment, loss of consciousness, lost time from work or a job change are OSHA recordable.

Many incidents are not OSHA recordable but still require a written report to establish that an incident occurred.

An Occupational Injury
is any injury which results from a work accident or from a single instantaneous exposure in the work environment.

An Occupational Illness 
is any abnormal condition or disorder, other than one resulting from an occupational injury, caused by exposure to environmental factors associated with employment. It includes acute and chronic illnesses or diseases which may be caused by inhalation, absorption, ingestion, direct contact or repeated trauma.
 

Recognizing Workplace Hazards

Types

Biological: Bloodborne Pathogens - HIV, Hepatitis B, C, D, E Airborne Pathogens - TB, surgical smoke

Chemical: Disinfectants, sterilizing agents, cleansers, housekeeping products, latex proteins, lab chemicals and chemotherapeutic agents.

Mechanical: Pinch points and sharp injuries.

Physical:  Noise, radiation, lasers, heat and cold.

Psychological:  Shiftwork, workplace violence, job stress, downsizing.

Ergonomic: Lifting, bending, pushing, pulling and static pressure.
 

Measuring Workplace Hazards

Dose 
What quantity of a hazardous substance is the worker exposed to?

Duration/Frequency 
How often and for what amount of time is the person exposed?

Toxicity 
How toxic is the hazardous substance?

Personal Characteristics 
What is the sensitivity, age, sex and health of the person working with the hazardous substance?

Contact vs. Exposure
Are adequate hazard control measures in place to prevent exposure?

Contact with hazardous materials occurs when the product is used in a manner that protects the health and the safety of the worker - adequate hazards control measures are in place.

Exposure occurs when the use of a material or product results in an adverse health effect. Hazard controls are not in place or are not followed.
 

Controlling Workplace Hazards

Methods to control hazards include:

  • Elimination of hazardous materials and dangerous activities.
  • Substitution of less hazardous materials and modification of actions to 
    eliminate danger.
  • Engineering Controls provide mechanical equipment to contain hazardous materials or actions.
  • Administrative Controls provide policies which limit workers exposure to hazards.
  • Personal Protection Equipment (PPE) provides barriers and filters to hazardous materials and substances. PPE may be used in conjunction with other types of controls.

An example of biological hazard control includes handwashing, and universal precautions.
 

Sources of Information in the Workplace

  • Department Supervisors
  • Safety Directors
  • Safety Committees
  • Material Safety Data Sheets (MSDS)
  • Product Information
  • Professional Journals

Worker Protection

OSHA General Duty Clause:
The Occupational Health and Safety Act of 1970, Section 5 (a) (1) states, employers must furnish to employees, employment and a place of employment free from recognized hazards that are causing or are likely to cause death or serious harm to employees. Employers must comply with occupational safety and health standards issued under the Act.

Policies/Protocols
Policies are formulated by the employer, often with input from the workers directly involved with using that policy in their work. It is the employers responsibility to review, update and promulgate policies as they are created, as well as to provide the training, safety equipment, information required by the policy. It is the employees responsibility to work according to the policy and to notify appropriate supervisory personnel when the policy cannot be followed or applied. They can change your job or working conditions and are thus a mandatory subject of bargaining. It is the employees right to know about workplace hazards to have appropriate training, equipment and resources to do their jobs safely. Employees covered by collective bargaining agreements should notify their union committee as soon as policy changes are talked about or become known.

Americans with Disabilities Act
The Americans with Disabilities Act (ADA) and Massachusetts General Laws, Chapter 151 B (MGL-151B) 51 B) are both written to protect an individual with disability who meets the skill, experience, education and other job related requirements of a position held or desired, and who, with or without reasonable accommodation, can perform the essential functions of the job. Discrimination against the handicapped is prohibited in all aspects of the employment process including application, testing, hiring, assignments, evaluation, disciplinary actions, training, promotion, medical examinations, lay-off/recall, termination, compensation, leaves of absence, and benefits among others. Reasonable accommodation is required unless it would impose undue hardship on the employer. The Federal law is enforced by the U.S. Equal Employment Opportunity Commission (EEOC), 800.669.3362 or 617.565.3200. The Massachusetts counterpart is enforced by the Massachusetts Commission Against Discrimination (MCAD), 617.727.3990.

Workers’ Compensation 
Workers’ Compensation is an insurance system that subsidizes part of your wages if you are injured on the job or contract a work-related illness. It is a no-fault system, which means that you do not have to prove negligence to collect wage and medical benefits. However, the burden is on you to prove that your disability is work-related. You must file a first report of injury as soon as you are aware of being injured, whether or not you are able to continue working. Since the regulations concerning Workers’ Compensation are complex and subject to change, you may consider hiring an attorney familiar with this area of the law to represent you through the various phases. Information is available to you from the Massachusetts Department of Industrial Accident. Regional offices are in Boston, 617.727.4900, Lawrence, 978.683.6420 Fall River, 508.676.3406 Worcester, 508.753.2072 Springfield, 413.784.1133 and for the hearing impaired, 800.224.6196.

Reporting Hazardous Conditions to OSHA
Employees may report uncorrected workplace hazards to OSHA (See government listings U.S. Department of Labor in telephone directory). Notify the union also. OSHA will investigate claims of unsafe conditions and require correction. Penalties may be assessed against the employer.

Whistleblower Protection
The Federal Government provides whistleblower protection to those employed by U.S. governmental facilities and in those businesses with federal government contracts. Some states have comparable laws and regulations. In Massachusetts, call the Attorney General’s Office, 617.727.2200.
 

Resources

Federal Agencies

  • U.S. Department of Labor
    • Occupational Safety & Health Administration (OSHA)
  • U.S. Department of Health & Human Services
    • Centers for Disease Control (CDC)
    • National Institute of Occupational Safety & Health (NIOSH)
  • U.S. Environmental Protection Agency (EPA)
  • U.S. Food and Drug Administration (FDA)
  • U.S. Federal Information Number 800.688.9889


Federal, State and Local Agencies
Consult the government listings in the telephone directory under:

• Labor
• Health
• Environment Protection
• Consumer Protection


In Massachusetts

  • Department of Public Health: 
    • 617.624.6000 or 617.624.5621
  • Department of Labor and Occupational Safety: 
    • 617.727.3452
  • Department of Environmental Protection:  
    • 617.292.5500;
  • Massachusetts Nurses Association:  
    • 781.821.4625
  • Massachusetts Committee on Occupational Safety 
    • MassCOSH:  617.524.6686 
    • Western MassCOSH:  413.731.0760

 

 
         

 

 

 

 

 

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