Category Archives: Health & Safety

The Disruptive Force of Lateral Violence in the Health Care Setting

Source: William C. Rainford, Stacey Wood, Patricia C. McMullen, Nayna D. Philipsen, Volume 11 Issue 2, February 2015
(subscription required)

From the abstract:
The health care workplace is intensely stressful, regulated by levels of bureaucracy, enforced by strict norms of behavior, and characterized by challenging and sizable workloads. This can create a breeding ground for lateral violence, commonly referred to as workplace bullying. This article is designed to help nurse practitioners understand lateral violence consequences and prevention strategies. Response to lateral violence is an ethical obligation for nurse practitioners. In order to reduce disruption to patient care and prevent monetary losses to health care organizations, nurse practitioners should advocate for changes in nursing education, accreditation standards, and policies targeted at the elimination of lateral violence.

Erratum to “Acute symptoms associated with chemical exposures and safe work practices among hospital and campus cleaning workers: A pilot study”

Source: Soo-Jeong Lee, Bora Nam, Robert Harrison and OiSaeng Hong, American Journal of Industrial Medicine, American Journal of Industrial Medicine, Special Issue: Moving Research to Practice in Construction Safety and Health, Volume 58, Issue 8, August 2015
(subscription required)

Acute symptoms associated with chemical exposures and safe work practices among hospital and campus cleaning workers: A pilot study
Source: Soo-Jeong Lee, Bora Nam, Robert Harrison and OiSaeng Hong, American Journal of Industrial Medicine, Early View, September 15, 2014
(subscription required)

From the abstract:
Background: Cleaning workers are regularly exposed to cleaning products containing hazardous chemicals. This study investigated acute symptoms associated with chemical exposures among cleaning workers and their safe work practices.

Methods: This cross-sectional study included 183 cleaning workers employed in an academic medical center and affiliated health sciences campuses in Northern California. Data on respiratory, eye, skin, neurological, and gastrointestinal symptoms and occupational factors were collected by in-person interviews or self-administered questionnaires.

Results: Chemical-related symptoms (several times monthly or more often) were more common among workers who performed patient area cleaning (44%) than hospital custodians (36%) or campus custodians (28%). After controlling for age, sex, and job title, symptoms were associated with exposure to carpet cleaners, spray products, solvents, and multi-purpose cleaners). Except for gloves, regular use of personal protective equipment was infrequent.

Conclusions: Study findings suggest a need for additional interventions such as use of less toxic products to reduce health risks among cleaning workers.

Unequal risk

Source: Center for Public Integrity, 2015

Workers in America face risks from toxic exposures that would be considered unacceptable outside the job — and in many cases are perfectly legal.

Articles include:
How government, business and labor can better protect workers
Source: Jamie Smith Hopkins, Maryam Jameel, Center for Public Integrity, July 6, 2015

Major reform would take an act of Congress, but improvements are possible now.

Slow-motion tragedy for American workers
Source: Jim Morris, Jamie Smith Hopkins, Maryam Jameel, Center for Public Integrity, June 30, 2015

Lung-damaging silica, other toxic substances kill and sicken tens of thousands each year as regulation falters.

After 44 years, halting progress on workplace disease
Source: Jim Morris, Center for Public Integrity, July 6, 2015

OSHA has made limited headway against substances that sicken and kill America’s workers; the agency’s stormy history helps explain why.

The impenetrable world of Mark Flores
Source: Jim Morris, Center for Public Integrity, July 1, 2015

Yvette Flores unknowingly worked around lead and other harmful substances while she was pregnant; a severely disabled son was the result.

A tattered safety net for workers
Source: Yue Qiu and Jamie Smith Hopkins, Center for Public Integrity, June 29, 2015

Federal workplace exposure limits for chemicals are meant to safeguard people from significant harm. Often they don’t, as the Occupational Safety and Health Administration itself warns.

The campaign to weaken worker protections
Source: Jamie Smith Hopkins, Center for Public Integrity, June 29, 2015

Who’s to blame for thousands of work-related deaths and illnesses each year? Business, Congress, the White House and federal agencies.

Read their stories: How job-related illnesses upended these families’ lives
Source: Jamie Smith Hopkins, Jim Morris and Maryam Jameel, Center for Public Integrity, June 29, 2015

Deadly dust: A bricklayer’s job nearly kills him
Source: Maryam Jameel, Center for Public Integrity, June 29, 2015

Methodology of Unequal Risk investigation

Investigation of Air Quality Problems in an Indoor Swimming Pool: A Case Study

Source: Benoit Lévesque, Lorraine Vézina, Denis Gauvin and Patrice Leroux, The Annals of Occupational Hygiene, Advance Access, First published online: June 19, 2015
(subscription required)

From the abstract:
Introduction: Trichloramine (NCl3) is the contaminant suspected the most to cause irritative respiratory symptoms among swimmers and swimming pool workers. Following complaints by employees working in an indoor swimming pool, this study set out to identify the determinants of NCl3 air concentrations in that particular swimming pool.

Methods: To document NCl3 air levels, air samples were collected once or twice a day for 3h, at least 3 days per week, between October and December 2011. Water samples were taken three times during air sampling to verify free chlorine, chloramines, alkalinity, conductivity, pH, water temperature, and turbidity. Water changes were also recorded, along with the number of bathers. Ventilation (outdoor air flow) was modified to verify the influence of this important variable. Data were evaluated by analysis of variance.

Results: Mean NCl3 air concentration was 0.38mg m−3. The best model explaining variations of NCl3 air levels (r 2 = 0.83) included sampling period (P = 0.002, NCl3 was higher in the evening versus the morning), water changes (P = 0.02, NCl3 was lower with water changes between 60 and 90min day−1 versus <60min day−1), and ventilation (P = 0.0002, NCl3 was lower with ≥2 air changes per hour (ACH) versus <1 ACH). Discussion and conclusion: Although based on only 26 air samples, our results indicate that ventilation is an important determinant of NCl3 air concentration in swimming pool air. There is limited information available on the air quality of indoor swimming pools and the relationship with ventilation. Efforts are needed to document the situation and to develop state-of-the-art facilities for ventilation of indoor swimming pools.

Taking the Burden Off Their Backs: Technology and Sensible Systems Greatly Reduce Risk of Injuries to Caregivers While Improving Patient Safety

Source: Taylor Lincoln, Public Citizen, June 16, 2015

From the press release:
A new Public Citizen report (PDF), “Taking the Burden Off Their Backs,” outlines a number of recommended technologies and policies to reduce injuries to nurses and other caregivers.

This report is the second in a five-part series, “Nursing: A Profession in Peril,” exploring the problem of injuries sustained by caregivers when they lift and reposition patients. Health care workers suffer more injuries – requiring time away from work – than those of any profession, according to the federal government, and many of these injuries result from handling patients. …

… Public Citizen’s latest report briefly describes several devices that assist in lifting, transferring and repositioning patients. These range from powered ceiling mounted or floor-based devices that are capable of elevating a patient’s entire body, to simpler solutions, such as reduced-friction sheets that enable turning or laterally transferring a patient much more easily than via conventional means.

Even if patient handling equipment is available, experts say that successful patient handling programs rely on numerous management-directed factors to succeed. Public Citizen’s report outlines several of these, including the need for written policies and committees governing patient handling practices, methods for employees to report concerns or incidents without fear of retribution, reliable systems to measure incidents and injuries, and the existence of policies that align physical stress demands on employees with their capacities…..
Nursing: A Profession in Peril
A Five-Part Series On Health Care Workers Injured On The Job

The first report in this series explores the real life challenges of nurses who suffer devastating injuries while moving and lifting patients. Subsequent pieces will concern technological and policy oriented approaches to minimize injuries; a discussion of safe-patient handling laws that have been passed in the states; an examination of the economic benefits realized by hospitals that have implemented safe-patient handling programs; and an assessment of the prevalence of implementation of recommended safe-patient handling practices across the national health care system.

Part One: The Health Care Industry’s Castoffs
Nurses Injured at Work Often Find Themselves Out of Work and Suffering From Chronic Pain
June 9, 2015 — As Public Citizen reported in 2013, more health care workers are forced off the job due to injury than workers in any other profession. But how serious are these injuries in the long run? This Public Citizen report documents the nature and repercussion of injuries suffered by six nurses. All six were forced out of their job due to their injuries and report suffering from chronic pain.
Read the Press Release
Read the Report

Physical assault, physical threat, and verbal abuse perpetrated against hospital workers by patients or visitors in six U.S. hospitals

Source: Lisa A. Pompeii, Ashley L. Schoenfisch, Hester J. Lipscomb, John M. Dement, Claudia D. Smith and Mudita Upadhyaya, American Journal of Industrial Medicine, Early View, Article first published online: June 15, 2015
(subscription required)

From the abstract:
Background: An elevated risk of patient/visitor perpetrated violence (type II) against hospital nurses and physicians have been reported, while little is known about type II violence among other hospital workers, and circumstances surrounding these events.

Methods: Hospital workers in different geographic areas were invited to participate in an anonymous survey.

Results: Twelve-month prevalence of type II violence was 39%; 2,098 of 5,385 workers experienced 1,180 physical assaults, 2,260 physical threats, and 5,576 incidents of verbal abuse. Direct care providers were at significant risk, as well as some workers that do not provide direct care. Perpetrator circumstances attributed to violent events included altered mental status, behavioral issues, pain/medication withdrawal, dissatisfaction with care. Fear for safety was common among worker victims (38%). Only 19% of events were reported into official reporting systems.

Conclusions: This pervasive occupational safety issue is of great concern and likely extends to patients for whom these workers care for.

Traditional and environmentally preferable cleaning product exposure and health symptoms in custodians

Source: Jennifer L. Garza, Jennifer M. Cavallari, Sara Wakai, Paula Schenck, Nancy Simcox, Tim Morse, John D. Meyer and Martin Cherniack, American Journal of Industrial Medicine, Early View, Article first published online: June 4, 2015
(subscription required)

From the abstract:
Background: We investigated the associations between traditional and environmentally preferable cleaning product exposure and dermal, respiratory, and musculoskeletal symptoms in a population of custodians.

Methods: We analyzed associations between symptoms and exposure to traditional and environmentally preferable cleaning product exposure among 329 custodians.

Results: We observed increased odds of dermal, upper and lower respiratory, and upper extremity, back, and lower extremity musculoskeletal symptoms associated with increased typical traditional cleaning product exposure. We observed significant trends for increased odds of dermal and back and lower extremity musculoskeletal symptoms associated with increased typical environmentally preferable cleaning product exposure.

Conclusions: Fewer positive associations and reduced odds of health symptoms associated with environmentally preferable cleaning product exposure suggest that these products may represent a safer alternative to traditional cleaning products.

Occupational safety and health protections against Ebola virus disease

Source: Knut Ringen, Philip J. Landrigan, Jeffrey O. Stull, Richard Duffy, James Melius and Melissa A. McDiarmid, American Journal of Industrial Medicine, Volume 58 Issue 7, July 2015
(subscription required)

From the abstract:
Even as the Ebola epidemic is finally showing signs of remitting, controversy continues regarding the modes of disease transmission, the understanding of which necessarily dictates methods of prevention. The initial public health response to the epidemic was based on assumptions formed during previous outbreaks, and in the belief that transmission was restricted to direct “contact” with other infected patients. However, the current Ebola outbreak differed from previous experiences in its intensity of transmission, speed of spread, and fatality rate and was also particularly unforgiving on health workers occupationally infected. Even with these differences, however, other modes of transmission were not considered by public health authorities, thus denying both the hard-hit health worker populations and the wider public more protective guidance. International Labor Conventions require employers to provide a comprehensive safety program that anticipates work-related risks and specifies strategies for protection against them. Such a precautionary approach is recommended in future epidemic planning, especially where evidence regarding transmission is incomplete.

Does Mortality Differ Between Public and Private Sector Workers?

Source: Alicia H. Munnell, Jean-Pierre Aubry and Geoffrey T. Sanzenbacher, Center for Retirement Research at Boston College (CRR), SLP#44, June 2015

The brief’s key findings are:
– In projecting pension costs, state and local plans assume their workers will live longer than private sector workers. Is this assumption accurate and, if so, why?
– The analysis confirms that public sector workers – particularly women – have lower mortality rates than their private sector counterparts.
– The question is whether lower mortality reflects the nature of the job or the nature of the workers.
– The answer is the workers – specifically their education levels. Controlling for education, the gap between public and private workers disappears.