Health care workers suffer more injuries and illnesses on the job than those in any other industry, thanks in large part to limited federal safety standards and inspections of health care facilities, says a new report by a national advocacy non-profit.
The report by Public Citizen shows health care workers had about 654,000 workplace injuries and illnesses in 2010, about 152,000 more than the next most afflicted industry sector, manufacturing. Even though health care workers outnumber construction workers 2-1, the agency responsible for worker safety — the Occupational Safety and Health Administration — conducts nearly 20 times more inspections of construction sites than health care sites, according to the Public Citizen report.
"The record is clear that the government has broken its promise to health care workers," said Keith Wrightson, worker safety and health advocate for Public Citizen and co-author of the report. Health care workers face a wide range of hazards on the job, including needle sticks, back injuries from lifting patients and moving equipment, latex allergies and violence, according to the Centers for Disease Control and Prevention.
Although the severity of injuries in the manufacturing sector could explain the volume of inspections, the report says OSHA's limited resources — $535 million for fiscal year 2013 to monitor 7 million work sites — are to blame.
"In fairness to OSHA, these industries still witness more fatalities. But, health care is undoubtedly deserving of significantly more inspections than it currently gets," said Taylor Lincoln, a research director at Public Citizen and co-author of the study.
OSHA officials did not respond directly to the report. But in a 2010 statement on the issue, the head of the agency, Assistant Secretary of Labor David Michaels, acknowledged safety problems must be addressed.
"It is unacceptable that the workers who have dedicated their lives to caring for our loved ones when they are sick are the very same workers who face the highest risk of work-related injury and illness," Michaels wrote in response to a 2010 OSHA study that found high numbers of work-related injuries in the health care field.
The agency has implemented several health care safety standards, including a blood-borne pathogens standard which requires exposure, control, storage and disposal of sharp devices and needles. State laws and employer mandates also require safe patient handling,
But the agency lacks a specific standard to measure and reduce physical stress from activities like prolonged exertion of the hands and lifting patients — also known as ergonomic standards. A 2000 law requiring health facilities to protect employees from ergonomic stressors was repealed by Congress in early 2001.
OSHA rebounded by creating a National Emphasis Program to address worker safety. The program — which covers nursing homes and residential care facilities — issued only seven citations for unsafe ergonomic conditions since October 2011, the report says. Other citations for unsafe conditions are filed under the agency's catch-all "general duty clause" — a clause that requires the agency to provide a large amount of evidence to prove claims, OSHA said in response to questions by the advocacy group.
Nursing aides, orderlies and attendees who often exert themselves physically by lifting patients out of beds or pushing medical equipment have the highest rate of musculoskeletal injuries than workers in any other field, costing the U.S. about $7 billion annually, according to data from the Bureau of Labor Statistics. By contrast, two of the most hazardous industries — agriculture and construction — are safer today than they were a decade ago, according to the CDC.
In a statement, OHSA wrote it does not have "resources to move forward on all rule-making necessary to address all the pressing workplace health and safety hazards."
The report recommends safety standards that require the use of lifting and transfer aids to encourage safe patient handling, a zero-tolerance policy for workplace violence and periodic reviews of the safety of sharp devices.
"Establishing a culture of safety for safe patient handling and mobility is a paradigm shift, much like wearing gloves and protective equipment for all blood and body fluid precautions was 20 years ago," said Suzy Harrington, director of the American Nurses Association's health and safety division.
The report also warns that additional OSHA funding is needed to "dramatically increase" the number of inspections and enforce new legislation," especially as the number of Baby Boomers requiring care grows over time.
"We can't afford to lose health care workers to injury and still meet rising demands for health care services," Harrington said.
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