OSHA Speeches
Safety and Health for the Frontline Healthcare
Workers.
OSHA Speeches -
Table of Contents
- Record Type: Speech
- Subject: Safety and Health for the Frontline Healthcare
Workers.
- Information Date: 08/07/2000
- Presented To: Frontline Healthcare Workers Safety Conference
- Speaker: Jeffress , Charles N.
"This document was published prior to the publication of OSHA's final
rule on Ergonomics Program (29 CFR 1910.900, November 14, 2000), and
therefore does not necessarily address or reflect the provisions set forth
in the final standard."
Charles N. Jeffress Frontline Healthcare Workers Safety
Conference Washington, D.C. August 7, 2000
- Have you ever thought of yourself as a warrior? Perhaps that's not a
picture that comes readily to mind. As healthcare professionals, you've
dedicated your career to preserving lives, promoting health and offering
comfort.
- Still, the warrior image may be apt. You face a battle against a
myriad of hazards. Some of those hazards are fatal. In caring for your
patients, you may place your own health at risk.
- Your mission, as defined by Hippocrates nearly 2500 years ago, is
"to help, or at least to do no harm." While Hippocrates focused on
preventing harm to the patient, it's equally important to avoid harm to
the healthcare provider.
- People have always been the most important element in healthcare.
Whether it's someone using the computer for a more accurate diagnosis or
someone holding a fragile newborn, people make the difference. Our
healthcare system depends on healthy, skilled workers who have a special
gift for caring for others.
- So before you go into battle, be sure you're prepared. Use the most
effective weapons. For example, you need needles with safer designs,
ergonomics programs to reduce your risk of back injury, scavenging
systems to eliminate waste anesthesia gases.
- OSHA is on your side in this effort. Preserving frontline workers'
health is not at odds with good patient care. On the contrary, it's part
and parcel of good patient care. We can and must accomplish both goals
together. I believe good healthcare and good occupational protection go
hand in hand. It's not either/or. It's both/and.
- OSHA takes your health as seriously as you take the health of your
patients. We'll be discussing the nexus between patient care and
healthcare employee health at a best practices conference we're
co-sponsoring in October in Pennsylvania. I hope many of you will be
able to come to that event.
- You'll be talking more today and tomorrow about specific ways to
prevent needlesticks and protect against bloodborne pathogens. Since 80
percent of the occupational exposures to blood occur through
needlesticks, these injuries are of grave concern.
- Let me put it a little more personally. Each of you sitting here
today faces a one-in-seven chance of experiencing a needlestick this
year. That's because in 2000, we estimate 600,000 to 800,000
needlesticks will occur among the 5.6 million healthcare workers in the
U.S.
- Over and above needlesticks, in 1998, nearly 490,000 recordable
injuries occurred in U.S. hospitals and nursing homes-about eight
percent of all workplace injuries and illnesses in the private sector.
While injuries have declined, that number is still far too high.
- One of the ways we are seeking to address that problem is by
focusing our resources on the workplaces with high injury and illness
rates. This year, OSHA identified 13,000 specific worksites, including
2,600 healthcare facilities, with higher than average injury and illness
rates. Our inspections are focused on these high risk sites.
- In the spring, I wrote to each of the 13,000 sites, alerting
employers to their high rates and encouraging them to improve their
safety and health programs. For hospitals, we even offer a special web
page on our Internet site filled with useful information and links to
other helpful sites.
- We will continue our efforts, through both enforcement and
education, to work with healthcare employers, unions and associations to
make your workplaces safer.
- Many of you were here two years ago for the last Frontline
conference. I want to talk for a few minutes about some of the
developments that grew out of that session.
- At the last conference, I announced that OSHA would be requesting
information on preventing needlesticks. In September 1998, we asked the
public for details on engineering and work practice controls used to
prevent needlesticks. We received nearly 400 responses, and the
healthcare community sent us a great deal of valuable information.
- We learned that a variety of safer devices exist. But they aren't in
widespread use. So there are still many, many needlesticks occurring
that could be prevented. Comments also made clear that training and
education are critical. Just buying safer devices isn't enough.
Involving frontline workers in evaluating new devices is especially
important in selecting the equipment best suited to each facility.
- Based on the information we received, OSHA updated its bloodborne
pathogens compliance directive, as I promised we would. The directive we
issued last fall does not change the standard or create new legal
duties, but is a restatement, clarification and further explanation of
the standard's requirements.
- For one thing, it emphasizes the importance of reviewing a
facility's exposure control plan at least once a year. A key part of
that plan is identifying and implementing the engineering controls that
form the first line of defense against exposure to bloodborne pathogens.
The directive makes plain that every year workplaces covered by the
standard should consider whether more effective devices are available to
protect workers against needlesticks. If better devices exist, the
facility needs to consider which ones would be the most appropriate to
use. It's also important to review basic work practices, personal
protective equipment and administrative controls.
- Further, we've expanded the sections in the directive that focus on
coverage of multi-employer worksites such as home health services,
employment agencies, personnel services and independent contractors.
- Discussions at the last Frontline conference also called our
attention to safety hazards posed by glass capillary tubes used for
blood samples, a subject that Diane Mawyer will talk about later this
morning. OSHA, NIOSH and the FDA published a joint safety advisory in
February 1999 to warn about the dangers associated with accidental
breakage of the tubes. When tubes break, blood may splatter on
healthcare workers or glass fragments may cut you. About 2,800 injuries
occur every year from broken tubes.
- The advisory got widespread distribution, both through the agencies
and through professional journals. Purchasers and manufacturers took
notice. Some suppliers are no longer offering glass tubes, and some
manufacturers have switched to other materials for the tubes they make.
- We believe that this effort has made the healthcare setting safer
for thousands of workers. It's an example of how government, employers,
researchers, employees and the media can work together towards a common
goal.
- Another concern for healthcare workers discussed at the last
Frontline conference was latex allergies. In April 1999, OSHA issued
guidance to field personnel that was widely circulated in the healthcare
community alerting people to the potential for allergic reactions among
workers using latex gloves. We estimate 8-12 percent of healthcare
workers are latex sensitive.
- OSHA's technical information bulletin provides a detailed discussion
of the latest research on latex allergy. It covers the types of allergic
reactions that can develop once workers become sensitized to latex.
Perhaps more importantly, the bulletin lists strategies healthcare
facilities can use to minimize the risk of allergic reaction. Recent
studies verify that reducing the risk of latex allergy is sound business
practice because it reduces disability among essential healthcare
workers.
- In addition to the materials we've developed to help healthcare
employers and workers address health concerns, OSHA is looking at other
ways to promote workplace safety in healthcare facilities. Partnership
is one of those ways. We've encouraged healthcare facilities to join our
Voluntary Protection Programs, which recognize outstanding safety and
health programs. Two nursing homes in Missouri and two hospitals in Ohio
are currently participating.
- Also, in early June, we renewed our partnership with the Joint
Commission on Accreditation of Healthcare Organizations. We've worked
with the Joint Commission since 1996 to develop training materials and
publications for healthcare facilities. And the Joint Commission's
accreditation manuals now include specific examples to illustrate how
compliance with OSHA standards also satisfies Joint Commission
standards.
- OSHA is also developing a course for our inspectors that focuses on
the healthcare industry with special emphasis on hospitals. We've had
help from many stakeholders, and the first session will run this
November.
- As many of you know, OSHA is revising its recordkeeping standard.
One of the issues we're looking at is whether all exposure incidents
resulting from contaminated needles and other sharps should be reported.
Now, only those that lead to illness or require medical care beyond
first aid must be entered on the OSHA log.
- Of course, any new rule would include strong privacy and security
safeguards. Our recordkeeping rule should be published before the end of
the year.
- Ergonomics is OSHA's top priority for standard setting. The reason
is very simple. That's where the injuries are. Back injuries, carpal
tunnel syndrome and other MSDs total more than one-third of the most
serious work-related injuries each year. About 1.8 million workers
experience these injuries each year. This includes 600,000 injuries
serious enough to cause workers to miss work. More than 65,000 of those
injuries involve healthcare workers.
- OSHA's proposal focuses on high risk jobs such as lifting patients.
The proposal requires employers to fix jobs where there are problems.
Employers would also provide medical treatment if needed and pay for
lost time.
- It's a sensible, flexible proposal. It would eliminate an average of
300,000 serious injuries each year and save $10 billion in medical
treatment, workers' compensation, and related costs.
- To hear our critics talk, you'd think that you all are suffering
these back injuries and MSDs from playing tennis on weekends, not from
lifting patients. You'd also think that investing in your health will
bankrupt your employer. Make not mistake about it, the fight over
ergonomics is a fight over your health. You and your employers will win
by implementing effective ergonomics programs, and we cannot let the
partisan attacks prevent us from accomplishing our goals.
- One thing I want to make very clear: We will complete an
ergonomics standard this year. Our ergonomics team is committed to doing
that. I am committed to doing that. The Secretary of Labor is committed
to doing that. And the President and Vice President are committed as
well.
- One final thank you from me to you: This afternoon you will present
the Susan Harwood Memorial Awards for Outstanding Student Research. I
appreciate your honoring the memory of this dedicated OSHA employee in
such an appropriate manner. Dr. Harwood was a key member of OSHA's staff
for 17 years and was instrumental in the development of the BBP
standard, which was just one of the multitude of standards to which she
contributed. Cotton dust, formaldehyde, lead in construction...were
other areas where she worked diligently to protect workers. OSHA now
names its training grants The Susan Harwood Grants in her honor. Thank
you for helping to honor further a woman who fought hard and won a major
victory for workers with publication of the BBP standard.
- Frontline healthcare workers wage war against disease on behalf of
all of us. You do your best to see that your patients go home whole and
healthy. And we all appreciate that.
- You have a right to go home whole and healthy every day, too. And
OSHA has a responsibility to do our best to see that you, too, have a
safe and healthful workplace. I look forward to continuing to work with
you toward that end.
OSHA Speeches -
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