Healthcare is the most dangerous industry for injuries and illnesses, with 653,000 nurses, aides, orderlies and others injured or falling ill every year, according to a new Public Citizen Report.

Forty-five percent of all workplace violence incidents in the USA that result in lost workdays occur in the health care sector. Among attendants, orderlies, and nursing aides in 2011, the incidence rate of injuries requiring days off work was 486 cases per 10,000 employees, over four times higher than the national average for all workers.

Even though health care workplaces are more dangerous than anywhere else, OSHA (the Occupational Safety and Health Administration) carries out relatively few inspections of health care facilities. The authors added that even when it does find safety problems, there is often not much OSHA can do because of "an absence of much needed safety standards".

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

More musculoskeletal injuries are suffered by orderlies, attendants, nurses and nursing aides than workers in any other industry. Back injuries in the health care industry are estimated to cost over $7 billion every year.

Dr. L. Toni Lewis, chair of the health care division of the Service Employees International Union, which advised Public Citizen on the report, said:

"Most Americans are not aware that hospitals and other medical facilities are actually the most frequent site for workplace injuries. 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. The current patchwork approach is not working for workers."

In 2010, there were 152,000 workplace injuries and illnesses in the manufacturing sector, compared to a whopping 653,000 in health care.

The industry with the most inspections, construction, has been criticized for not having enough OSHA inspections and enforcements.

Health care, the most people and fewest inspections

The two stark statistics below clearly show how desperately in need the healthcare industry is for safety regulations, inspections and enforcements:

  • Health care has twice as many workers as construction
  • For every OSHA inspection in health care facilities, there are more than 20 in construction sites. There were 52,179 construction site inspections in 2011 compared to just 2,504 in health care and social assistance facilities.

Suzy Harrington, director of the American Nurses Association's Department for Health, Safety and Wellness, said:

"It's alarming that health care workers rank right alongside laborers, truck drivers and other physical, labor-intensive jobs in terms of musculoskeletal injuries. This is a primary reason health care workers leave direct patient care. We can't afford to lose health care workers to injury and still meet rising demands for health care services."

Assistant Secretary of Labor, David Michaels, who is also head of OSHA, said in 2012 regarding the safety problems that need to be addressed in health care "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."

When preparing the report, Public Citizen asked OSHA why it is not more involved in raising standards in health care workplaces, OSHA responded "At this time, OSHA is not pursuing a rule on safe patient handling for health care workers. We continue to be concerned about this serious issue and promote sensible solutions through the National Emphasis Program, guidance, and outreach activities. However, OSHA does not have resources to move forward on all rulemaking necessary to address all the pressing workplace health and safety hazards."

The report blames Congress

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The authors say that Congress is to blame for OSHA for not being able to protect health care workers. OSHA's budget of $535million is "woefully inadequate" to monitor 7 million job sites.

In 2000, the authors wrote that after OSHA published a final standard to protect all workers in every industry from ergonomic stressors, Congress repealed the rule before it came into effect.

At the beginning of the Obama administration, OSHA proposed a rule to "add a column on employers' incident reporting logs to designate whether workplace injuries were musculoskeletal disorders." The administration dragged its feet until Congress finally blocked it.

OSHA is trying to address the injury rates among nursing home workers with a "National Emphasis Program" (NEP), which aims to address ergonomic stressors, falls, trips, slips, workplace violence, tuberculosis and bloodborne pathogens. However, NEP does not cover health care settings, not even hospitals, where injury rates are particularly high.

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As there is no specific standard for ergonomic safety in the health care industry, OSHA has to rely on its catch-all "general duty clause" to issue citations for unsafe working conditions.

Over the last two fiscal years only seven citations regarding ergonomics have been issued to nursing homes, the authors revealed.

The report recommends that OSHA increase the number of inspections of health care facilities significantly ("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 authors also urge Congress to increase OSHA's funding "significantly".

Statement by the American Nurses Association (ANA)

In an online communiqué, the American Nurses Association wrote that an enormous number of health care workers are suffering preventable back, shoulder and neck injuries from manual patient handling. Workers and their managers often are not aware that these potentially career-ending injuries commonly occur after years of repetitive strain, rather than from one event.

Why should a nurse consider moving a 90-pound person up in bed as quick and easy when no other profession would see that weight as "light"? In no other sector would a 90-pound weight be lifted without mechanical support.

The ANA added "Research shows that the use of assistive technology reduces injuries to workers and patients, and lowers costs attributable to workers' compensation, lost productivity, and turnover."

Written by Christian Nordqvist