Occupational Health and Safety in Hospitals

Occupational Health and Safety in Hospitals

Introduction

·        Occupational Health and Safety (OHS) in hospitals refers to the policies, programs, and practices designed to protect healthcare workers, administrative staff, and support staff from workplace-related injuries, illnesses, and hazards.

·        Hospitals are unique workplaces because they expose employees to biological, chemical, physical, ergonomic, and psychosocial risks on a daily basis.

·        The World Health Organization (WHO) and International Labour Organization (ILO) emphasize that ensuring safety in healthcare not only protects employees but also enhances patient safety, reduces absenteeism, improves productivity, and ensures regulatory compliance.

Universal Precautions

·        Universal precautions are a set of infection prevention practices applied to all patients regardless of diagnosis or infection status to prevent transmission of bloodborne pathogens (like HIV, HBV, HCV) and other infections.

Key Components

  1. Hand Hygiene
    • Wash hands before and after patient contact.
    • Use alcohol-based hand rubs when soap and water are not available.
    • Critical after contact with blood, body fluids, or contaminated surfaces.
  2. Personal Protective Equipment (PPE)
    • Gloves: for handling blood, secretions, body fluids, mucous membranes, or broken skin.
    • Gowns/Aprons: when splashes or sprays are likely.
    • Masks, Eye Protection, Face Shields: for protection from droplet or aerosol exposure.
  3. Safe Handling of Sharps
    • Use needle cutters and puncture-proof sharps containers.
    • Do not recap, bend, or manually remove used needles.
    • Follow post-exposure prophylaxis (PEP) protocols for needle-stick injuries.
  4. Environmental Cleaning
  5. Waste Management
    • Segregation of biomedical waste at the point of generation (color-coded bins).
    • Safe disposal of infectious, chemical, and sharps waste.
  6. Respiratory Hygiene
    • Covering nose and mouth when coughing/sneezing.
    • Use of N95 masks in airborne precautions (e.g., TB, COVID-19).

Occupational Hazards in Hospitals

1. Administrative Offices

  • Hazards:
    • Ergonomic issues (poor posture, repetitive strain injuries).
    • Stress from workload, long working hours, or administrative pressure.
    • Indoor air quality concerns (poor ventilation, dust).
    • Eye strain from prolonged computer use.
  • Control Measures:
    • Ergonomically designed chairs, desks, and computer screens.
    • Regular breaks and workplace exercises.
    • Adequate lighting and ventilation.
    • Stress management programs.

2. CSSD (Central Sterile Supply Department)

  • Hazards:
    • Exposure to infectious agents while handling contaminated instruments.
    • Burns and injuries from autoclaves, boilers, and sterilizers.
    • Inhalation of sterilizing chemicals (e.g., ethylene oxide, glutaraldehyde).
    • Cuts from sharp instruments during cleaning.
  • Control Measures:
    • Mandatory use of PPE (gloves, masks, aprons, goggles).
    • Proper training in handling contaminated equipment.
    • Ventilation and exhaust systems for sterilization rooms.
    • Mechanical washers instead of manual scrubbing.

3. Laundry Department

  • Hazards:
    • Exposure to infectious materials from soiled linen.
    • Accidents from heavy machinery (washing machines, dryers, steam presses).
    • Chemical exposure (detergents, disinfectants, bleach).
    • Risk of slips, trips, and falls from wet floors.
  • Control Measures:
    • Color-coded segregation of contaminated linen.
    • Staff training in safe handling and disinfection protocols.
    • Use of gloves, masks, aprons, and boots.
    • Adequate ventilation and non-slippery flooring.

4. Radiology Department

  • Hazards:
    • Radiation exposure from X-rays, CT scans, fluoroscopy.
    • Chemical hazards from contrast media and processing solutions.
    • Ergonomic hazards from moving patients and equipment.
  • Control Measures:
    • Lead aprons, thyroid shields, and protective goggles.
    • Radiation monitoring badges (dosimeters).
    • Compliance with Atomic Energy Regulatory Board (AERB) safety standards.
    • Regular machine calibration and quality assurance checks.

5. Dietary Department (Hospital Kitchen)

  • Hazards:
    • Burns, cuts, slips, and falls while cooking.
    • Food contamination and infection risk.
    • Chemical hazards from cleaning agents.
    • Heat stress in poorly ventilated kitchens.
  • Control Measures:
    • Use of protective gloves, aprons, and footwear.
    • Strict food hygiene and safety protocols (HACCP guidelines).
    • Regular pest control and sanitation.
    • Fire safety training and extinguishers.

6. Morgue

  • Hazards:
    • Exposure to infectious agents from dead bodies.
    • Chemical hazards from preservatives like formalin.
    • Psychological stress and trauma from dealing with cadavers.
    • Risk of injuries from sharp instruments (scalpels, saws).
  • Control Measures:
    • Full PPE (gloves, masks, aprons, goggles, boots).
    • Adequate ventilation and fume hoods for chemical use.
    • Vaccination of staff (Hepatitis B, Influenza, Tetanus).
    • Psychological support programs and counseling.

Workplace Stress in Hospitals

·        Workplace stress is one of the most common but often ignored occupational hazards in healthcare settings.

Causes of Stress

  • Long working hours and shift duties.
  • High workload and staff shortages.
  • Exposure to critically ill or dying patients.
  • Workplace violence or abuse from patients/relatives.
  • Lack of recognition or career progression.

Effects of Stress

  • Physical: headaches, insomnia, hypertension.
  • Emotional: anxiety, depression, burnout.
  • Professional: decreased productivity, absenteeism, medical errors.

Stress Management Strategies

  • Organizational Level:
    • Adequate staffing and shift rotation.
    • Encouragement of teamwork and communication.
    • Employee assistance programs (EAPs).
  • Individual Level:
    • Time management and relaxation techniques (yoga, meditation).
    • Seeking counseling or peer support.
    • Maintaining work-life balance.

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