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An upcoming National Exposure at Work survey may go beyond the usual questions about physical hazards and gauge attitudes about the health care "safety climate."
At two "stakeholders" meetings held by the National Institute for Occupational Safety and Health (NIOSH), participants said they would like more than just statistical information on the use of ergonomics equipment and sharps safety devices, says James M. Boiano, MS, CIH, project manager and chief of the hazard section in NIOSH’s Divi-sion of Surveillance, Hazard Evaluations and Field Studies.
For example, the survey might seek to determine how often ergonomic equipment is used and why workers fail to use it. The survey would include identical questions posed to workers and management, perhaps about the facility’s safety climate.
"There might be an on-site component to the survey as well [with visits to hospitals and other health care facilities]," Boiano says. "That was done in our previous hazard surveys. We know that would be a fairly expensive component, but we’re not ruling that out."
Advocates for health care workers are looking forward to a survey that is tailored to the health care sector and includes worker input, says Karen Worthington, MS, RN, COHN-S, occupational safety and health specialist for the American Nurses Association in Washington, DC.
"In the past, they focused heavily on chemical hazards. They didn’t include worker interviews or worker input," she says. "From health care worker unions’ perspective, it’s important to look at broader groups of hazards."
The survey will influence NIOSH’s research priorities. But Worthington also notes that it could have broader implications. "We’ll be able to use that data to identify how well health care facilities are doing voluntarily with programs to protect workers or complying with existing regulations. The quantitative assessment of [safety programs] will help everyone understand what real priorities there are. It may help [the Occupational Safety and Health Administration] conduct enforcement that’s more effective against real hazards."
The stakeholder meetings were well attended in Baltimore and Seattle, with representatives of labor, hospitals, and academia. Ergonomics experts presented information on methods for preventing musculoskeletal disorder (MSD) injuries, the most common lost-work injury in health care. Attendees broke into small groups to discuss their information needs related to stress, violence, chemical hazards, and biologic hazards.
NIOSH conducted National Exposure at Work surveys in the early 1970s and 1980s, with a single survey that was used for all workplaces. This time, distinct surveys will be developed for different types of employers. Health care is the first area of focus.
"By approaching this sector by sector, we thought we could get more specific information that would be more valuable [to employers]," Boiano says. NIOSH expects to begin conducting pilot tests of a survey this summer. The survey would probably be conducted in 2003, she says.
"The biggest challenge will be for NIOSH to take all the input and decide what to include in the survey," he says. "We need to go after what we feel are the most important issues, the issues that will have the most impact."
By focusing on health care alone, hospitals may finally get some national occupational health data that can be used for benchmarking, says MaryAnn Gruden, MSN, CRNP, NP-C, COHN-S/CM, employee health nurse practitioner with Western Pennsylvania Hospital in Pittsburgh and executive president of the Association of Occupational Health Professionals in Healthcare.
"There’s not a lot of good data out there," she says. "If we had national data, I think it would really help a lot of clinicians who are trying to promote safety programs or injury reduction programs in their facilities."