Transcript Occupational Skin Diseases - Isfahan University of Medical

Health Care Workers
Occupational
Diseases
Dr. Alireza Safaeian
Occupational Medicine Specialist
What is healthcare?
 Healthcare is involved, directly or indirectly, with
the provision of health services to individuals.
 These services can occur in a variety of work
settings, including hospitals, clinics, dental
offices, out-patient surgery centers, birthing
centers, emergency medical care, home
healthcare, and nursing homes.
Other than doctors and nurses,
what workers are exposed?
 physicians, nurses,
technicians, clinical
laboratory workers, first
responders, building
maintenance, security
and administrative
personnel, social
workers, food service,
housekeeping, and
mortuary personnel
What types of hazards do
workers face?
 bloodborne pathogens and biological hazards
 potential chemical and drug exposures (formaldehyde,
ethylene oxide, glutaraldehyde )
 waste anesthetic gas exposures
 respiratory hazards
 ergonomic hazards from lifting and repetitive tasks
 laser hazards
 workplace violence
 hazards associated with laboratories
 radioactive material and x-ray hazards.
Hazards in hospital
HCWs: Clinical areas
• Bloodborne pathogens
• Airborne pathogens
• Ergonomic
• Slips, trips, falls
• Sharps
Surgical Suite
• Anesthetic gases
• Bloodborne pathogens
• Compressed gases
• Lasers
• Ergonomic
• Latex
HCWs: Lab Workers
• Infectious diseases
• Chemical agents(formaldehyde, toluene, xylene)
• Ergonomic
• Slips, trips, falls
• Sharps
HCWs: Radiology
• Radiation
• Ergonomics
• Airborne pathogens
• Bloodborne pathogens
• Slips, trips, falls
HCWs: Physical Therapy
• Ergonomics
• Trips, falls
• Equipment hazards
• Bloodborne
pathogens
HCWs: Pharmacy
• Drug absorption
• Ergonomic
• Slips, trips, falls
• Latex
HCWs: Central Supply
• Compressed gases
• Anesthetic gases
• Chemical agents (sterilizers, cleaners)
• Ergonomic
• Burns, cuts
HCWs: Laundry Workers
• Contaminated laundry
• Noise
• Heat
• Lifting
• Sharps
• Slips, trips, falls
• Fire hazard
HCWs: Housekeepers
• Chemical agents
• Contaminated
objects
(infectious agents)
• Latex
• Sharps
• Lifting hazard
• Slips, trips, falls
HCWs: Dietary
• Foodborne diseases
• Heat
• Moving machinery
• Fire hazards
• Slips, trips, falls
• Electrical equipment
Stress
• Life threatening illnesses
and injuries
• Understaffing
• Malfunctioning equipment
• Patient death
• Hierachy of authority
• Demanding patients
• Excessive paperwork
• Health Effects: loss of appetite, ulcers, mental disorder, migraines, difficulty
in sleeping emotional instability, disruption of social and family life, and the
increased use of cigarettes, alcohol, and drugs. Stress can also affect worker
attitudes and behavior.
Reduce Stress
• Define aggravating factors
• Establish discussion/support groups
• Change work design
• Involve Employee Assistance personnel
How to Prevent Musculoskeletal
Disorders (NIOSH)
Prevent Ergonomic Injuries
• Use proper lifting techniques
• Have more than one HCW assist on lifts
• Use lifting assist devices
• Change positioning
Lifting guidelines for health
care workers
 Never transfer patients/residents when off balance.
 Lift loads close to the body.
 Never lift alone, particularly fallen patients/residents, use
team lifts or use mechanical assistance.
 Limit the number of allowed lifts per worker per day.
 Avoid heavy lifting especially with spine rotated.
 Training in when and how to use mechanical assistance.
Patient handling tasks pose
increased ergonomic risk if they are:

repetitive

done in awkward postures

done using a great deal of force

lifting heavy objects

combining these factors.
Safe Patient Handling
 Equipment, which can range from ceiling-mounted
lifts to simple slide sheets that facilitate lateral transfer
 Minimal-lift policies and patient assessment tools
 Training for all caregivers or for dedicated lifting teams
on proper use of the equipment
Mechanical Lift Equipment - Patient Transfer Systems
Sling-Type Full Lift
A Safety and Health
Management System
also known as an injury and illness prevention program
is a proactive, collaborative process to find and fix
workplace hazards before employees are injured or become
ill.
Almost all successful systems include six core elements:
 Management leadership
 Employee participation
 Hazard identification and assessment
 Hazard prevention and control
 Education and training
 Program evaluation and improvement
Workplace violence
 The National Institute for Occupational Safety
and Health (NIOSH) defines workplace violence
as "violent acts (including physical assaults and
threats of assaults) directed toward persons at
work or on duty.“
 Workplace violence is any physical assault,
threatening behavior, or verbal abuse occurring in the
work setting
The risk factors
 The increasing number of acute and chronic mentally ill patients
 The availability of drugs or money at hospitals, clinics and pharmacies
 Unrestricted movement of the public in clinics and hospitals and long waits in
emergency or clinic areas that lead to client frustration over an inability to obtain
needed services promptly;
 The increasing presence of drug or alcohol abusers, trauma patients or distraught
family members;
 Low staffing levels during times of increased activity such as mealtimes, visiting
times and when staff are transporting patients;
 Isolated work with clients during examinations or treatment;
 Solo work, often in remote locations with no backup or way to get assistance,
such as communication devices or alarm systems (this is particularly true in highcrime settings);
 Lack of staff training in recognizing and managing escalating hostile and
assaultive behavior;
 Poorly lit parking areas.
Hazardous Drugs
 Preparation, administration, manufacturing,
and disposal of hazardous medications
 Healthcare facilities and the pharmaceutical
industry,
 Antineoplastic cytotoxic medications,
anesthetic agents, anti-viral agents, and others
 These hazardous medications are capable of
causing serious effects including cancer,
organ toxicity, fertility problems, genetic
damage, and birth defects.
Hazards control and prevention
 engineering and work practice controls
 administrative controls
 ensure the use of personal protective clothing and equipment
 provide training
 medical surveillance
 hepatitis B vaccinations
 signs and labels
 Engineering controls are the primary means of eliminating or
minimizing employee exposure and include the use of safer
medical devices, such as needleless devices, shielded needle
devices, and plastic capillary tubes.
Personal
Protective Equipment
Healthcare Workers
Why You Need to Wear
Assigned PPE
 You could face a variety of workplace hazards
 Safety controls don’t always eliminate hazards
 When hazards can’t be eliminated, PPE serves as a
barrier between you and the hazards
Common Healthcare Hazards
Requiring PPE
Skin penetration by
sharps
Chemicals
Antineoplastic and
other potentially
harmful drugs
Blood and other
potentially infected
materials
TB or other airborne
bacteria
Common Healthcare
Hazards Requiring PPE (cont.)
Mechanical hazards
Heat
X rays
Light radiation (e.g., lasers or UV)
Any other identified hazard
PPE Is Your Personal Defense
Against Hazards
Eyes and face
Skin
Respiratory system
Feet
Hearing
Head
Eye and Face Protection
Shatterproof safety
glasses
Goggles
Filtered lenses
Face shields
Eye protection with
prescription glasses
Skin Protection
Gloves
Disposable
Cotton
Leather
Rubber, neoprene,
or vinyl
Heat resistant
Protective clothing
Respiratory Protection
Respirators
Respirator fit
testing and
training
Foot Protection
Sensible, sturdy
shoes with nonslip
soles
Safety shoes
Boots
Shoe covers
Hearing Protection
Earmuffs
Earplugs
Canal caps
Homemade
hearing protection
IS NOT effective
and should NOT
be used
Head Protection
 Hard hats protect your
head in two ways:
Hard outer shell resists
blows and
penetration
Shock-absorbing
suspensions act as a
barrier between the
outer shell and your
head to absorb
impact
Inspect PPE Before Use
 Inspect before each use
 Look for holes, tears, cracks, wear, or other
problems
 Don’t use defective, worn, or damaged PPE.
Turn it in and get an effective replacement.
Get a Good Fit
 PPE fits well when it:
Provides you with the
protection you need
Is comfortable
enough to allow you
to move and perform
your job well
 Remember to check fit
before each use
Remove and Dispose
of PPE Correctly
 Remove PPE when it’s contaminated
 Remove PPE from the top down, wearing gloves to
protect your skin
 Grasp contaminated gloves on the inside and peel
down without touching the outside
 Place contaminated PPE in assigned containers
 Wash thoroughly after removing PPE
Maintain PPE Properly
Clean PPE before
you put it away
Store PPE in a safe
place where it won’t
be damaged or lost
Thanks for your attention
Any questions ?