Occupational health and safety risks in the healthcare sector
Occupational health and safety (OSH) issues are an important part of quality manage- ment risk management and corporate social responsibility (CSR).
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CHAPTER 4 - SAFETY RISK MANAGEMENT PROGRAM
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CHAPTER 4 - SAFETY RISK MANAGEMENT PROGRAM
A risk assessment is an information gathering exercise about: Hazards Risks and Controls Requires information on: • Substances • Work processes (location & duration) • Assessments of the levels of exposure • Evaluations of control measures
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workplace safety to management systems and supporting control programs aligned with internationally-recognized safety management standards such as CSA Z-1000 or OHSAS 18001 Organizations with strong safety management systems frequently embed safety into their core values which are visibly embraced by corporate leadership
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What is a risk management tool?
- This tool/technique actually transcends several of the risk management steps, because you must identify and assess hazards, but is best considered a control used to manage the hazards that must remain in the workplace for mission accomplishment.
How do I create a safety worksheet?
- Worksheet developed by: Safety Coordinator's name Step 1 Identify Hazard Step 2 Assess Hazard Step 3 Develop Controls Residual Risk Step 4 How/Who to Implement Step 5 Supervise/ Evaluate Lifting heavy objects causes back injury or other body trauma RAC 2
What documentation is needed for a risk management program?
- Documentation for the Risk Management Program includes: 1. Job/Workplace Hazard Analyses periodically reviewed and changed whenever personnel/processes change, or new hazards are introduced into the workplace. 2.
What is a high risk hazard?
- The level of risk is very high when many are exposed for long periods of time. For example, tripping injuries on steps may be high in our facilities because so many are exposed to the hazard everyday. IMMEDIATELY CORRECT HAZARDOUS CONDITION (or reduce to LOW risk) WHEN IDENTIFIED.
Guide to prevention and good practice
Occupational health
and safety risks in the healthcare sector This publication is supported by the European Union Programme for Employment and Social Solidarity -PROGRESS (2007-2013).
This programme is implemented by the European Commission. It was established to nancially support the
implementation of the objectives of the European Union in the employment, social aairs and equal oppor-
tunities area, and thereby contribute to the achievement of the Europe 2020 Strategy goals in these elds.
The seven-year Programme targets all stakeholders who can help shape the development of appropriate and
eective employment and social legislation and policies, across the EU-27, EFTA-EEA and EU candidate and
pre-candidate countries. For more information see: http://ec.europa.eu/progressEuropean Commission
Directorate-General for Employment, Social Aairs and InclusionUnit B.3
Manuscript completed in December 2010
Occupational health and safety risks
in the healthcare sectorNeither the European Commission nor any person acting on behalf of the Commission may be held responsible for the use
that may be made of the information contained in this publication.© Cover photos: iStock
For any use or reproduction of photos which are not under European Union copyright, permission must be sought directly
from the copyright holder(s).This guide has been produced by the Bundesanstalt für Arbeitsschutz und Arbeitsmedizin (BAuA), Berufsgenossenschaft
für Gesundheitsdienst und Wohlfahrtspege (BGW), contec Gesellschaft für Organisationsentwicklung mbH, Deutsches
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Reproduction is authorised provided the source is acknowledged.Printed in Luxembourg
PRINTED ON ELEMENTAL CHLORINE-FREE BLEACHED PAPER (ECF) 3Preamble
7Introduction and vision
11 1. Prevention and health promotion as a management task 13Description of good company practice 21
2.How to carry out a risk assessment 23
2.1.Introduction
242.2.
Roles and responsibilities 24
2.3. What should be considered before I start the risk assessment 28 2.4.How do I get started with the risk assessment? 28
2.5. Inclusion of gender aspects in the risk assessment 34 2.6.Description of good company practice 35
2.7. Links 402.8.
Relevant European Union directives 43
2.9.OiRA: Online risk assessment tool, EU-OSHA 43
2.10.Literature
432.11. Example of a risk assessment based on the task of manually handling patients 44 2.12. Example of a risk assessment based on the task of surface disinfection 45 3.
Biological risks 49
3.1.Introduction
503.2. General risk assessment of potential occupational exposure to infection 51 3.3.
Special risk assessment of biological risks 69
3.3.1.
Risk of blood-borne infections 69
3.3.2.
Risk of airborne infection 80
3.3.3.
Risk of direct and indirect contact infection 84
3.3.4.
Description of good company practice: 88
- handling contact infections - preventive measures in the ambulance service 903.3.5.
Special infections 92
Contents
4 3.4.Pregnancy
1013.5.
Relevant European Union directives 102
3.6. Links 1033.7.
Literature
1054.
Musculoskeletal risks 107
4.1. Risks for the development of musculoskeletal disorders 1084.1.1.
Introduction
1084.1.2.
Nature of the risk 109
4.1.3.
Basic criteria for a speci c risk assessment for the prevention of MSDs 1114.1.4.
Work situations with the greatest exposure 116
4.1.5.
E?ects on health and safety 121
4.1.6.
Preventive and protective measures 124
4.1.7.
Behaviour in critical situations -
Recommendations for workers
1324.1.8.
Main messages and conclusions 136
4.1.9.
Relevant European Union directives 137
4.1.10.
Description of good company practice 139
4.1.11.
Links 1514.1.12.
Literature
1564.2.
Prevention of accidents due to slips,
trips and falls? 85157
4.2.1.
Introduction
1574.2.2.
Nature of the risk 158
4.2.3.
Basic criteria for a speci c risk assessment for the prevention of slip, trip and fall accidents 1594.2.4.
Work situations with the greatest exposure 160
4.2.5.
E?ects on health and safety 161
4.2.6.
Preventive and protective measures 161
4.2.7.
Personal protective equipment 164
4.2.8.
Behaviour in critical situations -
Recommendations for workers
1664.2.9.
Main messages and conclusion 166
4.2.10.
Relevant European Union directives 166
4.2.11.
Links 1684.2.12.
Literature
1705.
Psychosocial risks 171
5.1.Introduction
1725.2.
Stress and burnout 176
5.2.1.
Nature of risk dealt with 176
5.2.2.
Basic criteria for a speci c risk assessment 176
5.2.3.
Work situations with the greatest exposure 182
55.2.4. Eects on health and safety 182
5.2.5.
General preventive and protective measures 183
5.2.6.
Description of speci?c preventive techniques and procedures 184 5.3.Prevention and monitoring of violence and mobbing
(bullying and harassment) at the workplace 1865.3.1.
Nature of the risk dealt with 186
5.3.2.
Basic criteria for a speci?c risk assessment 188
5.3.3.
Work situations with the greatest exposure 192
5.3.4.
Eects on health and safety 192
5.3.5.
General preventive and protective measures 193
5.3.6.
Description of the speci?c preventive
techniques and procedures 1945.3.7.
Examples of good corporate practice 194
5.3.8.
Appropriate modes of behaviour in critical situations 1945.3.9.
Most important knowledge and conclusions 195
5.4.Working hours 196
5.4.1.
Nature of risk dealt with 196
5.4.2.
Basic criteria for a speci?c risk assessment 196
5.4.3.
Description of the work situations with the greatest exposure 1985.4.4.
Descriptions of the eects on health and safety 1985.4.5.
General preventive and protective measures 200
5.4.6.
Description of the speci?c preventive techniques and procedures 2015.4.7.
Examples of good corporate practice 201
5.4.8.
Appropriate modes of behaviour in critical situations 2025.4.9.
Most important knowledge and conclusion 202
5.5.Drug abuse 203
5.5.1.
Nature of the risk dealt with 203
5.5.2.
Basic criteria for a speci?c risk assessment 203
5.5.3.
Work situations with the greatest exposure 205
5.5.4.
Eects on health and safety 205
5.5.5.
General preventive and protective measures 205
5.5.6.
Speci?c preventive techniques and procedures 205
5.5.7.
Appropriate modes of behaviour in critical
situations 2065.5.8.
Most important knowledge and conclusions 207
5.6.Relevant European Union directives 208
5.7.Description of good company practice 209
5.7.1.
Interview with Havelland Clinics, Nauen, on psychosocial risks 2095.7.2.
Interview with St Elisabeth Hospital, Tilburg, on psychosocial risks 211 5.8. Links 2135.9.
Literature
215Annex 217
6 6.
Chemical risks 219
6.1.Introduction
2206.2. Nature of the risk dealt with: Special risks attributed to dangerous substances and preparations 221
6.3.
Basic criteria for assessing chemical risks 221
6.3.1.
Risk assessment 225
6.4.General preventive and protective measures?(
135136
Implementation of protective measures taking into account the risk assessment 227
6.4.1.
Protective measures (
137138
227
6.4.2.
Provision of information/instruction to workers 2296.4.3.
Monitoring the e?ectiveness of measures 230
6.5.Cleaning and disinfection work 230
6.5.1.
Descriptions of the work situations with the greatest exposure 2316.5.2.
Description of the e?ect on health and safety 232
6.5.3.
Speci c preventive techniques and procedures 233
6.6.Cytostatic/cytotoxic drugs 234
6.6.1.
Description of the work situations with the greatest exposure 2346.6.2.
Description of the e?ect on health and safety 236
6.6.3.
Speci c prevention techniques and procedures 236
6.7.Activities involving anaesthetic gases 241
6.7.1.
Description of work with maximum exposure 242
6.7.2.
Description of the e?ect on health and safety 242
6.7.3.
Speci c prevention techniques and procedures 244
6.8.Activities involving substances which
endanger reproduction 2476.9.
Relevant European Union directives 250
6.10.Description of good company practice 251
6.10.1.
Interview with General Hospital Vienna (AKH Vienna) on safe working in disinfection activities 2516.10.2.
Working safely with cytostatic drugs 254
6.11. Links 2586.12.
Literature
263Imprint
265Annexes
269Preamble
8 OCCUPATIONAL HEALTH AND SAFETY RISKS IN THE HEALTHCARE SECTOR 1OJ L 183, 29.6.1989, pp.
1-8. About 10?% of workers in the European Union belong to the health and welfare sector, and many of them work in hospitals. These workers may be exposed to a very wide variety of risks. EU legislation on health and safety at work currently covers most of these risks - nevertheless, the combination of such diverse risks arising at the same time and the fact that this is clearly a high-risk sector have given rise to a debate on the need for a speci?c approach in order to improve the protection of the health and safety of hospital personnel at Union level. All the considerations and any measures designed to improve the health and safety of hospital personnel can be extended to workers in the health sector in general.Background
In November 2001, a rst meeting was held with the representatives of the Member States" governments to discuss the situation in their countries and the initial positions on the question of possible Community measures aimed at improving occupational health and safety in the hospital sector. It was considered appropriate to start with contacts with government representatives because it was felt important to have an overview of the particular situation concerning occupational health and safety in healthcare establishments in the EU and the implementation of the Community provi sions in force in this area. During the meeting, the participants particularly welcomed the Commission"s initia tive to launch a debate on the situation in a sector which employs a high percentage of the EU"s working population and where the workers are exposed to a large num ber of dierent types of concomitant risks (infections, chemical agents, carcinogens, musculoskeletal disorders, accidents, radiation, etc.). The participants were unanimous in their view that, although new specic Community legislation for the hospital sec- tor does not seem necessary at present, the adoption of other, non-legislative meas ures, such as a recommendation and the production at Community level of guides to good practice for this sector, would be a very positive and necessary step. Particular importance was also attached to the dissemination of information and the exchange of experience in this area, especially via the European Agency for Health and Safety atWork (EU-OSHA), based in Bilbao.
It was also felt that the creation of an ad hoc group on Health and safety in the hos pital sector" within the Advisory Committee would make it possible to continue the analysis of possible Community measures within a tripartite context. The ad hoc group was also tasked with preparing a draft opinion for the consideration of the Advisory Committee on possible Community measures to improve protection of the health and safety of workers in the hospital sector. The working party adopted a draft opinion which was presented for discussion and later adopted by the committee. The committee was of the opinion that there are a number of possible initiatives that could be taken at Community level. Having dis cussed the various options available, the committee agreed that all occupational health and safety risks within the healthcare sector are already adequately covered by the framework directive, Council Directive 89/391/EEC of 12 June 1989 on the intro- duction of measures to encourage improvements in the safety and health of workers at work( 1 ), and other health and safety at work directives. 9PREAMBLE
Furthermore, the Committee agreed that priority should be given to the production, at Community level, of a guide to prevention and good practice for hospital workers, focusing on the most signicant risks in the sector, especially: a) biological agents b) musculoskeletal disorders c) psychosocial disorders, and d) chemical agents. These risk groups are being targeted from the occupational health and safety per- spective, and exclude all public health considerations except where these impinge on health and safety. Other potential risks have been excluded from the guide since they already fall within the scope of other European Union legislation in force. The guide to prevention and good practice has been designed and produced as a very practical, easily understood tool that can be used as the basis for initial and periodic training measures for hospital personnel. The guide takes account, in particular, of the latest technical and scientic knowledge available in the eld of prevention, as well as the guides and good-quality materials already existing at national level, together with the information available via EU-OSHA.quotesdbs_dbs20.pdfusesText_26[PDF] industrial sources of air pollution
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