Occupational Health Hazards for Health care Workers An- Najah National University Faculty of Human Medicine Sabreen H. Madieh
methods and advices for the prevention of occupational health hazards for HCW. • Immunization and vaccine programs for HCW. • Palestinian Public health art and HCW
Prevent Chemical Exposure : 1) Substitute less hazardous chemicals 2) Change to non-spill containers 3) Keep containers closed 4) Work under hoods 5) Wear personal protective equipment(gloves, masks, aprons)
Prevent Ergonomic Injuries : The training programs for health care works should emphasize : • Proper lifting techniques . • Preventing initial back injuries because a back that has already a previous injury is most like to be reinjured. • Requesting help. • Performing back exercises for strengthen the back muscles and help prevent back injury.
Transferring patients : pt. transfers are particularly hazardous for hospital workers and are not often covered in general publications on preventing back injury . • HCW should plan for the action to the pt. and other workers should corporate to do the transfer process smoothly without any sudden and unexpected moves • Ensure good footing for the staff and pt. and should maintain the eye contact and communication with patient . • Request for co-workers before attempting the transfer if needed.
Reduce Stress : • Define aggravating factors. • Establish discussion/support groups. • Change work design. • Involve Employee Assistance personnel.
Prevent Physical Injuries : • Muffle noisy machinery or wear ear plugs • Guards on machines • Use “sharps” containers • Dry wet surfaces
Prevent Infection: 1) Hand washing : Hand washing prevents spread of infection from patient to HCW and from patient to patient.
Prevent Infection: • Immunization : A) Recommended Immunoprophylaxis B) Drug C) prophylaxis • Hepatitis B • Hepatitis C • HIV • MMR Meningococcus • Influenza • Hepatitis A • Varicella • Tetanus • * Laboratory workers with specific exposures (typhoid, vaccinia, others)
Recommendations for administration of vaccines and other immunobiologic agents to HCWs are organized in three broad disease categories: 1) Those for which active immunization is strongly recommended because of special risks for HCWs (i.e., hepatitis B, influenza, measles, mumps, rubella, and varicella). 2) Those for which active and/or passive immunization of HCWs may be indicated in certain circumstances (i.e., tuberculosis, hepatitis A, meningococcal disease, typhoid fever, and vaccinia) or in the future (i.e.,pertussis). 3) Those for which immunization of all adults is recommended (i.e., tetanus, diphtheria, and pneumococcal disease).
OTHER CONSIDERATIONS IN VACCINATION OF HEALTH-CARE WORKERS include: 1) maintenance of complete immunization records 2) policies for catch-up vaccination of HCWs 3) work restrictions for susceptible employees who are exposed to vaccine-preventable diseases 4) control of outbreaks of vaccine-preventable disease in health-care settings. 5)Additional vaccines not routinely recommended for HCWs may be indicated for those who travel to certain other regions of the world to perform research or health-care work (e.g., as medical volunteers in a humanitarian effort).
1) Immunization Records • An immunization record should be maintained for each HCW. • The record should reflect documented disease and vaccination histories as well as immunizing agents administered during employment. • At each immunization encounter, the record should be updated and the HCW encouraged to maintain the record as appropriate.
2) Catch-Up Vaccination Programs : • Managers of health-care facilities should consider implementing catch-up vaccination programs for HCWs who are already employed, in addition to policies to ensure that newly hired HCWs receive necessary vaccinations. • This will help prevent outbreaks of vaccine preventable diseases . Because education enhances the success of many immunization programs, reference materials should be available to assist in answering questions regarding the diseases, vaccines, and toxoids, and the program or policy being implemented.
3) Outbreak Control : Hospitals should develop comprehensive policies and protocols for management and control of outbreaks of vaccine-preventable disease. Outbreaks of vaccine-preventable diseases are costly and disruptive. Outbreak prevention, by ensuring that all HCWs who have direct contact with patients are fully immunized, is the most effective and cost-effective control strategy.
4)Vaccines Indicated for Foreign Travel : • Hospital and other HCWs who perform research or health-care work in foreign countries may be at increased risk for acquiring certain diseases (e.g, hepatitis A, poliomyelitis, Japanese encephalitis, meningococcal disease, plague, rabies, typhoid, or yellow fever). • Vaccinations against those diseases should be considered when indicated for foreign travel .
Palestinian Public Health Act قانون الصحة العامة الفلسطيني • Public Health Code Number 20 for the year 2004 • Published on April 23, 2005. • There are 10 chapters & 85 articles . • There are two main articles :
1- Chapter V ( Occupational Health ) • Article (35) : Each ministry is held responsible for both initial and periodic check-ups for its staff members. • المادة (35) تتحمل كل منشأة الأولية والدورية المحددة من الوزارات التي تجري للعاملين فيها
2) Chapter VIII ( Health institutions) • Article (50)1 - All workers in the health institution must be free from infectious diseases and their causes. 2 – A health institution must take all measures to guarantee safety of its employees. • المادة (50) 1-يشترط في جميع العاملين بالمؤسسة الصحية خلوهم من الأمراض المعدية ومسبباتها. 2-تعمل المؤسسة الصحية على وقاية العاملين فيها مما قد يضر بصحتهم الجسدية أو النفسية
According to Palestinian public health act about the health institution • Article (46)1 - The Ministry distributes health institutions and services in accordance with the requirements of health of the citizens and their whereabouts. 2 - The ministry is to renew the conditions and specifications required for each health institution, in order to carry out its work duly. • Article (47) Setting up new health institution is allowed, provided obtaining a license from the Ministry.
No specific article about health hazards for HCW ( including infections , ect… ) • There’s is no articles to protect The HCW who work in a private clinic in case of biological hazards . • There’s no articles for reparation or compensations in case of injury specially for HCW who work in private clinics. • They can only have the health insurance by insurance company in case of having any of the occupational hazards .
References: • http://www.moh.gov.ps/newsite/ar/index.php?action=view&page=legislations&id=176 • http://www.pimacare.net/en/news_details.php?id=29 • http://www.cdc.gov/niosh/az/h.html • http://www.ncbi.nlm.nih.gov/pubmed • http://www.who.int/en/ • http://www.agius.com/hew/resource/hcw.htm • http://www.immunize.org/catg.d/p2017.pdf • http://aids.about.com/od/technicalquestions/f/healthrisk.htm • http://www.hazards.org
http://www.eeoc.gov/facts/health_care_workers.html • http://www.webmd.com/ • http://www.health.nsw.gov.au/policies/pd/2005/pdf/PD2005_162.pdf • http://www.opas.org.br/gentequefazsaude/bvsde/bvsamat/hazards-worker.pdf • http://www.ncbi.nlm.nih.gov/ • http://www.opas.org.br/gentequefazsaude/bvsde/bvsacd/cd49/88-119-c.pdf • http://www.geres.org/docpdf/riskvhc.pdf • http://www.cdc.gov/ • http://www.ama-assn.org/