Healthcare in the United States is fast growing; employing more than 19 million workers and reporting a substantial burden of occupational injuries and illnesses. Healthcare workers encounter serious health and safety hazards including exposures to chemicals. In 2011, the National Institute for Occupational Safety and Health (NIOSH) conducted an anonymous, voluntary, multimodal, web based survey of select healthcare practitioners to determine adherence to precautionary practices for hazardous chemical exposures. This presentation describes survey design, selected results and overarching recommendations of the study.
METHODS:
Twenty-one professional practice organizations representing healthcare occupations that routinely in contact with selected chemical hazards invited respondents by email, to participate in the survey.
The survey included a screening module, core module and seven hazard modules. The hazard modules addressed aerosolized medications, anesthetic gases, chemical sterilants, high level disinfectants, surgical smoke and administration or compounding of antineoplastic drugs. Each hazard module elicited information on frequency and duration of exposure, training on safe handling, facility specific guidelines, use of engineering controls and PPE, exposure monitoring and medical surveillance. The core module captured demographic information, occupation of respondents and employer type, size and location. The screening module identified eligible respondents, i.e., those who used or were in contact with the chemical agent in the seven days prior to the survey.
RESULTS:
Over 12,000 completed at least one chemical hazard module; 10,781 reported an occupation; 55% were nurses. Respondents represented all regions of the US and predominantly worked in large non-public hospitals. Training and time since last training, use of recommended PPE, adherence to established guidelines or standards and presence of employer standard procedures for reducing exposure varied widely. For example, 94% of workers who administered/handled antineoplastic drugs reported having employer procedures; only 32% with exposure to surgical smoke reported employer procedures were available. Use of recommended protective clothing, e.g. double-layer chemotherapy gloving or non-absorbent gowns with closed front and tight cuffs, when compounding antineoplastic drugs was not 100%. In some cases, though there are recommendations to use protective clothing, respondents reported that recommended PPE was unavailable.
CONCLUSIONS:
This is the largest survey of US healthcare workers to assess knowledge and adherence to safety and health practices while exposed to hazardous chemicals. Despite the availability of safe-handling guidelines for many of the studied exposures, implementation was not universal, putting workers at risk. Although employers are responsible for ensuring a safe workplace, employees can be partners in this effort.