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OSHA data shows decrease in healthcare worker injuries


April 1, 2019

It turns out that 2017 was a slightly safer year to be a worker in the healthcare industry. That doesn’t mean the numbers are good, but in a healing industry where injury statistics are perennially higher than any other workplace in America, any improvement is welcome.

There were approximately 2.8 million nonfatal workplace injuries and illnesses reported by private industry employers in 2017, which occurred at a rate of 2.8 cases per 100 full-time equivalent (FTE) workers, the U.S. Bureau of Labor Statistics (BLS) said in an annual report released in December 2018.

In hospitals, there were 51,380 cases that resulted in days away from work (DAFW) in 2017, an incidence rate of 129.8 cases per 10,000, which was down from 134.3 in 2016. The incidence rate for DAFW cases resulting from overexertion and bodily reaction decreased to 56.7 cases per 10,000 FTE workers in 2017, from 62.1 in 2016.

Cases resulting from falls on the same level increased to 25.2 cases per 10,000 FTE workers in 2017, from 23.6 in 2016. In all, healthcare practitioners suffered 23,570 DAFW cases in 2017, down 600 cases from 2016.

In the social assistance sector, the number of DAFW cases in 2017 fell by 4,750 cases to 19,360. The incidence rate fell to 88.4 cases per 10,000 FTE workers, from 113.8 in 2016. Slips, trips, and falls were among the leading types of event or exposure leading to DAFW cases in 2017 with 6,250 cases, a decline of 1,410 cases from 2016.

Not surprisingly, nursing and residential care facilities came in on top, with 10.7% of workers (per 100 workers) being injured on the job. That’s still much less than 2016, which saw an incident percentage of almost 14%. Hospitals saw an incidence rate of 7.8% in 2017, down from 8.2% a year earlier. In 2017, psychiatric and substance abuse hospitals saw an injury rate of 7.8%; however, that sector did not appear on the 2016 list.

Despite their inherent mission of healing others, healthcare workers are still among the most commonly injured of any industry in the U.S.—a fact that has not escaped OSHA. Injury incidences have been going down, though, thanks to greater awareness, more education, and new employer reporting standards.
In 2010, the healthcare and social assistance industry reported more injury and illness cases than any other private-industry sector, about 653,900 cases. Most of them resulted from bloodborne pathogens and biological hazards, chemical and drug exposures, respiratory hazards, ergonomic hazards from lifting and repetitive tasks, workplace violence, lab hazards, and exposure to radioactive material and x-ray hazards. Nursing aides, orderlies, and attendants had the highest rates of musculoskeletal disorders among all occupations in 2010. The incidence rate of work-related musculoskeletal disorders for these occupations was 249 per 10,000 workers. This compared to an average rate of 34 per 10,000 workers across all industries.

The downward trend in healthcare injuries is due to enhanced workplace injury prevention programs as well as stricter injury reporting rules. Since 2012, OSHA has beefed up the Hazard Communication standard, specifically the worker training and container labeling required under the Globally Harmonized System (GHS). Under the GHS rule, OSHA has required not only workplaces but chemical manufacturers to replace the old material safety data sheets (MSDS) with the new safety data sheets (SDS).

Additionally, in 2015, OSHA updated its Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers, known to many in healthcare safety as OSHA Rule 3148. In response to a higher incidence of active shooters and other violent events in healthcare facilities, OSHA published the update to help facilities better prepare for these incidents.

Also, OSHA released a toolkit designed to help healthcare workers and safety professionals understand proper protection during infectious disease outbreaks. The guidance manual, entitled Hospital Respiratory Protection Program Toolkit: Resources for Respirator Program Administrators, is a collaboration with the CDC and NIOSH that covers topics including why hospitals need a respiratory protection program, the types of respirators and protection available, and how to develop a protection program in a facility.

Lastly, OSHA beefed up the recordkeeping rules for workplaces, requiring employers to step up their paperwork game and instituting hefty fines for noncompliance. Along with personnel records, surveyors have taken a hard stance on requiring OSHA 300 worker injury logs and hazardous chemical inventory sheets. One of the newest requirements over the last five years mandates employers to report any worker fatality within eight hours and any amputation, loss of an eye, or hospitalization of a worker within 24 hours. There are also improved online recordkeeping and reporting requirements.

What the statistics say

According to a June 2017 BLS report, private-industry hospital workers exhibit a higher incidence of injury and illness—six cases per 100 full-time workers—than employees working in other industries traditionally considered dangerous, such as manufacturing and construction. Hospital workers routinely face hazards related to lifting, moving, or otherwise physically interacting with patients.

In terms of employment, the healthcare and social assistance sector is one of the largest service-providing sectors in the U.S. economy, and BLS says it will be the fastest-growing sector through 2024, with healthcare occupations expected to add more jobs than any other occupational group.

OSHA doesn’t seem to track injury rates of workers in medical clinics, but instead focuses on incidence rates of nonfatal workplace injuries and illnesses in three types of hospitals, many of which belong to healthcare groups that also maintain small outpatient medical clinics.

Also, BLS admits that there are various challenges in researching hospital injury and illness incidence rates. For instance, services offered by different types of hospitals may be “intermixed”—so, as an example, psychiatric services might be included as a subunit in a general medical and surgical hospital. In such cases, injury and illness statistics specific to psychiatric services would not be differentiated from those for the entire hospital. Another challenge is the injury and illness rate for contracted hospital workers. These injuries may not be included in hospital incident reports. Visiting doctors or emergency medical technicians generally report injuries to their employer (a contractor) rather than the hospital in which the injury was incurred.

Hospitals are classified as general medical and surgical hospitals, psychiatric and substance abuse hospitals, or specialty hospitals. All three types provide diagnostic and medical treatment, are equipped for inpatient care (maintaining beds and providing food services to patients), and offer additional services (such as outpatient care, clinical laboratory testing, and diagnostic x-rays). However, each hospital type offers different services.

General medical and surgical hospitals offer the most diverse operating room services for various procedures, while psychiatric and substance abuse hospitals offer mental health services in areas such as psychiatry, psychology, and social work. Specialty hospitals typically provide diagnostic and medical treatment to patients with a specific type of disease or medical condition (excluding psychiatric and substance abuse conditions). They also may provide long-term care for the chronically ill, and rehabilitative, restorative, and adjustive services to physically challenged or disabled people. Specific offerings in these areas include physical therapy, educational and vocational services, and psychological and social work services.

The physical nature of many hospital jobs causes higher incidents of injury and illness. In addition, the injuries of hospital workers tend to carry substantial financial costs. An OSHA report using data on workers’ compensation claims estimated that the average loss per claim settled for hospital workers’ injuries in 2011 was $15,860. Other studies cited in the report point to high financial and societal costs associated with replacing nurses who leave the profession because of workplace injury or illness.

According to OSHA statistics—for private-industry and local government hospitals, which are predominantly medical and surgical hospitals—the most common event leading to injuries in 2015 was overexertion and bodily reaction, which includes injuries from lifting or moving patients. This event accounted for 45% of cases (24,040) in private hospitals and 44% of cases (3,090) in local government hospitals. The second most common event leading to workplace injuries and illnesses in private-industry and local government hospitals was slips, trips, and falls. This category represented 25% of cases (13,230) in private hospitals and 24% of cases (1,690) in local government hospitals.

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