OCCUPATIONAL EXPOSURE TO CHEMICAL, PHYSICAL, ERGONOMIC

AND PSYCHOSOCIAL HAZARDS

INTRODUCTION

• Healthcare workers face numerous occupational hazards beyond exposure to infectious microorganisms.

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• These exposures include:

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• Daily use of cleaning chemicals.
• Repeated patient lifting.
• Poor workstation design.
• Long shifts.
• Continuous exposure to noise.
• Exposure to radiation.
• Poor indoor environmental quality.
• Aggressive patient behavior.

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• Effective Occupational Health programmes adopt a holistic approach that protects both physical and psychological well-being of employees.

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• EHP contributes by identifying hazards, evaluating the risks and recommending preventive interventions.

SCOPE

• Chemical hazard in healthcare.

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• Routes of chemical exposure.

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• Health effects of chemical exposure.

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• Safe chemical management.

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• Physical hazards.

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• Ergonomic hazards.

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• Psychosocial hazards.

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• Controlling chemical, physical, ergonomic and psychosocial hazards.

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• Programme evaluation and continuous improvement.

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• Comprehensive case study.

CHEMICAL HAZARDS IN HEALTHCARE

• Every day hundreds of chemicals are used throughout Healthcare facilities.

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• Cleaning chemicals. (Detergents, disinfectants, sanitisers, surface cleaners)

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• Sterilizing agents. (Hydrogen peroxide, Peracetic acid)

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• Laboratory chemicals. (Acids, solvents, reagents)

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• Hazardous medicines. (Cytotoxic medicines, antiviral medicines, hazardous pharmaceutical products).

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ROUTES OF CHEMICAL EXPOSURE

• Exposure may be through:

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• Inhalation.

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• Skin contact.

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• Eye contact.

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• Ingestion.

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• Accidental injection.

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HEALTH EFFECTS OF CHEMICAL EXPOSURE

• Exposure may results in:

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• Acute effects

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• Headaches.
• Dizziness.
• Skin burns.
• Eye irritation.
• Respiratory irritation.
• Chemical poisoning.

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• Chronic effects

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• Occupational asthma.
• Dermatitis.
• Liver damage.
• Kidney damage.
• Reproductive effects.
• Certain cancers (depending on the type of chemical and level of exposure).

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SAFE CHEMICAL MANAGEMENT

• Healthcare must implement comprehensive chemical safety programmes.

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• Programmes should include:

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• Chemical inventories.
• Safe storage.
• Appropriate labelling.
• Safety data sheet (SDS).
• Staff education and training.
• Spill response procedures.
• Safe disposal.
• Routine inspections.

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• Chemical management systems must be reviewed regularly by EHP’s.

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SAFE CHEMICAL MANAGEMENT (Cont….)

• Safety Data Sheets must provide the following information:

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• Chemical hazards.

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• Safe handling procedures.

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• PPE requirements.

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• Storage.

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• Spill response.

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• First aid.

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• Fire-fighting measurements.

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• Disposal methods.

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SAFE CHEMICAL MANAGEMENT (Cont….)

• Chemical spill management procedures must include the following principles:

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• Restrict access.

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• Identify the chemical.

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• Consult the SDS.

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• Wear appropriate PPE.

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• Contain the spill safely.

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• Dispose of the contaminated materials correctly.

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• Report the incident.

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• Investigate the cause.

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PHYSICAL HAZARDS

• Healthcare workers may be exposed to physical hazards.

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• Radiation.

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• Noise.

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• Electricity.

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• Slips & trips.

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• Falls.

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• Poor lighting.

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• Heat.

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• Cold.

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• Inadequate ventilation.

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• Physical hazards contributes to occupational injuries.

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ENVIRONMENTAL HEALTH PERSPECTIVE

• EHP contributes by:

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• Conducting chemical risk assessment.

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• Reviewing chemical storage.

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• Monitoring indoor environmental quality.

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• Evaluating ventilation systems.

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• Conducting workplace inspection.

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• Investigating chemical incidents.

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• Supporting OHS Committee.

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• Promoting safer workplaces through environmental management

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ERGONOMIC HAZARDS

• Ergonomics is the science of designing work, equipment and workplaces (man to the job AND NOT THE JOB TO THE MAN).

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• Healthcare workers (pending where they work) are exposed to:

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• Manual lifting of patients.

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• Repositioning patients.

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• Pushing hospital beds.

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• Pulling trolleys.

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• Prolonged standing.

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• Repetitive movements.

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• Awkward body positions.

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• Poor workstation design.

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• Inadequate seating.

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ERGONOMIC HAZARDS (Cont….)

• Poor ergonomics contributes to musculoskeletal disorders that is one of the main causes of occupational illnesses in healthcare.

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• Common conditions include:

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• Lower back pain.

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• Neck pain.

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• Shoulder injuries.

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• Tendonitis.

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• Carpal tunnel syndrome.

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• Knee injuries.

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PREVENTING ERGONOMIC INJURIES

• Implementation of the following controls:

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• Engineering Controls.

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• Adjustable beds.
• Patient lifting devices.
• Height-adjustable workstations.
• Mechanical trolleys.
• Ergonomic seating.

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• Administrative Controls.

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• Safe lifting procedures.
• Job rotations.
• Rest breaks.
• Staff training.
• Adequate staffing.
• Early reporting of symptoms.

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• Worker Practices.

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• Use lifting equipment correctly.
• Request assistance when needed.
• Avoid twisting while lifting.
• Maintain good posture.

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WORKPLACE DESIGN

• To create a physical environment that promotes a safe work environment consider the following:

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• Sufficient working space.

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• Good lighting.

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• Appropriate bench heights.

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• Adequate storage.

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• Safe traffic flow.

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• Reduced clutter.

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• Easy access to equipment.

PSYCHOSOCIAL HAZARDS

• Arise from the way work is organized and managed.

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• Excessive workload.

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• Long working hours.

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• Shift work.

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• Fatigue.

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• Workplace bullying.

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• Harassment.

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• Violence.

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• Poor communication.

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• Lack of organizational support.

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• Exposure to traumatic events.

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Affects both physical and mental health

WORKPLACE STRESS

• Stress occurs when work demands exceed individuals ability to cope:

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• Staff shortages.

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• Heavy workloads.

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• Time pressures.

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• High patient acuity.

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• Frequent emergencies.

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• Poor management support.

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• Role conflict.

Burnout, reduced concentration,

Absenteeism, increased errors,

poor job satisfaction

BURNOUTS

• Burnout is characterised by:

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• Emotional exhaustion.

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• Depersonalisation.

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• Reduced personal accomplishment.

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Affects worker’s wellbeing, patient safety,

teamwork, staff retention

FATIGUE MANAGEMENT

• Fatigue may impair:

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• Decision-making.

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• Communication.

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• Concentration.

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• Manual dexterity.

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• Infection Prevention and Control compliance.

Appropriate rostering, rest breaks, workload

management, staff support, monitoring excessive

overtime.

CONTROLLING CHEMICAL, PHYSICAL, ERGONOMIC AND PSYCHOSOCIAL HAZARDS

CONTROLLING CHEMICAL, PHYSICAL, ERGONOMIC AND PSYCHOSOCIAL HAZARDS (Cont….)

Indoor Air Quality

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• EHP’s routinely assess:

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• Temperature.
• Humidity.
• Ventilation.
• Lighting.
• Air quality.
• Noise.
• Odours.

Fatigue, headaches, respiratory irritation, reduced productivity

CONTROLLING CHEMICAL, PHYSICAL, ERGONOMIC AND PSYCHOSOCIAL HAZARDS (Cont….)

Safe chemical management programme

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• An effective programme includes:

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• Chemical inventory.

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• Risk assessments.

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• Appropriate storage.

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• Safety Data Sheets.

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• Staff competency.

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• Routine inspections.

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• Spill procedures.

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• Waste disposal.

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• Exposure monitoring.

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CONTROLLING CHEMICAL, PHYSICAL, ERGONOMIC AND PSYCHOSOCIAL HAZARDS (Cont….)

Radiation protection

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• Programme should include:

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• Risk assessments.

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• Appropriate shielding.

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• Exposure monitoring.

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• Staff education.

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• Equipment maintenance.

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• Warning signage.

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• Restricted access.

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PROGRAMME EVALUATION AND CONTINUOUS IMPROVEMENT

Monitoring Programme Performance

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PROGRAMME EVALUATION AND CONTINUOUS IMPROVEMENT (Cont…)

Workplace Inspections

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• Environmental health inspections should assess:

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• Chemical storage.

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• Ventilation.

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• Lighting.

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• Housekeeping.

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• Ergonomic design.

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• Noise.

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• Radiation safety.

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• Spill preparedness.

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• Staff wellbeing concerns.

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PROGRAMME EVALUATION AND CONTINUOUS IMPROVEMENT (Cont…)

Staff education

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• Training should include:

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• Chemical safety.

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• Ergonomics.

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• Manual handling.

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• Workplace violence prevention.

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• Stress management.

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• Spill response.

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• Safe use of equipment.

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COMPREHENSIVE CASE STUDY

A tertiary hospital reports increasing staff absenteeism in the Central Sterile Services Department (CSSD) and Laundry Departments.

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Investigation

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EHP conducts a multidisciplinary assessment.

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Findings

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• Poor ventilation.
• Repeated manual lifting.
• Chemical odours.
• Excessive heat.
• High staff workload.
• Limited rest breaks.
• Increasing stress-related absenteeism.

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Improvement Plan

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• Improved ventilation.
• Better chemical storage.
• Staff rotation.
• Additional staffing during peak periods.
• Mental health support.
• Ergonomic redesign of workstations.

COMPREHENSIVE CASE STUDY (Cont…)

Outcome

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Within one year:

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• Musculoskeletal injuries decline.
• Chemical complaints decrease.
• Staff morale improves.
• Sick leave decreases.
• Productivity improves.
• Patient services become more efficient.