by Brianna Crandall — May 22, 2015—The Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH) have just released the Hospital Respiratory Protection Toolkit, a resource for health-care employers to use to protect all hospital/health-care staff from respiratory hazards.
Respiratory risks for all health-care personnel
OSHA defines health-care personnel as paid and unpaid persons who provide patient care in a health-care setting or support the delivery of health care by providing clerical, dietary, housekeeping, engineering, security, or maintenance services. Health-care personnel of all types may potentially be exposed to aerosol transmissible disease (ATD) pathogens.
In order to protect employees from ATDs, OSHA says health-care facilities must implement comprehensive infection control plans utilizing a “hierarchy of controls,” trying the most effective method first: the elimination of hazards or substitution of less hazardous processes, chemicals, or products; the use of engineering controls, isolating the hazard and/or using specialized ventilation; administrative (i.e., training and vaccination) and work practice controls (i.e., following cough etiquette strategies or keeping chemical containers capped); and providing for the use of respirators and other personal protective equipment (PPE) as a line of last defense.
Respirators are used to protect against exposures to airborne transmissible infectious diseases as well as chemicals and certain drugs that may be used in health-care settings, explains OSHA. OSHA’s Respiratory Protection Standard requires that health-care employers establish and maintain a respiratory protection program in workplaces where workers may be exposed to respiratory hazards.
“Hospitals are one of the most hazardous places to work,” said Assistant Secretary of Labor for Occupational Safety and Health Dr. David Michaels. “One of the ways that we can protect workers in a health-care setting is by providing employers with the resources needed to ensure a safe workplace. This toolkit will help protect those workers who dedicate their lives to caring for others.”
Hospital Respiratory Protection Toolkit
The Hospital Respiratory Protection Toolkit covers respirator use, existing public health guidance on respirator use during exposure to infectious diseases, hazard assessment, the development of a hospital respiratory protection program, and additional resources and references on hospital respiratory protection programs. Appendix D is an editable document that each hospital can customize to meet its specific needs.
Educational monograph
To supplement the toolkit, The Joint Commission developed an educational monograph, Implementing Hospital Respiratory Protection Programs: Strategies from the Field, to assist hospitals in implementing respiratory protection programs. The monograph, produced in collaboration with NIOSH’s National Personal Protective Technology Laboratory, identifies common implementation challenges, provides specific examples of innovative strategies from health-care organizations, and examines the role of leadership, quality improvement, fit testing and training challenges, and program evaluation.
General worker safety in health-care settings
Taking a broader look, rates of OSHA-recordable injuries and illnesses are generally decreasing in hospitals as in all U.S. industries. However, the injury and illness rate in hospitals remains nearly double the rate for private industry as a whole, and it is also higher than the rates in construction and manufacturing—two industries that are traditionally thought to be relatively hazardous. OSHA explains that in the last 20 years, improvements in workplace safety in both construction and manufacturing have surpassed those in hospitals.
In addition to the special challenges of health-care personnel who work with patients, hospitals face the diverse safety challenges associated with food services, materials handling, maintenance, cleaning, office work, and various other functions. OSHA provides a suite of resources on protecting all workers at health-care facilities on its Worker Safety in Hospitals Web page.
