Home > RNJ > 2010 > September/October > Editorial: Occupational Health and Safety for Nurses Benefits Patients, Too

Editorial: Occupational Health and Safety for Nurses Benefits Patients, Too
Claire C. Caruso, PhD RN

This issue of Rehabilitation Nursing is devoted to worker safety and health. We greatly appreciate our authors' efforts to share their expertise for this special issue. Their articles discuss risks posed by violence, smoking, fatigue and sleep loss, and patient lifting.

Although the rehabilitation work environment and other healthcare settings may appear clean and orderly, they actually expose workers to many hazards such as life-threatening infections including HIV and hepatitis. Workers also may be repeatedly exposed to hazardous chemicals, such as cleaning agents, cancer drugs, and other toxic substances. In addition, healthcare workers often are called upon to perform physically demanding tasks, such as patient lifting, and they may experience latex allergy, violence, and job stress. Compared to other industrial sectors, the healthcare social assistance (HCSA) sector sustains the second highest number of nonfatal injuries and illnesses (Bureau of Labor Statistics & U.S. Department of Labor, 2006). In 2005 the combined number of injury and illness cases involving days away from work for nursing aides, orderlies and attendants, and registered nurses accounted for more than 30% of all occupational injuries and illnesses (National Occupational Research Agenda [NORA] Healthcare Social Assistance Council, 2009). Also in 2005, two-thirds of personal assaults and violent acts associated with occupations occurred in the HCSA sector.

Hazards in the healthcare work environment also endanger sick people and those requiring care. Exposures to airborne infectious agents, spills of industrial-grade disinfectants or anticancer drugs, and encounters with violent emergency department visitors affect both patients and workers. Demanding work hours are linked to many types of illnesses and injuries for workers and increased risk for fatigue-related medical errors.

Fortunately, evidence-based strategies are available to protect workers and patients from many of these hazards. Adopting these strategies in the workplace and promoting a culture of safety benefits workers, patients, family members, and all who enter healthcare facilities. Consequently, safety programs should not discriminate between patients and workers. Rather, programs should promote comprehensive systems of safety and cultures of safety that address all known hazards and receive support from all levels of HCSA organizations. Although there are many examples of institutions that have successfully adopted comprehensive approaches to safety and health, widespread implementation in the HCSA sector remains the goal. One barrier is this sector's entrenched belief that patient care issues supersede the personal safety and health of workers, and that it is acceptable for HCSA workers to have less than optimal protections against hazardous exposures. Because patients and providers share the healthcare environment, efforts to protect all people within a setting can be complementary, even synergistic, when pursued through a comprehensive integrated approach.

The National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention is a source for additional information. NIOSH was established by the Occupational Safety and Health Act of 1970 and charged with conducting research and making recommendations to prevent work-related injury and illness. This Act also established the Occupational Safety & Health Administration (OSHA), which is charged with setting and enforcing regulations. The NIOSH website features a wealth of information to help reduce risks posed by hazards in the workplace. A NIOSH topic page is devoted to healthcare workers and healthcare organizations (www.cdc.gov/niosh/topics/healthcare/). This website is updated as new documents, statistics, and resources become available. Visit this site to access information and strategies to guard against hazards in the healthcare environment.

Healthcare workers, patients, healthcare organizations, and society all benefit from improved worker safety and health. According to OSHA, the American Society of Safety Engineers, the American Industrial Hygiene Association, Liberty Mutual Insurance Company, and others, companies with effective health and safety programs can expect a return on investment of at least $3–$6 for every $1 invested, in addition to benefits such as reduced workplace injuries and illnesses, improved employee morale, and a more positive public image as a safety and health leader.


The findings and conclusions in this report are those of the author and do not necessarily represent the views of NIOSH.

The NORA publication cited in this article's reference list offers additional statistics and information related to this editorial's discussion. The document discusses many of the risks encountered in the healthcare work environment, challenges connected to the healthcare culture, and recommendations for progress.


Bureau of Labor Statistics & U.S. Department of Labor. (2006, October 19). Workplace injuries and illnesses in 2005. Retrieved July 2, 2010, from www.bls.gov/iif/oshwc/osh/os/osnr0025.txt.

National Occupational Research Agenda Healthcare and Social Assistance Sector Council. (2009). State of the sector—Health care and social assistance: Identification of research opportunities for the next decade of NORA (DHHS [NIOSH] Publication No. 2009-139). Cincinnati, OH: Author.