chapter 12 | Promoting a Healthy Workplace 173public hospital are at more risk for HIV and
tuberculosis than the staff members working in the
newborn nursery. All staff members have the right
to be made aware of potential risks. No worker
should feel intimidated or uncomfortable in the
workplace.
Reducing Risk
OSHA
The Occupational Safety and Health Act of 1970
and the Mine Safety and Health Act of 1977 were
the first federal guidelines and standards related to
safe and healthful working conditions. Through
these acts, the NIOSH and OSHA were formed.
OSHA regulations apply to most U.S. employers
that have one or more employees and that engage in
businesses affecting commerce. Under OSHA reg-
ulations, the employer must comply with standards
for providing a safe, healthful work environment.
Employers are also required to keep records of all
occupational (job-related) illnesses and accidents.
Examples of occupational accidents and injuries
include burns, chemical exposures, lacerations, hear-
ing loss, respiratory exposure, musculoskeletal
injuries, and exposure to infectious diseases.
OSHA regulations provide for workplace
inspections that may be conducted with or without
prior notification to the employer. However, cata-
strophic or fatal accidents and employee complaints
may also trigger an OSHA inspection. OSHA
encourages employers and employees to work
together to identify and remove any workplace haz-
ards before contacting the nearest OSHA area
office. If the employee has not been able to resolve
the safety or health issue, the employee may file a
formal complaint, and an inspection will be ordered
by the area OSHA director (U.S. Department of
Labor, 1995). Any violations found are posted
where all employees can view them. The employer
has the right to contest the OSHA decision. The
law also states that the employer cannot punish or
discriminate against employees for exercising their
rights related to job safety and health hazards
or participating in OSHA inspections (U.S.
Department of Labor, 1995).
OSHA inspections have focused especially on
blood-borne pathogens, lifting and ergonomic
(proper body alignment) guidelines, confined-space
regulations, respiratory guidelines, and workplace
violence. Since September 11, 2001, the OSHA has
added protecting the worksite against terrorism
(osha.gov). Table 12-1 lists the major categories of
potential hazards found in hospitals as identified by
the OSHA. The U.S. Department of Labor pub-
lishes fact sheets related to various OSHA guide-
lines and activities. They can be obtained from your
employer, at the local public library, or via the
Internet at osha.govtable 12-1
Potential Hospital Hazards
Hazard Definition Examples
Biological Infectious/biological agents such as bacteria, HIV, vancomycin-resistant enterococcus,
viruses, fungi, parasites methicillin-resistant Staphylococcus aureus, hepatitis
B virus, tuberculosis
Chemical Medications, solutions, and gases that are Ethylene oxide, formaldehyde, glutaraldehyde, waste
potentially toxic or irritating to the body anesthetic gases, cytotoxic agents, pentamidine
system ribavirin
Psychological Factors and situations encountered in or Stress, workplace violence, shiftwork, inadequate
associated with the work environment staffing, heavy workload, increased patient acuity
that create or potentiate stress, emotional
strain, and/or interpersonal problems
Physical Agents that cause tissue trauma Radiation, lasers, noise, electricity, extreme temperatures,
workplace violence
Environmental, Factors in work environment that cause Tripping hazards, unsafe or unguarded equipment, air
mechanical, or lead to accidents, injuries, strain, quality, slippery floors, confined spaces, obstructed
biomedical or discomfort work areas or passageways, awkward postures,
localized contact stresses, temperature extremes,
repetitive motions, lifting and moving patients
Adapted from osha.gov/SLTC/healthcarefacilities/hazards