Where do most workplace injuries happen? Oil drilling, you might think, or construction,
or truck driving. But in an ironic twist, the workers in the most
dangerous industry don't have to go very far if they get injured; they
work in the health care sector.
According to a new report by Public Citizen's Congress Watch, a consumer advocacy group, nearly half -- 45 percent -- of all incidents of workplace violence
that result in lost workdays occur in the health care industry. Nursing
aides, orderlies and attendants are seven times more likely than the
average worker to suffer musculoskeletal disorders (requiring days off
work), according to the latest data, and also seven times more likely to
be injured in an assault on the job.
"I think a lot of the reasons may have to do with people being on
medication, and being off medication," explains Keith Wreightson, the
work safety and health advocate at Public Citizen's Congress Watch, and a
co-author of the report. He believes many of the violent incidents
occur in psychiatric facilities, and in general, "a lot of people are
not particularly happy to be in a health care facility. They're angry."
Workplace Not Monitored: The Occupational Safety and
Health Administration, the federal body tasked with ensuring workplace
safety, devotes only a fraction of its attention to the health care
industry compared to other high-risk occupations, according to the
Congress Watch report, which was created with assistance from the
Service Employees International Union. Part of the reason is that there
are only a tiny number of regulations on the books that affect the
sector.
"If they show up in a health care facility, there's nothing to cite them
on, fine them on, write them up on, or say anything about it," says
Wreightson. "... Employers in the health care industry are more likely
to be cited for frayed electrical cords over physical harm or ergonomic
harm to an employee."
And while injury rates are falling in other risky professions, in the
health care industry, injuries and illnesses are rising. Workplace
violence alone, which OSHA calls "a recognized hazard" in the industry, jumped 13 percent between 2009 and 2010.
Enormous Number of Cases: The private health care
industry doesn't have the highest rate for all injuries and illnesses,
but with such a enormous workforce, it has the highest number.
In 2010, there were almost 654,000 cases in the health and social
assistance sector, 152,000 more cases than the next highest --
manufacturing. And when it comes to back injuries, disease, and
workplace violence, health care workers are particularly vulnerable, the
report states, with rates far exceeding the national average. Health
care workers experience percutaneous injuries -- punctures of the skin
with sharp instruments or needles -- 400,000 times a year, which can
pose a high risk of exposure to HIV and hepatitis.
Despite the staggering number of injuries among health care workers, the
report documents how OSHA conducts very few inspections of health care
workplaces. Employers in the health care and social assistance sector
reported more than twice the number of injuries than employers in construction,
yet OSHA conducted more than 52,000 inspections of construction sites
in 2010, compared to 2,500 inspections of health care facilities. At the
same time, the report adds, construction workers are far more likely to
die on the job than anyone working in health care.
"Thirty years ago we had an economy that was based on industry and
manufacturing and we've drastically stepped away from that in a matter
of years," says Wreightson. "OSHA has not been able to kept up with that
pace increase. ... It's completely blinded them essentially that health
care is now the biggest industry in the United States."
The Public Citizen's Congress Watch recommends more standards in the
industry, such as one concerning ergononomic stressors to reduce back
injuries and a zero-tolerance approach to verbal and physical abuse.
When OSHA issued a new rule in 1991 requiring health care facilities to
offer free hepatitis B vaccinations, the report points out, infections
declined from 17,000 cases in 1983 to 400 in 1995.
But new regulations are always tricky to pass, particularly in recent
years. OSHA actually issued an ergonomics standard in 2000, but in 2001,
the House and Senate repealed it before it took effect.