Occupational Health Hazards in Hospitals, What Health Care Workers Should Know?

Occupational hazards are classified in four categories, including biological and infectious, chemical, physical and psychosocial hazards (McDiarmid, 2006):
1. Biological and infectious hazards: They include infectious and biological agents, such as bacteria, viruses, fungi, or parasites.
2. Chemical hazards: They include various forms of chemicals that are potentially toxic or irritating to the body system, including medications, solutions and gases.
3. Physical hazards: They include radiation, electricity, extreme temperatures, noise and musculoskeletal disorders.
4. Psychosocial hazards: They include factors that create or potentiate stress, emotional strain or interpersonal problems.
Chemical hazards:
There are multiple chemical agents existing in the hospital work environment. The effect of exposure depends on type and dose of the chemical, frequency and duration of exposure, work practices and the individual's susceptibility. Toxic chemicals in use in hospitals include (McDiarmid, 2006):
-Hazardous drugs requiring preparation prior to parenteral administration to the patients.
-Chemical sterilizers, in particular gluteraldehyde and ethylene oxide used for the sterilization of endoscopes and other equipment that cannot be steam sterilized.
-Tissue preservatives such as formaldehyde used to store and preserve body tissue prior to histopathology.
-Anesthetic gases in the operating theatre.
-Occupational exposure to latex allergens.
-Cleaning agents.
Radiation
Ionizing radiation is used in diagnostic procedures such as x-ray, fluoroscopy angiography and in treatment using radioactive implantations or injections. Non-ionizing radiation includes microwaves and magnetic fields used in diagnostic magnetic resonance imaging. Workers at risk of exposure are radiologists, radiologic and x-ray technician, dental assistants, dentists, physicians, nurses and nuclear medicine staff (Donaldson, 2007).
Cumulative and long-term health effects of exposure to ionizing radiation include cataracts, adverse reproductive outcomes and subclinical genetic changes, leukemia, breast and skin (basal cell) cancers. Exposure to non ionizing radiation leads to skin and eyes burns. Neurological, behavioral and immunological effects also may occur (Chodick et al., 2008).







Noise, extreme temperature and electricity:
Excessive noise and heat are commonly found in kitchens, laundries and boiler rooms. Permanent hearing loss can result from long term exposure to noise in excess of 80 decibels. At lower levels, noise from equipment, alarms, conversation and other sources can impede communication and interfere with concentration. Cold, heat and sunlight are hazards for grounds and building maintenance personnel. Skin burns can result from exposure to hot surfaces, hot liquids or from exposure to excessive sunlight. Cold temperatures can produce frostbite or a dangerous generalized cooling of the body (hypothermia). Human exposure to electrical hazards can result in burns and gaseous embolism (Donaldson, 2007).
Violence:
Workplace violence ranges from offensive or threatening language to homicide. The national institute for occupational safety and health (NIOSH) defines workplace violence as violent acts (including physical assaults and threats of assaults) directed toward persons at work or on duty. Although anyone working in a hospital may become a victim of violence, nurses and aides who have the most direct contact with patients are at higher risk. Other hospital personnel at increased risk of violence include emergency response personnel, hospital safety officers and all healthcare providers (McPhaul and Lipscomb 2004).
Violence may occur anywhere in the hospital, but it is most frequent in psychiatric wards, emergency rooms, waiting rooms and geriatric units. The effects of violence can range in intensity and include physical injuries, temporary and permanent physical disability, psychological trauma and death. Violence may also have negative organizational outcomes such as low worker morale, increased job stress, increased worker turnover, reduced trust of management and a hostile working environment (Gerberich et al., 2005).
Factors that increase violence in work are working directly with volatile people, working when understaffed especially during meal times and visiting hours, long waits for overcrowded service, uncomfortable waiting rooms, working alone, poor environmental design, inadequate security , lack of staff training and policies for preventing and managing crises with potentially volatile patients drug and alcohol abuse (McPhaul and Lipscomb 2004).
Musculoskeletal disorders:
Work related MSD are defined as an injury of the muscles, tendons, ligaments, nerves, joints, cartilage, bones and blood vessels in the extremities or back. They are caused or aggravated by manual handling work tasks such as lifting, pushing, pulling and working in postures with very repetitive or static forceful exertions (Smith et al., 2006).
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