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Occupational Health Nursing

Christina Barrick

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Objectives

• Describe legislation impacting on OHN

• Utilize an occupational health history.

• Identify prevalent occupational health disorders.

• Describe the profile of a worker population.

• Apply epidemiology to OHN.

• Describe the roles of the OHN.

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Scope of Occupational Health Problems

• Every 5 seconds a worker is injured

• 10,000,000 injuries a year

• 100,000 deaths a year

• Every 10 seconds a worker is disabled

• Incidence of work-related injuries increasing

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Trends

• 1/3 of life at work

• Lost time from illness and injury

• Primary care in occupational setting

• Increase the proportion of worksites that have health services (Healthy People, 2010).

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Evolution of Occupational Health

• “Part of job”

• Horrible accidents

• Occupational, safety, and health administration (OSHA, l970)

– set and enforce standards

– demand for OHN’s

• National Institute for Occupational Safety and Health (NIOSH).

– Identifies, monitors, educates, & researches

• Super fund Amendment & Reauthorization Act

– Nurse key role

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Role of OHN

• Beyond emergency and band aid care• Goal of OHN

– Removing health hazards from the environment• Largest group of occupational workers• Diverse levels of preparation• Multiple roles

– clinician, case manager, educator, consultant, researcher, corporate manager, program planner

– skills: provision of emergency care, health assessment, worker’s compensation management

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Characteristics of the Workplace

• High tech

• Health and computer-related occupations

• Increase in part-time and temporary work

• Increase in contractual workers

• Reduced job security

• Increase in shift work

• Development of new chemicals

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Characteristics of Worker Population

• Characteristics of workplace• Older worker (65 and over)

– Will double by 2050– Mean age of nurses?

• More racially diverse– Fastest growing group?

• Women with children and aging parents. Implications?• Workers with chronic physical or mental health problems• High job demand, low supply

– Increase health status, employment longevity, and satisfaction of workers

• Fastest growing occupations– Computer-related, Nursing and Home Health, Personal care aid

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Application of the Epidemiological Model

• Host factors: – age, gender, work practices, health status,

lifestyle– hyper susceptible– greatest risks for accidents?

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Application of the Epidemiological Model

• Types of Agent Factors:– Biological– Chemical

• *.1% of millions known chemical have been tested

– Ergonomic or mechanical– Physical – Psychosocial

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Application of the Epidemiological Model

• Environment: all external conditions that influence host and agent interaction

Examples?

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Issues with Occupational Health Programs

• Widely vary

• Organization exemption

• OSHA sanctions

• Limited # of inspectors

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Worker Assessment

• Overall health assessment

• Occupational health assessment

– list current and past jobs

– exposure history

– job titles and responsibilities

– host factors (smoking)

– masked risk: retiree or housewife

– family members

• Assessment Guide: page 1084.

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Workplace Assessment

• Walk-through, plant survey– What are you looking for?

• Review the Standard Industrial Classification (SIC) code

• Describe demographic info. of workers• Review policies and procedures• Epi. data collection about injuries and

illnesses

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Hazard Communication Standard

• Cannot eliminate all toxins

• Report known toxins

• Provide safety education on identification, toxicity, and protective measures

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Workers Compensation

• Financial compensation

• State laws

• Varies by state

• Prevention is less costly

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Nursing Interventions at the Worksite

• Primary prevention– Health promotion – Prenatal care– Risk reduction– Immunizations– Injury prevention– Use of personal protective gear

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Nursing Interventions at the Worksite

• Secondary

– Pre-employment screening

– Periodic screening

– Environmental screening

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Nursing Interventions at the Worksite

• Tertiary– Prevent the spread of communicable diseases– Prevent complications of acute and chronic

illnesses– Assess fitness to return to work.

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Indicators of Psychological Health Problems

• Increased absenteeism• Mood changes• Increase in minor accidents• Fatigue or general decrease in energy• Sudden weight loss or gain• Increased blood pressure• Frequent stress-related illnesses• Bloodshot or bleary eyes

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Psychological Stress

• “Job strain”

• Tenth leading cause of occupational disease

• Health care and service workers

• Sources of stress

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In-Class Activity

• Identify occupational health hazards for Towson University nursing students. Identify all possible factors that might influence health, then take one factor and analyze its potential health effects . (Can be psychosocial as well as biologic.