Title: Occupational Safety and Health of Healthcare Workers
1Occupational Safety and Health of Healthcare
Workers NGO Forum for Health 24 May 2006 World
Health Assembly Susan Wilburn WHO Occupational
Health
2Objectives
- Review WHO commitment to Occupational Health of
Healthcare Workers and Resources - Identify hazards in health care setting and
measures to prevent or control risks - Describe WHO Project Protecting healthcare
workers preventing needlestick injuries
328 April World Day for Safety and Health at
Work7 April World Health Day
- 28th April decent work occupational and
safety HIV/AID - Celebrated by ILO ISSA UNIONS world wide
- 7th of April Human resources for Health
- Support and protect health workers Safe and
supportive working conditions must be ensured
and salaries resources and management structures
improved. - Opportunities for joining forces and creating
synergies
4Health care workers in WHO
- No person should be injured or harmed at work
basic human right fundamental principle on which
occupational health is based - Health care workers are workers (59 million
including from direct care providers to medical
waste handlers) - Without a healthy safe and motivated workforce
the public health goals of the countries cannot
be met
5Occupational Health in WHO
- Global Strategy on Occupational Health for All
(96) - Global Plan of Action on Workers Health to be
presented at the WHA 2007 - Focus on primary prevention 25 of the Global
Burden of Disease is due to occupational and
environmental risk factors - Partnerships
- ILO ICN Unions Employers
- Network of 70 Collaborating Centers on
Occupational Health - Focus on priority areas including health care
workers
6Healthcare WorkersOccupational Hazards
- Biological (Avian Influenza SARS TB HIV
Hepatitis) - Chemical (drugs disinfectants pesticides)
- Ergonomic (lifting transfers)
- Stress/Violence (staffing shortages shift
rotation) - Physical Hazards (radiationheatnoise)
7Adapting the definition from the Safe Injection
Global Network (SIGN)A safe health care
practice does no harm to the recipient does not
expose the provider to any avoidable risk and
does not result in any waste that is dangerous
for other people
8- Be sure to secure your own oxygen mask first
before helping another.
9Protecting Healthcare Workers
10Occupational Exposure to Bloodborne Pathogens
- 2 million exposures per year
- In Healthcare workers
- 40 of Hepatitis B
- 40 of Hepatitis C
- 4.4 of HIV
- Are due to needlestick injuries
- Although only 1000 hcw deaths per year from
occupational HIV all can and should be
prevented! - And fear/stigma affects care and migration
- WHO Environmental Burden of Disease 2003
11Risk of Virus TransmissionFollowing Percutaneous
Injury
- Virus Chance of HCW Infection
HBV 6 30 out of 100 people HCV 3 10 out
of 100 people HIV 1 out of 300 people
12Highest Risk Needlesticks
Of the 55 CDC documented cases of
occupational transmission of HIV 90 were
from contaminated hollow- bore needles that
pierced the skin
CDC HIV-AIDS Prevention 12/98
13Occupational Health Hierarchy of ControlsIn
Order From Most to Least Effective (applied to
needlestick injuries)
- Elimination or substitution of sharp (eliminate
unnecessary injections jet injectors needleless
IV systems blunt suture needles) - Engineering Controls (A-D syringes safer needle
devices sharps containers) - Administrative (policies and training programmes)
- Work Practice Controls (Universal Precautions no
recapping provision placement removal of
sharps containers) - Personal Protective Equipment (gloves masks
gowns etc) - See www.who.int/hiv/pub/prev_care/healthservices/e
n/index.html Annex 4
14Decline in HBV Cases Among Healthcare Workers
Following Vaccination
17000
OSHA mandates HBV vaccination
800
This regulation had the greatest impact in
eliminating HBV transmission among healthcare
workers.
Mahoney F et al. Archives of Int Med 157 (1997)
2601-2603
15 Fraction of HCV HBV HIV by Region
16But . . . Over 80 of Healthcare Workers Remain
Unimmunized in many parts of the world
- Despite 95 Efficacy of HBV Immunization
17WHO-ICN Protecting Healthcare Workers
Preventing Needlestick Injuries project
- Prevention of needlestick injuries in health care
workers to prevent infection with HIV and
Hepatitis B and C a collaborative effort lead by
WHO and ICN in close coordination with ILO - Pilot in South Africa Tanzania and Vietnam
resulting in development of new tool kit
expansion throughout southern Africa Egypt and
Venezuela - Key elements
- National collaborative planning (OH NNA MOH)
- Assessment of products practices then implement
surveillance - Needlestick prevention committee (using data for
prevention) - IEC control measures supplies (sharps
containers PPE safer devices) - HBV Immunization PEP and Treatment
18Thank You for Caring for those who care !
- Susan Wilburn
- wilburns_at_who.int
