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HAZARDS FACED BY HEALTH AND SOCIAL CARE SERVICE WORKERSSERVICE WORKERS

3 Health Care and Social Assistance

3.4 HAZARDS FACED BY HEALTH AND SOCIAL CARE SERVICE WORKERSSERVICE WORKERS

Working with patients and clients as well as interacting with the general public contributes to the hazards faced by health and social care service workers.

The hazards covered in this book are the primary ones that affect retail workers found in facility and store operations. In most cases the most frequent hazards faced by retail workers are

. Walking and working surfaces

. Equipment dangers

. Material handling=lifting of containers

. Slips, trips, and falls

. Strains=sprains

. Trauma injuries

. Vehicle accidents

. Fires

. Office hazards

. Repetitive=cumulative trauma

. Violence and security

. Radiation

. Biological hazards 3.5 OCCUPATIONS 3.5.1 HEALTHCARESERVICES

As the largest industry in 2004, health care provided 13.5 million jobs—13.1 million jobs for wage and salary workers and about 411,000 jobs for self-employed and unpaid family workers. Of the 13.1 million wage and salary jobs, 41% were in hospitals; 22% were in nursing and residential care facilities; and 16% were in offices

TABLE 3.6

Occupational Illnesses by Number of Cases and Percent for Health and Social Care Services

Illness Type Number Percent

Skin diseases and disorders 7,100 15

Respiratory conditions 5,700 12

Poisoning 400 0.8

Hearing loss 100 0.2

All others 32,600 71

Source: From Bureau of Labor Statistics, U.S. Department of Labor, Workplace Injuries and Illnesses in 2004. Available at http:==

bls.gov.

of physicians. About 92% of wage and salary jobs were in private industry; the rest were in state and local government hospitals. The majority of jobs for self-employed and unpaid family workers in health care were in offices of physicians, dentists, and other health practitioners—about 282,000 out of the 411,000 total self-employed.

Workers in health care tend to be older than workers in other industries. Health care workers are also more likely to remain employed in the same occupation, due, in part, to the high level of education and training required for many health occupations.

Health carefirms employ large numbers of workers in professional and service occupations. Together, these two occupational groups account for three out of four jobs in the industry. The next largest share of jobs, 18%, is in office and administrative support. Management, business, andfinancial operations occupations account for only 4% of employment. Other occupations in health care make up only 3% of the total.

Some of the occupations found in health care services are audiologists, cardiovascular technologists and technicians, chiropractors, clinical laboratory technologists and technicians, dental assistants, dental hygienists, dentists, diagnostic medical sonogra-phers, dietitians and nutritionists, emergency medical technicians and paramedics, licensed practical and licensed vocational nurses, medical and health services man-agers, medical assistants, medical records and health information technicians, medical secretaries, medical transcriptionists, nuclear medicine technologists, nursing, psychi-atric, and home health aides, occupational therapist assistants and aides, occupational therapists, medical, dental and ophthalmic laboratory technicians, opticians, dispensing, optometrists, personal and home care aides, pharmacists, pharmacy assistants, phar-macy technicians, physical therapist assistants and aides, physical therapists, physician assistants, physicians, surgeons, podiatrists, psychologists, radiologic technologists and technicians, receptionists and information clerks, recreational therapists, registered nurses, respiratory therapists, social and human service assistants, social workers, speech-language pathologists, and surgical technologists.

Professional occupations, such as physicians and surgeons, dentists, registered nurses, social workers, and physical therapists, usually require at least a bachelor’s degree in a specializedfield or higher education in a specific health field, although registered nurses also enter through associate degree or diploma programs.

Other health professionals and technicians work in many fast growing occupa-tions, such as medical records and health information technicians and dental hygien-ists. These workers may operate technical equipment and assist in health diagnosing and treating practitioners. Graduates of 1 year or 2 year training programs oftenfill such positions; the jobs usually require specific formal training beyond high school, but less than 4 years of college.

Service occupations attract many workers with little or no specialized education or training. For instance, some of these workers are nursing aides, home health aides, building cleaning workers, dental assistants, medical assistants, and personal and home care aides. Nursing or home health aides provide health-related services for ill, injured, disabled, elderly, or infirm individuals either in institutions or in their homes.

By providing routine personal care services, personal and home care aides help the elderly, disabled, and ill to live in their own homes instead of in an institution.

Most workers in health care jobs provide clinical services, but many also are employed in occupations with other functions. Numerous workers in management

and administrative support jobs keep organizations running smoothly. Although many medical and health service managers have a background in a clinical specialty or training in health care administration, some enter these jobs with a general business education.

Each segment of the health care industry provides a different mix of wage and salary health-related jobs.

3.5.2 SOCIALASSISTANCE

More than one third of nongovernmental social assistance jobs are in professional and related occupations. Social workers counsel and assess the needs of clients, refer them to the appropriate sources of help, and monitor their progress. They may specialize in child welfare and family services, mental health, medical social work, school social work, community organization activities, or clinical social work. Social and human service assistants work in a variety of social and human service delivery settings. Job titles and duties of these workers vary, but they include human service worker, case management aide, social work assistant, mental health aide, child abuse worker, community outreach worker, and gerontology aide. Counselors help people evaluate their interests and abilities and advise and assist them with personal and social problems.

Many occupations are found in social assistance services such as childcare workers, counselors, education administrators, nursing, psychiatric, and home health aides, personal and home care aides, social and human service assistants, social workers, teachers—adult literacy and remedial education, teachers—self-enrichment education, and teacher assistants.

Almost one third of employment in the social assistance industry is in many of the service occupations. Personal and home care aides help the elderly, disabled, and ill live in their own homes, instead of in an institution, by providing routine personal care services. Although some are employed by public or private agencies, many are self-employed. Persons in food preparation and serving-related occupations serve residents at social assistance institutions. Home health aides provide health-related services for ill, injured, disabled, or elderly individuals in their homes.

Obtaining affordable, quality child day care, especially for children under age 5, is a major concern for many parents. Child day care needs are met in different ways. Care in a child’s home, care in an organized child care center, and care in a provider’s home—known as family child care—are all common arrangements for preschool-aged children. Older children also may receive child day care services when they are not in school, generally through before- and after-school programs or private summer school programs. With the increasing number of households in which both parents work full time, this industry has been one of the fastest growing in the U.S. economy.

As in most industries, office and administrative support workers—secretaries and bookkeepers, for example—as well as managers account for many jobs. How-ever, the social assistance sector employs a much smaller percentage of production, installation, maintenance, repair, and sales jobs than does the economy as a whole.

Certain occupations are more heavily concentrated in some segments of the industry than in others. Individual and family services employ the greatest numbers

of social workers, social and human service assistants, and personal and home care aides. Vocational rehabilitation services provide the most jobs for adult literacy and remedial and self-enrichment education teachers.

3.6 APPLICABLE OSHA REGULATIONS

Another way to garner an understanding of the hazards faced by health and social care services workers is to see the types of violations that Occupational Safety and Health Administration (OSHA) have found during their inspections of health and social care services establishments. These violations provide another way of target-ing hazards that have the potential to cause injury, illness, and death of workers. As can be seen from the 50 most frequently cited violations, OSHA cites this industry under the general industry standard (29 CFR 1910) and the recordkeeping standard (29 CFR 1904) (see Tables 3.7 and 3.8).

TABLE 3.7

Twenty-Five Most Frequent OSHA Violations for Health Care Services

CFR Standard Number Cited Description

1910.1030 885 Bloodborne pathogens

1910.1200 169 Hazard communication

1904.29 104 Forms

1910.132 82 Personal protective equipment, general requirements 1910.147 73 The control of hazardous energy, lockout=tagout 1910.305 67 Electrical, wiring methods, components and equipment 1910.37 65 Maintenance, safeguards, and operation features for exit routes 1910.151 59 Medical services andfirst aid

1910.303 55 Electrical systems design, general requirements

1904.32 45 Annual summary

1910.134 43 Respiratory protection

1904.41 35 Annual OSHA injury and illness survey of ten or more employees

1910.133 33 Eye and face protection

1910.146 32 Permit-required confined spaces

1910.22 31 Working=walking surfaces, general requirements 1910.212 27 Machines, general requirements

1904.8 22 Recording criteria for needlestick and sharps injuries

1910.1001 22 Asbestos

1910.157 20 Portablefire extinguishers

1910.304 20 Electrical, wiring design and protection

1910.215 18 Abrasive wheel machinery

1910.219 17 Mechanical power-transmission apparatus 1910.23 16 Guardingfloor and wall openings and holes

1910.1048 14 Formaldehyde

1904.7 11 General recording criteria

Note: Standards cited by federal OSHA for the health care services sector from October 2005 to September 2006 are included here.

3.6.1 HEALTH ANDSOCIAL CARESERVICES

Although the previous were the 25 most frequently issued violations, OSHA has cited other hazards with less frequency. Some of these are as follows:

. Hand protection

. Ethylene oxide

. Compressed gases

. Hazardous locations

. Lead

. Fixed industrial stairs

. Sanitation

. Asbestos TABLE 3.8

Twenty-Five Most Frequent OSHA Violations for Social Care Services

CFR Standard Number Cited Description

1910.1030 16 Bloodborne pathogens

1910.1200 12 Hazard communication

1910.305 5 Electrical, wiring methods, components and equipment

1910.134 4 Respiratory protection

1910.22 3 Working=walking surfaces, general requirements 1910.23 3 Guardingfloor and wall openings and holes 1910.132 3 Personal protective equipment, general requirements 1910.151 3 Medical services andfirst aid

1910.178 3 Powered industrial trucks (forklifts)

1910.36 2 Design and construction requirements for exit routes 1910.147 2 The control of hazardous energy, lockout=tagout 1910.212 2 Machines, general requirements

1910.303 2 Electrical systems design, general requirements

1910.1001 1 Asbestos

5A1 1 General duty clause (section of OSHA act)

1904.2 1 Partial exemption for establishments in certain industries

1904.39 1 Reporting fatalities and multiple hospitalization incidents to OSHA 1904.40 1 Providing documents to government representatives

1904.41 1 Annual OSHA injury and illness survey of ten or more employees

1910.38 1 Emergency action plans

1910.133 1 Eye and face protection

1910.332 1 Electrical, training

1910.334 1 Electrical, use of equipment 1926.21 1 Safety training and education 1926.50 1 Medical services andfirst aid

Note: Standards cited by federal OSHA for the social care services sector from October 2005 to September 2006 are included here.

. Automatic sprinklers

. Ladders

. Fixed ladders

. Air receivers

. Safeguard for personnel protection

. Bakery equipment

With the hazards faced by this sector it is imperative that safety and health be an integral part of doing business, with the specific purpose of protecting its employees.

REFERENCES

Bureau of Labor Statistics, U.S. Department of Labor. National Census of Fatal Occupational Injuries in 2005. Available at http:==bls.gov.

Bureau of Labor Statistics, U.S. Department of Labor, Workplace Injuries and Illnesses in 2004. Available at http:==bls.gov.

4 Leisure and Hospitality