1. 1 Occupational Health Nursing Christina Barrick

2. 2 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.

3. 3 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

4. 4 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).

5. 5 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

6. 6 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

7. 7 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

8. 8 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

9. 9 Application of the Epidemiological Model Host factors: –age, gender, work practices, health status, lifestyle –hyper susceptible –greatest risks for accidents?

10. 10 Application of the Epidemiological Model Types of Agent Factors: –Biological –Chemical *.1% of millions known chemical have been tested –Ergonomic or mechanical –Physical –Psychosocial

11. 11 Application of the Epidemiological Model Environment: all external conditions that influence host and agent interaction Examples?

12. 12 Issues with Occupational Health Programs Widely vary Organization exemption OSHA sanctions Limited # of inspectors

13. 13 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.

14. 14 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

15. 15 Hazard Communication Standard Cannot eliminate all toxins Report known toxins Provide safety education on identification, toxicity, and protective measures

16. 16 Workers Compensation Financial compensation State laws Varies by state Prevention is less costly

17. 17 Nursing Interventions at the Worksite Primary prevention –Health promotion –Prenatal care –Risk reduction –Immunizations –Injury prevention –Use of personal protective gear

18. 18 Nursing Interventions at the Worksite Secondary –Pre-employment screening –Periodic screening –Environmental screening

19. 19 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.

20. 20 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

21. 21 Psychological Stress “Job strain” Tenth leading cause of occupational disease Health care and service workers Sources of stress

22. 22 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.