Occupational health and safety risks in the healthcare sector

1 Guide to prevention and good practiceOccupational health and safety risks in the healthcare sectorThis publication is supported by the European Union Programme for Employment and Social Solidarity - PROGRESS (2007-2013). This programme is implemented by the European Commission. It was established to financially support the implementation of the objectives of the European Union in the employment, social affairs and equal oppor-tunities area, and thereby contribute to the achievement of the Europe 2020 Strategy goals in these fields. The seven-year Programme targets all stakeholders who can help shape the development of appropriate and effective employment and social legislation and policies, across the EU-27, EFTA-EEA and EU candidate and pre-candidate more information see: CommissionDirectorate-General for Employment, Social Affairs and InclusionUnit completed in December 2010 Occupational health and safety risks in the healthcare sectorNeither the European Commission nor any person acting on behalf of the Commission may be held responsible for the use that may be made of the information contained in this publication.

2 Cover photos: iStockFor any use or reproduction of photos which are not under European Union copyright, permission must be sought directly from the copyright holder(s).This guide has been produced by the Bundesanstalt f r Arbeitsschutz und Arbeitsmedizin (BAuA), Berufsgenossenschaft f r Gesundheitsdienst und Wohlfahrtspflege (BGW), contec Gesellschaft f r Organisationsentwicklung mbH, Deutsches Netz Gesundheitsf rdernder Krankenh user (DNGfK) and BAD/ Team Prevent Direct is a service to help you find answers to your questions about the European UnionFreephone number (*):00 800 6 7 8 9 10 11(*) Certain mobile telephone operators do not allow access to 00 800 numbers or these calls may be information on the European Union is available on the Internet ( ).Cataloguing data as well as an abstract can be found at the end of this : Publications Office of the European Union, 2011 ISBN 978-92-79-19454-2 European Union, 2011 Reproduction is authorised provided the source is in LuxembourgPrinted on elemental chlorine-free bleached PaPer (ECF)3 Preamble 7 Introduction and vision 111.

3 prevention and health promotion as a management task 13 Description of good company practice 212. How to carry out a risk assessment Introduction Roles and responsibilities What should be considered before I start the risk assessment How do I get started with the risk assessment? Inclusion of gender aspects in the risk assessment Description of good company practice Links Relevant European Union directives OiRA: Online risk assessment tool, EU-OSHA Literature Example of a risk assessment based on the task of manually handling patients Example of a risk assessment based on the task of surface disinfection 453. Biological risks Introduction General risk assessment of potential Occupational exposure to infection Special risk assessment of biological risks Risk of blood-borne infections Risk of airborne infection Risk of direct and indirect contact infection Description of good company practice: 88 - handling contact infections - preventive measures in the ambulance service Special infections Pregnancy Relevant European Union directives Links Literature 1054.

4 Musculoskeletal risks risks for the development of musculoskeletal disorders Introduction Nature of the risk Basic criteria for a specific risk assessment for the prevention of MSDs Work situations with the greatest exposure Effects on health and safety Preventive and protective measures Behaviour in critical situations Recommendations for workers Main messages and conclusions Relevant European Union directives Description of good company practice Links Literature prevention of accidents due to slips, trips and falls (85) Introduction Nature of the risk Basic criteria for a specific risk assessment for the prevention of slip , trip and fall accidents Work situations with the greatest exposure Effects on health and safety Preventive and protective measures Personal protective equipment Behaviour in critical situations Recommendations for workers Main messages and conclusion Relevant European Union directives Links Literature 1705.

5 Psychosocial risks Introduction Stress and burnout Nature of risk dealt with Basic criteria for a specific risk assessment Work situations with the greatest exposure Effects on health and safety General preventive and protective measures Description of specific preventive techniques and procedures prevention and monitoring of violence and mobbing (bullying and harassment) at the workplace Nature of the risk dealt with Basic criteria for a specific risk assessment Work situations with the greatest exposure Effects on health and safety General preventive and protective measures Description of the specific preventive techniques and procedures Examples of good corporate practice Appropriate modes of behaviour in critical situations Most important knowledge and conclusions Working hours Nature of risk dealt with Basic criteria for a specific risk assessment Description of the work situations with the greatest exposure Descriptions of the effects on health and safety General preventive and protective measures Description of the specific preventive techniques and procedures Examples of good corporate practice Appropriate modes of behaviour in critical situations

6 Most important knowledge and conclusion Drug abuse Nature of the risk dealt with Basic criteria for a specific risk assessment Work situations with the greatest exposure Effects on health and safety General preventive and protective measures Specific preventive techniques and procedures Appropriate modes of behaviour in critical situations Most important knowledge and conclusions Relevant European Union directives Description of good company practice Interview with Havelland Clinics, Nauen, on psychosocial risks Interview with St Elisabeth Hospital, Tilburg, on psychosocial risks Links Literature 215 Annex 21766.

7 Chemical risks Introduction Nature of the risk dealt with: Special risks attributed to dangerous substances and preparations Basic criteria for assessing chemical risks Risk assessment General preventive and protective measures (135)(136): Implementation of protective measures taking into account the risk assessment Protective measures (137)(138) Provision of information/instruction to workers Monitoring the effectiveness of measures Cleaning and disinfection work Descriptions of the work situations with the greatest exposure Description of the effect on health and safety Specific preventive techniques and procedures Cytostatic/cytotoxic drugs Description of the work situations with the greatest exposure Description of the effect on health and safety Specific prevention techniques and procedures Activities involving anaesthetic gases Description of work with maximum exposure Description of the effect on health and safety Specific prevention techniques and procedures Activities involving substances which

8 Endanger reproduction Relevant European Union directives Description of good company practice Interview with General Hospital Vienna (AKH Vienna) on safe working in disinfection activities Working safely with cytostatic drugs Links Literature 263 Imprint 265 Annexes 269 Preamble8 Occupational health AND safety risks IN tHE healthcare sector (1) OJ L 183, , pp. 1 10 % of workers in the European Union belong to the health and welfare sector , and many of them work in hospitals. These workers may be exposed to a very wide variety of risks . EU legislation on health and safety at work currently covers most of these risks nevertheless, the combination of such diverse risks arising at the same time and the fact that this is clearly a high-risk sector have given rise to a debate on the need for a specific approach in order to improve the protection of the health and safety of hospital personnel at Union the considerations and any measures designed to improve the health and safety of hospital personnel can be extended to workers in the health sector in November 2001.

9 A first meeting was held with the representatives of the Member States governments to discuss the situation in their countries and the initial positions on the question of possible Community measures aimed at improving Occupational health and safety in the hospital sector . It was considered appropriate to start with contacts with government representatives because it was felt important to have an overview of the particular situation concerning Occupational health and safety in healthcare establishments in the EU and the implementation of the Community provi-sions in force in this the meeting, the participants particularly welcomed the Commission s initia-tive to launch a debate on the situation in a sector which employs a high percentage of the EU s working population and where the workers are exposed to a large num-ber of different types of concomitant risks (infections, chemical agents, carcinogens, musculoskeletal disorders, accidents, radiation, etc.)

10 The participants were unanimous in their view that, although new specific Community legislation for the hospital sec-tor does not seem necessary at present, the adoption of other, non-legislative meas-ures, such as a recommendation and the production at Community level of guides to good practice for this sector , would be a very positive and necessary step. Particular importance was also attached to the dissemination of information and the exchange of experience in this area, especially via the European Agency for health and safety at Work (EU-OSHA), based in was also felt that the creation of an ad hoc group on health and safety in the hos-pital sector within the Advisory Committee would make it possible to continue the analysis of possible Community measures within a tripartite context. The ad hoc group was also tasked with preparing a draft opinion for the consideration of the Advisory Committee on possible Community measures to improve protection of the health and safety of workers in the hospital working party adopted a draft opinion which was presented for discussion and later adopted by the committee.