Occupational health and safety

for health workers in the context of COVID-19

WHO / P. Phutpheng

Module 2: Physical risks to health and safety

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 Learning objectives

By the end of this module, you should be able to:

§ list the major risk factors for musculoskeletal disorders in the

health sector;

§ describe high risk activities when handling patients; and

§ describe the major types of occupational hazards that health

workers face and how to prevent them.

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 Musculoskeletal risks

§ Musculoskeletal disorders (MSDs) including back injury, neck and

lower back pain and carpal tunnel syndrome are among the most
common but also the most preventable occupational diseases.

§ Musculoskeletal disorders result in absenteeism, difficulty in carrying

out daily tasks and interfere with the delivery of care.

§ Makeshift hospitals, temporary isolation and treatment centres,

triage and testing facilities may not have appropriate ergonomic
design of the workplace to prevent musculoskeletal disorders.

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 Major risk factors for musculoskeletal
disorders in the health sector

§ Poor design and positioning of patient beds, chairs and

wheelchairs requiring bending, stretching, twisting of the body of
the carer while patient lifting or re-positioning

§ Awkward positions in providing emergency care to a patient on the

floor or in a vehicle

§ Manual handling of loads – lifting, carrying of heavy objects

§ Lack of knowledge related to safe handling and lifting

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 Preventing back injury in patient handling
and manual lifting of loads (1)

§ First, consider whether moving the patient or the load can be avoided;
if not, then assess the risks.

§ Assess the risks and plan the handling of the patient or the load in
terms of the number of people and kind of equipment needed.

§ If your job involves handling of patients or manual handling of loads,

take training on how to do this safely.

In all cases: Avoid full body lifting without equipment where possible.

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 Preventing back injury in patient handling
and manual lifting of loads (2)
§ Use mechanical devices – electrically powered
adjustable beds, lifts, stretchers, trolleys, sit to
stand or standing aids and hoists.

§ Use handling aids – transfer boards, transfer

Trolley for moving loads
belts, glide boards, sliding mats.

§ If these are unavailable, make sure that enough

workers are available lift the patient or load.

§ Keep fit – strong abdominal muscles protect

backs.
Hoist for moving patients

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 Prolonged sitting

§ Prolonged sitting can cause back pain, low physical activity and
the resulting consequences, such as obesity, cardiovascular
diseases, and even cancer.

§ Many health workers, such as those doing contact tracing on

the phone, dispatchers, receptionist, administrative staff,
telework may have prolonged sitting.

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 Prevent the problems related to
prolonged sitting
§ Take breaks and alternate posture every 30 minutes - 1 hour (maximum)

§ Set up computer workstations so that:

• upper edge of monitor is aligned with eyes - let your arm rest on a surface;
• if working on a laptop, use a stand with a keyboard;
• extend the laptop screen (if possible) with a larger monitor or TV - facilitate
sitting/standing.

§ Use adjustable tops – sit/stand desks

§ Use Bluetooth accessories to facilitate communication (e.g. headsets,

cameras, etc.) to allow for standing while communicating

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 How to safely use disinfectants (1)

The most common disinfectants for COVID-19 are:

§ Ethanol 70-90%

§ Chlorine-based products (e.g., hypochlorite) at 0.1% (1000 ppm)

for general environmental disinfection or 0.5% (5000 ppm) for
blood and body fluids

§ Hydrogen peroxide >0.5%

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 How to safely use disinfectants (2)

§ Disinfectant solutions must be prepared and used according to the

manufacturer’s recommendations for volume and contact time.

§ Disinfectant solutions should always be prepared in well-ventilated areas.

Avoid combining disinfectants, both during preparation and usage, as
such mixtures can cause respiratory irritation and can release potentially
fatal gases, in particular, when combined with hypochlorite solutions.

§ Personnel preparing or using disinfectants in healthcare settings require

specific PPE, and should be trained to use PPE properly.

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 Appropriate use of disinfectants

§ Spraying individuals with disinfectants (such as in a tunnel, cabinet, or

chamber) is not recommended under any circumstances.

§ Spraying individuals with chlorine and other toxic chemicals could

result in eye and skin irritation, bronchospasm due to inhalation, and
gastrointestinal effects such as nausea and vomiting.

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 Prolonged use of PPE:
Masks and goggles

§ Symptoms include: itching, rash, acne, pressure injury, contact

dermatitis, urticaria and aggravation of pre-existing skin diseases.

§ Use a properly fitted mask – avoid over-tight goggles, which can

damage the skin and generate fogging of the goggles.

§ Try to avoid sustained friction or pressure on the same site.

§ Apply moisturizers or gel before wearing facial protective equipment to

lubricate and reduce friction between skin and masks or goggles.

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 Prolonged use of PPE:
Gloves

§ If you have a latex allergy, use of nitrile gloves is recommended.

§ Frequent cleansing and prolonged use of gloves may cause or aggravate

existing hand eczema.

§ Frequent application of moisturizing creams can decrease hand irritation.

§ Oil-based hand creams that contain petroleum jelly should not be used,
because they may damage latex rubber gloves.

§ Seek medical care if sustained rashes or inflammatory symptoms appear.

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 Prolonged use of PPE:
Heat stress

§ PPE traps body heat and sweat, limits cooling of the body and
increases body temperature.

§ Symptoms of heat stress include:

§ heat rash, muscle cramps, syncope (fainting) exhaustion;
§ heat stroke – requiring emergency treatment to prevent organ damage
(brain, heart, kidney, liver, muscle); and
§ death.

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 Preventive measures for heat stress

§ Buddy system – monitor self and

partner co-workers for symptoms of
heat stress

§ Limit exposure time – then rest in a

cooling area

§ Drink plenty of cool, potable water

§ Monitor urine output for colour and

volume Urine colour as a sign of dehydration

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 Slips, trips, falls

§ Work-related slip, trip, and fall incidents can frequently result in

serious disabling injuries that impact health workers’ ability to do their
jobs, often resulting in lost workdays, reduced productivity and
diminished ability to care for patients.

§ Most risk factors for slips, trips and falls are the same for health
workers and for patients.

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 Common risks for slips, trips, falls

§ Contaminants on the floor § Inadequate lighting

§ Water, grease, oil and food can
make walking surfaces slippery
§ Unsafe, uneven stairs and
§ Poor Drainage handrails
§ Leaking pipes and drains

§ Tripping hazards
§ Indoor and outdoor walking surface § Clutter, loose cords, hoses,
irregularities wires, medical tubing

§ Improper use of floor mats and

§ Rain, mud, ice and snow runners

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 Prevention of slips, trips and falls

§ Fix any of the hazards listed previously

§ Ensure adequate lighting

§ Eliminate uneven floors and obstructed passageways

§ Quickly clean up spills

§ Ensure staff wear non-slip, full coverage shoes

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 Summary: How you can avoid
occupational injury and illness

ü Follow all safety instructions

ü Monitor for hazards in your environment

ü Report potential hazards to your supervisor so these can be fixed

ü Report any occupational injury or illness

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