Occupational Health Nursing

Christina Barrick

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 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.
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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
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 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).

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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
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 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

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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
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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

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 Application of the Epidemiological Model

• Host factors:
– age, gender, work practices, health status,
lifestyle
– hyper susceptible
– greatest risks for accidents?

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 Application of the Epidemiological Model

• Types of Agent Factors:

– Biological
– Chemical
• *.1% of millions known chemical have been tested
– Ergonomic or mechanical
– Physical
– Psychosocial

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 Application of the Epidemiological Model

• Environment: all external conditions

that influence host and agent interaction

Examples?

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 Issues with Occupational Health Programs

• Widely vary
• Organization exemption
• OSHA sanctions
• Limited # of inspectors

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 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.

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

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 Workers Compensation

• Financial compensation
• State laws
• Varies by state
• Prevention is less costly

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 Nursing Interventions at the Worksite

• Primary prevention
– Health promotion
– Prenatal care
– Risk reduction
– Immunizations
– Injury prevention
– Use of personal protective gear

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 Nursing Interventions at the Worksite

• Secondary
– Pre-employment screening
– Periodic screening
– Environmental screening

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 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.

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

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 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.

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