Lessons from Ebola patient zero

There is a lot to learn about the spread of the Ebola virus from patient zero Eric Duncan in Dallas to two of his healthcare providers. But perhaps the most important lesson has little to do with Ebola. Rather, the Duncan case highlights the need for greater attention to workplace injuries in hospitals and other healthcare settings.

As David Michaels, director of the Occupational Safety and Health Administration (OSHA), said Monday at the American Industrial Hygiene Association (AIHA) meeting in Arlington, Va.: “Hospitals can be very dangerous places to work.”

{mosads}Incidents of nonfatal occupational illness and injury are twice as high among healthcare workers than most other industries. Of note, hospital workers are more likely to suffer injury or work-related disease than workers in other jobs identified as “dangerous,” such as construction and manufacturing.

Although Ebola is currently dominating the news cycle, hospital workers are routinely exposed to a variety of hazards. Among the most prominent injuries include needle-stick injuries and other exposures to bloodborne pathogens, back strain, latex allergies, workplace violence and stress.

Incidents of musculoskeletal sprains and strains are 10 times higher amongst health care workers than those in other industries. Hospital workers are more likely to be injured than other healthcare workers. And women are twice as likely as men to be injured.

Both the Center for Disease Control and Prevention (CDC) and OSHA are working together to ensure that hospital workers are trained in proper use of personal protective equipment (PPE) in Ebola patients.

But healthcare workers also face infectious disease hazards such as tuberculosis, influenza and MRSA (as well a variety of new and emerging infectious disease threats). OSHA announced an infectious disease pre-rulemaking describing “the need for a standard to ensure that employers establish a comprehensive infection control program and control measures to protect employees from exposures to infectious agents that can cause significant disease.” The infectious disease proposal builds on successes learned in OSHA’s bloodborne pathogen standards.

OSHA’s infectious disease pre-rulemaking is an important step toward modernizing OSHA standards to protect the present-day workforce.

When the Occupational Safety and Health Act (OSH Act) was enacted in 1970 “to prevent workers from being killed or seriously harmed at work,” the U.S. had not yet transitioned to a service economy. Today, there about 12 million healthcare workers throughout the U.S., and as an industry, healthcare represents 18 percent of the nation’s GDP. What’s more, healthcare is the fastest-growing sector of our economy. That means, unless we take additional precautions and develop new protective systems, we can expect even more workers exposed to health-related workplace dangers.

The OSH Act “requires employers to provide their employees with working conditions that are free of known dangers.” The Eric Duncan case highlights the need for all hospitals to evaluate their policies and ensure that they are taking care to protect their workers. OSHA’s infectious disease pre-rulemaking is a step in the right direction for one type of peril suffered by health workers. But hospitals should not limit their actions to infectious disease protections, nor should hospitals wait for OSHA regulations to take action.

Hospitals and other healthcare providers need to take greater precautions to protect workers — and inform the public how they are doing so — now.

Geltman is an associate professor and program director for Environmental & Occupational Health Sciences at the City University of New York (CUNY) School of Public Health and the Urban School of Public Health at Hunter College.