Hazards and Solutions

General References

• Compliance Assistance Quick Start. OSHA. By following this step-by-step guide, you can identify many of the major OSHA requirements and guidance materials that may apply to your workplace. Small and new businesses may find Quick Start helpful as an introduction to the compliance assistance resources on OSHA's website.
  • Health Care Industry. Applies to employers and employees in the health care field.
    
• Hospital. OSHA eTool. Identifies a large variety of health hazards and solutions commonly found in healthcare facilities.
  
  
• Caring for Caregivers [7 MB PDF^*, 52 pages]. OSHA Job Safety and Health Quarterly (JSHQ), (2002, Winter).
  
  
• Hand Hygiene in Healthcare Settings. Centers for Disease Control and Prevention (CDC).
  
  
• Home Healthcare Workers: How to Prevent Exposure in Unsafe Conditions [1 MB PDF, 2 pages]. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2012-121, (2012, February). Home healthcare workers may encounter unsanitary homes, temperature extremes, homes without water that is safe to drink, or hostile pets.
  
  
• Home Healthcare Workers: How to Prevent Driving-Related Injuries [1 MB PDF, 2 pages]. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2012-122, (2012, February). Driving from client to client, home healthcare workers are at high risk for car accidents that could result in injury or death. Distracted driving, aggressive driving, lack of seatbelt use, driving while tired or after having used alcohol or drugs, poor weather conditions, and poorly maintained vehicles can all contribute to car accidents.

CDC Infection Control Guidelines

• 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings [3 MB PDF, 225 pages]. This document is intended for use by infection control staff, healthcare epidemiologists, healthcare administrators, nurses, other healthcare providers, and persons responsible for developing, implementing, and evaluating infection control programs for healthcare settings across the continuum of care.
  
  
• Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care. (2011, May). This document provides a summary guide of infection prevention recommendations for outpatient (ambulatory care) settings. The recommendations are not new but rather reflect existing evidence-based guidelines produced by the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee.
  
  
• Guidelines for Infection Control in Dental Health-Care Settings --- 2003. (2003, December 19). This report consolidates previous recommendations and adds new ones for infection control in dental settings. These recommendations were developed in collaboration with and after review by authorities on infection control from CDC and other public agencies, academia, and private and professional organizations.
  
  
• Guideline for Environmental Infection Control in Health-Care Facilities. Also available as a 1 MB PDF, 249 pages. (2003, June 6). Features an extensive background section including information on air, water, environmental services, environmental sampling, laundry and bedding, animals in healthcare facilities, and regulated medical waste. Also includes specific healthcare worker recommendations which address the rationale behind the guideline and rating categories. The CDC is recommending that healthcare workers take steps to measure performance as suggested to evaluate the recommendations. These steps are provided in the introductory section of the Guideline.
  
  
• Guideline for Infection Control in Health Care Personnel, 1998 [1 MB PDF, 66 pages]. MMWR Recommendations and Reports December 19, 2003 / 52(RR17);1-61. This guideline updates and replaces the previous edition of the Centers for Disease Control and Prevention (CD) “Guideline for Infection Control in Hospital Personnel,” published in 1983. Note: An updated version of the guideline is planned for 2012.

For additional information, see OSHA's Safety and Health Topics Pages on:

• Eye and Face Protection
  
  
• Hazard Communication
  
  
• Nursing Homes and Personal Care Facilities
  
  
• Occupational Asthma
  
  
• Reproductive Hazards
  
  
• Respiratory Protection

Specific Hazards

Chemicals

Ethylene Oxide

• 29 CFR 1910.1047, Ethylene oxide. OSHA Standard.
  • Appendix A, Substance safety data sheet for ethylene oxide (Non-mandatory)
  • Appendix B, Substance technical guidelines for ethylene oxide (Non-mandatory)
  • Appendix C, Medical surveillance guidelines for ethylene oxide (Non-mandatory)
  • Appendix D, Sampling and analytical methods for ethylene oxide (Non-mandatory)
    
• OSHA's Small Business Guide for Ethylene Oxide [14 MB PDF^*, 87 pages]. OSHA Publication 3359, (2009, April). Provides guidance to help employers understand the EtO standard, with particular emphasis on how to monitor the quality of the air in workplaces where EtO is processed, used, or handled. Air monitoring is an important activity that can help alert employers when unsafe levels of EtO are present in the air so they can take steps to reduce employee exposure.
  
  
• Ethylene Oxide (EtO): Understanding OSHA's Exposure Monitoring Requirements. OSHA Publication 3325-01N, (2007). Also available as a 183 KB PDF, 32 pages.
  
  
• Ethylene Oxide [48 KB PDF^*, 2 pages]. OSHA Fact Sheet, (2002).
  
  
• Ethylene Oxide Sterilizers in Health Care Facilities - Engineering Controls and Work Practices. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 87-107 (Current Intelligence Bulletin 52), (1989, July 13).
  
  
• For additional information, see OSHA's Ethylene Oxide Safety and Health Topics Page.
  

Formaldehyde

• 29 CFR 1910.1048, Formaldehyde. OSHA Standard.
  • Appendix A, Substance technical guidelines for formalin
  • Appendix B, Sampling strategy and analytical methods for formaldehyde
    
• Controlling Formaldehyde Exposures During Embalming. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 98-149 (Hazard Control 26), (1998, October).
  
  
• Formaldehyde [1 MB PDF^*, 2 pages]. OSHA Fact Sheet, (2011, April).
  
  
• For additional information, see OSHA's Formaldehyde Safety and Health Topics Page.

Glutaraldehyde

• Hospital. OSHA eTool.
  • Healthcare Wide Hazards: Glutaraldehyde. Exposure of employees to glutaraldehyde.
    
• Best Practices for the Safe Use of Glutaraldehyde in Health Care. OSHA Publication 3258-08N, (2006). Also available as a 263 KB PDF, 48 pages.
  
  
• Glutaraldehyde: Occupational Hazards in Hospitals. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2001-115, (2001, May).

Emergency Response

• Hospital. OSHA eTool.
  • Emergency Department (ED) Module: Terrorism. Potential hazards and solutions for healthcare emergency department workers exposed to biological agents, chemical agents, and mass causalities as a result of terrorist attacks or events.
    
• Emergency Preparedness and Response. OSHA Safety and Health Topics Page.
  
  • Response and Recovery Workers. Provides information on medical response to emergencies.
    
• Hospitals and Community Emergency Response -- What You Need to Know. OSHA Publication 3152, (1997). Protecting health care workers who respond to emergencies involving hazardous substances is critical. Health care workers dealing with emergencies may be exposed to chemical, biological, physical, or radioactive hazards.
  
  
• OSHA Best Practices for Hospital-Based First Receivers of Victims from Mass Casualty Incidents Involving the Release of Hazardous Substances. OSHA, (2005, January). Provides hospitals with practical information to assist them in developing and implementing emergency management plans that address the protection of hospital-based emergency department personnel during the receipt of contaminated victims from mass casualty incidents occurring at locations other than the hospital. Covers topics such as victim decontamination, personal protective equipment, employee training, and includes several informational appendices.

Hazardous Drugs

• Preventing Occupational Exposure to Antineoplastic and Other Hazardous Drugs in Health Care Settings. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2004-165, (2004, September). Increases awareness among healthcare workers and their employers about the health risks posed by working with hazardous drugs and to provide them with measures for protecting their health.
  
  
• List of Hazardous Drugs in Healthcare Settings Allows Healthcare Workers to Minimize Exposure and Reduce Health Risks. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2011-189, (2011, August). Hazardous drugs include drugs used for chemotherapy, antiviral drugs, hormones, and some immunosuppressant drugs—all of which may have damaging effects on the body. When these drugs must be prepared and administered, there are workplace best practices that can minimize potentially harmful exposure.
  
  
• Anesthetic Gases: Guidelines for Workplace Exposures. OSHA, (2000, May 18). Provides guidelines and controls to help reduce occupational exposure to waste anesthetic gases.
  
  
• Controlling Exposures to Nitrous Oxide During Anesthetic Administration. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication 94-100 (Alert), (1994).
  
  
• For additional information, see OSHA's Hazardous Drugs and Waste Anesthetic Gases Safety and Health Topics Pages.

Infectious Diseases

Bloodborne Pathogens and Biological Hazards

• Bloodborne Pathogens and Needlestick Prevention. OSHA Safety and Health Topics Page.
  
  
• Preventing Exposures to Bloodborne Pathogens among Paramedics [1 MB PDF, 4 pages]. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2010–139, (2010, April).
  
  
• Home Healthcare Workers: How to Prevent Needlestick and Sharps Injuries [775 KB PDF, 2 pages]. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2012-123, (2012, February). Needlestick and other sharps injuries are a serious hazard in any healthcare setting. Contact with contaminated needles, scalpels, broken glass, and other sharps may expose healthcare workers to blood that contains pathogens which pose a grave, potentially lethal risk.
  
  
• Use of Blunt-Tip Suture Needles to Decrease Percutaneous Injuries to Surgical Personnel: Safety and Health Information Bulletin. OSHA and the National Institute for Occupational Safety and Health (NIOSH) Publication No. 2008-101 (SHIB 03-23-2007), (2007, October). Also available as a 281 KB PDF, 4 pages.
  
  
• Model Plans and Programs for the OSHA Bloodborne Pathogens and Hazard Communications Standards. OSHA Publication 3186-06N, (2003). Also available as a 521 KB PDF, 29 pages.
  
  
• Bloodborne Pathogen Exposure Control Plan. Oklahoma State University (OSU), Environmental Health & Safety (EHS), (2007, December). The OSHA standard requires a written exposure control plan. This site offers an example plan that can be tailored to your facility.
  Influenza (Seasonal and Pandemic)

Influenza (Seasonal and Pandemic)

• Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers. OSHA Publication 3328-05, (2007). Also available as a 409 KB PDF, 104 pages.
  
  
• Frequently Asked Questions on Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers.
  
  
• For additional information, see OSHA's Pandemic Influenza and Seasonal Flu Safety and Health Topics Pages.

Severe Acute Respiratory Syndrome (SARS)

• Information Regarding Severe Acute Respiratory Syndrome (SARS). OSHA. Provides information on SARS for employers, employees and others.
  
  • SARS: Protecting Workers. OSHA Slide Presentation.
    
• Severe Acute Respiratory Syndrome (SARS) [353 KB PDF^*, 2 pages]. OSHA Fact Sheet, (2004). Provides an overview of worker protection issues.
  
  
• Severe Acute Respiratory Syndrome (SARS). Centers for Disease Control and Prevention (CDC). Contains the latest SARS information including CDC guidelines and recommendations for clinicians, health departments, laboratories, travelers, air travel workers, and international resources.

Tuberculosis

• Overview of Enforcement for Occupational Exposure to Tuberculosis. OSHA Slide Presentation. Provides an overview of Enforcement Procedures and Scheduling for Occupational Exposure to Tuberculosis.
  
  
• Tuberculosis. National Institute for Occupational Safety and Health (NIOSH) Workplace Safety and Health Topic.
  
  • Efficacy of Ultraviolet Irradiation in Controlling the Spread of Tuberculosis. National Institute for Occupational Safety and Health (NIOSH), (2002, October 19).
    
• TB Respiratory Protection Program In Health Care Facilities Administrator's Guide. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication 99-143, (1999, September).
  
  
• Protect Yourself Against Tuberculosis -- A Respiratory Protection Guide for Health Care Workers. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication 96-102, (1995, December).
  
  
• Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Facilities 1994. Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR) 43(RR13);1-132, (1994, October 28).
  
  
• Core Curriculum on Tuberculosis: What the Clinician Should Know. Centers for Disease Control and Prevention (CDC), Division of Tuberculosis Elimination (DTBE). The Core Curriculum on Tuberculosis is accompanied by a slide series for use in presentations that can be ordered from CDC.
  
  
• For additional information, see OSHA's Tuberculosis Safety and Health Topics Page.

West Nile Virus

• Workplace Precautions Against West Nile Virus. OSHA Safety and Health Information Bulletin (SHIB), (2003, August 29). Also available as a 42 KB PDF, 5 pages. Includes recommendations for healthcare and laboratory workers.

Laboratories

• 29 CFR 1910 Subpart Z, Toxic and hazardous substances. OSHA Standard.
  • 1910.1450, Occupational exposure to hazardous chemicals in laboratories
    • Appendix B, References (Non-mandatory). Provides a list of references to assist in the development of a chemical hygiene plan which is required under the Occupational Exposure to Hazardous Chemicals in Laboratories Standard.
      
• For additional information, see OSHA's Laboratories Safety and Heath Topics Page.

Lasers

• Laser/Electrosurgery Plume. OSHA Safety and Health Topics Page.
  
  
• Laser Hazards. OSHA Safety and Health Topics Page.

Latex Allergies

• Home Healthcare Workers: How to Prevent Latex Allergies [565 KB PDF, 2 pages]. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2012-119, (2012, February). Latex products are made from natural rubber, and sensitivity can develop after repeated exposure. Limiting exposure to latex can help prevent allergic reactions for both home healthcare workers and their clients.
  
  
• For additional information, see OSHA's Latex Allergy Safety and Health Topics Page.

Safe Patient Handling

• Home Healthcare Workers: How to Prevent Musculoskeletal Disorders. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2012-120, (2012, February). A work-related musculoskeletal disorder is an injury of the muscles, tendons, ligaments, nerves, joints, cartilage, bones, or blood vessels in the arms, legs, head, neck, or back that is caused or aggravated by work tasks such as lifting, pushing, and pulling. Symptoms include pain, stiffness, swelling, numbness, and tingling. Lifting and moving clients create a high risk for back injury and other musculoskeletal disorders for home healthcare workers.
  
  
• Safe Patient Handling for Schools of Nursing [3 MB PDF, 40 pages]. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2009-127, (2009, November). The NIOSH "Safe Patient Handling and Movement" presentation and CD-ROM download are also available below).
  
  
• Safe Patient Handling and Movement Web-Based Training. Safe Patient Handling and Movement Web based Training. A CD-ROM is also available for advanced users.
  
  
• Beyond Getting Started: A resource guide for Implementing a Safe Patient Handling Program in the Acute Care Setting [641 KB PDF, 34 pages]. OSHA and the Association of Occupational Health Professionals in Healthcare (AOHP) Alliance, (Revised 2011).
  
  
• Ergonomics. OSHA Safety and Health Topics Page.
  
  
• Guidelines for Nursing Homes: Ergonomics for the Prevention of Musculoskeletal Disorders. OSHA, (Revised 2009). Also available as a 761 KB PDF, 44 pages. also includes several informational appendices.

Workplace Violence

• Home Healthcare Workers: How to Prevent Violence on the Job [517 KB PDF, 2 pages]. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2012-118, (2012, February).
  
  
• Guidelines for Preventing Workplace Violence for Health Care & Social Service Workers. OSHA Publication 3148-01R, (2004). Also available as a 244 KB PDF, 47 pages.
  
  
• Violence Occupational Hazards in Hospitals. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2002-101, (2002, April). Increases worker and employer awareness of the risk factors for violence in hospitals and to provide strategies for reducing exposure to these factors.
  
  
• Guidelines for Security and Safety of Health Care And Community Service Workers . Cal/OSHA Publication, (1998, March 10).
  
  
• For additional information, see OSHA's Workplace Violence Safety and Health Topics Page.

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