Health Care Workers Suffer Highest Total Worker Injury Toll While Having Few Federal Safety Protections, Study Shows

Health care workers suffer more injuries and illnesses on the job each year than those in any other industry, but the Occupational Safety and Health Administration (OSHA) conducts relatively few inspections of health care facilities and is hamstrung in its ability to take action to resolve unsafe conditions by an absence of needed safety standards, a new report by Public Citizen shows.

"OSHA is required by law to ensure safe conditions for every employee in the United States," said Keith Wrightson, worker safety and health advocate for Public Citizen, and a co-author of the report, available at https://www.citizen.org/health-care-workers-unprotected-report. "The record is clear that the government has broken its promise to health care workers."

Nurses, nursing aides, orderlies and attendants suffer more musculoskeletal injuries than workers in any other field. Costs associated with back injuries in the health care industry are estimated to be more than $7 billion annually.

"Most Americans are not aware that hospitals and other medical facilities are actually the most frequent site for workplace injuries," said Dr. L. Toni Lewis, chair of the health care division of the Service Employees International Union (SEIU), which advised Public Citizen on the report. "This is an issue that affects so many frontline workers and their patients - nurses, CNAs, radiologists, physical therapists - women and men who are trying to meet the needs of their patients safely and effectively. The current patchwork approach is not working for workers."

In 2010, health care employers reported 653,900 workplace injuries and illnesses, about 152,000 more than the next most afflicted industry sector, manufacturing. The construction industry is the subject of the most inspections, and even that industry needs more OSHA inspection and enforcement. Although health care workers outnumber construction workers more than two-to-one, OSHA conducts just one-twentieth as many inspections of health care facilities as construction sites.

"It's alarming that health care workers rank right alongside laborers, truck drivers and other physical, labor-intensive jobs in terms of musculoskeletal injuries," said Suzy Harrington, director of the American Nurses Association's Department for Health, Safety and Wellness. "This is a primary reason health care workers leave direct patient care. We can't afford to lose health care workers to injury and still meet rising demands for health care services."

OSHA's leader, Assistant Secretary of Labor David Michaels, has acknowledged that health care safety problems need to be addressed, saying in 2012, "It is unacceptable that the workers who have dedicated their lives to caring for our loved ones when they are sick are the very same workers who face the highest risk of work-related injury and illness." In response to questions posed by Public Citizen for the report, OSHA argued that it does not have the resources necessary to develop certain standards. OSHA's responses are included in the report's appendix.

The fault for OSHA's failure to protect health care workers does not rest entirely with the agency. Congress has impeded OSHA's ability to carry out is mission. The agency's $535 million budget is woefully inadequate to oversee the 7 million job sites in its purview. Meanwhile, the agency's rulemaking efforts have been obstructed. In 2000, the agency published a final standard to protect workers in all industries from ergonomic stressors. But Congress repealed the rule before it took effect. At the outset of the Obama administration, the agency proposed a rule to add a column on employers' incident reporting logs to designate whether workplace injuries were musculoskeletal disorders. But the administration delayed the proposed rule and Congress subsequently blocked it.

The agency is attempting to partially address the frequency of injuries among nursing home employees with a "national emphasis program," which aims to address ergonomic stressors, bloodborne pathogens, tuberculosis, workplace violence, and slips, trips and falls. But the program does not cover hospitals or other health care settings, where high injury rates also have been reported. In the absence of a specific standard for ergonomic safety, the agency must rely on its catch-all "general duty clause" to issue citations for unsafe ergonomic conditions. General duty clause cases require a high evidentiary threshold, and only seven citations regarding ergonomics have been issued to nursing homes over the past two fiscal years.

Public Citizen recommends that OSHA increase the number of inspections of the health care industry facilities by several fold and pursue binding standards to ensure that workers are protected from the risks posed by musculoskeletal disorders, workplace violence and other threats. The report also recommends that Congress significantly increase funding of OSHA.