NIOSH to update HCW safety guidelines
NIOSH to update HCW safety guidelines
Agency seeks comments from EHPs
The National Institute for Occupational Safety and Health (NIOSH) plans to update a comprehensive set of guidelines for protecting the safety and health of health care workers, but questions about the scope and format of a new document have prompted the agency to seek comments from employee health practitioners and other concerned professionals.1
A request for comments published late last year in the Federal Register largely escaped notice by the affected public, says Brenda Boutin, MS, document manager in NIOSH’s education and information division in Cincinnati and team leader of the guidelines project.2
"We got only three responses from the Federal Register, so obviously [the request for comments] is not getting to people," Boutin says. "We’re trying to get a good mailing list together to blanket the country, but it’s difficult to do."
Certainly the times have changed’
Because the original guidelines were published in 1988, much of the information on occupational hazards now is outdated. Many additional recommendations have been issued relating to such hazards as tuberculosis and bloodborne pathogens.
"The document originally was drafted for hospital administrators, and certainly the times have changed now. We have to reach more people. We want to make sure end users are getting the information they need and want," she says.
To that end, NIOSH is calling for comments, questions, and suggestions regarding any aspect of a new document to address the entire scope of issues related to HCW safety. The exact scope and format of the final document have not been determined and will largely depend on the comments received. (See editor’s note at end of article for instructions on how to submit comments.)
"Would people prefer a book with tabs? Guidelines with references? Do they want more in-depth information in certain areas? More on ergonomics? What would be the easiest format for people to use? These are some of the questions team members are considering," Boutin says.
Updating the document will be a "huge undertaking," she adds, given the wide range of issues affecting HCW safety and health. (See document outline, p. 53.) According to the Federal Register notice, more than 8 million HCWs nationwide are exposed to hazards such as toxic chemicals, biological agents, radiation, ergonomic stressors, violence, and stress.
"Few workplaces are as complex as hospitals, where more than 50% of health care workers are employed. The number and type of hazards are extremely large. For example, maintenance workers may be exposed to solvents, asbestos, and electrical hazards. Housekeepers are exposed to detergents and disinfectants that can cause skin rashes and eye and throat irritation. Also, housekeepers may be exposed to infectious diseases such as hepatitis or acquired immunodeficiency syndrome (AIDS) from hypodermic needles that have not been properly discarded. Nurses confront such potential hazards as exposure to infectious diseases and toxic substances, back injuries, radiation exposure, and stress," the notice states.
To ensure that information included in the new document is appropriate and reaches target audiences, NIOSH points out several issues to be considered by commenters:
• The 1988 guidelines addressed only hazards associated with hospitals, assuming that information relevant for hospitals also was relevant for other health care facilities. The issue is whether information about health care facilities other than hospitals should be included in the revised guidelines.
• The 1988 format was based on the type of hazard (such as physical, ergonomic, and chemical). The issue is whether this is the best approach, or if another format (such as presenting hazards by job task or occupation) would be better. Another format-related issue is whether suggested chapters should be deleted or additional chapters included.
• The development of smaller documents for different health care settings (such as biomedical laboratory, nursing home, home care) or occupations (such as nursing aides, radiological technicians, pharmacists) would be useful. The issue is whether these smaller documents should be done in place of one larger, all-inclusive document or in addition to that document.
• Potential users of the guidelines include occupational physicians/nurses, facility administrators, engineers, nursing aides, safety professionals, industrial hygienists, and safety and health committees. The issue is whether the language and content should be targeted to specific occupations.
• Information and recommendations applicable to controlling health care industry hazards change regularly. A number of mechanisms can be utilized to update this information, such as providing updates on an Internet Web site and/or providing the information on a CD-ROM that is updated regularly. The issue is what the best mechanism is for reaching intended audiences.
[Editor’s note: Written comments should be submitted to Diane Manning, NIOSH Docket Office, 4676 Columbia Parkway, M/S C-34, Cincinnati, OH 45226. Comments or data may be submitted on the following topics, but are not limited to these: (1) target audience, (2) format, (3) content, and (4) methods of distribution. Comments also may be faxed to (513) 533-8285, or submitted by e-mail to: dmm2@ NIOSDT1.em.cdc.gov as WordPerfect 5.0, 5.1/5.2, 6.0/6.1, or ASCII files. No deadline for comments has been established, but commenters should respond as soon as possible.
Technical information may be obtained from John J. Whalen, NIOSH, CDC, 4676 Columbia Parkway, M/S C-14, Cincinnati, OH 45226. Telephone: (513) 533-8270.]
References
1. U.S. Department of Health and Human Services. Guidelines for Protecting the Safety and Health of Health Care Workers. Washington, DC: DHHS; 1988.
2. Department of Health and Human Services. Request for comments on the proposed NIOSH document on guidelines for protecting the safety and health of health care workers. Fed Reg 1996; 61:66,281-66,282.
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.