1. 1 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 43 The Nurse in Occupational Health

2. 2 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Objectives 1. Describe the nursing role in occupational health. 2. Discuss current trends in the United States workforce. 3. Give examples of work-related illness and injuries. 4. Use the epidemiological model to explain work- health interactions. 5. Cite at least three host factors associated with increased risk from an adverse response to hazardous workplace exposure.

3. 3 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Objectives, Cont’d 6. Explain one example each for biological, chemical, enviromechanical, physical, and psychosocial workplace hazards. 7. Complete an occupational health history. 8. Differentiate between the functions of OSHA and NIOSH. 9. Explain an effective disaster plan in occupational health.

4. 4 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Definition and Scope  Occupational and environmental health nursing:  Specialty practice that focuses on the promotion, prevention, and restoration of health within the context of a safe and healthy environment  American Association of Occupational Health Nurses (AAOHN)  AAOHN Code of Ethics

5. 5 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. History and Evolution  1888: Industrial nursing started  Employee health service grew rapidly during early 1900s  Provision of worksite health services led to a more productive workforce  Occupational Safety and Health Act of 1970  Created OSHA and NIOSH  1993: Office of Occupational Health Nursing was established  1999: AAOHN published its first set of competencies in occupational health nursing

6. 6 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Roles and Professionalism  Role has extended beyond emergency treatment and prevention of illness and injury to include promotion and maintenance of health, overall risk management, care for environment, and efforts to reduce health- related costs in businesses  Occupational health nurses hold positions as nurse practitioners, clinical nurse specialists, managers, supervisors, consultants, educators, and researchers.

7. 7 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Workers as a Population Aggregate Characteristics of the Workforce Characteristics of Work Work-Health Interactions

8. 8 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Characteristics of the Workforce  Shift from manufacturing to service  Longer hours, compressed workweeks, shift work, reduced job security, part-time and temporary work  New chemicals, materials, processes, and equipment  Changing workforce  Older and more racially diverse

9. 9 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Characteristics of Work  Shift in types of jobs  From agrarian to manufacturing to technological  New occupational hazards  Complex chemicals  Nanotechnology  Non-ergonomic workstation design  Work organization issues Job stress Burnout Exhaustion  Global economy

10. 10 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Work-Health Interactions  In 2007, 3.9 work injuries and occupational illnesses per 100 workers  Occupational injuries alone cost billions in lost wages and lost productivity, administrative expenses, health care, and other costs (2007).  Many work-related health problems go unreported  Changes to decrease workplace injuries

11. 11 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Application of the Epidemiological Model  Host  All employed individuals and groups are at risk of being exposed to occupational hazards  Agent  Occupational exposures that are classified as biological, chemical, enviromechanical, physical, or psychosocial  Environment  Workplace conditions, such as temperature extremes, crowding, shift work, and inflexible management styles

12. 12 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Organizational and Public Efforts to Promote Worker Health and Safety  Unless they have OSHA-regulated exposures, businesses are not required to provide occupational health and safety services that meet any specified standards  On-site occupational health and safety programs

13. 13 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing Care of Working Populations  Levels of prevention  Worker assessment  Occupational health history  Workplace assessment  Worksite walk-though or survey

14. 14 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Worksite Assessment Guide

15. 15 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Healthy People 2020  Occupational safety and health objectives were identified to promote good health and well-being among workers, including the elimination and reduction of elements in occupational environments that cause death, injury, disease, or disability.  Promotes the minimization of personal damage from existing occupationally related illness

16. 16 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Legislation  Mine Safety and Health Act of 1968  Occupational Safety and Health Act of 1970  Hazards Communication Standard  National Institute for Occupation Safety and Health (NIOSH)  National Occupational Research Agenda (NORA)  Workers’ Compensation Acts  Vary by state

17. 17 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Disaster Planning and Management  Superfund Amendment and Reauthorization Act (SARA)  Required written disaster plans be shared with key resources in the community.  Effective disaster plans