786 
Zinta Podniece
Project Manager
Hans-Horst Konkolewsky
Director
European Agency for Safety and Health at Work
Bilbao
Spain
Health and social work is one of the largest sectors in Europe. In 2002 it employed 16 million people, and between 1995 and 2002 it showed the second-largest increase in workforce (18%), with a steeper increase among women (20%) than men (14%).(1) While workers in the sector aim to preserve people’s health, they themselves often suffer from ill-health caused by their work. Around 35% of the workforce employed in the sector report that they feel their health is at risk because of work. The main risk factors and related health problems are well known and include musculoskeletal loads (ie, poor working postures, manual handling of patients), biological hazards, chemical substances (ie, disinfectants, anaesthetic gases and antibiotics), radiological hazards and psychosocial factors.(1,2,3)
The European Agency for Safety and Health at Work
The European Agency for Safety and Health at Work was set up by the EU to meet the increasing need for information in the field of safety and health at work. Its goal is to improve the lives of people at work by stimulating the flow of technical, scientific and economic information among all those involved in occupational safety and health (OSH) issues. The Agency has three key areas of activity:
- Collecting information through national networks of designated experts and organisations.
- Communicating information printed publications and campaigns through the internet.
- Developing knowledge through the Agency’s information networks on significant occupational safety and health themes, including new and emerging risks.
Biological hazards
Healthcare workers can be at risk of exposure to biological hazards during direct patient intervention, handling and transporting samples, and dealing with sharps waste, laundry or other contaminated materials. The health and social work and public administration sectors account for the majority of cases of occupational hepatitis C (97%), hepatitis A (88%), tuberculosis (88%) and hepatitis B (60%).(3) All occupational groups in the healthcare sector are at risk from biological hazards – from nurses and anaesthetists to laboratory workers, cleaners and other support staff.
Risk assessment and effective health and safety management in healthcare are the keys to preventing and reducing workers’ exposure to biological hazards.(2,4) This includes:
- Established health and safety management systems.
- Risk assessment covering all the biological hazards present and identifying who could be harmed and how they could be harmed.
- Reduction of risk to the workers by: elimination or substitution; exposure prevention and control; or worker consultation, information and training.
- Providing health surveillance where appropriate.
- Integration of OSH into other management processes (eg, purchasing and contract tendering).
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Needle injuries
Needlestick injuries can cause bloodborne infections, such as HIV or hepatitis B or C, to health workers. Therefore, it is essential to implement the following preventive measures:(2)
- Eliminate the use of needles where safe and effective alternatives are available.
- Implement the use of devices with safety features and evaluate their use to determine which are most effective and acceptable.
- Modify work practices that pose a needle injury hazard to make them safer; avoid recapping needles.
- Train workers in the safe use and disposal of needles in appropriate sharps containers.
Emerging biological risks
The Agency’s Risk Observatory was created to identify and anticipate OSH trends in Europe. With a special focus on new and emerging risks, it gathers the latest knowledge in the biological hazards area. The research in this area has not been finalised yet, although a number of revelations have already emerged from an expert survey. Indeed, a series of emerging biological risks have been highlighted that particularly affect healthcare staff:
- Antimicrobial-resistant pathogens such as multidrug-resistant tuberculosis and methicillin/oxacillin-resistant Staphylococcus aureus.
- New and exotic infectious diseases spread in Europe such as SARS, avian flu, Lassa fever and Ebola haemorrhagic fever.
- Legionella, aspergillosis and indoor moulds spread by poorly maintained air-conditioning systems in hospitals.
- Nursing at home, where the working conditions are not as controlled and safe as in hospitals, which increases the risk of exposure to biological hazards.
Forthcoming activities
A number of the Agency’s activities taking place in 2006/7 will also be linked to promoting OSH among healthcare workers. The European Week 2006 campaign “Safe Start” focuses on the health and safety of young workers across Europe. It will promote OSH in the training of nurses and doctors – both in relation to their own health and safety and for the diagnosis of their future patients.
In 2007, the European Week campaign will be dedicated to musculoskeletal disorders. It will highlight OSH risks such as handling patients, painful postures, prolonged standing or sitting. It will be coordinated with the senior labour inspectors committee campaign across the EU Member States, focusing on the manual handling of loads in the healthcare sector.
Regulatory framework
Two EU directives are directly linked to the prevention of biological hazards within the healthcare sector. A framework directive is provided to ensure a higher degree of protection by implementating preventive measures to guard against occupational diseases and accidents at work through consultation, balanced participation, and informing and training workers and their representatives.(5) The framework directive is supported by an individual directive on biological agents, which focuses on protecting workers against risks to their health and safety – including the prevention of risks that arise or are likely to arise from exposure to biological agents at work.(6) These directives can be found in the Agency’s legislation pages (www.osha.eu.int/legislation).
References
- Eurostat. Work and health in the EU: a statistical portrait. Data 1994–2002. Brussels: European Commission; 2003.
- European Agency for Safety and Health at Work. Safety and health practice online for the healthcare sector. Bilbao: OSHA; 2003.
- Eurostat. Statistics in focus: occupational diseases in Europe in 2001. Brussels: European Commission; 2004.
- 4. Work. Biological agents. Bilbao; OSHA: 2003.
- Council Directive 89/391. EEC 12 June 1989. Introduction of measures to encourage improvements in the safety and health of workers at work.
- Directive 2000/54/EC of the European Parliament and the Council. 18 September 2000. The protection of workers from risks related to exposure to biological agents at work.
