1

Occupational Health Nursing

Christina Barrick
2
Objectives
Describe legislation impacting on OHN
Utilize an occupational health history.
Identify prevalent occupational health
disorders.
Describe the profile of a worker population.
Apply epidemiology to OHN.
Describe the roles of the OHN.

3
Scope of Occupational Health Problems

Every 5 seconds a worker is injured
10,000,000 injuries a year
100,000 deaths a year
Every 10 seconds a worker is disabled
Incidence of work-related injuries
increasing

4
Trends
1/3 of life at work
Lost time from illness and injury
Primary care in occupational setting
Increase the proportion of worksites that
have health services (Healthy People,
2010).
5
Evolution of Occupational Health
Part of job
Horrible accidents
Occupational, safety, and health administration (OSHA,
l970)
set and enforce standards
demand for OHNs
National Institute for Occupational Safety and Health
(NIOSH).
Identifies, monitors, educates, & researches
Super fund Amendment & Reauthorization Act
Nurse key role



6
Role of OHN
Beyond emergency and band aid care
Goal of OHN
Removing health hazards from the environment
Largest group of occupational workers
Diverse levels of preparation
Multiple roles
clinician, case manager, educator, consultant,
researcher, corporate manager, program planner
skills: provision of emergency care, health assessment,
workers compensation management



7
Characteristics of the Workplace
High tech
Health and computer-related occupations
Increase in part-time and temporary work
Increase in contractual workers
Reduced job security
Increase in shift work
Development of new chemicals
8
Characteristics of Worker Population

Characteristics of workplace
Older worker (65 and over)
Will double by 2050
Mean age of nurses?
More racially diverse
Fastest growing group?
Women with children and aging parents. Implications?
Workers with chronic physical or mental health problems
High job demand, low supply
Increase health status, employment longevity, and satisfaction of
workers
Fastest growing occupations
Computer-related, Nursing and Home Health, Personal care aid


9
Application of the Epidemiological Model
Host factors:
age, gender, work practices, health status,
lifestyle
hyper susceptible
greatest risks for accidents?
10
Application of the Epidemiological Model
Types of Agent Factors:
Biological
Chemical
*.1% of millions known chemical have been tested
Ergonomic or mechanical
Physical
Psychosocial

11
Application of the Epidemiological Model
Environment: all external conditions
that influence host and agent interaction

Examples?
12
Issues with Occupational Health Programs
Widely vary
Organization exemption
OSHA sanctions
Limited # of inspectors
13
Worker Assessment
Overall health assessment
Occupational health assessment
list current and past jobs
exposure history
job titles and responsibilities
host factors (smoking)
masked risk: retiree or housewife
family members
Assessment Guide: page 1084.
14
Workplace Assessment
Walk-through, plant survey
What are you looking for?
Review the Standard Industrial
Classification (SIC) code
Describe demographic info. of workers
Review policies and procedures
Epi. data collection about injuries and
illnesses


15
Hazard Communication Standard
Cannot eliminate all toxins
Report known toxins
Provide safety education on
identification, toxicity, and protective
measures
16
Workers Compensation

Financial compensation
State laws
Varies by state
Prevention is less costly


17
Nursing Interventions at the Worksite
Primary prevention
Health promotion
Prenatal care
Risk reduction
Immunizations
Injury prevention
Use of personal protective gear
18
Nursing Interventions at the Worksite
Secondary
Pre-employment screening
Periodic screening
Environmental screening

19
Nursing Interventions at the Worksite
Tertiary
Prevent the spread of communicable diseases
Prevent complications of acute and chronic
illnesses
Assess fitness to return to work.
20
Indicators of Psychological Health Problems
Increased absenteeism
Mood changes
Increase in minor accidents
Fatigue or general decrease in energy
Sudden weight loss or gain
Increased blood pressure
Frequent stress-related illnesses
Bloodshot or bleary eyes

21
Psychological Stress
Job strain
Tenth leading cause of occupational disease
Health care and service workers
Sources of stress
22
In-Class Activity
Identify occupational health hazards for
Towson University nursing students.
Identify all possible factors that might
influence health, then take one factor and
analyze its potential health effects . (Can be
psychosocial as well as biologic.