Occupational Health Nursing

Dedy Purwito, S.Kep, Ns, M.Sc

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.
2

Scope of Occupational Health Problems

An average of 137 individuals die each day Every 5 seconds a worker is injured Every 10 seconds a worker is disabled Incidence of work-related injuries increasing

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).

Evolution of Occupational Health

Part of job Horrible accidents Occupational, safety, and health administration (OSHA, l970) set and enforce standards National Institute for Occupational Safety and Health (NIOSH). Identifies, monitors, educates, & researches Super fund Amendment & Reauthorization Act Nurse key role
5

Role of OHN
Beyond emergency and band aid care 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
6

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
7

Application of the Epidemiological Model

Host factors:
age, gender, work practices, health status, lifestyle greatest risks for accidents?

Application of the Epidemiological Model

Types of Agent Factors:

Biological Chemical Ergonomic or mechanical Physical Psychosocial

Application of the Epidemiological Model

Environment: all external conditions

that influence host and agent interaction

Examples?

10

Issues with Occupational Health Programs

Widely varies Organization exemption OSHA sanctions Limited # of inspectors

11

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
12

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
13

Hazard Communication Standard

Cannot eliminate all toxins Report known toxins Provide safety education on identification, toxicity, and protective measures

14

Workers Compensation

Financial compensation State laws Varies by state Prevention is less costly

15

Nursing Interventions at the Worksite

Primary prevention
Health promotion Prenatal care Risk reduction Immunization status Injury prevention
16

Nursing Interventions at the Worksite

Secondary

Pre-employment screening Periodic screening Environmental screening Treatment of existing conditions Emergency responses
17

Nursing Interventions at the Worksite

Prevent the spread of communicable diseases Prevent the occurrence of acute conditions Prevent complications of chronic illnesses Assessing fitness to return to work.

18

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
19

Psychological Stress
Job strain Tenth leading cause of occupational disease Health care and service workers Sources of stress

20

Ethical Case Dilemna

A young attractive woman reports to you a ling history of sexual harassment by her immediate supervisor, a man. This man is the person to whom your supervisor reports. Your supervisor advises you to ignore them because this man has a tendency to be vindictive. What would you do?
21

Copyright 2007