Occupational safety and health

Occupational safety and health (OSH), also commonly referred to as occupational health and safety (OHS), workplace health and safety (WHS), or occupational health, pertains to the safety, health, and welfare of people at work. The discipline is a vital aspect of management in companies, contributing to the wellbeing of individual employees and the productivity of the organization.

Historical Perspective

The interest in occupational safety and health arose with the industrial revolution, which introduced new health risks associated with factory work. As awareness of these risks grew, so did efforts to develop safety regulations and health standards in various industries, such as mining and manufacturing.

Core Aspects

OSH covers a broad range of workplace hazards. It includes preventing accidents and injuries associated with machinery operation, falls, fire, or exposure to harmful substances. It also deals with occupational diseases and long-term health problems, such as occupational stress, overuse injuries, and diseases related to chemical or noise exposure. Occupational safety and health further includes promoting a culture of safety at work, with both employers and employees participating in creating safe and healthy working conditions.

Legislation and International Standards

In many countries, legislation has been enacted to enforce standards in occupational safety and health. This legislation often establishes the responsibilities of employers to ensure a safe and healthy work environment and defines the rights of employees in this context. Internationally, the International Labour Organization (ILO) and the World Health Organization (WHO) set out conventions, guidelines, and standards for occupational safety and health. These international standards aim to ensure that workers worldwide can benefit from safe and healthy working conditions.

Occupational Safety and Health Professions

Several professions are dedicated to ensuring occupational safety and health, including occupational health physicians, safety engineers, and occupational hygienists. These professionals work to evaluate, mitigate, and manage risks associated with work, often as part of a multidisciplinary team.

Future Directions

As workplaces evolve with new technologies, so do the associated health and safety challenges. In this context, the field of occupational safety and health is continuously evolving, seeking to address emerging risks associated with modern work practices, including remote work, digitalisation, and novel manufacturing processes. In this vein, research and practice in occupational safety and health aim to ensure not only physical safety but also psychosocial wellbeing in the workplace.

Glossary of terms

• Accreditation- a determination by the Joint Commission on Accreditation of Healthcare Organizations that an eligible organization complies with applicable Joint Commission Standards.

• American College of Radiology - is the principal organization of radiologists, radiation oncologists, and clinical medical physicists in the United States.

• Activities of Daily Living - an index or scale which measures a patient's degree of independence in bathing, dressing, using the toilet, eating, and moving from one place to another.

• ACM Asbestos-Containing Materials.

• Acute Care - medical treatment rendered to individuals whose illnesses or health problems are of a short-term or episodic nature. Acute care facilities are those hospitals that mainly serve persons with short-term health problems.

• Administrative Control - a method of controlling employee exposures by job rotation, work assignment, or training in specific work practices designed to reduce the exposure.

• AHA - is the national organization that represents and serves all types of hospitals, health care networks, and their patients and communities. Close to 5,000 institutional, 600 associate, and 40,000 personal members come together to form the AHA.

• Anesthetic Agent - a drug used to reduce or abolish the sensation of pain, e.g. halothane, enfluorane, isoflurane, desofluorane, sevofluorane, and methoxyfluorane.

• Antineoplastic Drugs- are drugs used in the treatment of cancer and other tumors.

• Ambulatory Health Care -a type of health care service provided without the patient being admitted. It is also called outpatient care.

• Ancillary Services - supplementary services which may laboratory, radiology, physical therapy, and inhalation therapy that are provided in conjunction with medical or hospital care.

• APIC - The Association for Professionals in Infection Control and Epidemiology, Inc. ia a multi-disciplinary voluntary international organization with over 10,000 members. Its purpose is to influence, support, and improve the quality of healthcare through practicing and managing infection control and applying epidemiology in all health settings. The organization, which is based in Washington, DC, is led by an elected board of members who volunteer their time and expertise.

• Aperture - any opening in the protective housing or other enclosure of a laser product through which laser or collateral radiation is emitted thereby allowing human access to such radiation.

• Approval - for Medicare, a function performed by the HCFA regional office based on the State agency certification recommendations; for Medicaid, the State Medicaid agency approves a State agency certification recommendation.

• (APIC- Association for Proficiency in Infection Control.

• ASHE - is the professional society that represents individuals responsible for the environment of care used in healthcare delivery. The membership is served by providing leadership through education and advocacy.

• ASHRM - is the preeminent society for healthcare risk management. This professional organization strives to advance risk management in the healthcare field through professional development, membership services, enhanced communications, risk management innovation, and effective governance.

• BBP- means pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV).

• BSC- are primary containment devices used by workers when handling moderate and high risk organisms.

• Board Certified - physicians who have completed residency requirements and have passed board examination in their specialty. Board certification is not required by law and is not the same as licensure, which is granted by the state.

• Board of Commissioners - the governing body of the Joint Commission.

• CAMTS - Commission of Accreditation of Medical Transport Systems.

• CAP The College of American Pathologists is the mission of CAP, the principal organization of board-certified pathologists, is to represent the interests of patients, the public, and pathologists by fostering excellence in the practice of pathology and laboratory medicine worldwide.

• Capitation - a method of payment to providers used in managed care.

• Carpal Tunnel Syndrome - the compression and entrapment of the median nerve where it passes through the wrist into the hand--in the carpal tunnel. The median nerve is the main nerve that extends down the arm to the hand and provides the sense of touch in the thumb, index finger, middle finger, and half of the fourth, or ring, finger.

• Case Management - monitoring and coordinating of treatment given to patients with specific diagnosis or requiring high-cost or extensive services.

• Charge Nurse - a registered or licensed practical or vocational nurse assigned to be in charge of a nursing unit.

• Chronic Care- care and treatment rendered to individuals whose health problems are of a long-term and continuing nature.

• Code Blue - a hospital's emergency call for professionals to respond to a person in cardiac arrest.

• Collimated beam - beam that is effectively parallel.

• Compliance - to accurately follow the federal government's rules on medicare billing system requirements and other regulations.

• Custodial Care- basic care provided on a 24 hour basis that meets an individual's basic physical needs; simple assistance or total care may be needed.

• Customary Charge - one of the factors determining a physician's payment for a service under Medicare.

• Deemed Status - a health care facility that participates in the Medicare/Medicaid program by virtue of its accreditation by a national accrediting organization, whose standards have been determined to be at least equivalent to those of Medicare/Medicaid.. For Medicare, the facility is deemed to meet the Medicare conditions of participation, and is not surveyed by the SA for Medicare purposes. Currently, hospitals accredited by the Joint Commission and the AOA have Adeemed status.

• de Quervain's Disease - a painful inflammation of tendons in the thumb (tenosynovitis). The result is pain at the base of the thumb which may increase with thumb and wrist motion, particularly when pinching or grasping objects. de Quervain's Disease may be caused by overuse and repetitive grasping, various workplace tasks may also aggravate the condition. Anyone can get this condition but it affects women eight to 10 times more often than men. The symptoms are pain along the back of the thumb, directly over the two thumb tendons. The condition can occur gradually or suddenly; and the pain may travel into the thumb or up the forearm.

• Department of Health and Human Services - the federal agency that oversees Medicare, Medicaid, and other federal health care programs.

• Diverging beam - beam that increases in diameter the further away it is from the aperture.

• EAP - Employee Assistance Program

• Ergonomics - is the science of fitting the job to the worker. When there is a mismatch between the physical requirements of the job and the physical capacity of the worker, work-related Musculoskeletal Disorders (MSD) can result.

• Ethylene Oxide Gas - is a colorless liquid below 51.7°F, or a gas that has an ether-like odor at concentrations above 700 parts per million (ppm) and is both flammable and highly reactive. EtO is used within central supply as a sterilant for items that can not be exposed to steam sterilization.

• Excimer laser - a pulsed ultraviolet laser in which the active medium is a short-lived molecule containing a rare gas such as xenon and a halogen such as chlorine.

• Extended Care Facility- a facility in which patients are care for after hospitalization.

• Gatekeeper - a primary care physician or his/her staff who is responsible for determining when and what services a patient can access or receive reimbursement.

• Ground-fault - a fault, or insulation failure, in the wire used to create a path to ground.

• GFCIa device that detects an insulation failure by comparing the amount of current flowing to electrical equipment with the amount of current returning from the equipment. Whenever the difference is greater than 5 milliamps, the GFCI trips and thereby interrupts the flow of electricity.

• Glutaraldehyde is a toxic chemical that is used as a cold sterilant to disinfect and clean heat-sensitive medical, surgical and dental equipment.

• HCFA - the Health Care Financing Administration (HCFA) is a federal agency within the U.S. Department of Health and Human Services. HCFA runs the Medicare and Medicaid programs.

• (HCS) - Hazard Communication Standard is based on the concept that: Employees have both a need and a right to know the hazards and the identities of the chemicals they are exposed to when working, and what protective measures are available or needed to prevent adverse effects from occurring.

• Health Care Financing Administration - an agency in the U.S. Department of Heath and Human Services which administers the Medicare and Medicaid program.

• Health Care Provider - health care professionals and institutions, including hospitals, clinics, laboratories, physicians, therapists, home health agencies, chiropractors, etc.

• HEPA - High-Efficiency Particulate Air.

• Home Care- services provided by health professional's in an individual's place of residence on a per-visit or hour basis to patients or clinics who have or are at risk of an injury, illness, or disabling conditions or who are terminally ill and require short-term or long-term interventions by health care professionals.

• Hospice - a health care facility or program for individuals dying from terminal illnesses.

• Hospital - a health care facility that has a governing body, an organized medical and professional staff, and inpatient facilities and provides medical, nursing, and related services for injured patients.

• Iatrogenic- complications, injuries or unfavorable result that are due to medical care, especially drug reactions and hospital-acquired infections.

• Informed Consent - refers to the requirement that a patient or resident be apprised of the nature, risks, and alternatives of a medical procedure or treatment before the physician or other health care professional begins any such course.

• Inpatient - a person who has been admitted at least overnight to a hospital or other health facility.

• Intermediate Care Facility - a facility which is licensed under state law to provide on a regular basis, health-related care and services to individuals who do not require the degree of care or treatment which a hospital or skilled care facility would require.

• Internship - after graduating from medical school, the first year of patient care training, to be followed by residency.

• Joint Commission on Accreditation of Healthcare Organizations (JCAHO) - an independent, not-for-profit organization dedicated to improving the quality of care in organized health care settings. The major functions of the Joint Commission include developing accreditation standards, awarding accreditation decisions, and providing education and consultation to health care organizations.

• Latex Allergy workers exposed to latex gloves and other products containing natural rubber latex may develop allergic reactions such as skin rashes; hives; nasal, eye, or sinus symptoms; asthma; and (rarely) shock.

• Long Term Care - a set of health care, personal care and social services required by persons who have lost, or never acquired, some degree of functional capacity in an institution or at home on a long-term basis.

• LPN- an individual who has completed a one year nursing program and who has passed the licensing examination for practical nurses.

• Machine Guarding machine guarding can be accomplished through the positioning of hazards so they are inaccessible to employees (i.e. provide barrier guards over dangerous equipment to prevent hazards of strangulation or amputations).

• Managed Care - an organized system of health care that encourages providers to deliver the most appropriate care in the most effective manner. Managed care plans are also known as HMOs or coordinated health plans.

• Medicaid (Title XIX) - a State/Federal medical assistance program which provides a basic set of health related services to public assistance clients of the State, and at the State's option, other needy individuals. Services may only be delivered by Medicaid approved providers and suppliers.

• Medicare (Title XVIII) - a Federal health program providing a basic set of hospital and supplemental benefits through providers and suppliers participating in the program. Benefits are payable for most people over age 65, social security disability beneficiaries under age 65, and individuals needing renal transportation at any age.

• Musculoskeletal Disorders result when there is a mismatch between the physical capacity of workers and the demands of the job. Each year thousands of workers in the United States report work related MSDs such as tendinitis, epicondylitis, carpal tunnel syndrome, and back injuries. Many of these are caused or aggravated by work related stressors such as such as lifting, reaching, pulling, pushing, and bending.

• NIOSH - The National Institute for Occupational Safety and Health is the Federal agency responsible for conducting research and making recommendations for the prevention of work-related disease and injury. The Institute is part of the (CDC).

• (NFPA) - The National Fire Protection Association is a worldwide leader in providing fire, electrical, and life safety to the public.

• Nosocomial - an infection or disease acquired in a hospital or other health care facility.

• Nurse Practitioner- a registered nurse who has received advanced training in physical examination and assessment; in some areas, the NP can diagnose and prescribe under a physician's supervision.

• Nursing Assistant- an individual who gives basic nursing care under the supervision of a registered nurse or an licensed practical nurse; also called nurse's aide, nursing attendants, health care assistant and orderly.

• Nursing Home - includes a wide range of institutions which provides various levels of maintenance and personal or nursing care to people who are unable to care for themselves and who have health problems which range from minimal to very serious.

• Nursing Team - the individuals involved in providing nursing care: registered nurses, LPNs, and nursing assistants.

• Ombudsperson or Ombudsman - a person within a managed care organization or a person outside of the health care system (such as an appointee of the state) who is designated to receive and investigate complaints from beneficiaries about quality of care, inability to access care, discrimination, and other problems that beneficiaries may experience with their managed care organization. This individual often functions as the beneficiary's advocate in pursuing grievances or complaints about denials of care or inappropriate care.

• OPIM - Other Potentially Infectious Materials - means (1) The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids; (2) Any unfixed tissue or organ (other than intact skin) from a human (living or dead); and (3) HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV-containing culture medium or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or HBV.

• Outpatient - a patient who is receiving ambulatory care at a hospital or other facility without being admitted to the facility.

• (PPE) - Personal protective equipment - is equipment employees wear that provides a protective barrier between the employee and an MSD hazard. Examples of PPE are vibration-reduction gloves and carpet layer's knee pads.

• Registered Nurse- an individual who has studied nursing for 2, 3, or 4 years and who has passed a licensing examination.

• Research Laboratory - means a laboratory producing or using research-laboratory-scale amounts of HIV or HBV. Research laboratories may produce high concentrations of HIV or HBV but not in the volume found in production facilities.

• Residency - hospital training in a specialty, consisting of two or more years following internship.

• Resident - the recipient of care from a long term care provider. In this case, the term "resident" can be used interchangeably with "client", "customer", or "patient".

• Residential Services - care given in a residential crisis bed, a respite bed, a therapeutic group home, a group home, or residential rehabilitation program.

• Rotator Cuff the four tendons that comprised the rotator cuff are the main source of stability and mobility for the shoulder. They rotate the arm inward and outward and away from the side. The tendons pass through a small opening between the humerus and the acromion. A bursa (a small fluid-filled sac) normally protects the tendons from irritation.

• Rotator Cuff Tendonitis the most common shoulder tendon disorder. Inflammation of the tendons of the rotator cuff of the shoulder, closely related to impingement syndrome. It can be caused by continuously working with the arms raised overhead, repeated throwing actions, or other repetitive movements of the arm.

• Safer Needle Devices or Sharps with engineered sharps injury protections means a non needle sharp or a needle device used for withdrawing body fluids, accessing a vein or artery, or administering medications or other fluids, with a built-in safety feature or mechanism that effectively reduces the risk of an exposure incident.

• Sharpscontaminated Sharps means any contaminated object that can penetrate the skin including, but not limited to, needles, scalpels, broken glass, broken capillary tubes, and exposed ends of dental wires.

• Skilled Nursing Facility - a Medicare approved institution which is primarily engaged in providing to residents skilled nursing care and related services for residents who require medical or nursing care, or rehabilitative services for the rehabilitation of injured, disabled, or sick person, and is not primarily for the care and treatment of mental diseases.

• Sonographer - a medical professional who operates ultrasound imaging devices to produce diagnostic images.

• Sonologist - a physician skilled in diagnostic ultrasound practice and interpretation.

• Specular reflection - a mirror-like reflection.

• OSHA Technical Manual - provides technical information and guidance on occupational safety and health topics. The purpose of the manual is to assist OSHA Compliance Safety and Health Officers in hazard recognition and to provide guidance in accident prevention.

• Tendonitis tendon inflammation occurring when a muscle or tendon is repeatedly tensed from overuse or unaccustomed use.

• Tenosynovitisinflammation or injury to the synovial sheath surrounding the tendon. Usually results from excessive repetitive motion.

• Thoracic Outlet Syndrome compression of the nerves and blood vessels between the muscles of the neck and shoulder or between the first rib and clavicle. Burning, tingling, and numbness along arm, hand, and fingers. Associated with repeated reaching above shoulder level. Symptoms caused by compression of the nerves in the brachial plexus (nerves that pass into the arms from the neck) or blood vessels. Thoracic outlet syndrome can be caused by compression of the nerve by an extra rib, scar tissue from healing from an accident, or repetitive motion with the arms held overhead or extended forward. Patients may have pain in the shoulder, arm, or hand, or in all three locations. The hand pain is often most severe in the fourth and fifth fingers. The pain is aggravated by the use of the arm, and "fatigue" of the arm is often prominent.

• Triage - classification of ill or injured persons by severity of conditions, most commonly occurs in emergency room.

• Universal Precautions an approach to infection control which treats all human blood and other potentially infectious materials (OPIM), as if they were infectious for HIV and HBV or other bloodborne pathogens 29 CFR 1910.1030(b).

• UUVGI - Upper-Air Ultraviolet Germicidal Irradiation

• Waiver- approval that HCFA may grant to State Medicaid programs to exempt them from specific aspects of Title XIX, the federal Medicaid law.

• Waste Anesthetic Gases are those gases that are inadvertently released into the workplace and/or can no longer be used. They include all fugitive anesthetic gases and vapors that are released into anesthetizing and recovery locations, from equipment used in administering anesthetics under normal operating conditions, as well as those gases that leak from the anesthetic gas scavenging system, or are exhaled by the patient into the workplace environment. Waste gases are also those excess gases in the breathing circuit that are ultimately scavenged. Spills of liquid anesthetic agents also contribute to ambient levels of waste gases. Waste anesthetic gases may include N2O and vapors of potent inhaled volatile anesthetic agents such as halothane, enflurane, isoflurane, desflurane and sevoflurane.

References

Occupational safety and health Resources
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