Prevention
through Design
in Health-Care Settings
NIOSH Program Makes Strides
in Protecting Workers
BY DONNA S. HEIDEL, JAMES W. COLLINS AND ERICA J. STEWART
The persistence in the United States of a large occupational morbidity, mortality, and injury burden demonstrates the need for a more concerted effort to reduce
workplace risks than has been attempted in the past. The NIOSH
Prevention through Design initiative, or PtD, provides a vital
framework for saving lives and
preventing work-related injuries
and illnesses by applying hazard
elimination and risk minimization
methods in the design of work facilities, processes, equipment, tools
and work methods.
Although the goal of PtD is to “design
out” potential hazards rather than deal
with problems inherent in completed
systems, PtD methods can be applied to
existing processes and equipment. Eliminating hazards and minimizing risks
during the design, redesign and retrofit
of facilities, work processes and equipment may ultimately save money and,
more critically, will protect workers
(Schulte et al. 2008).
Benefits for Workers and Patients
Health care is the second-fastest-grow-ing sector of the U.S. economy, employing more than 12 million workers.
Health-care workers are exposed to infectious agents; chemical agents, including hazardous drugs and anesthetic
gases; physical agents, including ionizing radiation; ergonomic hazards associated with lifting and repetitive tasks; and
workplace violence. Health-care workers
also experience higher rates of occupational injuries and illnesses than workers
in all private industry. Recordable and
lost-time injury rates for health-care
workers in hospitals and nursing and
residential care are particularly high.
A number of initiatives provide compelling evidence that the health care and
social assistance sector presents significant opportunities for injury and illness
reduction from PtD.
Mechanical Lifting
Tests in real-world settings show that
mechanical lifting equipment, when used
as part of a safe patient handling and
movement program, significantly re-
duces musculoskeletal injuries among
health-care workers in nursing homes
and hospitals. The elements of a compre-
hensive safe patient handling and move-
ment program include:
• Ergonomic assessment for patient-
care environments
• An enthusiastic peer leader to
promote and sustain the program
• Mechanical patient lifts and reposi-
tioning aides
• Patient-care assessment protocols to
prescribe the best patient transfer
methods
• Written safe lifting policies
• Training on the proper use of patient
handling equipment
• Management support
A six-year field study conducted by
NIOSH demonstrated that a comprehen-
sive safe resident handling program sig-
nificantly reduced workers’ compensation
injury rates by 61 percent, lost workday
injury rates by 66 percent, and restricted
workdays by 38 percent (injuries attrib-
uted to resident-handling only) (Collins
et al. 2004). Additionally, the number of
workers suffering repeat injuries was
significantly reduced.
