Needlesticks and infectious diseases are hazards to which large numbers of health care workers are exposed.

NORA Panel Outlines Health Care Agenda

The next decade of NIOSH's research for the fastest-growing, most diverse sector of the U.S. economy should tackle big, persistent hazards: lifting, chemicals, diseases, stress, and violence in facilities and nonhospital settings, including home care.

NIOSH has posted the executive summary and the full text of a "State of the Sector" document focused on health care and social assistance (HCSA). This is a huge segment of the U.S. economy: about 17 million workers, 11 percent of the U.S. workforce overall, with 80 percent of them working in health care. Twelve of the 20 fastest-growing U.S. occupations through 2014 are in health care, and its proportion of women and minority workers is unmatched by any other sector, according to the summary. The sector's need for effective solutions to persistent health and security problems is also high.

Part of NIOSH's updated National Occupational Research Agenda (NORA), this document was prepared by experts and stakeholders on the NORA HCSA Sector Council who looked at today's problems and trends. They cited the 668,000 nonfatal occupational injuries and illnesses among health care and social assistance workers in 2005. Nursing aides, orderlies and attendants, and registered nurses that yea accounted for more than 30 percent of all lost-time occupational injuries and illnesses, the document states.

A concrete example of a key research need identified in the text is research to resolve the controversy over fit testing of respirators for health workers -- a topic of immediate concern because of the imminent North American flu season. Health care workers are not accustomed to wearing fit-tested respiratory protection and don't welcome it; the executive summary observes that HCSA "is burdened by the historical and entrenched belief that patient care issues supersede the personal safety and health of workers and that it is acceptable for HCSA workers to have less than optimal protections against the risks of hazardous exposures or injuries. Because patients and providers share the healthcare environment," it adds, "efforts to protect patients and providers can be complementary, even synergistic, when pursued through a comprehensive, integrated approach."

The document lists these opportunities for research: safety culture and climate, the business case for managing safety and health, work organization, public health emergencies/mass casualty events, Prevention through Design, the HCSA environment, shortages of nurses and other professionals, and occupational health surveillance.

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