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Ann N Y Acad Sci. 2006 Sep;1076:601-6.
Chemical hazards in health care: high hazard, high risk, but low protection.
McDiarmid MA.
Occupational Health Program, School of Medicine, University of Maryland, Baltimore, MD 21201, USA. mmcdiarm@medicine.umaryland.edu
It is counter-intuitive that the healthcare industry, whose mission is the care of the sick, is itself a « high-hazard » industry for the workers it employs. Possessing every hazard class, with chemical agents in the form of pharmaceuticals, sterilants, and germicidals in frequent use, this industry sector consistently demonstrates poor injury and illness statistics, among the highest in the United States, and in the European Union (EU), 34% higher than the average work-related accident rate. In both the United States and the EU, about 10% of all workers are employed in the healthcare sector, and in developing countries as well, forecasts for the increasing need of healthcare workers (HCW) suggests a large population at potential risk of health harm. The explosion of technology growth in the healthcare sector, most obvious in pharmaceutical applications, has not been accompanied by a stepped up safety program in hospitals. Where there is hazard recognition, the remedies are often voluntary, and often poorly enforced. The wrong assumption that this industry would police itself, given its presumed knowledge base, has also been found wanting. The healthcare industry is also a significant waste generator threatening the natural environment with chemical and infectious waste and products of incineration. The ILO has recommended that occupational health goals for industrial nations focus on the hazards of new technology of which pharma and biopharma products are the leaders. This unchecked growth cannot continue without a parallel commitment to the health and safety of workers encountering these « high tech » hazards. Simple strategies to improve the present state include: (a) recognizing healthcare as a « high-hazard » employment sector; (b) fortifying voluntary safety guidelines to the level of enforceable regulation; (c) « potent » inspections; (d) treating hazardous pharmaceuticals like the chemical toxicants they are; and (e) protecting HCWs at least as well as workers in other high-hazard sectors.