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HEALTHCARE AND SOCIAL ASSISTANCE

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Inputs: Occupational Safety and Health Risks

Workers in the Healthcare and Social Assistance (HCSA) sector are potentially exposed to a wide range of health and safety hazards including infectious, chemical, and physical agents; sprains and strains associated with lifting and repetitive tasks; workplace stress, workplace violence; and risks associated with changing organization of work. Although it is possible to prevent or reduce worker exposure to these hazards, workers in the HCSA sector are experiencing higher rates of illness and injury as compared to all private industry. The information below provides data on the magnitude, distribution and trends of occupational injuries and illnesses in the HCSA sector. Special emphasis is placed on predominant injury and illness outcomes and conditions in the HCSA sector including strains and sprains, overexertion, falls on the same level, assaults and violent acts, slips and trips injuries, respiratory conditions and skin disorders. Web links to additional information is also provided. Beginning in 2006, the number of industries (i.e.., NAICS four, five and six digit levels) for which estimates were tabulated was significantly expanded.

Nonfatal Injuries and Illnesses

Of the 14 industries reporting 100,000 or more nonfatal occupational injury and illness cases in 2008, 3 of these were in the HCSA sector — general medical and surgical hospitals (NAICS 6221) with 258,200 cases, ambulatory healthcare services (NAICS 621) with 120,800 cases, and nursing care facilities (NAICS 6231) with 113,800 cases. The total number of injury and illness cases in these three healthcare subsectors or industries rank second, seventh and eighth, respectively, among all industry sectors. General medical and surgical hospitals accounted for over 4 in 10 injury and illness cases in the HCSA sector, and reported more cases than any other single industry for which estimates were tabulated in 2008. These three industries reported 100,000 or more cases for the past six years. The total recordable case incidence rate of occupational injuries and illnesses for the HCSA sector, as well as private industry, has steadily declined since 2003 (Figure 1), with a few exceptions (ambulatory healthcare services in 2006 and 2007 and social assistance in 2005. The relative rates among subsectors remained the same over this four year period, with nursing and residential care facilities and hospitals having the highest rates, about 2 to 3 times higher than private industry (Figure 1).

Nonfatal Occupational Injuries Involving Days Away from Work

In 2008, sprains and strains injuries involving days away from work accounted for 84,380 cases or 20% of all such cases in private industry (Table 2) Among subsectors, hospitals and nursing care facilities accounted for nearly three-quarters of the strains and sprains injury cases. The highest incidence rate was in nursing and residential care facilities (122.7 cases per 10,000 full-time workers), followed by hospitals (91.4). The highest incidence rate among industries was in other ambulatory healthcare services (176.0 cases per 10,000 full-time workers), followed by nursing care facilities (146.0) and community care facilities (104.3). By comparison, the incidence rate in private industry was 43.8 cases per 10,000 full-time workers. Six year (2003-2008) trend data for the number of cases and incidence rates of sprains and strains for the HCSA sector as a whole and by subsector are presented in Figure 2 and Figure 3, respectively.

In 2008, overexertion injuries involving days away from work accounted for 56,950 cases or nearly 23% of all such cases in private industry. (Table 3) Hospitals and nursing care facilities accounted for nearly three-quarters of the overexertion injury cases in the sector. The highest incidence rate among subsectors was in nursing and residential care facilities (86.0 cases per 10,000 full-time workers), followed by hospitals (60.0). The highest incidence rate among industries was in other ambulatory healthcare services (136.7 cases per 10,000 full-time workers), followed by nursing care facilities (110.8) and community care facilities (81.9). By comparison, the incidence rate in private industry was 26.4 cases per 10,000 full-time workers. Six year (2003-2008) trend data for the number of cases and incidence rates of overexertion injuries for the HCSA sector as a whole and by subsector are presented in Figure 4 and Figure 5, respectively.

Injuries due to falls on the same level involving days away from work accounted for 34,910 cases or 22% of all such cases in private industry in 2008. (Table 4) Nursing and residential care facilities and hospitals accounted for over two-thirds of the fall injury cases in the sector. The highest incidence rate among the subsectors was in nursing and residential care facilities (53.4 cases per 10,000 full-time workers), followed by hospitals (32.4). The highest incidence rate among industries was in nursing care facilities (59.9 cases per 10,000 full-time workers), followed by psychiatric and substance abuse hospitals (34.4) and general medical and surgical hospitals (32.5). By comparison, the incidence rate in private industry was 16.6 cases per 10,000 full-time workers. Six year (2003-2008) trend data for the number of cases and incidence rates of injuries from falls on same level for the HCSA sector as a whole and by subsector are presented in Figure 6 and Figure 7, respectively.

Injuries due to slips and trips (without fall) involving days away from work accounted for 6,850 cases or over 19% of all such cases in private industry in 2006. (Table 4) Hospitals and nursing and residential care facilities accounted for nearly two-thirds of the slip and trip injury cases in the sector. Nursing and residential care facilities had the highest incidence rate among the subsectors (9.6 cases per 10,000 full-time workers), followed by social assistance (7.6). The highest incidence rates among industries was in vocational rehabilitation services (21.6), followed by outpatient care centers (10.3) and individual and family services (9.2). By comparison, the incidence rate in private industry was 3.7 cases per 10,000 full-time workers. Six year (2003-2008) trend data for the number of cases and incidence rates of injuries due to slips and trips for the HCSA sector as a whole and by subsector are presented in Figure 8 and Figure 9, respectively.

In 2008, injuries due to assaults and violent acts involving days away from work accounted for 10,610 cases or over 46% of all such cases in private industry.(Table 5) Nursing and residential care facilities accounted for nearly half (47%) of the assaults and violent acts injury cases in the sector and had the highest incidence rate among the subsectors (20.8 cases per 10,000 full-time workers). The highest incidence rates among industries were in psychiatric and substance abuse hospitals (70.2), followed by other residential care facilities (59.0), and residential care facilities (45.8). By comparison, the incidence rate in private industry was 2.4 cases per 10,000 full-time workers. Six year (2003-2008) trend data for the number of cases and incidence rates of injuries due to assaults and violent acts for the HCSA sector as a whole and by subsector are presented in Figure 10 and Figure 11, respectively.

Total Nonfatal Occupational Injuries

Of the nearly 3.7 million nonfatal occupational injuries and illnesses reported by private industry in 2008, approximately 3.5 million (94.9%) were injuries. The HCSA sector accounted for 615,900 (17.5%) of the 3.5 million injury cases (Table 6). Hospitals and nursing and residential care facilities accounted for nearly three-quarters of the nonfatal occupational injuries in the sector. Nursing and residential care facilities had the highest incidence rate among the subsectors (8.0 cases per 100 full-time workers). The highest incidence rates among industries was in nursing care facilities (8.4), followed by community care facilities (8.0) and other ambulatory healthcare services (7.8). By comparison, the incidence rate in private industry was 4.0 cases per 100 full-time workers. Six year (2003-2008) trend data for the incidence rates of nonfatal injuries for the HCSA sector as a whole, by HCSA subsector, and for private industry are presented in Figure 12.

Nonfatal Occupational Injuries and Illnesses Involving Days Away from Work

Six year (2003-2008) trend data for the incidence rates of nonfatal injuries and illnesses involving days away from work for the HCSA sector as a whole, by HCSA subsector, and for the private sector are presented in Figure 13. In each of the six years, incidence rates in nursing and residential care facilities were highest of the four subsectors, followed by hospitals, social assistance, and ambulatory healthcare services. (Figure 13) During this period, the rates for nursing and residential care facilities more than doubled that of private industry while the rates in hospitals were about 40% higher. The rates in social services were essentially the same as private industry while the rates in ambulatory healthcare services were lower. Within each subsector, incidence rates have declined or leveled off over the six year period with exception of ambulatory healthcare service, which has slightly increased from 2007 to 2008.

Nonfatal Occupational Illnesses

Overall, occupational illnesses accounted for about 5% (187,400 cases) of the 3.7 million injury and illness cases reported by private industry employers in 2008. The HCSA sector accounted for more than 23% of all illness cases reported in the private sector. About half of the illness cases in this sector were reported by general medical and surgical hospitals. The incidence rate of occupational illnesses in this sector is nearly double that of private industry — 36.1 versus 19.7 cases per 10,000 full-time workers. (Table 7) Hospitals had the highest incidence rate among the subsectors (59.1 cases per 10,000 full-time workers), followed by nursing and residential care facilities (38.2 cases per 10,000 workers) and ambulatory healthcare services (22.9 cases per 10,000 workers). The highest incidence rates among industries were in other ambulatory healthcare services (79.9),specialty hospitals (78.9), and general medical and surgical hospitals (58.8). (Table 7). Six year (2003-2008) trend data for the incidence rates of nonfatal illnesses for the HCSA sector as a whole, by HCSA subsector, and for private industry are presented in Figure 14.

Nonfatal occupational skin disorders involving days away from work in the HCSA sector in 2008 accounted for 9,300 cases or nearly 26% of all such cases in private industry. (Table 8) Hospitals and ambulatory healthcare services accounted for over half of skin disorder cases in the sector. Hospitals had the highest incidence rate among the subsectors (9.3 cases per 10,000 full-time workers), followed by social assistance (5.6). The highest incidence rate among industries was in community care facilities (19.3), followed specialty hospitals (18.9), and home healthcare services (11.1). By comparison, the incidence rate in private industry was 3.8 cases per 10,000 full-time workers. Six year (2003-2008) trend data for the incidence rates of skin disorders for the HCSA sector as a whole, by HCSA subsector, and for private industry are presented in Figure 15.

Nonfatal occupational respiratory conditions involving days away from work in the HCSA sector in 2008 accounted for 5,100 cases or nearly 35% of all such cases in private industry. (Table 8) Hospitals accounted for over half of the respiratory disorder cases in the sector. Hospitals had the highest incidence rate among the subsectors (7.7 cases per 10,000 full-time workers), followed by ambulatory healthcare services (3.1). The highest incidence rate among industries was in other ambulatory healthcare facilities (10.5), followed by specialty hospitals (9.5), and general medical and surgical hospitals (7.7). By comparison, the incidence rate in private industry was 1.6 cases per 10,000 full-time workers. Six year (2003-2008) trend data for the incidence rates of respiratory conditions for the HCSA sector as a whole, by HCSA subsector, and for private industry are presented in Figure 16.

Source:BLS Workplace Injury and Illness Summary - 2008

Detailed data on nonfatal injuries and illnesses in the HCSA sector can be found at:

Fatalities

In 2008, the HCSA sector experienced 113 work-related fatalities. Nearly half (49%) of the fatalities occurred in ambulatory healthcare services, followed by hospitals (20%) and nursing and residential care services (18%). Most (52%) of the fatalities occurred as a result of highway accidents, with assaults and violent acts accounting for 25%. The number of fatalities in this sector in 2008 were two less than the number of fatalities in 2007.

Source:Fatal occupational injuries by industry and selected event or exposure, 2008

Additional BLS occupational fatality information can be found in the Census of Fatal Occupational Injuries(CFOI) and the CFOI news release.

Resources:

NIOSH Worker Health Chartbook, 2004
DHHS (NIOSH) Publication 2004-146
The Worker Health Chartbook, 2004 is a descriptive epidemiologic reference on occupational morbidity and mortality in the United States. A resource for agencies, organizations, employers, researchers, workers, and others who need to know about occupational injuries and illnesses, the Chartbook includes more than 400 figures and tables describing the magnitude, distribution, and trends of the nation's occupational injuries, illnesses, and fatalities.

For additional health and safety information on healthcare workers, please see the NIOSH Healthcare Workers topic page.

The Occupational Safety and Health Administration (OSHA)also provides technical links to numerous health and safety topics of relevance in the HCSA sector.

 

 
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  • Page last reviewed: October 31, 2012
  • Page last updated: October 31, 2012
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