Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to site content Skip directly to page options
CDC Home


Rates of musculoskeletal injuries from overexertion in healthcare occupations are among the highest of all U.S. industries.Data from the Bureau of Labor Statistics (BLS) show that in 2011, the rate of overexertion injuries averaged across all industries was 38 per 10,000 full time workers.By comparison, the overexertion injury rate for hospital workers was twice the average (76 per 10,000), the rate for nursing home workers was over three times the average (132 per 10,000), and the rate for ambulance workers was over six times the average (238 per 10,000).1The single greatest risk factor for overexertion injuries in healthcare workers is the manual lifting, moving and repositioning of patients, residents or clients, i.e., manual patient handling.

Most of the patient handling which occurs in health care settings is performed by nurses and support staff such as nursing aides and orderlies.The most recent data available from the BLS (2010) show that within the health care industry, workers in these occupations suffered the most lost-time cases of general musculoskeletal pain (11,960) and back pain (4,700).2

Nurse using mechanical aid to lift patient

Rising obesity rates in the United States3 increase the physical demands on caregivers, and the aging of the workforce likely contributes to the problem; recent data indicate that the average age of a registered nurse in the U.S. is approximately 44 years. Nursing work demands have also been strained by an ongoing shortage of nurses which is projected to reach 260,000 unfilled nursing positions by the year 2025 in the US.4

Occupational safety and health programs have fostered research to identify injury risk factors and safety interventions to prevent injuries during patient handling.Evidence-based research has shown that safe patient handling interventions can significantly reduce overexertion injuries by replacing manual patient handling with safer methods guided by the principles of “Ergonomics.” Ergonomics refers to the design of work tasks to best suit the capabilities of workers.In the case of patient handling, it involves the use of mechanical equipment and safety procedures to lift and move patients so that health care workers can avoid using manual exertions and thereby reduce their risk of injury.At the same time, patient handling ergonomics seeks to maximize the safety and comfort of patients during handling.This web page contains links to multiple resources for further information on safe patient handling.


1 BLS Table R8. Incidence rates for nonfatal occupational injuries and illnesses involving days away from work per 10,000 full-time workers by industry and selected events or exposures leading to injury or illness, private industry, 2011.

2 BLS Table R9. Number of nonfatal occupational injuries and illnesses involving days away from work by occupation and selected natures of injury or illness, private industry, 2010.

3 Flegal, KM, Carroll, MD, Ogden, CL, Curtin, LR.[2010] Prevalence and Trends in Obesity Among US Adults, 1999-2008 JAMA. 2010;303(3):235-241

4 Buerhaus, PI, Auerbach, DI, Staiger, DO, [2009] The Recent Surge In Nurse Employment: Causes and Implications, Health Affairs July/August 2009 vol. 28 no. 4 w657-w668.

NIOSH Health Care and Social Assistance Program (HCSA) and the National Occupational Research Agenda (NORA)

“Healthcare and Social Assistance” (HCSA) is one of many occupational sectors studied by U.S. federal agencies such as the Bureau of Labor Statistics (BLS), The Occupational Safety and Health Administration (OSHA), and the National Institute for Occupational Safety and Health (NIOSH).Guided by NORA-identified research priorities, the mission of the NIOSH HCSA research program is to eliminate occupational diseases, injuries, and fatalities among workers in this sector.Much of this research focuses on safe patient handling.

Collaboration among partners in government, industry, and academia has provided a great deal of information on safe patient handling through publications, conferences, and safety training programs.To date, most of the research has focused on the handling of “average-sized” patients in institutional settings such as hospitals and nursing homes. Continued research in these and other settings such as home health care and emergency response, and with obese and morbidly obese (“bariatric”) patients is needed.The research-based evidence gathered thus far has led to the development of safe patient handling standards, and ongoing legislation to enact laws requiring or promoting the use of safe patient handling programs in health care settings.

You can use the links and references shown below to find more information on publications, injury data networking, conferences, training programs, standards, and legislation on safe patient handling.

NIOSH Publications

Safe Lifting and Movement of Nursing Home Residents
DHHS (NIOSH) Publication Number 2006-117 (February 2006)

State of the Sector Healthcare and Social Assistance Identification of Research Opportunities for the Next Decade of NORA
Chapter 11: Musculoskeletal Disorders and Ergonomic Issues
DHHS (NIOSH) Publication No. 2009-139 (June 2009)

NIOSH Hazard Review: Occupational Hazards in Home Healthcare
Chapter 2: Musculoskeletal Disorders and Ergonomic Interventions
DHHS (NIOSH) Publication No. 2010-125 (January 2010)

Safe Patient Handling Training for Schools of Nursing
DHHS (NIOSH) Publication No. 2009-127 (March 2010)

NIOSH fast facts: home healthcare workers - how to prevent musculoskeletal disorders.
DHHS (NIOSH) Publication Number 2012-120 (February 2012)


NIOSHTIC-2 is a searchable bibliographic database of occupational safety and health publications, documents, grant reports, and journal articles supported in whole or in part by NIOSH.

View search results on Safe Patient Handling

NIOSH Blogs about Safe Patient Handling

Prevention of Back Injuries in Healthcare Settings

Strains, Sprains and Pains in Home Healthcare: Working in an Uncontrolled Environment

NIOSH Occupational Health Safety Network (OHSN)

The OHSN is a secure electronic surveillance system designed to promote analysis and benchmarking of existing occupational health data to prevent injury and illness among healthcare workers. Occupational health staff and workplace safety managers can use OHSN Tools to convert data to OHSN format, then upload without worker identifiers to the secure web portal. Current modules focus on traumatic injuries among healthcare workers including musculoskeletal injuries from patient handling events; slips, trips, and falls; and workplace violence.

Other Resources

American Association for Safe Patient Handling and Movement

American Journal of Safe Patient Handling & Movement (SPHM)

American Nurses Association (ANA) Safe Patient Handling and Mobility

Association of Safe Patient Handling Professionals

Occupational Safety and Health Administration (OSHA) Worker Safety in Hospitals: Safe Patient Handling

Occupational Safety and Health Administration (OSHA) Ergonomics: Guidelines for Nursing Homes

Safe Lifting Portal

Safe Patient Handling in Washington State

U.S. Department of Veterans Affairs Safe Patient Handling Program

Work Injured Nurses Group (WING USA)

Upcoming Conferences

2016 Safe Patient Handling and Mobility
Reaching for Excellence in Safe Patient Handling and Mobility
with a Track on Falls, Pressure Ulcers and Mobility
April 11-15, 2016
Renaissance Hotel, Glendale, AZ

National Safe Patient Handling Standards

One of the goals established by the NORA Healthcare and Social Assistance (HCSA) Sector Council was for organizations to establish national standards to guide a reduction in musculoskeletal disorders in healthcare workers. The American Nurses Association (ANA) facilitated this effort with several Council members and other interprofessional national subject matter experts, reaching across the continuum of care. On June 26, 2013, ANA released Safe Patient Handling and Mobility Interprofessional National Standards . For more information about the NORA HCSA Sector Council’s involvement in this and other activities, contact the NORA coordinator at

Safe Patient Handling Legislation in the USA

Safe patient handling legislation has been introduced in numerous states and at the federal level.

At the state level, the following safe patient handling laws have been enacted:

  • California Labor Code Section 6403.5 signed into law On October 7, 2011
  • Illinois Public Act 97-0122 signed into law on July 30, 2011
  • New Jersey S-1758/A-3028 signed into law January 2008
  • Minnesota HB 712.2 signed into law May 2007
  • Maryland SB 879 signed into law April 2007
  • Rhode Island House 7386 and Senate 2760, passed on July 7, 2006
  • Hawaii House Concurrent Resolution No. 16 passed on April 24, 2006
  • Washington House Bill 1672 signed into law on March 22, 2006
  • Ohio House Bill 67, Section 4121.48 signed into law on March 21, 2006
  • New York companion bills A11484, A07836, S05116, and S08358 signed into law on October 18, 2005
  • Texas Senate Bill 1525 signed into law on June 17, 2005

To date, no federal safe patient handling law has yet been enacted. The most recently introduced federal bill is the Nurse and Health Care Worker Protection Act of 2015 (H.R.4266 and S.2408).

Contact Us:
  • Page last reviewed: August 2, 2013
  • Page last updated: January 13, 2016 The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Rd. Atlanta, GA 30329-4027, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC-INFO