Proceedings of the International Commission on Occupational Health and American College of Occupational and Environmental Medicine 2007 State-of-the-Art Conference Pre-conference Workshop: protecting the health of health care workers: a global perspective, 25 Oct 2007, Vancouver, British Columbia.
Fundamental elements for the provision, organization, and establishment of occupational health and safety (OHS) services for health care workers in rural/remote areas and developing countries include adequate resources, a strong safety culture, recognition of occupational health professionals, collaborative practice, and capability for communication and local risk analysis. First, however, assessment of existing OHS services is required. Adaptable needs assessment tools designed for use by local health care workers should allow progression from analysis to action. Essential elements of these tools include utility, recognition of the surrounding political, health care, and physical environments, and clear definition of the roles and responsibilities of users to act upon findings and implement solutions. Securing adequate financial, physical, and human resources for occupational health and safety requires critical analysis of topics such as health care culture, political motivation, health care worker migration, and national and international financing. It is necessary to reshape attitudes towards valuing the health of health care workers. This includes acknowledging occupational health professional accreditation and educating health care students about OHS. It is also crucial to create awareness of workers' health among health care managers and administrators and to develop their knowledge and capability to support OHS. Resources such as the Pan American Health Organization's (PAHO) document "Workers' Health and Safety in the Health Sector: A Manual for Managers and Administrators" are valuable assets. Suggestions for collaborative practice include the formation and use of local OHS committees that involve decision makers, administrators, and health care workers. Communication strategies involve the free flow of information between policy makers, educators, employers, research laboratories, and health care workers. Mobile occupational health clinics and portable libraries are two examples of innovative methods of communication and information dissemination. Risk analyses allow occupational health practitioners to target local services to the most needed areas. Point prevalence surveys and workplace audit tools are effective methods to collect this data in remote and resource poor settings. Priorities for prevention of blood-borne and air-borne disease transmission include education and comprehensive protocols and guidelines. Adequate, up-to-date, and ongoing OHS education and training for health care workers is essential. Protocols and guidelines should direct practice and uphold internationally endorsed standards while being responsive to local realities and needs. Protocol and guideline development and implementation must also involve the multiple stakeholder groups such as infection control, public health, funders, administrators, and health care workers. Immunizations and adequate access to post exposure management are vital for secondary prevention. Information such as prevalence and incidence rates of diseases endemic to the local area, transmission patterns and trends, and population projections are necessary to make informed decisions about vaccination priorities. Adequate institutional support for post exposure prophylaxis and follow-up consultations is also vital to ensure the quality of appropriate care following work-related injuries.