Healthcare and Social Assistance Program

What are our priorities?

The National Institute for Occupational Safety and Health (NIOSH) Healthcare and Social Assistance (HCSA) Program works with partners in industry, labor, trade associations, professional organizations, and academia. The program focuses on these areas:

  • Reducing the negative effects of poor work organization on outcomes such as stress, anxiety, fatigue, depression, burnout, suicide, and chronic illnesses.
  • Preventing injuries from lifting, falls, sharp instruments, and a variety of physical hazards including radiation and noise.
  • Interrupting transmission of bloodborne and respiratory pathogens and drug-resistant organisms.
  • Minimizing exposure to hazardous drugs, chemicals, allergens, and other substances associated with risk for cancer, adverse reproductive outcomes, dermal diseases, and work-related asthma.
  • Reducing injuries associated with violent acts, especially among home care workers and workers in non-standard work arrangements.
What do we do?
  • Conduct surveillance for work-related deaths, injuries, diseases, and risk factors. Provide findings to the research community,employers, workers, and other stakeholders to guide research and prevention efforts.
  • Address knowledge gaps and barriers to developing effective prevention strategies. Examples include determining risk factors for disease transmission and injury mechanisms.
  • Develop and demonstrate effective methods of prevention. Make recommendations that
    can be used by professional organizations, employers, workers, and government agencies.
  • Disseminate useful prevention strategies for all HCSA workers. Reduce disparities through outreach to higher-risk, underserved, and vulnerable HCSA worker populations.
  • Seek opportunities to make workers safer and healthier by addressing hazards without negatively affecting patient care.
What have we accomplished?
  • Described risk of hospital cleaning staff pdf iconexperiencing nasal and eye irritation, wheeze, and shortness of breath following work-related exposure to a cleaning agent made up of hydrogen peroxide, peracetic acid, and acetic acid.
  • Examined the prevalence of adverse health indicators (healthcare coverage, health-related behaviors, and health outcomes) among patient care aides (PCAs) by healthcare setting. PCAs in-home health had the most adverse results for multiple metrics.
  • Assessed standardized mortality ratios for suicide among U.S. veterinarians and veterinary technicians during 2003–2014 by sex, using
    data from the National Violent Death Reporting System. See figure to the right.
  • Issued a policy briefpdf icon in partnership with the American Academy of Nursing on fatigue, sleep, and health, to help ensure both worker and patient safety.
  • Published a Morbidity and Mortality Weekly Report that detailed the characteristics of healthcare personnel (HCP) with coronavirus disease 2019 (COVID-19). Of 9,282 reported cases, the median age was 42 years and 73% were female. HCP patients reported contact with COVID-19 patients in healthcare, household, and community settings.
What’s next?
  • Characterize airborne exposures at a dental clinic following a health hazard evaluation
  • Describe the development and testing of an easy-to-use ultraviolet germicidal irradiation disinfection system that can be used on full-facepiece respirators between uses during disease pandemics.
  • Examine the association between handling of antineoplastic drugs, use of exposure controls, and risk of miscarriage among nurses.
  • Develop and disseminate online safety culture curriculum for health care workers for health science schools and organizations.
  • Support the CDC’s response to the 2019 Novel Coronavirus (COVID-19) outbreak.

Mention of any company or product does not constitute endorsement by the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention


The Healthcare and Social Assistance Program’s mission is to eliminate occupational diseases, injuries, and fatalities in industries providing human and veterinary healthcare and social assistance services across a broad range of settings such as hospitals, clinics, nursing and private homes, and child day care. This snapshot shows recent accomplishments and upcoming work.

Veterinarian suicides (n=73) identified by analysis of National Violent Death Reporting System, 2003-2014
Picture graph

Source: Witte et al. [2019] J Am Vet Med Assoc. 255(5):595-608.

Percentage of hospital cleaning staff exposed to a cleaning product containing hydrogen peroxide, peracetic acid, and acetic acid, who reported work-related symptoms in last four weeks
Percentage of hospital cleaning staff exposed

Source: NIOSH Health Hazard Evaluation Report No. 2017-0114-3357.

To learn more, visit
November 2020

Page last reviewed: October 28, 2020