Health and Safety Practices Survey of Healthcare Workers

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How the study was done

Here, you will learn how we collected information from healthcare workers and the overall strengths and limitations of the survey.  

How information was collected

Twenty-one healthcare professional practice organizations collaborated with NIOSH to develop and implement the anonymous, multi-module, internet-based survey. Members from these organizations, representing healthcare occupations that routinely use or come in contact with selected hazardous chemicals and drugs, were asked to complete the survey. The survey included a screening module, seven hazard modules (see below) and a core module. The core module collected demographic, occupation and employer characteristics of respondents and issues relevant to all of the occupations studied. Respondents were eligible to complete the survey if they indicated in the screening module that they used/came in contact with any of the chemical hazards in the seven days prior to the survey. The survey was programmed to present, based on screening questions, the most relevant hazard module first, then the core module, followed by a second hazard module, if indicated.

The seven hazard modules addressed the following chemical hazards:

  • Aerosolized medications (three submodules: antibiotics amikacin, colistin and tobramycin; pentamidine; ribavirin)
  • Anesthetic gases
  • Antineoplastic drugs, compounding
  • Antineoplastic drugs, administration
  • Chemical sterilants
  • High-level disinfectants
  • Surgical smoke (two submodules: laser surgery; electrosurgery)  

The hazard modules gathered information on:

  • How often and how long respondents worked with the chemical(s) during the past week
  • Training on safe handling precautions
  • Availability of safe handling procedures
  • Use of engineering and administrative controls
  • Use of personal protective equipment (PPE) and barriers to PPE use, if applicable
  • Spills and availability of spill kits, if applicable
  • Medical surveillance programs and exposure monitoring, if applicable

Strengths of the survey

This survey represents the largest federally sponsored survey addressing chemical hazards in healthcare. Participants represented a wide range of professional, technical and support occupations. Overall, survey participants completed over 18,000 chemical hazard modules/submodules and nearly 11,000 completed the core module. Longstanding practices such as cognitive and pilot testing of the survey instrument were used in the development and implementation of the web-based survey. The survey provides valuable information regarding adherence to best practices, as well as barriers to using PPE and other exposure controls. Identification of barriers to using best practices is expected to foster additional research on approaches to overcoming these barriers.

Limitations of the survey

Because the survey was not a probability sample, the findings are not generalizable to all healthcare workers who use the targeted chemicals. Nonetheless, the findings from this survey provide valuable insight on self-reported adherence to best practices including use of exposure controls and impediments to their use. The findings are also expected to help NIOSH, partners, employers and healthcare workers to better understand current health and safety practices relative to working with hazardous chemicals, identify gaps in what we know about those practices, and guide research to address those gaps.

Additional information

You may find more detailed information on the methods usedExternal to

  • Identify professional practice organizations
  • Develop and perform cognitive testing on survey questions and instructions
  • Develop and test the functionality of the web survey instrument
  • Implement the online survey
Page last reviewed: March 14, 2017