Compliance and determinants of infection prevention and control practices among sanitary workers in public hospitals, Eastern Ethiopia: A cross-sectional study

Background

Best practice of infection prevention and control (IPC) is a hallmark for the patient care in health care settings, but it is a major problem in developing countries like Ethiopia where resources are limited. Ethiopia Federal Ministry of Health working to strengthen its IPC program, but still it there is no organized study conducted on assessment of performance gaps and implementation challenges of IPC practice faced by hospital staffs particularly among sanitary workers (SWs) at public hospitals inline to national and international guidelines.

Aim

This study focuses on compliance and determinants of IPC among sanitary worker in public hospitals in eastern Ethiopia: A cross sectional study design.

Method

A cross-sectional study was conducted among 809 SWs and eight IPC experts in public hospitals, eastern Ethiopia, from May to August 2023. A standard questionnaire was used to collect data. Face-to-face interview was conducted. Ten (10) question pursued to answer YES/NO were prepared. The cut point for categories of IPC practice was 1: Good (16-20 scores), 2: Fair (10-15 scores), and 3: Poor (<10 scores). The cut point for compliance and noncompliance of IPC practice among hospitals was mean (500.1). Multi-level ordinal logistic regression models was applied to explore the association of dependent and independent variables at individual level (Model 1), hospital level (Model 2) and at both (Model 3). Crude odds ratio (COR) and adjusted odds ratio (AOR) at 95% confidence interval (CI) were used to report the result.

Result

The compliance of IPC practice among SWs was 36.21% (32.72, 39.82%). The Multilevel ordinal logistic regression model shows that SWs who have good knowledge of IPC trend (AOR: 4.70, 95% CI: 2.11-10.46), SWs who are not addictive with alcohol (AOR: 2.35, 95% CI: 1.15,4.78) and chew Khat (AOR: 1.62, 95% CI: 1.06,2.46) and smoke cigarette (AOR: 3.15, 95% CI: 2.35-5.41), and SWs without job stress (AOR: 1.46, 95% CI: 0.86-2.48) were more compliant to IPC practice. Similarly, those who do not have workload (AOR: 2.74, 95% CI: 1.56-4.82), work <8 h/day (AOR: 1.46, 95% CI: 0.92-2.30), and those who have good social recognition in hospitals (AOR: 6.08, 95% CI: 4.24-8.71) were more likely to increase the compliance of IPC practice among SWs. The multilevel random-effect model revealed 93.71% of the variability of compliance of IPC practice explained by both individual and hospital level factors.

Conclusion

The overall study found that inadequate IPC practice was reported among SWs as well as by IPC experts due to poor knowledge of IPC trend and individual behaviors and working environment. Thus, the study advised that hospitals have to develop and establish IPC implementation guidelines in order to solve the concerns among these groups; national IPC office should follow its implementation across health care settings particularly at public hospitals.

Prevalence, response and associated factors of needlestick injury among health care workers in Orotta National Referral Hospital, Eritrea

BACKGROUND

Healthcare workers are at risk of occupational exposure to blood and other body fluids after sustaining needlestick injury which constitutes a risk for transmission of blood-borne pathogens such as Hepatitis B virus, Hepatitis C virus or Human Immune-deficiency Virus.

OBJECTIVES

To assess the prevalence, response, and associated factors of needlestick injury by medical sharps among healthcare workers in Orotta National Referral Hospital, Asmara, Eritrea.

METHODS

Cross sectional study was conducted between September and December 2017 among healthcare workers. This was a census study whereby a total of 383 healthcare workers who had contact with sharp medical equipment were taken as study population. An aided self-administered questionnaire, checklist and key informant interviews were used as data collection tools. Analysis was done using Statistical Package for Social Sciences, version 22. Bivariate and binary logistic regression analyses were carried out and the level of significance was set at P < .05.

RESULTS

The prevalence of needlestick injury 12 months preceding the study was 37.1% (134/361). Midwives had the highest occurrence (45%) among others while adult intensive care unit were found to have higher prevalence of needlestick injury (61.5%) as compared to the other sections. As an immediate response to needlestick injury, only 15.7% washed the injured part with soap and water. The factors associated with needlestick injury include age > 40 years (AOR = .314, p = .05), marital status (married (AOR = 0.595, p = .05)), additional duty that made healthcare workers rush during working hours (AOR = 2.134, p = .002) and back bone problem (AOR = 2.239, p = .002).

CONCLUSION

The overall finding of the study indicated that there was a great risk of contracting blood-borne infections among the healthcare workers especially midwives. Therefore, there is need for adequate supply of safety engineered devices, Hepatitis B vaccine, better reporting, and surveillance of needlestick injury cases at the hospital. Moreover, further research on assessment of the knowledge, attitude, and practice of healthcare workers toward occupational safety and health, particularly needlestick injury, is necessary.

Magnitude and associated factors of occupational hazard exposures among sanitary workers: Propose RASM model for risk mitigation for the public hospitals, eastern Ethiopia

BACKGROUND

Hospital sanitation workers (SWs) are exposed to numerous occupational hazards due to workplace conditions such as unsafe and unhygienic working environment in the hospitals. Therefore, knowing magnitude, types and source of occupational hazard exposures with their determinants are very significant for further mitigations.

METHODS

Hospital based cross-sectional study design was conducted in public hospitals, eastern Ethiopia from 1st May to August 30th, 2023. 809 SWs participated. Data was entered into Epi Data Version 3.1 and Stata 17MP version used for analysis. Descriptive analysis was applied to describe the data. While, multilevel logistic regression was explored to determine the association between outcome and independents among at individual level (model 1), at hospitals (model 2) and combination of the two (model 3). The crude odds ratio (COR) and adjusted odds ratio (AOR) for models 2 and 3 were reported. Variables with an AOR with a 95% confidence interval (CI) at a p-value < 0.05 were reported.

RESULT

Out of 809 SWs, 729 (90.11%) responded. The overall magnitude of self-reported occupational hazard exposures among SWs was 63.65% (95% CI 0.60-0.67). Of this, biological, chemical, and ergonomic hazards accounted for 82.44%, 74.76%, and 70.92%, respectively. The multilevel logistic regression shows that having social recognition (AOR: 0.37, 95% CI 0.14, 0.91), neutral attitude (AOR: 0.48, 95% CI 0.17, 1.41) as compared to negative attitude. The model also found that SWs those supervised could reduce the likelihood of occupational hazard exposures by 50% times (AOR: 0.50, 95% CI 0.18, 1.38) as compared to non-supervised SWs. The final model predicted the variation of occupational hazard exposures among sanitary workers from the hospitals to hospitals was 26.59%.

CONCLUSIONS

The concluded that hospital sanitary workers are facing biological, chemical, ergonomic, physical, psychological, mechanical, and electrical hazards. This study's findings predicted that dissatisfied with their environment, working more than 8 hr per a day,  a negative attitude towards workplace risks and inadequate supervision may serve as contributing factors for the likelihood of occupational hazard exposures among these groups. Thus, the study suggested that hospitals could reduce these hazard risks if they implement the Risk Assessment and Safety Management (RASM) model, which includes multi-modal strategies, indicators and tripartite philosophy.

Occupational exposure to chemical substances and health outcomes among hospital environmental services workers: A scoping review of international studies

Environmental services (EVS) workers are essential to preventing the spread of disease in hospitals. However, their exposure to hazardous chemicals and drugs is understudied. This scoping review will synthesize literature on hazardous chemical exposures and adverse health outcomes among EVS workers to identify research gaps and trends for further investigation. The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure complete and accurate reporting. The scoping review included 25 studies on occupational exposure to chemicals among EVS workers in hospitals. Most studies focused on exposure to cleaning products, which led to dermal, respiratory, and ocular symptoms, oxidative stress, and inflammation. While personal protective equipment (PPE), training, education, and policies have the potential to enhance safety, further research is required to examine the long-term impacts of exposure and the cost-effectiveness of interventions. Future studies should utilize longitudinal approaches and self-reported data collection methods, such as diaries and interviews, to comprehensively assess exposure risks and develop effective interventions and policies. Future research is needed to understand the potential health risks faced by EVS workers from exposure to chemicals in hospitals. Longitudinal studies with objective exposure assessments and larger sample sizes should be conducted. Policies and interventions must be developed and implemented to improve safe work practices and reduce negative health outcomes.

The Prevalence of Occupational Accidents and the Associated Factors Among Janitorial Staff at a University Teaching Hospital in South Ethiopia

Background

The healthcare industry is widely regarded as a high-risk environment for workers' occupational health and safety. As a result, healthcare workers are constantly exposed to a wide range of hazards, including biological, chemical, physical, ergonomic, and psychosocial hazards. Consequently, janitorial staff are the most vulnerable section of the healthcare workforce to occupational injuries when compared to others due to the nature of their work. Therefore, this study aims at assessing the magnitude of occupational accidents and associated factors among Janitorial staff at Dilla University Teaching Hospital.

Methods

This cross-sectional institutional-based study was conducted from August to September 2022 at a University Teaching Hospital in South Ethiopia. A total of 105 janitorial staff were included in the study with a response rate of 93.8%. The data were collected using a structured interviewer-administered questionnaire. Data were entered using Epi Info version 7.2.5 and exported to IBM SPSS statistics 22 for further cleaning and analysis. The binary logistic regression model was used to identify predictors of occupational accidents and variables with a p-value of <0.05 during the multivariable analysis were considered statistically significant.

Results

The prevalence of occupational accidents is 61% (95% CI: 51.4, 70.5). Of the total study participants, 52 (45.5%) and 33 (31.4%) of the participants had reported that they have experienced chemical splash and needle stick injury, respectively. The age of participants was one of the factors for occupational accidents. The participants who did not receive training were 3 times [AOR=2.9, 95% CI (1.04, 8.02)] more likely exposed. Having good practice was protective against occupational injuries.

Conclusion

The study highlights the high prevalence of occupational accidents, particularly chemical splashes, and needle stick injuries, among janitors in the study settings. The study emphasizes the importance of age, training, awareness, and adherence to infection prevention and control strategies as factors influencing the likelihood of experiencing occupational injuries.

The effectiveness of simulation-based training on KAU hospital housekeeping staff performance

BACKGROUND

Hospital Housekeeping staff play a key role in maintaining safe and clean environments to prevent infection and its spread in hospital. Innovative training approaches are necessary for this category; especially since their educational level is below average. Simulation based training can be a valuable tool for them in health care sector. However, no studies have explored the impact of simulation-based training on housekeeping staff performance, which is the focus of this study.

OBJECTIVE

This research focuses on exploring the effectiveness of simulation-based training for Hospital Housekeeping Staff.

METHODS

The study used pre-post training data from 124 housekeeping staff in different work areas at KAUH to measure the effectiveness of the program on their performance. The training includes five segments: General Knowledge training, Personal Protective Equipment, Hand Hygiene, Cleaning Biological Materials, and Terminal Cleaning. The study incorporated a two-sample paired T-test, One-Way ANOVA to detect differences in mean performance pre-and post-training and between groups in terms of gender and work area.

RESULTS

Study results show a significant improvement in housekeeping staff performance after the training, where the performance measure of GK was improved by 33%, PPE 42%, HH 53%, Biological Spill Kit is 64%, and terminal cleaning 11% However, there is no significant difference in performance improvements in all stations in regards of gender and work area except for the Biological Spill Kit in terms of the work area.

CONCLUSION

Results show the effectiveness of training as there are statistically significant differences in housekeeping staff mean performance pre-and post-training. The simulation-based training changed the behavior of the cleaners, as they became more confident and understanding in performing their work. Expanding the use of simulation as a basis for training this important group and further study is recommended.

Determinants of Occupational Health and Safety Outcomes Among Sanitation Workers Across Worldwide: A Systematic Review on Cross-Sectional Studies

As a result of working conditions, a variety of determinants or risk factors lead to the development of occupational health and safety impairments or outcomes such as injuries and musculoskeletal disorders among sanitary personnel, which must be identified in order to anticipate concerns. PubMed, Medline, Embase, and Lilacs databases were used from 2010 to April 2022. Searched strategies used logical words "AND/OR": Occupational *OR Work AND Injuries OR Musculoskeletal Disorder AND Associated Factors [Socio-demographic *OR Behavioral factors *OR Institution Factors *OR Work pattern] AND Sanitary workers [Waste collectors and emptier *OR Street Sweepers *OR Sewage workers *OR Health facilities Cleaners] AND Cross-Sectional Studies. The databases and other collected data and reports yielded a total of 86 studies and finally 16 studies were included. From total of sanitary workers (5833), 4990 (85.5%) were solid waste collectors, and 618 (10.6%) and 225 (3.9%) were and healthcare cleaners and street sweepers, respectively. Regarding associated factors, Age (OR: 22.57, 7.29-69.88); education (OR: 2.22, 1.22-4.00); and experience (OR: 1.92, 1.11-3.31) were predictors for occurrence of injuries. Smoking cigarettes (OR:2.6, 1.55-4.34); sleeping disturbance (OR: 2.57, 1.48-4.47); eating/smoking/drinking at work (OR: 3.85, 1.34-11.06); and lack of personal protective equipment (OR: 2.62; 1.48-4.63) are the other predictors. On other side, Education (OR: 6.73, 1.92-23.51), age (OR: 7.56, 2.18-26.18), and job experience (OR: 10.79, 3.49-33.38) are socio-demographic variables that impact the development of MSDs. Cigarette smoking (OR: 0.14, 0.03-0.64) and job satisfaction (OR: 11.43, 2.04-64.08) are behavioral factors. While, working longer than 8 h (OR: 3.5, 1.543-8.204) and time pressure (OR: 3.25, 1.08-9.77), working for more than 2 h (OR: 8, 2.25; 28.85) and having a bad back (OR: 15.7, 6.47-38.18) were risk factors for MSDs where all P-value < .05. According to current reviewed evidence, socio-demographic indicators, occupational safety with work pattern features, and behavioral factors all significantly contributed to musculoskeletal disorders; occupational injuries among sanitation workers, which require emphasis from government policy and other initiatives.

Cleaning in the 21st Century: The musculoskeletal disorders associated with the centuries-old occupation - A literature review

Workers performing cleaning duties experience higher injury rates, especially in the form of musculoskeletal disorders (MSDs), than other industries. It is essential to understand the inherent risks associated with the nature of this occupation. Based on the Balance Theory (Smith & Carayon-Sainfort, 1989), this review surveys the current literature, especially those published since the previous review paper (Kumar & Kumar, 2008), and identifies which elements contributing to MSD risks were examined: task, technology, organization, environment, individual, and their interactions. Thirty-nine research papers published between 2005 and 2021 are identified and summarized. Among these papers, task and individual elements received the most attention, at 42 and 34 occurrences, respectively. The interaction elements of technology-organization, technology-environment, and organization-environment received less than three mentions. The goal of this literature review is to update the knowledge base and identify current trends for the cleaning occupation. Possible interventions for risk reduction and future research directions are suggested.

Work-related injury burden, workers' compensation claim filing, and barriers: Results from a statewide survey of janitors

BACKGROUND

Janitors are a low-wage, ethnically and linguistically diverse, hard-to-reach population of workers with a high burden of occupational injury and illness.

METHODS

Data from an extensive multimodal (mail, phone, web) survey of janitors in Washington State were analyzed to characterize their working conditions and occupational health experiences. The survey included questions on demographics, work organization and tasks, health and safety topics, and discrimination and harassment. The survey was administered in eight languages.

RESULTS

There were 620 complete interviews. The majority completed the survey by mail (62.6%), and in English (85.8%). More than half of responding janitors were female (56.9%), and the mean age was 45 years. Twenty percent reported having a (health-care-provider diagnosed) work-related injury or illness (WRII) in the past twelve months. Women and janitors who were Latino had significantly higher relative risk of WRII. Increased risk was also associated with several work organization factors that may indicate poor working conditions, insufficient sleep, and possible depression. Half of injured janitors did not file workers' compensation (WC) claims.

CONCLUSIONS

Janitors reported a high percentage of WRII, which exceeded previously published estimates from Washington State. Women and Latino janitors had significantly increased risk of WRII, and janitors' working conditions may influence the unequal distribution of risk. WRII surveillance via WC or medical care usage in janitors and other low-wage occupations may reflect substantial underreporting. Characterizing the nature of janitors' work experience can help identify avenues for prevention, intervention, and policy changes to protect the health and safety of janitors.

Risk factors for occupational injuries in schools among educators and support staff

INTRODUCTION

School districts employ a large number of employees who work in educational (e.g., teachers) or other support roles, including educational assistants, custodians, food service, bus drivers, and community and recreation workers. District employees perform a wide array of job tasks and experience a wide spectrum of work-related risks and injuries.

METHODS

Workers' compensation data were coupled with Minnesota Department of Education district employee denominator data to evaluate risk factors for injury and severity. Variables included district location and type, employee job classification, age, and gender. Rates of injury and rate ratios were calculated to measure comparative injury risk using negative binomial regression and 95% confidence internals. Incidence and frequency of injury cause, nature, and body part we calculated.

RESULTS

Saint Paul and Minneapolis metropolitan area (versus non-metro) districts had higher risk (RR = 1.35, 95%CI = 1.18-1.54) of employee injuries. All job classifications in support roles had increased risk of injury claims versus educators, however food service (RR = 5.14, 95%CI = 4.61-5.74), custodial (RR = 3.85, 95%CI = 3.41-4.34), and transportation (RR = 4.15, 95%CI = 3.38-5.10) exhibited the highest comparative risk to educators; significant risk of lost-time injury was also present in these workers. Males and females had similar risk of injury for all claims, however males had elevated risk of lost-time injury (RR = 1.46, 95%CI = 1.26-1.69) versus females. All age groups >41-years-old exhibited increased risk of injury as compared to 31-40-year-olds. The magnitude of lost-time injury risk also increased with age. Falls and slips (29.1%), strains/sprains/ruptures (45.2%), and upper extremities (31.3%) most frequent cause, nature, and body part injured, respectively.

CONCLUSIONS

Characteristics of districts, schools, workers, and their jobs tasks and hazards vary. Many categories of support staff in schools have elevated risk of injury, including lost-time injury, as compared to educators. Practical Applications: Injury prevention in schools should be approached by targeting job classifications; high risk jobs can be prioritized for prevention.

Using Behavioral Risk Factor Surveillance System Data as an Occupational Health Profile: Washington State Janitors, 2011 to 2017

OBJECTIVE

Janitorial workers have a high burden of occupational injury and illness, but little information exists on their overall health.

METHODS

Data from the Washington State Behavioral Risk Factor Surveillance System (BRFSS) were analyzed to characterize the working population of Janitors in Washington State from 2011 to 2017 (n = 490) as compared with all other workers (n = 38,885).

RESULTS

Compared with other workers, Janitors were significantly more diverse, had lower socioeconomic status, and reported poorer general health and higher rates of arthritis and depression. Janitors were less likely to have adequate sleep, health insurance, and access to technology. Janitors reported higher rates of smoking and marijuana use.

CONCLUSIONS

Multiple risk factors compound the vulnerability of Janitors. BRFSS data can be used to characterize the health of occupational groups. Identifying overall health needs can better inform policy and help formulate strategies to improve workers' health.

Prevalence and Associated Factors of Musculoskeletal Disorders Among Cleaners Working at Mekelle University, Ethiopia

Background

Musculoskeletal disorder is a common cause of morbidity, disability, and poor quality-of-life. Its burden among cleaners in developed countries ranges from 56–90%. However, there are a lack of studies in developing countries, particularly in the study area. Thus, the result of this study will help to resolve health problems caused by musculoskeletal disorders among cleaners.

Purpose

The objective of this study was to identify the prevalence and associated factors of musculoskeletal disorders among cleaners working at Mekelle University.

Materials and Methods

An institutional-based cross-sectional study was conducted on 270 cleaners. Simple random sampling was used to select the study participants. Data were collected through interview using the standard Nordic Musculoskeletal Questionnaire. Descriptive statistics and bivariate logistic regression were done to identify factors associated with musculoskeletal disorder. In bivariate logistic regression analysis, variables with a P-value<0.25 were modeled to multivariate analysis. Variables with a P-value≤0.05 with 95% confidence interval (CI) in multivariate model were taken as statistically significant. Finally, AOR with 95% CI at a P-value<0.05 was reported.

Results

This study found that the prevalence of musculoskeletal disorders among cleaners was 52.3% in the past 12 months and 31.8% in the last 7 days. Time pressure (AOR=3.25, 95% CI=1.08–9.77), work experience (AOR=2.49, 95% CI=1.12–5.52), feeling exhausted (AOR=2.68, 95% CI=1.16–6.20), working hours per day (AOR=3.55, 95% CI=1.54–8.20), awkward posture (AOR=15.71, 95% CI=6.47–38.17), and those who work more than 2 hours in sustaining position (AOR=8.05, 95% CI=2.25–28.85) showed a statistically significant association with musculoskeletal disorder.

Conclusion

Musculoskeletal disorders were commonly reported among cleaners working at Mekelle University. Time pressure, work experience, feeling exhausted, working hours per day, awkward posture, and working >2 hours in sustaining position were statistically significant in their association with musculoskeletal disorders.

Work experiences of Latino building cleaners: An exploratory study

BACKGROUND

There are roughly 3.8 million cleaning workers in the United States. The cleaning workforce is largely composed of women, immigrants, and ethnic minorities who receive low wages and have low education levels. They are exposed to physical, chemical, biological, and psychosocial hazards.

METHODS

Qualitative methodology was used to investigate how Latino immigrants experience work as building cleaners. A grounded theory coding approach was used to analyze focus group data from 77 participants.

RESULTS

Three major themes were identified: economic vulnerability, psychosocial stressors, and health and safety effects. Although workers are aware of the safety hazards associated with their jobs, they believe their immigration status limits employment opportunities leading them to accept poor working conditions. They work through injuries and cope psychologically through minimizing negative health impacts and normalizing work-related injuries and illnesses.

CONCLUSIONS

The findings suggest that interventions for these workers should recognize the hostile organizational and psychosocial contexts within which immigrants often work.

Janitor workload and occupational injuries

BACKGROUND

This study was designed to identify potential effects of workload and sleep on injury occurrence.

METHODS

Questionnaires were disseminated to janitors in the SEIU Local 26 union; 390 responded and provided information on workload, sleep, and injury outcomes. Quantitative measurements of workload and sleep were collected via FitBit devices from a subset of 58 janitors. Regression techniques were implemented to determine risk.

RESULTS

Thirty-seven percent reported increased workload over the study period Adjusted analyses indicated a significant effect of change in workload (RR: 1.94; 95%CI: 1.40-2.70) and sleep hours (RR: 2.21; 95%CI: 1.33-3.66) on occupational injury. Among those with sleep disturbances, injury risk was greater for those with less than five, versus more than five, days of moderate to vigorous physical activity; RR: 2.77; 95%CI: 1.16-6.59).

CONCLUSIONS

Increased workload and sleep disturbances increased the risk of injury, suggesting employers should address these factors to mitigate occupational injuries.

Occupational Injury Among Janitors: Injury Incidence, Severity, and Associated Risk Factors

OBJECTIVE

Determine injury incidence and severity and potential associated risk factors for injury, among janitors.

METHODS

Questionnaires were disseminated to 1200 full-time janitors in the Service Employees International Union (SEIU) Local 26 union; 390 responded and provided information on their injury experiences and exposures, based on personal characteristics and work-related activities. Multivariable analyses, including bias adjustment, were implemented using directed acyclic graphs to determine potential risk.

RESULTS

Among the janitors, 34% reported experiencing at least one injury; 16% of cases resulted in hospital admittance. Significantly increased risks were identified for age, ethnicity, shift start time, and physician-diagnosed depression.

CONCLUSIONS

Knowledge of specific risk and protective factors is valuable, and can serve as a basis for further in-depth studies and inform the development of targeted intervention strategies aimed to reduce occurrence of these injuries.

Work-related injuries among commercial janitors in Washington State, comparisons by gender

INTRODUCTION

We analyzed workers' compensation (WC) data to identify characteristics related to workers' compensation claim outcomes among janitorial service workers in Washington State.

METHOD

We analyzed WC data from the Washington State Department of Labor & Industries (L&I) State Fund (SF) from January 1, 2003 through December 31, 2013, for janitorial service workers employed in the National Occupational Research Agenda (NORA) Services Sector. We constructed multivariable models to identify factors associated with higher medical costs and increased time lost from work.

RESULTS

There were 2,390 janitorial service compensable claims available for analysis. There were significant differences in injury type and other factors by gender, age, and language preference. Linguistic minority status was associated with longer time loss and higher median medical costs. Women were estimated to account for 35% of janitorial service workers but made up 55% of the compensable claims in this study.

CONCLUSIONS

Janitorial service workers comprise a large vulnerable occupational group in the U.S. workforce. Identifying differences by injury type and potential inequitable outcomes by gender and language is important to ensuring equal treatment in the workers' compensation process.

PRACTICAL APPLICATIONS

There were significant differences in injury and individual characteristics between men and women in this study. Women had twice the estimated rate of injury to men, and were more likely to require Spanish language materials. Improving communication for training and knowledge about the workers' compensation system appear to be high priorities in this population of injured janitorial service workers.

Hospital support services and the impacts of outsourcing on occupational health and safety

BACKGROUND

Outsourcing labor is linked to negative impacts on occupational health and safety (OHS). In British Columbia, Canada, provincial health care service providers outsource support services such as cleaners and food service workers (CFSWs) to external contractors.

OBJECTIVES

This study investigates the impact of outsourcing on the occupational health safety of hospital CFSWs through a mixed methods approach.

METHODS

Worker's compensation data for hospital CFSWs were analyzed by negative binomial and multiple linear regressions supplemented by iterative thematic analysis of telephone interviews of the same job groups.

RESULTS

Non-significant decreases in injury rates and days lost per injury were observed in outsourced CFSWs post outsourcing. Significant decreases (P < 0.05) were observed in average costs per injury for cleaners post outsourcing. Outsourced workers interviewed implied instances of underreporting workplace injuries.

CONCLUSIONS

This mixed methods study describes the impact of outsourcing on OHS of healthcare workers in British Columbia. Results will be helpful for policy-makers and workplace regulators to assess program effectiveness for outsourced workers.

Differences in the prevalence of musculoskeletal symptoms among female and male custodians

BACKGROUND

The prevalence of musculoskeletal symptoms among custodians is high. We sought to compare musculoskeletal symptoms between female and male custodians and to explore how task might affect this relationship.

METHODS

A cross-sectional study was performed among 712 custodians who completed a survey assessing upper extremity, back, and lower extremity musculoskeletal symptoms and exposure to cleaning tasks. Chi-square tests and logistic regression analyses were used to test for associations between gender, cleaning tasks, and musculoskeletal symptoms.

RESULTS

Gender was significantly (P < 0.05) associated with musculoskeletal symptoms in χ(2) tests and multivariate analyses. The prevalence ratio of symptoms among women was roughly 50% higher than men, regardless of the tasks that workers performed.

CONCLUSIONS

The prevalence of musculoskeletal symptoms differed for female and male custodians and appeared to be consistent across a range of job tasks. Am. J. Ind. Med. 59:841-852, 2016. © 2016 Wiley Periodicals, Inc.

Acute symptoms associated with chemical exposures and safe work practices among hospital and campus cleaning workers: a pilot study

BACKGROUND

Cleaning workers are regularly exposed to cleaning products containing hazardous chemicals. This study investigated acute symptoms associated with chemical exposures among cleaning workers and their safe work practices.

METHODS

This cross-sectional study included 183 cleaning workers employed in an academic medical center and affiliated health sciences campuses in Northern California. Data on respiratory, eye, skin, neurological, and gastrointestinal symptoms and occupational factors were collected by in-person interviews or self-administered questionnaires.

RESULTS

Chemical-related symptoms (several times monthly or more often) were more common among workers who performed patient area cleaning (44%) than hospital custodians (36%) or campus custodians (28%). After controlling for age, sex, and job title, symptoms were associated with exposure to carpet cleaners (OR = 2.98, 95% CI 1.28-6.92), spray products (OR = 2.82, 95% CI 1.16-6.82), solvents (OR = 2.71, 95% CI 1.20-6.15), and multi-purpose cleaners (OR = 2.58, 935% CI 1.13-6.92). Except for gloves, regular use of personal protective equipment was infrequent.

CONCLUSIONS

Study findings suggest a need for additional interventions such as use of less toxic products to reduce health risks among cleaning workers.

A survey study of musculoskeletal disorders among eye care physicians compared with family medicine physicians

PURPOSE

To evaluate the prevalence of musculoskeletal disorders among eye care physicians compared with family medicine physicians.

DESIGN

Case control study.

PARTICIPANTS AND CONTROLS

Ophthalmologists and optometrists at the University of Iowa and Mayo Clinic (participants) and family medicine physicians at the University of Iowa and Mayo Clinic (controls).

METHODS

An electronic survey was e-mailed to all subjects.

MAIN OUTCOME MEASURES

The prevalence of musculoskeletal symptoms between eye care providers and family medicine physicians (control group).

RESULTS

One hundred eight-six surveys were completed by 94 eye care physicians and 92 family medicine physicians with a response rate of 99% and 80%, respectively. There were no significant differences between the 2 groups with regard to mean age, gender, body mass index, years with current employer, or years in practice. Eye care providers, compared with their family medicine colleagues, reported a higher prevalence of neck (46% vs 21%; P<0.01), hand/wrist pain (17% vs 7%; P = 0.03), and lower back pain (26% vs 9%; P<0.01). A greater proportion of eye care physicians classified their job as a high-strain job (high demand, low control; 31% vs 20%) and a lower proportion classified their job as an active job (high demand, high control; 24% vs 47%; p = 0.01). Several job factors reported by eye care providers to contribute to musculoskeletal symptoms included performing the same task repeatedly, working in awkward/cramped positions, working in the same position for long periods, and bending/twisting the back (all P<0.01).

CONCLUSIONS

In this survey, the study group, composed of ophthalmologists and optometrists, had a higher prevalence of neck, hand/wrist, and lower back pain compared with family medicine physicians; repetitive tasks, prolonged or awkward/cramped positions, and bending/twisting were contributory factors. Given the ramifications of these findings, future efforts should concentrate on modifications to the eye care providers' work environment to prevent or alleviate musculoskeletal disorders and their personal and socioeconomic burden.

Work organisation and gender among hospital cleaners in Quebec after the merger of 'light' and 'heavy' work classifications

In Québec, Canada, cleaning tasks were once divided into 'light' or 'heavy' cleaning, assigned respectively to women and men. These categories are being merged; in principle, both genders are assigned the same tasks. Activity analysis using observations and interviews examined work activity of male and female cleaners in two hospitals. In one hospital, work activity could be compared before (time 1) and after the work reorganisation (time 2). Some gender segregation of tasks appeared to have persisted at time 2, in both hospitals. Some route assignments contained components that were difficult for all cleaners, especially women of average strength. Only about one-third of the recommendations for improvement made at time 1 had been carried out by time 2, 12 years later. In a low-status job, it may be hard to meet equality, health and efficiency goals because commitment to improving equipment and worksite design may be lacking.

PRACTITIONER SUMMARY

Current attempts to desegregate jobs should be accompanied by attention to physical job demands in order to protect employee health and access to equal employment. The study also shows the need to follow up ergonomic interventions, particularly in low-status jobs such as cleaning, where recommendations can be forgotten.

Medical care utilization for work-related injuries in the United States 2002-2006

OBJECTIVE

To examine racial-ethnic/gender differences in the odds of injury and in the odds of seeking medical treatment among workers in the United States.

METHODS

Logistic regression models were used to estimate the odds of having a work injury and the odds of seeking medical treatment for these injuries in a sample of non-Latino Black, Latino, and non-Latino white workers from the Medical Expenditure Panel Survey (2002-2006).

RESULTS

Significant variation in the odds of injury was observed across racial-ethnic/gender groups. Although race-gender groups had significant variation in the odds of experiencing a work injury, we found few differences in treatment seeking. Among the 6 subgroups, we found that white women were significantly less likely to report an injury and significantly more likely to seek treatment when injured. Having health insurance played a key role in utilization among injured workers. The odds of seeking treatment were 33% lower for uninsured workers compared with those with private insurance. Publicly insured workers were no different from privately insured workers.

CONCLUSIONS

Our study sheds light on current trends in work injuries and associated medical care utilization among a nationally representative sample of workers.

Bridging the knowledge gap: an innovative surveillance system to monitor the health of British Columbia's healthcare workforce

OBJECTIVE

Healthcare workers are exposed to a variety of work-related hazards including biological, chemical, physical, ergonomic, psychological hazards; and workplace violence. The Occupational Health and Safety Agency for Healthcare in British Columbia (OHSAH), in conjunction with British Columbia (BC) health regions, developed and implemented a comprehensive surveillance system that tracks occupational exposures and stressors as well as injuries and illnesses among a defined population of healthcare workers.

INTERVENTION

Workplace Health Indicator Tracking and Evaluation (WHITE) is a secure operational database, used for data entry and transaction reporting. It has five modules: Incident Investigation, Case Management, Employee Health, Health and Safety, and Early Intervention/Return to Work.

OUTCOMES

Since the WHITE database was first introduced into BC in 2004, it has tracked the health of 84,318 healthcare workers (120,244 jobs), representing 35,927 recorded incidents, resulting in 18,322 workers' compensation claims. Currently, four of BC's six healthcare regions are tracking and analyzing incidents and the health of healthcare workers using WHITE, providing OHSAH and healthcare stakeholders with comparative performance indicators on workplace health and safety. A number of scientific manuscripts have also been published in peer-reviewed journals.

CONCLUSION

The WHITE database has been very useful for descriptive epidemiological studies, monitoring health risk factors, benchmarking, and evaluating interventions.