Occupational Health Nursing

Dedy Purwito, S.Kep, Ns, M.Sc

Objectives
Describe legislation impacting on OHN
Utilize an occupational health history.
Identify prevalent occupational health
disorders.
Describe the profile of a worker population.
Apply epidemiology to OHN.
Describe the roles of the OHN.
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Scope of Occupational Health Problems

An average of 137 individuals die each day

Every 5 seconds a worker is injured
Every 10 seconds a worker is disabled
Incidence of work-related injuries
increasing

Trends

1/3 of life at work

Lost time from illness and injury
Primary care in occupational setting
Increase the proportion of worksites that
have health services (Healthy People,
2010).

Evolution of Occupational Health

Part of job
Horrible accidents
Occupational, safety, and health administration (OSHA,
l970)
set and enforce standards
National Institute for Occupational Safety and Health
(NIOSH).
Identifies, monitors, educates, & researches
Super fund Amendment & Reauthorization Act
Nurse key role
5

Role of OHN

Beyond emergency and band aid care

Largest group of occupational workers
Diverse levels of preparation
Multiple roles
clinician, case manager, educator, consultant,
researcher, corporate manager, program planner
skills: provision of emergency care, health assessment,
workers compensation management
6

Characteristics of the Workplace

High tech
Health and computer-related occupations
Increase in part-time and temporary work
Increase in contractual workers
Reduced job security
Increase in shift work
Development of new chemicals
7

Application of the Epidemiological Model

Host factors:
age, gender, work practices, health status,
lifestyle
greatest risks for accidents?

Application of the Epidemiological Model

Types of Agent Factors:

Biological
Chemical
Ergonomic or mechanical
Physical
Psychosocial

Application of the Epidemiological Model

Environment: all external conditions

that influence host and agent interaction

Examples?

10

Issues with Occupational Health Programs

Widely varies
Organization exemption
OSHA sanctions
Limited # of inspectors

11

Worker Assessment
Overall health assessment
Occupational health assessment
list current and past jobs
exposure history
job titles and responsibilities
host factors (smoking)
masked risk: retiree or housewife
family members
Assessment Guide
12

Workplace Assessment
Walk-through, plant survey
What are you looking for?

Review the Standard Industrial

Classification (SIC) code
Describe demographic info. of workers
Review policies and procedures
Epi. data collection about injuries and
illnesses
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Hazard Communication Standard

Cannot eliminate all toxins
Report known toxins
Provide safety education on
identification, toxicity, and protective
measures

14

Workers Compensation

Financial compensation
State laws
Varies by state
Prevention is less costly

15

Nursing Interventions at the Worksite

Primary prevention
Health promotion
Prenatal care
Risk reduction
Immunization status
Injury prevention
16

Nursing Interventions at the Worksite

Secondary

Pre-employment screening
Periodic screening
Environmental screening
Treatment of existing conditions
Emergency responses
17

Nursing Interventions at the Worksite

Prevent the spread of communicable
diseases
Prevent the occurrence of acute conditions
Prevent complications of chronic illnesses
Assessing fitness to return to work.

18

Indicators of Psychological Health Problems

Increased absenteeism
Mood changes
Increase in minor accidents
Fatigue or general decrease in energy
Sudden weight loss or gain
Increased blood pressure
Frequent stress-related illnesses
Bloodshot or bleary eyes
19

Psychological Stress

Job strain
Tenth leading cause of occupational disease
Health care and service workers
Sources of stress

20

Ethical Case Dilemna

A young attractive woman reports to you a
ling history of sexual harassment by her
immediate supervisor, a man. This man is
the person to whom your supervisor reports.
Your supervisor advises you to ignore them
because this man has a tendency to be
vindictive. What would you do?
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Copyright 2007