McDiarmid Melissa A
Occupational Health Program, School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
Ann N Y Acad Sci. 2006 Sep;1076:601-6. doi: 10.1196/annals.1371.032.
It is counter-intuitive that the healthcare industry, whose mission is the care of the sick, is itself a "high-hazard" industry for the workers it employs. Possessing every hazard class, with chemical agents in the form of pharmaceuticals, sterilants, and germicidals in frequent use, this industry sector consistently demonstrates poor injury and illness statistics, among the highest in the United States, and in the European Union (EU), 34% higher than the average work-related accident rate. In both the United States and the EU, about 10% of all workers are employed in the healthcare sector, and in developing countries as well, forecasts for the increasing need of healthcare workers (HCW) suggests a large population at potential risk of health harm. The explosion of technology growth in the healthcare sector, most obvious in pharmaceutical applications, has not been accompanied by a stepped up safety program in hospitals. Where there is hazard recognition, the remedies are often voluntary, and often poorly enforced. The wrong assumption that this industry would police itself, given its presumed knowledge base, has also been found wanting. The healthcare industry is also a significant waste generator threatening the natural environment with chemical and infectious waste and products of incineration. The ILO has recommended that occupational health goals for industrial nations focus on the hazards of new technology of which pharma and biopharma products are the leaders. This unchecked growth cannot continue without a parallel commitment to the health and safety of workers encountering these "high tech" hazards. Simple strategies to improve the present state include: (a) recognizing healthcare as a "high-hazard" employment sector; (b) fortifying voluntary safety guidelines to the level of enforceable regulation; (c) "potent" inspections; (d) treating hazardous pharmaceuticals like the chemical toxicants they are; and (e) protecting HCWs at least as well as workers in other high-hazard sectors.
医疗行业的使命是照料病人,但对于其雇佣的工人而言,该行业本身却是一个“高风险”行业,这有违直觉。该行业具备各类风险,频繁使用药品、消毒剂和杀菌剂等化学制剂,其工伤和疾病统计数据一直很差,在美国和欧盟都位居高位,比平均工作相关事故率高出34%。在美国和欧盟,约10%的工人受雇于医疗行业,在发展中国家也是如此,对医疗工作者需求不断增加的预测表明,大量人群面临健康受损的潜在风险。医疗行业技术增长迅猛,在制药应用方面最为明显,但医院并未相应加强安全计划。即便识别出了风险,补救措施往往也是自愿性的,而且执行不力。认为该行业凭借其假定的知识基础就能自我监管的错误假设也被证明是不成立的。医疗行业还是一个巨大的废弃物产生源,化学和传染性废物以及焚烧产物威胁着自然环境。国际劳工组织建议,工业国家的职业健康目标应关注新技术带来的风险,制药和生物制药产品在新技术中占主导地位。如果不同时致力于保障接触这些“高科技”风险的工人的健康和安全,这种无节制的增长就无法持续。改善当前状况的简单策略包括:(a) 将医疗行业视为“高风险”就业部门;(b) 将自愿性安全指南强化到可执行法规的水平;(c) 进行“有力”检查;(d) 将危险药品视为化学毒物来对待;(e) 至少像保护其他高风险行业的工人一样保护医疗工作者。