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Health and safety in the hospital sector OPSEU health and safety committee members in the hospital sector surveyed last fall identified workplace stress and workload as the two most important health and safety problems facing membership. Exposure to infectious diseases, musculoskeletal injuries, sharps injuries and working alone also ranked high on the list of important health and safety issues. The short survey was developed by Frank Pezzutto and Brendan Kilcline, the two elected OPSEU representatives on the newly-created Joint Central Committee on Health and Safety (JCCHS), Joan Murray, the alternate member of the JCCHS, and OPSEU staff. The survey was developed to provide a snapshot of health and safety conditions for OPSEU members in the hospital sector. Your representatives at the JCCHS will use information from the survey to assist them with their work at the committee. The survey asked respondents to describe their local Joint Health and Safety Committee (JHSC) structure; whether they thought their JHSC was working effectively; to prioritize a list of health and safety problems in their workplace; and to provide contact information for local OPSEU health and safety representatives. Just over 80 surveys were sent out by e-mail to presidents or highest-ranking officers in all of our hospital locals. Twenty-seven completed surveys that could be analyzed were returned to OPSEU. Although the total number of surveys analyzed is small, they represent over one-third of our member hospitals which is considered a good response rate and representative of the sector. Respondents were given a list of the following nine potential hazards and asked to number them in order of importance to their members: workplace stress, workload, musculoskeletal or repetitive strain injuries, infectious diseases, sharps injuries, working alone, exposure to toxic chemicals, workplace violence and lack of health and safety training. It is extremely disturbing to see that 27 out of 27 respondents placed workplace stress as one of their top five hazards. In fact, 23 out of 27 respondents ranked stress as one of their top three. Workload also figured very high: 24 out of 27 respondents ranked workload as one of their top five hazards. These particular results pose a challenge to your representatives who meet with hospital employers at the JCCHS. As many health and safety activists have learned, using the Occupational Health and Safety Act to address workplace stress and workload problems is difficult, because the Act does not refer specifically to either of these hazards. Attempts to rely on the Ministry of Labour (MOL) inspectors or litigation under the OHSA at the Ontario Labour Relations Board to deal with workload and workplace stress have often been unsuccessful. This does not mean these are not legitimate health and safety issues. However, in order to address them using available health and safety resources such as JHSC or MOL, it means specific health and safety issues within the larger concern must be identified. For example, under the umbrella of workload, workers might have a specific concern about patient violence when working alone, or the hazard of musculoskeletal injuries because there aren’t enough workers to assist with a patient transfer or lift. Both of those issues can be addressed by JHSCs and by MOL inspectors if the JHSC is unsuccessful. Concerns about the hazards of infectious diseases and musculoskeletal and repetitive strain injuries (MSI/RSI) were ranked almost equally, as the third most important hazards, by respondents. Twenty-one respondents placed infectious diseases in their top five list; nineteen respondents placed musculoskeletal injuries in their top five. It is interesting that respondents ranked the hazard of exposure to infectious diseases slightly higher than the hazard of MSI/RSI. Among health care workers, the largest category of injuries compensated by the Workplace Safety Insurance Board consistently falls under the MSI/RSI umbrella. Although healthcare workers do contract infectious diseases such as hepatitis C and hepatitis B from workplace exposures, these are relatively rare events compared to the numbers of workers compensated for back, shoulder, neck and other soft tissue injuries. It may be that respondents were reacting to the SARS outbreak of 2003 which drew attention to inadequate infection control policies, protocols and workplace education within many hospitals. “Sharps” hazards were ranked next by respondents. Seventeen out of 27 placed sharps into the top-five category. OPSEU is already quite active in this area. At last year’s OPSEU Convention, delegates passed a motion requesting the union to lobby for the introduction of safe sharps devices. As a result, OPSEU has made a number of representations to MOL encouraging the introduction of necessary legislation. And in November 2004, a recommendation by the OPSEU members of the JCCHS regarding risk assessments and the introduction of Safety Engineered Sharps Devices (SEMD) was passed unanimously by the committee. That recommendation will now go to the OHA’s Health and Safety Advisory Committee for consideration. The survey presented a few surprising results. The hazards of violence in the workplace and lack of health and safety training ranked lowest on the list of hazards. Only seven respondents placed violence in the top five hazards; nineteen ranked violence as one of the bottom four hazards. Lack of health and safety training ranked even lower – twenty-one respondents placed lack of training as one of the bottom four. These findings deserve further investigation. While it is encouraging that members do not perceive violence in the workplace as one of the most important hazards they face, OPSEU staff do receive reports about violence involving workers in the sector. Additionally, while it is encouraging that lack of training was not ranked as an important issue, the SARS outbreak in 2003 revealed that many health care workers did not fully understand their rights under the OHSA, that they often had little or no training on the use of some personal protective equipment, and that they often did not understand the role of the JHSC to ensure employers were taking reasonable precautions to protect their health and safety. All of these problems point to shortcomings in health and safety training for workers. Respondents were divided when it came to assessing how effective their JHSC were. Just over half of the respondents said that their JHSC worked effectively, nine respondents said that their JHSC did not work, and the rest indicated that their committee worked sometimes or that it worked very slowly. These findings indicate there is work to be done to improve the functioning of JHSCs. The OPSEU members of the JCCHS and OPSEU staff will use the survey results, plus the contact information, to assist in their future work with the JCCHS and with individual locals. And this information, especially the issues of escalating workloads and stress, will be provided to the Hospital Professionals Division Executive for consideration and action. To successfully address the complex issues of workload and workplace stress to create healthier workplaces requires a coordinated multi-pronged approach: enforcement of existing collective agreements, collective bargaining goals, member education and activism, and various occupational health and safety strategies.
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