Workplace Health & Safety

A 57-year-old male working as a security supervisor in an office building was seen for return to work by the on-site occupational health nurse. He was observed to have slow gait as he entered the clinic waiting area, was pale, diaphoretic, and slow in responding to questions. His return to work note stated he was recovering from West Nile Virus (WNV). Implications for return to work are presented.

B virus is endemic in macaque monkeys, which are frequently used for research studies. B virus is a risk for every employee working with macaque monkeys, their tissues or cells. Although the risk for B virus infection is low, the risk of death or permanent neurological deficit is high if an exposure is not promptly evaluated and treated. Researcher training, routine use of personal protective equipment, first aid protocols, and prompt reporting to a provider knowledgeable about B virus treatment are essential to prevent this 70% lethal infection in untreated humans. This article presents the history and pathogenesis of B virus, first aid, treatment, and prevention.

The Ebola virus disease first appeared in 1976 in the Sudan and the Democratic Republic of Congo. The most recent outbreak occurred in West Africa in March 2014 and quickly spread in surrounding countries. Ebola spreads through direct contact with the body fluids of an infected individual. The incubation period for Ebola is 2 to 21 days. Individuals are infectious when symptomatic. Identifying individuals at high risk for Ebola in the United States includes early recognition of symptoms and a history of travel to an Ebola-affected area. Multiple diagnostic tests exist and should include a complete blood count and a comprehensive metabolic profile. Standard, contact, and droplet precautions are advised when taking care of patients with Ebola. Appropriate personal protective equipment as recommended by the Centers for Disease Control and Prevention should be worn. No vaccine or antiviral drug has been approved, but vaccine trials are under way. Occupational health nurses play a key role in educating employees about this disease.

Evidence suggests that diabetes education can be delivered at the worksite to better support employees’ diabetes self-management and improve productivity and health care costs. This study was conducted to address the feasibility of a diabetes worksite education program for employees at a large urban academic health care institution. The diabetes education program was delivered in the diabetes center at the institution, a resource that was previously underutilized by employees. Through collaboration with groups in the institution, 20 employees of diverse ethnicity participated in the worksite diabetes education program with positive outcomes: improved glycemic control measured (HbA1c), attainment of self-management goals, and satisfaction with the program. Work absences trended downward, but numbers of hospitalizations and emergency department visits were unchanged in the 3 months following education. Recommendations include replication of the study with more employee participation and program evaluation over a longer period of time to continue assessment of employees’ educational needs.

Occupational health nursing plays a critical part in improving the safety of foreign labor workers. The development and implementation of safety training programs do not always regularly take into account language barriers, low literacy levels, or cultural elements. This oversight can lead to more injuries and fatalities among this group. Despite established health and safety training programs, a significant number of non-native English speakers are injured or killed in preventable, occupation-related accidents. Introducing safety programs that use alternative teaching strategies such as pictograms, illustrations, and hands-on training opportunities will assist in addressing challenges for non-English laborers. Occupational health nursing has an opportunity to provide guidance on this subject and assist businesses in creating a safer and more productive work environment.

Healthy People 2020 lists Bisphenol A (BPA) as a potential endocrine disruptor for which exposure should be reduced. The Healthy People 2020 Environmental Health Objectives focus on addressing environmental factors that negatively affect individuals’ health even though the health effects of some toxic substances are not yet fully understood. An American Association of Occupational Health Nurses (AAOHN) position statement outlined the role occupational health nurses play in creating healthy and productive workplaces by promoting worker health. BPA is implicated in a variety of health outcomes such as breast and prostate cancer, menstrual irregularities, genital abnormalities in male babies, infertility in men and women, early puberty in girls, and metabolic disorders such as diabetes and obesity. The overall health issues attributed to BPA exposure are complex and controversial. Concerns regarding environmental health are growing as individuals become more dependent on plastics. Numerous health concerns have been directly connected to daily exposures to products manufactured with BPA. Government agencies support the use of BPA as a safe consumer product with the exception of BPA use in baby bottles and sippy cups, which has been banned in the United States and several other countries. Many agencies (e.g., Federal Drug Administration [FDA], World Health Organization [WHO], U.S. Department of Health & Human Services [U.S. DHHS], and the Centers for Disease Control and Prevention [CDC]) have expressed “some concern” about BPA based on research, and stated further research is warranted.

Occupational and environmental health nurses should educate workers about ways to prevent tick bites, which can cause Lyme disease.