State-Based Safe Patient Handling Laws Have Yielded Improvements But Are Not Adequately Protecting Health Care Workers
Musculoskeletal disorders (MSDs), which often are caused by manual patient handling activities, are the leading cause of injuries for health care workers, especially nursing aides, orderlies and assistants (nursing assistants). The rate of work-related MSDs requiring days away from work for nursing aides was nearly six times higher than for average workers in 2013. MSDs accounted for 53 percent of total cases of reported injury that occurred to nursing assistants in 2013.
These injuries carry an enormous price tag. Costs associated with back injuries in the health care industry are estimated to be more than $7 billion annually. As the first report in this series, “A Profession in Peril,” showed, they also can wreck careers and leave victims suffering from lifelong pain with severely restricted mobility.
Officials at the Occupational Safety and Health Administration (OSHA), which is charged with ensuring safe workplaces, are well aware of the risks facing health care workers. The agency has documented problems in advisory publications and has taken some actions, such as establishing a program focusing on reducing MSDs in nursing homes.
But OSHA has devoted relatively little effort toward creating regulations to address safety risks at health care facilities, in part because the agency is hamstrung by congressional directives. OSHA has tried in the past to protect workers from the dangers of ergonomic stressors and MSDs. In November 2000, OSHA issued a regulation that required employers to implement safe ergonomics programs to combat work-related MSDs.7 But the rule never took effect. In 2001, the House and Senate passed a joint resolution repealing it.
In the absence of any legislation requiring a specific standard, the agency is required to rely on its catch-all “general duty” clause to ensure safe workplaces. This clause requires employers to provide conditions that are “free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employee.”
But very few cases of any kind are brought pursuant to this clause. As Public Citizen reported in 2013, OSHA’s national emphasis program on risks faced by employees of nursing homes and residential care facilities had resulted in just seven citations for unsafe ergonomic conditions in 2011 and 2012.
In June 2013, Rep. John Conyers (D-Mich.) and 16 other members of Congress introduced H.R. 2480, which would have directed the secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, nurses, and all other health care workers by establishing a safe patient handling, mobility, and injury prevention standard. The legislation did not receive a hearing. Versions of the bill were previously released in 2006 and 2009.