On July 16, 2013, the Occupational Safety and Health Administration (OSHA) announced that it is launching a campaign that aims to protect healthcare workers from musculoskeletal disorders (MSDs). While this campaign expressly targets the District of Columbia and three nearby states, it is part of a broader campaign by OSHA, unions, and health worker advocates to put increased pressure on inspections in the healthcare industry.
As part of this effort, on July 17, the Washington-based pro-union, advocacy group Public Citizen released a report — "Health Care Workers Unprotected" — that criticized OSHA for not inspecting more healthcare industry establishments and lacking standards addressing healthcare industry hazards. Officials from the Service Employees International Union and American Nurses Association appeared on a Public Citizen telephone news conference to endorse the report.
The Public Citizen report states that healthcare workers suffer more injuries and illnesses on the job each year than those in any other industry, but OSHA conducts relatively few inspections of healthcare facilities and is stymied in its ability to take action to address unsafe conditions by an absence of needed safety standards.
The Public Citizen report also argued that the lack of regulations applicable to healthcare hinders inspectors, who are hesitant to cite employers under the general duty clause for a violation that does not correspond to a specific safety standard. The report noted that OSHA issued an ergonomic standard that could have protected healthcare workers in 2000, but Congress repealed it before it could take effect. In the report, Public Citizen recommended that OSHA increase the number of inspections of the healthcare industry facilities and pursue standards to ensure that workers are protected from the risks posed by MSDs, workplace violence, and other threats. The report also recommends that Congress significantly increase funding of OSHA.
In addition to MSD injuries, the report states that workplace violence is another serious hazard in the healthcare industry. Public Citizen recommended that OSHA develop a standard for workplace violence. This standard, according to Public Citizen, should require employers to adopt zero-tolerance policies for violence and threats, provide protection for employees to deter co-worker retaliation, and develop workplace safety plans. [In 2004, OSHA published guidance on preventing workplace violence in healthcare settings.]
The report identified injuries from surgical instruments and needles as a third major concern. Although Public Citizen praised OSHA's bloodborne pathogen standard, it said the agency should update that rule to require injury logs that are reviewed by both managers and workers to assess potential hazards. The updated standard, according to Public Citizen, should also mandate employers purchase best available technology in needles and instruments, and that they consult with workers before making those purchasing decisions. [OSHA has begun a review of the standard and has said it will end its review and issue findings in later this year.]
These union-backed efforts follow the release of a little publicized OSHA letter of interpretation, dated April 5, 2013, wherein the agency announced for the first time that during an inspection of non-union worksites, employees can be represented by anyone selected by the employees, including outside union agents. OSHA's new policy will undoubtedly encourage unions to get involved in OSHA inspections in non-organized facilities as a means of gaining access to the facility. In short, these OSHA developments provide an open door to many union organizers targeting the healthcare industry — an industry sought after by labor organizations in recent years.
Now more than ever, healthcare employers should engage in vigorous compliance with federal and state safety standards.