Care for caregivers: Occupational hazards in hospitals

BENGALURU: US hospitals record 5.5 work-related injuries and illnesses per 100 full-time employees.

According to the United States Bureau of Labor Statistics, a hospital is the most dangerous place to work, even surpassing construction and manufacturing. U.S. hospitals record 5.5 work-related injuries and illnesses per 100 full-time employees, nearly twice the rate for the industry as a whole. Caregivers often risk their safety and health to care for a patient in the hospital.

DANGEROUS INFECTIONS: The most serious occupational hazard is needle stick injuries while operating or treating a patient suffering from AIDS, hepatitis and other infections, which can lead to death or serious illness of the doctor or health worker handling infectious material of the patient. Respiratory infections like tuberculosis, Covid-19, etc., and contact spread infections like hepatitis, Ebola, etc., are among the many dangerous infections that doctors and health workers are exposed to. Inadequate filtered recirculated air in air-conditioned rooms leads to accumulation of microbes in the hospital air. According to data collected by the Indian Medical Association, 1,596 doctors died of Covid-19 in India, 757 during the first wave and 839 in the second wave.

PHYSICAL INJURY: Lifting and moving a patient, especially a heavy patient, slipping, especially on wet floors, tripping over pipes and wires, and falling are a source of numerous injuries to healthcare workers. Safety hazards include mechanical and electrical problems with hospital equipment. Agitated or aggressive patients or visitors, especially in or near the emergency department and intensive care unit, have frequently physically attacked and abused physicians and nurses on duty.

Doctors treating seriously ill or injured patients are under great stress and their safety is seriously threatened. The risk is even greater during riots and civil unrest. Doctors and nurses working night shifts, especially women, are extremely vulnerable, as the recent horrific incident at RG Kar Hospital in Kolkata shows.

HAZARDOUS SUBSTANCES: Accidental exposure to corrosive substances such as formalin fumes, hazardous chemicals, detergents, disinfectants, sterilants, mercury, toxic drugs and anaesthetic gases has a serious impact on healthcare workers. Flammable gases and substances pose a major fire hazard, as was recently witnessed in the Newborn Hospital in Delhi.

Poor ventilation, especially in air-conditioned spaces such as operating rooms and laboratories, leads to the buildup of anesthetic agents and toxic chemicals. This can lead to serious health problems, including an increased risk of abortion in pregnant anesthesiologists who must remain in the operating room for hours.

STRESS RELATED: Doctors are often required to work 24 to 36 hours a day. Chronic stress and fatigue drastically affect the productivity, morale, and health of doctors and can lead to an increased risk of errors. Continuous high workloads, exposure to stress, poor work facilities and pay, and insecurity in the workplace all lead to anxiety, sleep disorders, depression, even alcohol and drug abuse and suicide. From January 2020 to December 2022, 118 suicides were reported among medical students and doctors in India, and the numbers are increasing every year.

THREAT FROM CRIMINALS: Though the use of narcotics and narcotics like fentanyl is strictly controlled, criminal drug traffickers pose a threat to the safety of doctors. Organ donation racketeers, fake drug mafia, medicolegal and forensic evidence manipulators, sex traffickers, insurance fraudsters, fake medical certificate brokers pose a serious threat to whistle blowers and doctors who do not submit to threats and extortion. Examiners in medical teaching hospitals receive threats from urban Naxals and corrupt politicians. Unethical pharmaceutical companies and their agents can ruin the career and life of a doctor. Terror threats of shootings, bombs, targeted killings and poisoning of water and food supplies pose very significant risks to life in hospitals.

SAFETY IN HOSPITALS: Hospitals must strictly enforce infection control procedures and policies. To keep staff, patients and visitors safe, hospitals need a range of safety measures including highly qualified and experienced security personnel, checking of stock, incoming persons and their belongings, CCTV cameras, emergency alarms for staff, effective internal and external communication systems, electronic access control systems, fire detection systems, checking all electrical equipment for safety and potential fire risks, fire safety equipment and emergency exits. It is also important to have quick ways to shut down equipment in the event of an emergency. For effective security, clear signage to guide patients and visitors, monitoring of traffic flows and suspicious activity, and stock and parking areas are essential. Secure biometric identification of all hospital staff and incoming persons, including suppliers and service providers, is necessary. Everyone who has regular access to the hospital must undergo a background and identification check to ensure they are qualified for their role and are of good character.

When safety and security are assured and healthcare providers have peace of mind, patients receive better care.

Dr PS Venkatesh Rao is a Consultant Endocrine, Breast and Laparoscopic Surgeon in Bengaluru.