Occupational Exposures of Home Healthcare Workers.

Population demographics in the United States are rapidly changing with increased dependence on home healthcare (HHC) by an aging population, patients suffering from chronic diseases, and inability to perform activities of daily living. Despite the occupational injury rates for HHC workers (HHCW) being higher than the national average, an understanding of the occupational safety and health experiences and exposures of HHCW is limited. The purpose of this study was to understand the health and safety risk factors for HHCW. One-on-one interviews were conducted with HHCW to elicit frequency of daily occupational exposures to hazards and risk factors during visits to patients' homes. Approximately 67% of the study population was over 40 years old and mostly obese, potentially increasing risk for injury. HHCW routinely perform physical tasks with increased risk for occupational musculoskeletal injuries. Exposures to drug residue from dispensing oral medications and anticancer medications and exposure to potentially infectious agents and cleaning chemicals used for infection prevention were reported. The majority of HHCW were also exposed to secondhand smoke and occasionally experienced violence. Developing and implementing intervention strategies that address engineering controls, establish employee safety-related policies, provide training and retraining, promote a healthy lifestyle among HHCW, and providing suitable personal protective equipment may help to decrease occupational injury rates.

Complexity of occupational exposures for home health-care workers: nurses vs. home health aides.

AIM: To identify occupational exposures for home health-care nurses and aides. BACKGROUND: Home health-care workers' occupational injury rates in the USA are higher than the national average, yet research on causative exposures and hazards is limited. METHODS: Participants were interviewed about annual frequency of occupational exposures and hazards. Exposure and hazard means were compared between home health-care nurses and aides using a Wilcoxon two-sample test. RESULTS: A majority of the sample was over 40 years old and obese, potentially increasing injury risks. Home health-care nurses performed more clinical tasks, increasing exposure to blood-borne pathogens. Home health-care aides performed more physical tasks with risk for occupational musculoskeletal injuries. They also dispensed oral medications and anti-cancer medications, and were exposed to drug residue at a frequency comparable to home health-care nurses. Both groups were exposed to occupational second-hand smoke. CONCLUSIONS: Establishing employee safety-related policies, promoting healthy lifestyle among staff, and making engineered tools readily available to staff can assist in decreasing exposures and hazards. IMPLICATIONS FOR NURSING MANAGEMENT: Implications for nursing management include implementation of health-promotion programmes, strategies to reduce exposure to second-hand smoke, ensuring access to and education on assistive and safety devices, and education for all staff on protection against drug residue.

A depiction of imported malaria in Connecticut.

In 2010, there were roughly 219 million cases of malaria reported worldwide resulting in an estimated 660,600 deaths [1]. In contrast, the total number of cases according to the Centers for Disease Control and Prevention (CDC) in the United States (USA) was only 1691 [2]. Of those, 1688 were cases of imported malaria [2]. This is the highest number of cases reported in U.S. since 1980 [2]. Here, we describe a case of imported malaria and conduct a retrospective case series at four Connecticut (CT) hospitals in order to describe the demographics of imported malaria and to identify potential barriers to timely diagnosis and treatment.