Pollution Prevention—Occupational Safety and Health in Hospitals: Alternatives and Interventions

Abstract

An integrated pollution prevention (P(2)) and occupational safety and health (OSH) worksite intervention and alternatives assessment strategy was developed in hospitals. It was called the Pollution Prevention-Occupational Safety and Health (P(2)OSH) assessment for the "Sustainable Hospitals Project." Methods included (a) developing a participatory intervention model for introducing more environmentally sound, healthy, and safe materials and work practices for specific hospital procedures; (b) developing an integrated P(2)OSH survey to evaluate environmental and occupational impacts of the intervention; and (c) conducting and evaluating interventions by applying the P(2)OSH assessment pre- and post-intervention. Eleven interventions were performed in six hospitals: an aliphatic fixative replaced xylene in three histology laboratories; a mercury reduction plan was implemented in three clinical laboratories; digital imaging replaced wet chemical film processing in three radiology departments; a less toxic aldehyde replaced formaldehyde in one hospital histopathology laboratory; and conventional mopping was replaced by microfiber mopping in one hospital. Occupational and environmental health and safety impacts were observed for all interventions. The alternatives generally were beneficial, although each had limitations that resulted in process and task changes with potentially negative P(2) and/or OSH impacts. When these were identified in the pilot phase they could be addressed before full-scale implementation. The P(2)OSH method shifts the focus of occupational and environmental hygiene from hazard control to substitution. Because few ideal alternatives exist, the emphasis is on a continuous process to identify, implement, and evaluate alternatives, rather than on a particular alternative. Occupational and environmental health and safety professionals have an important role as agents in hospital organizational change and in the search for healthier and safer alternatives. Through these activities they can become involved in the design/redesign of products, materials, and processes, thus expanding their traditional role.

O adoecer pelo trabalho na enfermagem: uma revisão integrativa

“…Os trabalhadores da saúde estão expostos a poluição ambiental (15) , mas mesmo com orientações como não utilizar campos apenas de algodão e sim mesclados commicrofibra e não fazer uso do mercúrio nas unidades de saúde, estas interferências não são relevantes para a diminuição da poluição ambiental.…”

“…Também identificou-se que os trabalhadores de enfermagem estão submetidos à poluição ambiental (15) . Os trabalhadores também podem apresentar dermatites nas mãos por fazerem uso de luvas para a realização de procedimentos.…”

“…Também aparece uma proposta de curso para o enfrentamento desses problemas (31) . Observou-se também nesta revisão integrativa que os trabalhadores da enfermagem sofrem acidentes com material pérfuro-cortante, com alto risco de contaminação com material biológico, podendo adquirir doenças como Hepatites e Aids (11)(12)(13)(14)(15)(16) . Para tanto, os profissionais da área da saúde necessitam aderir às Precauções Padrão, visto que estudo (13) demonstrou que os enfermeiros têm dificuldades para prevenir acidentes ocupacionais devido à falta de adesão às Precauções Padrão.…”

Implementing Safer Alternatives to Lithographic Cleanup Solvents to Protect the Health of Workers and the Environment

“…A large study of pollution prevention activities in the hospital industry concluded that legal standards remain important incentives for hospitals to reduce or eliminate hazards. (38) A crucial strategy for implementing safer lithographic cleanup products will be to bring regulations in other air districts up to the standards of the SCAQMD. The opportunity to address these challenges exists.…”

Prevention through design in the health care sector

“…They have courses that target the full life cycle of a process or product so that occupational safety and health concepts are considered in depth during the design and manufacturing phase as well as when the process or product is introduced into the work place. And they recently Environmental Health Risk V 191 published a study on how to implement more environmentally-sound, healthier and safer design alternatives in health care [8].…”