CDC logoSafer Healthier People  CDC HomeCDC SearchCDC Health Topics A-Z
NIOSH - National Institute for Occupational Safety and Health

Skip navigation links Search NIOSH  |  NIOSH Home  |  NIOSH Topics  |  Site Index  |  Databases and Information Resources  |  NIOSH Products  |  Contact Us

NIOSH Program Portfolio

 

Health Care and Social Assistance

Inputs: Occupational Safety and Health Risks

Workers in the Health Care and Social Assistance (HCSA) sector are potentially exposed to a wide range of health and safety stressors including infectious, chemical, and physical agents; ergonomic hazards associated with lifting and repetitive tasks; psychological hazards (stress); workplace violence; and risks associated with changing organization of work. Although it is possible to prevent or reduce worker exposure to these hazards, workers in the HCSA sector are experiencing higher rates of illness and injury as compared to all private industry.  The information below provides data on the magnitude, distribution and trends of occupational injuries and illnesses in the HCSA sector.  Special emphasis is placed on predominant injury and illness outcomes and conditions in the HCSA sector including strains and sprains, overexertion, falls on the same level, assaults and violent acts, slips and trips injuries, respiratory conditions and skin disorders.  Web links to additional information is also provided.  Beginning in 2006, the number of industries (i.e.., NAICS four, five and six digit levels) for which estimates were tabulated was significantly expanded.    

Nonfatal Injuries and Illnesses

Of the 14 industries reporting 100,000 or more nonfatal occupational injury and illness cases in 2006, 3 of these were in the HCSA sector — general medical and surgical hospitals (NAICS 6221) with 264,300 cases, ambulatory health care services (NAICS 621) with 127,500 cases, and nursing care facilities (NAICS 6231) with 121,100 cases.  The total number of injury and illness cases in these three healthcare subsectors or industries rank first, fifth and sixth, respectively, among all industry sectors.  General medical and surgical hospitals accounted for nearly 4 in 10 injury and illness cases in the HCSA sector, and reported more cases than any other single industry for which estimates were tabulated in 2006.  Hospitals have led the list of industries reporting 100,000 or more cases for the past four years; nursing and residential care facilities and ambulatory health care services have made this list the past four years as well.  The total recordable case incidence rate of occupational injuries and illnesses for the HCSA sector, as well as private industry, has steadily declined since 2003 (Figure 1), with the exception of  ambulatory health care services where the incidence rate increased from 2005 to 2006.  The relative rates among subsectors remained the same over this four year period, with nursing and residential care facilities and hospitals having the highest rates, about 2 to 3 times higher than private industry (Figure 1).  

Nonfatal Occupational Injuries Involving Days Away from Work

Sprains and strains injuries involving days away from work accounted for 86,130 cases or 18% of all such cases in the private industry in 2006. (Table 2)  Hospitals and nursing care facilities accounted for over three-quarters of the strains and sprains injury cases in the sector.  The highest incidence rate among the subsectors was in nursing and residential care facilities (135.9 cases per 10,000 full-time workers), followed by hospitals (97.0).  The highest incidence rate among industries was in other ambulatory healthcare services (211.3 cases per 10,000 full-time workers), followed by nursing care facilities (162.0) and community care facilities (123.3).  By comparison, the incidence rate in private industry was 51.1 cases per 10,000 full-time workers.  Four year (2003-2006) trend data for the number of cases and incidence rates of sprains and strains for the HCSA sector as a whole and by subsector are presented in Figure 2 and Figure 3, respectively.

Overexertion injuries involving days away from work accounted for 61,760 cases or nearly 22% of all such cases in private industry in 2006. (Table 3)   Hospitals and nursing care facilities accounted for over three-quarters of the overexertion injury cases in the sector.  The highest incidence rate among the subsectors was in nursing and residential care facilities (105.3 cases per 10,000 full-time workers), followed by hospitals (69.7).  The highest incidence rate among industries was in other ambulatory healthcare services (159.0 cases per 10,000 full-time workers), followed by nursing care facilities (138.3) and community care facilities (92.1).  By comparison, the incidence rate in private industry was 30.8 cases per 10,000 full-time workers.  Four year (2003-2006) trend data for the number of cases and incidence rates of overexertion injuries for the HCSA sector as a whole and by subsector are presented in Figure 4 and Figure 5, espectively.

Injuries due to falls on the same level involving days away from work accounted for 31,210 cases or 20.5% of all such cases in private industry in 2006. (Table 4)   Nursing and residential care facilities and hospitals accounted for over two-thirds of the fall injury cases in the sector.  The highest incidence rate among the subsectors was in nursing and residential care facilities (48.2 cases per 10,000 full-time workers), followed by hospitals (29.7).  The highest incidence rate among industries was in nursing care facilities (55.4 cases per 10,000 full-time workers), followed by vocational rehabilitation services (46.2) and other residential care facilities (44.5).   By comparison, the incidence rate in private industry was 16.4 cases per 10,000 full-time workers.  Four year (2003-2006) trend data for the number of cases and incidence rates of overexertion injuries for the HCSA sector as a whole and by subsector are presented in Figure 6 and Figure 7, respectively.

Injuries due to assaults and violent acts involving days away from work accounted for 10,130 cases or nearly 45% of all such cases in private industry in 2006. (Table 5Nursing and residential care facilities accounted for nearly half of the assaults and violent acts injury cases in the sector and had the highest incidence rate among the subsectors (21.8 cases per 10,000 full-time workers).  The highest incidence rates among industries was in individual and family services (122.8), followed by psychiatric and substance abuse hospitals (84.3) and other residential care facilities (70.0).  By comparison, the incidence rate in private industry was 2.4 cases per 10,000 full-time workers.  Four year (2003-2006) trend data for the number of cases and incidence rates of injuries due to assaults and violent acts for the HCSA sector as a whole and by subsector are presented in Figure 8 and Figure 9, respectively.

Injuries due to slips and trips (without fall) involving days away from work accounted for 5,040 cases or nearly 14% of all such cases in private industry in 2006. (Table 4)   Hospitals and nursing and residential care facilities accounted for nearly three-quarters of the slip and trip injury cases in the sector.  Nursing and residential care facilities had the highest incidence rate among the subsectors (8.0 cases per 10,000 full-time workers), followed by hospitals (5.5).  The highest incidence rates among industries was in community food and housing and emergency and other relief services (14.4), followed other residential care facilities (9.3) and nursing care facilities (9.0).  By comparison, the incidence rate in private industry was 3.8 cases per 10,000 full-time workers.  Four year (2003-2006) trend data for the number of cases and incidence rates of injuries due to slips and trips for the HCSA sector as a whole and by subsector are presented in Figure 10 and Figure 11, respectively.

Total Nonfatal Occupational Injuries

Of the approximately 4.1 million nonfatal occupational injuries and illnesses reported by private industry in 2006, approximately 3.9 million (94.4%) were injuries.  The HCSA sector accounted for 628,100 (16.3%) of these 3.9 million injuries (Table 6).  Hospitals and nursing and residential care facilities accounted for nearly three-quarters of the nonfatal occupational injuries in the sector.  Nursing and residential care facilities had the highest incidence rate among the subsectors (8.5 cases per 10,000 full-time workers).  The highest incidence rates among industries was in nursing care facilities (9.3), followed by psychiatric and substance abuse hospitals (8.6) and other ambulatory healthcare services (8.3).  By comparison, the incidence rate in private industry was 4.2 cases per 10,000 full-time workers.  Four year (2003-2006) trend data for the incidence rates of nonfatal injuries for the HCSA sector as a whole, by HCSA subsector, and for private industry are presented in Figure 12.

Nonfatal Occupational Injuries and Illnesses Involving Days Away from Work

Four year (2003-2006) trend data for the incidence rates of nonfatal injuries and illnesses involving days away from work for the HCSA sector as a whole, by HCSA subsector, and for the private sector are presented in Figure 13.  In 2006, incidence rates in nursing and residential care facilities doubled that of private industry while incidence rates in hospitals were nearly 25% higher. (Figure 13)  Ambulatory health care services and social assistance, by comparison, reported incidence rates at or below the rate in private industry over this same period.  Incidence rates have steadily declined since 2003, with the exception of ambulatory health care services which increased from 0.6 to 0.8 cases per 100 full-time workers from 2005 to 2006.

Nonfatal Occupational Illnesses
 

Occupational illnesses accounted for fewer than 6% (228,000 cases) of the 4.1 million injury and illness cases reported by private industry employers in 2006.   The HCSA sector accounted for more than 20% of these cases, with nearly half being reported by general medical and surgical hospitals.  The incidence rate of occupational illnesses in this sector is nearly double that of private industry — 40.8 versus 24.6 cases per 10,000 full-time workers. (Table 7)  Hospitals had the highest incidence rate among the subsectors (68.4 cases per 10,000 full-time workers), followed by nursing and residential care facilities (39.2 cases per 10,000 workers) and ambulatory healthcare services (27.9 cases per 10,000 workers).  The highest incidence rate among industries was in specialty hospitals (81.1), other ambulatory healthcare services (72.8) and general medical and surgical hospitals (68.6). (Table 7).   Four year (2003-2006) trend data for the incidence rates of nonfatal illnesses for the HCSA sector as a whole, by HCSA subsector, and for private industry are presented in Figure 14.

Nonfatal occupational skin disorders involving days away from work in the HCSA sector in 2006 accounted for 9,200 cases or nearly 22% of all such cases in private industry. (Table 8)   Hospitals and nursing and residential care facilities accounted for over two-thirds of skin disorder cases in the sector.  Nursing and residential care facilities had the highest incidence rate among the subsectors (12.4 cases per 10,000 full-time workers), followed by hospitals (10.2).  The highest incidence rate among industries was in community care facilities (14.8), followed specialty hospitals (14.1) and nursing care facilities (13.3).  By comparison, the incidence rate in private industry was 4.5 cases per 10,000 full-time workers.  Four year (2003-2006) trend data for the incidence rates of skin disorders for the HCSA sector as a whole, by HCSA subsector, and for private industry are presented in Figure 15.

Nonfatal occupational respiratory conditions involving days away from work in the HCSA sector in 2006 accounted for 6,400 cases or nearly 36% of all such cases in private industry. (Table 8)   Hospitals accounted for over half of the respiratory disorder cases in the sector.  Hospitals had the highest incidence rate among the subsectors (9.6 cases per 10,000 full-time workers), followed by ambulatory healthcare services (4.5).  The highest incidence rate among industries was in other ambulatory health care facilities (14.0), followed by specialty hospitals (10.4), general medical and surgical hospitals (9.6), and home healthcare services (9.6).  By comparison, the incidence rate in private industry was 1.9 cases per 10,000 full-time workers.  Four year (2003-2006) trend data for the incidence rates of respiratory conditions for the HCSA sector as a whole, by HCSA subsector, and for private industry are presented in Figure 16.

Source: BLS Workplace Injury and Illness Summary
External Link:http://www.bls.gov/iif/oshwc/osh/os/osnr0028.txt

Detailed data on nonfatal injuries and illnesses in the HCSA sector can be found at:

Fatalities

In 2006, the HCSA sector experienced 129 work-related fatalities.  Fifty-six (43%) of the fatalities occurred in ambulatory health care services (NAICS 621); home health care services (NAICS 6216) and other ambulatory health care services (NAICS 6219) accounted for over half of the fatalities in this subsector.  Most (44%) of the fatalities occurred as a result of highway accidents, with assaults and violent acts accounting for 26%.  The number of fatalities in 2006 represented a 24% increase from the number of fatalities in this sector the previous year.

Source: Fatal occupational injuries by industry and selected event or exposure, 2006
External Link: http://stats.bls.gov/iif/oshwc/cfoi/cftb0214.pdf

Additional BLS occupational fatality information can be found in the Census of Fatal Occupational Injuries (CFOI) and the CFOI news release .
External Link: http://stats.bls.gov/iif/oshcfoi1.htm
External Link: http://stats.bls.gov/news.release/cfoi.toc.htm

Resources:

NIOSH Worker Health Chartbook, 2004
DHHS (NIOSH) Publication 2004-146
The Worker Health Chartbook, 2004 is a descriptive epidemiologic reference on occupational morbidity and mortality in the United States. A resource for agencies, organizations, employers, researchers, workers, and others who need to know about occupational injuries and illnesses, the Chartbook includes more than 400 figures and tables describing the magnitude, distribution, and trends of the nation's occupational injuries, illnesses, and fatalities.

For additional health and safety information on healthcare workers, please see the NIOSH Health Care Workers topic page.

The Occupational Safety and Health Administration (OSHA) also provides technical links to numerous health and safety topics, some of relevance in the HCSA sector.
External Link: http://www.osha.gov/SLTC/index.html

 

Page last updated: October 20, 2008
Page last reviewed: October 20, 2008
Content Source: National Institute for Occupational Safety and Health (NIOSH) Division of Respiratory Disease Studies

< Economic Factors    |   Occupational Risks    |    National Research Agenda (NORA) >
NIOSH Program:

Health Care and Social Assistance

doctor and patient, man helping woman in wheelchair