Occupational health nurses serve as examples in preserving and improving the health of workers.

• Information Date:	09/16/1998
• Presented To:	American Assosiation of Occupational Health Nurses Conference of Leaders
• Speaker:	Jeffress, Charles N.
• Status:	Archived

NOTICE: This is an OSHA Archive Document, and may no longer represent OSHA Policy. It is presented here as historical content, for research and review purposes only.

Charles N. Jeffress
American Association of Occupational
Health Nurses
Conference of Leaders
Washington, D.C.
September 16, 1998

"Example is leadership," Albert Schweitzer once said. Occupational health nurses serve as examples -- leaders for their workplaces and communities -- in preserving and improving the health of workers.

As you look at ways to expand your influence by focusing on local leadership, I can think of no better example than your president, Bonnie Rogers. I have observed Bonnie's work in North Carolina for many years, and she epitomizes the best kind of leader -- one who sets high goals, motivates others and sees to it that her team at AAOHN gets the credit.

Occupational health nurses have a vital role to play in the workplace. Many of you are on the frontlines in safety and health. You are the health professional onsite. You are the one who knows what's really happening at your facility.

You identify employees at risk of illness or injury. You perform health surveillance. You identify safety and health problems. You track injuries and illnesses and treat hurt employees. You make a difference every day.

I know personally what effective leaders occupational health nurses can be. OSHA's Office of Occupational Health Nursing provides a focus for the agency on the day-to-day care for workers that occupational health nurses provide. It's a point of view that's proved invaluable to us as we seek practical ways to prevent injuries and illnesses in the workplace.

Elise Handelman and her team of nurses and rotating nurse interns have identified the occupational health and scientific underpinnings for our proposals and standards on bloodborne pathogens, tuberculosis and respiratory protection. Once standards are established, they also help develop compliance materials that detail the practical options for meeting the requirements.

The nurse intern program is mutually beneficial. Occupational health nurses join OSHA for 8-10 weeks as part of their graduate education. These nurses share their skills and also develop experience that will enable them to serve as leaders in the future.

Interns have worked with the ergonomics team, assisted OSHA field staff in heat stress cases and researched the literature on needlesticks. A number have worked alongside our inspectors in area offices in Philadelphia, Tampa and Parsippany, New Jersey. One intern's employer considered the experience so valuable that the company paid her salary while she was with us.

OSHA recognizes and supports your effort to improve worker safety and health. As licensed healthcare professionals you can handle many responsibilities in ensuring compliance with OSHA standards. That should include evaluating employees' fitness for wearing respirators. We welcome and appreciate your support on this issue. I trust when the courts resolve the matter, they will affirm state licensing boards have the authority to establish the scope of practice for health care professionals.

Hand in glove with leadership is partnership. The nurse intern program is one type of partnership. I would like to find others that OSHA might develop with occupational health nurses -- both at the national and local levels.

Two years ago, we formed an educational partnership with the Joint Commission on Accreditation of Healthcare Organizations. Together we are promoting effective employee safety and health programs. The Joint Commission's accreditation manual includes a section that identifies ways to meet OSHA standards along with accreditation requirements. Perhaps we might form a similar partnership with AAOHN.

Many of you are familiar with OSHA's Voluntary Protection Programs -- some of your sites fly the VPP flag. VPP is a site-based program OSHA has established to recognize excellence in workplace safety and health.

OSHA also has developed a number of local, group-based partnerships. But not too many people know about these.

For example, we have the Cowtown project in Fort Worth, HomeSafe in Denver, the poultry project in Georgia, the Roofers partnership in the Chicago area. The common thread through all these partnerships is the commitment of each organization and participant to work cooperatively with OSHA to implement effective safety and health programs.

We'd like more people to know about these partnerships. So we're going hold a one-day conference here in Washington on November 13 to showcase some of these partnerships. We'd also like to develop more of these local partnerships.

If you have a creative plan that might improve workplace safety and health in your community or your industry, I encourage you to call the area director at the OSHA office near you. Share your experience and strategies. Your practical suggestions might form the core of a new partnership model.

All of our partnerships are built on the foundation of safety and health programs. The key to safety at any site is real management commitment and worker participation in an organized, ongoing effort to protect workers.
At similar sites with similar potential hazards, the difference between a low injury rate and a high injury rate is an effective safety and health program.

Safety and health programs pay off for employers -- saving more than just workers' comp costs alone. But we still have work to do in convincing some employers that safety and health programs are profit centers, not cost centers.

On the regulatory front, we are developing a safety and health program proposal. That is one of my top priorities. Before I leave office, I want an effective safety and health program to become a fundamental responsibility of every employer in the country.

Our safety and health program proposal will incorporate five key elements: management leadership; employee participation; hazard assessment; hazard prevention and control; and information and training. And it will be flexible, with appropriate expectations for companies of different sizes in different industries. We hope to have our proposal out for comment by the end of this year. And we hope you will share your experience and expertise with us throughout the rulemaking process.

When it comes to safety and health programs, there is one issue that you may not have thought of -- Y2K, shorthand for computer glitches that may come with the Year 2000. It sounds like only a computer problem, but it can also be a safety and health issue. Many safety systems have embedded date-coded computer chips in them. They need to be checked to ensure that alarms work, that maintenance checks are made on time and that key health information is available when needed.

For instance, if you have technical equipment that monitors worker exposure to a particular chemical, it probably records the date and time of its measurements. If the date chip in that monitor is not Y2K compliant, it will stop working on December 31, 1999 -- and you may not know it until too late! Now is the time to check out all of your technical equipment.

A critical element of any safety and health effort is recordkeeping. It's important to track injuries and illnesses to better prevent them in the future. Accurate records are essential, and you are usually the key person in the recordkeeping process. Underreporting denies you and your management the information you need to make decisions on how to improve worker safety and health at your business, and it denies workers an accurate assessment of their own health experience. And oh, by the way, it's an OSHA violation we take seriously!

The accuracy of workplace injury and illness records is increasingly important to OSHA. To better utilize our resources, we're using injury and illness data to determine who most needs our intervention.

Last year we surveyed 80,000 employers in high hazard industries to identify those who most needed our help. We offered about 12,000 the opportunity for a reduced chance of inspection of they agreed to establish safety and health programs. While that partnership program -- the Cooperative Compliance Program -- has been stayed by the courts pending review, we are using the data we gathered to target our inspections. It is critically important to us that the data be correct.

At the same time, we are revising our recordkeeping requirements -- to make the forms simpler, the definitions clearer and the instructions easier to understand. I know that's welcome news to many of you who must fill these forms out. We expect to publish a final regulation next spring with extensive training on the new rules next fall. The new requirements would then be in place for records kept as of January 1, 2000.

Another recordkeeping matter that concerns many occupational health nurses is the confidentiality of medical information, particularly personal information that is unrelated to workplace issues. We have similar concerns. I want you to know that OSHA has a detailed, explicit process for assuring confidentiality when we seek medical records through a medical access order. We are interested only in identifying potential hazards and resulting injuries and illnesses in the workplace. We support and share your professional commitment to shield personal medical data.

Another top regulatory priority of mine is ergonomics I don't have to tell you that musculoskeletal disorders, or MSDs, represent a very serious problem in many workplaces. Nearly one-third of all occupational injuries and illnesses stem from overexertion or repetition. You have patients who come to you hurting. Many of you and your employers have found ways to reduce heavy lifting, eliminate awkward postures and cut back on repetitive motions to reduce the risk of injury for workers.

In fact, most work-related MSDs can be prevented by a sound ergonomics program. As you know, OSHA is working on an ergonomics proposal that will call for employers to develop such programs. We have met several times with stakeholders -- including AAOHN's Kae Livsey -- to discuss our progress. And we'll be meeting here again next week.

We know that OSHA's rule has to cover manufacturing operations and workers involved in manual handling throughout general industry -- where the highest risks are. We are looking at keyboarding operations and at employees who use scanners, such as supermarket cashiers. We are open to covering any operations in general industry where employees are being hurt and where feasible solutions exist.

In any case, we are aiming to develop a flexible framework, not a one-size-fits-all approach as our critics like to claim. We want to provide employers with the tools to solve the ergonomic problems they face. And the encouragement to do so, if they need it.

We've also been offering an opportunity for employers to share their successes in reducing MSDs through our regional best practices conferences over the past year. These one-day sessions that have been held throughout the country offer participants practical advice on improving their operations to cut repetition and overexertion.

Let's turn for a moment to the very real on-the-job health risks that you personally face as occupational health nurses. For some, particularly in healthcare settings, bloodborne pathogens represent a serious health threat.

OSHA is taking another look at this issue -- particularly preventing needlesticks that can result in life-threatening illnesses and sometimes even death. Needlesticks account for up to 80% of the accidental exposures to blood.

OSHA believes the key to avoiding needlesticks lies in a comprehensive strategy -- a programmatic approach. Just buying new devices labeled "safer" is not enough. For those of you who are exposed to or have employees exposed to needlesticks, I commend to you the training materials developed by our office of occupational health nursing and now available on the Internet.

In addition, last week we published in the Federal Register a formal Request for Information on needlestick prevention. It includes about a dozen questions on preventing needlesticks. But the bottom line is simple. We want to know what works. Once we find out strategies that make sense, we will share that information broadly. I encourage you to share your recommendations with us through this process.

For those who face routine exposure to blood and must regularly wear gloves, latex can pose a problem. Nurses who become sensitized to natural rubber latex on the job can face a life-threatening allergic reaction to an ordinary birthday balloon. Together with our federal partners in the Food and Drug Administration and the National Institute for Occupational Safety and Health, we are working to expand information and to reduce risk. At the same time, we need to maintain appropriate protection against bloodborne pathogens.

We're working on a second draft of a Hazard Information Bulletin on this issue and have solicited final stakeholder comments. We expect to distribute the bulletin shortly. The document outlines ways to minimize worker risk for developing latex allergies and to protect those who are already sensitized.

Another healthcare issue is occupational transmission of tuberculosis. Last October we published a proposal that we estimate would prevent occupational transmission of TB, with its potentially life-threatening consequence to healthcare workers and their families, at more than 100,000 facilities nationwide. The OSHA proposal is based on CDC's guidelines, but would be enforceable once it is final.

We've held hearings around the country on TB. And many occupational health nurses have participated in those hearings. Final post-hearing submissions are due early next month. Meanwhile we're evaluating the public comments and testimony we have already received. We'll be at work developing the final standard for some time to come.

As you can tell, OSHA is busy. I know you are, too. Each of us can make a difference, and if we work together in partnership, we can multiply our energies to achieve even more.

We appreciate all you do to keep workers safe and healthy on the job. And we look forward to finding new ways to partner with you. I salute the example you set and offer you OSHA's assistance to help you do your job.

NOTICE: This is an OSHA Archive Document, and may no longer represent OSHA Policy. It is presented here as historical content, for research and review purposes only.

Speeches - (Archived) Table of Contents

Back to Top	www.osha.gov	www.dol.gov
Contact Us \| Freedom of Information Act \| Customer Survey Privacy and Security Statement \| Disclaimers
Occupational Safety & Health Administration 200 Constitution Avenue, NW Washington, DC 20210

www.OSHA.gov	A-Z Index: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z