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Hospital eTool/Nursing Home eTool
Dietary Module
Click on the area for more specific information.
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Common safety and health topics:
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Potential Hazard
Dietary employees must perform many lifting, reaching, and repetitive tasks as part of their job
duties. Employee activities in this area, if occurring with sufficient duration, magnitude, and/or frequency, may create a
musculoskeletal disorder (MSD).
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![Figure 1 - Kitchen worker using extended/elevated reach Figure 1 - Kitchen worker using extended/elevated reach](https://webarchive.library.unt.edu/web/20081104053828im_/http://www.osha.gov/SLTC/etools/hospital/dietary/images/img01.gif)
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Kitchen worker using extended/elevated reach. |
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![Kitchen worker scooping ingredients with flexed wrist Kitchen worker scooping ingredients with flexed wrist](https://webarchive.library.unt.edu/web/20081104053828im_/http://www.osha.gov/SLTC/etools/hospital/dietary/images/img08.gif)
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Kitchen worker scooping ingredients with flexed wrist. |
Possible Solutions
Assess worksites for ergonomic stressors and identify and address ways to decrease them such as:
Reaching/Lifting:
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- Provide height adjustable workspaces appropriate for the task being performed, so that workers can keep elbows close to the
body. For example, lower countertops, or use height adjustable countertops or stands, or provide work stands for employees.
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- Redesign or reposition tasks to allow elbows to remain close to the body, (e.g., turn boxes over on side
to allow for easier access).
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![Figure 2 - Repositioned Task Figure 2 - Repositioned Task](https://webarchive.library.unt.edu/web/20081104053828im_/http://www.osha.gov/SLTC/etools/hospital/dietary/images/img02.gif)
Box placed on side, allows for less reaching. |
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- Avoid awkward postures (e.g., reposition work in front of worker rather than reaching above or behind to get supplies).
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![Keep most work activities within repetitive access area. Keep most work activities within repetitive access area.](https://webarchive.library.unt.edu/web/20081104053828im_/http://www.osha.gov/SLTC/etools/hospital/dietary/images/deskreach.jpg)
Keep most work activities within repetitive access area.
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- Use mechanical aids to reduce the need to lift. Use a spring device to automatically lift a load (e.g., use automatic plate and
cup riser dispensers).
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- Lighten a load that needs to be lifted or get help when lifting.
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- Train workers to use proper lifting techniques.
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Repetitive motions
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Rotate workers through repetitive tasks.
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Use mechanical aids for chopping, dicing or mixing foods (e.g., food processors, mixers).
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Select and use properly designed tools. For example, kitchen
scoops or kitchen knives that allow the wrist to remain straight.
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![Non Ergonomic Scoop Non Ergonomic Scoop](https://webarchive.library.unt.edu/web/20081104053828im_/http://www.osha.gov/SLTC/etools/hospital/dietary/images/badscoop.jpg)
Bent Wrist |
![Ergonomic Scoop Ergonomic Scoop](https://webarchive.library.unt.edu/web/20081104053828im_/http://www.osha.gov/SLTC/etools/hospital/dietary/images/goodsoop.jpg)
Straight Wrist |
- Maintain a neutral (handshake) wrist position.
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Restructure jobs to reduce repeated motions, forceful hand exertions, and prolonged bending.
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Kitchen knives |
![30 degree bend 30 degree bend](https://webarchive.library.unt.edu/web/20081104053828im_/http://www.osha.gov/SLTC/etools/hospital/dietary/images/knife1colored.jpg)
30 degree bend |
![upright handle upright handle](https://webarchive.library.unt.edu/web/20081104053828im_/http://www.osha.gov/SLTC/etools/hospital/dietary/images/knife2colored.jpg)
Upright Handle |
![pistol grip pistol grip](https://webarchive.library.unt.edu/web/20081104053828im_/http://www.osha.gov/SLTC/etools/hospital/dietary/images/knife3colored.jpg)
Pistol Grip |
![45 degree bend 45 degree bend](https://webarchive.library.unt.edu/web/20081104053828im_/http://www.osha.gov/SLTC/etools/hospital/dietary/images/knife4colored.jpg)
45 degree bend |
For additional information, see HealthCare Wide Hazards -
Ergonomics.
Additional Information:
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Ergonomics,
Safety and Health Topics Page.
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Hospital Kitchen and Food Preparation. Ergonomic Report.
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Potential Hazard
Kitchen equipment pose special hazards to the dietary
worker. Some of these hazards include: hot surfaces, which may cause
burns; cuts and lacerations from the use of sharp objects; becoming
caught in walk-in freezers; electrical shocks from contact with frayed
electrical cords, and amputations from unguarded equipment.
Possible Solutions
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- Employers must assess tasks to identify potential worksite hazards and provide and ensure employee use of appropriate
Personal Protective Equipment (PPE) [1910.132].
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- Employers shall require employees to use appropriate hand protection when hands are exposed to hazards such as cuts,
lacerations, and thermal burns. Examples include the use of oven mitts when handling hot items, and steel mesh or
Kevlar gloves
when cutting [1910.138(a)].
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Walk-in freezers must have a panic bar or other means of exit on the inside of freezers to prevent trapping
workers inside [1910.37].
- Ensure electrical equipment shall be free from recognized hazards [1910.303(b)(1)].
See Electrical Safety.
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- Good work practices include:
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The safe handling, use, and storage of knives and other sharp utensils.
Cutlery should be kept sharpened and in good condition: dull knives
tend to slip and may cause injuries. The direction of the cut should
always be away from the body.
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Knives, saws, and cleavers should be kept in
a designated storage area when not in use. The blades should not be
stored with the cutting edge exposed. Knife holders should be installed
on work tables to prevent worker injury. Knives and other sharp
objects should not be put into sinks between periods of use. Newly
purchased knives should be equipped with blade guards and knuckle
guards that protect the hand form slipping onto the blade.
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The wheels of food carts should be large, low rolling, low
resistance wheels, that can roll easily over mixed flooring as well
as gaps between elevators and hallways.
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- Use appropriate PPE and training to avoid steam burns when working with hot equipment or substances.
- When uncovering a container of steaming materials, the worker
should hold the cover to deflect steam from the face.
- The handles of cooking utensils should be turned away from the
front of the stove.
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Potential Hazard
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Possible fires from heat producing equipment such as burners, ovens, and grills due to:
- Poor housekeeping.
- Un-emptied grease traps (possible grease fires).
- Dirty ducts (possible flue fires).
- Improper storage of flammable items.
- Faulty or frayed electrical cords.
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Possible Solutions
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- Provide appropriate and effective employee training for safe handling of equipment.
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- Keep grill and grill duct work free from flammable residues and properly maintained
[1910.38(b)(3)
and (5)].
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- Keep flammable items must be stored away from heat producing equipment
[1910.38(b)(3)].
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- It is recommended that grease traps be routinely emptied.
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- Fixed dry chemical extinguishing systems used to fight grease fires must meet requirements of
1910.161 Dry Chemical Fire Extinguishers and
1910.160 Fixed Extinguishing Systems.
- Provide an emergency action plan, and a fire prevention plan.
- Emergency Action Plan (EAP):
- If fire extinguishers are required or provided in your workplace, and if anyone will be evacuating during a fire or other emergency, then OSHA's
1910.157 standard
requires you to have an EAP.
- Fire Prevention Plan:
- The purpose of a fire prevention plan is to prevent a fire from occurring in the workplace.
[1910.159]
- An employer must have a fire prevention plan when an OSHA standard requires one.
- Fire Prevention Plan requirements. Evacuation, Plans, and
Procedures eTool.
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For additional information, see HealthCare Wide Hazards -
Fire Hazard. |
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Potential Hazard
Employee exposure to possibly hazardous chemicals, such as
pesticides, disinfectants, and hazardous drugs in the workplace for
example:
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Ammonia, used as a cleaning agent, and chlorine solutions used as
disinfectants in dishwashing, can cause skin, eye, and nose
irritations. (Avoid mixing chlorine and ammonia solutions because a
chemical reaction may occur and deadly chlorine gas may be released).
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Drain cleaners, oven cleaners, and grill cleaners can be caustic
solutions that can cause skin burns and eye and skin
irritations.
Possible Solutions
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Implement a written program which meets the requirements of the
Hazard Communication Standard to provide for worker training, warning labels, and access to Material Safety Data Sheets
(MSDS).
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Provide appropriate PPE (e.g., gloves, goggles, splash aprons) when handling hazardous detergents and
chemicals [1910.132].
For more information see HealthCare Wide Hazards - PPE.
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Medical Services and First Aid: Where the eyes or body of any person may be exposed to corrosive materials,
suitable facilities for quick drenching or flushing of the eyes and body shall be provided within the work area for immediate
emergency use [1910.151(c)].
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To avoid employee contact with dishwashing detergents, good work practice recommends
using dishwashing machines with automated detergent dispensers.
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Workers must still be cautious and use appropriate PPE (e.g., goggles, and/or gloves) when changing out the containers of
detergent.
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Potential Hazard
Commercial dough mixers and other kitchen equipment pose a
hazard to workers from being caught in or by rotating blades and can present various hazards to the employee such as amputations,
strangulations, burns, cuts, broken bones, and other injuries. These machines
must have guards in place to protect the worker form reaching in, or
being pulled into, these hazards.
Possible Solutions
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Meat slicers must be properly guarded and operated by workers trained in safe work practices to avoid cuts and amputations.
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Use Tamps or push sticks or other hand tools to feed or remove food from grinders, slicers, or choppers
[1910.212(a)(3)(iii)].
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Continuous feed dishwashers should be properly guarded to prevent accidental scalding of workers by steam and hot water, and possible nip-point injuries from rollers and conveyors.
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Machine guarding can be accomplished by isolating hazards (e.g., providing barrier guards over a mixer when it is in use to
prevent strangulation or amputations).
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Other methods of machine guarding include:
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Two-handed tripping devices.
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Electronic safety devices.
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Examples of machine guarding for General Industry-Bakery equipment can be found in
[1910.263].
Paragraph (c) addresses general requirements for machine guarding in Bakeries.
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Food borne diseases, including food borne intoxications and food borne infections, are illnesses contracted by eating contaminated food. Contamination
can arise from toxins and bacterial growth that can occur before the food is eaten, or after the food is ingested, and are caused by such
organisms as Escherichia coli (E-coli), Salmonella, Staphylococcus Aurous, and Clostridium Perfringens.
OSHA Standard 1910.141(h)
states "In all places of employment where all or part of the food service is provided, food must be handled, processed,
prepared, and stored in such a manner as to protect against contamination". However, food borne disease is primarily a
public health concern and in most instances is regulated by local health authorities who enforce their own specific requirements.
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Potential Hazard
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Employees may develop food borne illness from eating or handling contaminated food.
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Possible Solutions
Contact local public health authorities for specific requirements in your area.
Recommended good work practices help ensure effective hand washing techniques, good personal hygiene, and safe food handling/preparation.
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Food Safety: Government food safety information site.
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Food Code: FDA published 1999 reference guide.
Provides guidance on how to prevent food borne illnesses in facilities such as nursing homes.
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![Wash Your Hands Sign Wash Your Hands Sign](https://webarchive.library.unt.edu/web/20081104053828im_/http://www.osha.gov/SLTC/etools/hospital/dietary/images/hands.jpg) |
Additional Information:
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Potential Hazard
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Employee exposure to wet kitchen floors or spills and clutter can lead to slips, trips, falls, and other possible injuries.
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Possible Solutions
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Floors shall be kept clean and dry
[1910.22(a)(2)].
In addition to being a slip hazard, continually wet surfaces promote the growth of mold, fungi, and bacteria which can
cause infections.
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Keep aisles and passageways clear and in good repair, with no obstruction across or in aisles that could create a hazard
[1910.22(b)(1)].
Provide floor plugs or ceiling plugs for equipment, so power cords do not run across pathways.
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For additional information, see HealthCare Wide Hazards -
Slips/Falls.
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Potential Hazard
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Electrocution or shock from unsafe work practices, faulty electrical equipment, or wiring. |
Possible Solutions
Employers must:
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Ensure that all electrical service near sources of water is properly grounded
[1910.304(f)(5)(v)].
- Ensure electrical equipment will be free from recognized hazards
[1910.303(b)(1)].
- Tag out and remove from service all damaged receptacles and portable electrical equipment
[1910.334(a)(2)(ii)].
- Repair all damaged receptacles and portable electrical equipment before placing them back into service
[1910.334(a)(2)(ii)].
- Ensure that employees are trained to not plug or unplug energized equipment when their hands are wet
[1910.334(a)(5)(i)].
For additional information, see HealthCare Wide Hazards -
Electrical Hazards.
Additional Information:
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Infectious Materials in Isolation Rooms
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Potential Hazard
Dietary employees may be exposed to respiratory hazards, blood or OPIM, if they are required to take dietary trays to patients in isolation rooms.
Exposure to infectious materials may also occur when handling red bagged contaminated food trays that have come from isolation
rooms, to the kitchen to be sterilized.
Possible Solutions
- Establish Universal Precautions:
- Universal Precautions: An approach to infection control which treats all human blood and other potentially infectious
materials (OPIM), as if they were infectious for HIV and HBV or other
bloodborne pathogens [1910.1030(b)].
- Universal Precautions 1910.1030(d)(1) in
The Bloodborne Pathogens Standard requires:
- Treat all blood and other potentially infectious materials with appropriate precautions such as: Use gloves, masks, and gowns if blood or OPIM exposure is anticipated.
- Use engineering and work practice controls to limit exposure.
- Educate and train all exposed employees to safely enter and exit isolation rooms and to safely handle food trays coming from isolation rooms.
- Encourage staff to special bag contaminated trays coming from isolation rooms and label the bag with what precautions are necessary to safely handle the contents (e.g., use universal precautions).
- Use only disposable trays and plastic ware in isolation rooms.
For additional information, see HealthCare Wide Hazards -
Tuberculosis,
Bloodborne Pathogens, and
Universal Precautions.
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