It's bad enough that health care workers have to worry about getting bird flu, Ebola and SARS. But even if they aren't in contact with infected patients there are many other hazards in a health care institution. Ergonomics issues are a big deal (I worked my way through school as a "transport" worker in a radiology department and lifting patients is a good wway to hurt your back; I know). And so are dangerous chemicals:
Nurses who are exposed to high levels of chemicals and drugs on the job are more likely to report having asthma, miscarriages and some cancers, according to a survey released today.More than 1,500 nurses nationwide, including a sample from Missouri and Illinois, were asked last year about their health histories and on-the-job exposures to cleaning products, radiation, mercury and other potentially hazardous materials. The survey was conducted by the Washington-based nonprofit Environmental Working Group.
Nurses who said they were exposed to high levels of radiation reported a 20 percent higher rate of breast cancer compared with nurses who had little or no exposure, according to the survey. High levels were defined as exposure at least once a week for 10 years or longer.
High exposures to any type of medication were associated with a 14 percent increase in cancer rates. Asthma rates were up to 50 percent higher in nurses who reported high exposures to disinfectants, cleansers and latex. Nurses who said they had high exposures to cancer drugs reported about 20 percent more miscarriages. (Blythe Bernhard, St. Louis Post Dispatch)
Not a surprise. The survey was done by an advocacy group, Health Care Without Harm. Whether it's representative of all nurses or not I'm not sure, but my own experience in hospitals tells me the basic facts are correct. Nurses and other health care workers are exposed daily to chemicals with potential for both help and harm. When they are given to patients, like chemotherapy drugs, the risk benefit balance is (we hope) on the side of benefit. But to the oncology nurse who may also be exposed while making up an IV bottle, there is no benefit side.
There are ways to protect yourself, of course. Hospital administrators are quick to point that out. But when the unit is short staffed and the supplies are not always ready to hand and no one has trained you, well, you know. Anyway, it's cancer in 30 years and you've got to pay the rent in 30 days and there are ten people waiting.
It's not like it's Ebola.
Just to play devil's advocate here (something I can't resist doing):
This survey sounds like it's really, really vulnerable to confirmation bias, given that it relies on memory, doesn't try to estimate objectively exposures, and couples questions about exposures with questions about health problems. Indeed, the very first sentence cited should have read, "Nurses who report exposure to high levels of chemicals and drugs on the job are more likely to report having asthma, miscarriages and some cancers, according to a survey released today." That makes the problem of potential confirmation bias clear. Worse, it says right in the newspaper article that the study didn't take into account other factors such as smoking habits and age, which makes its results pretty much worthless from a scientific viewpoint. There's also the "chicken and the egg" question for at least one of the health problems (namely asthma) in that the question is whether the exposure caused the problem or simply exacerbates a preexisting condition.
Couple the above flaws with the fact that the study was done by an advocacy group and was in essence science by press release (I don't see the study being published in a peer reviewed journal), I can't help but notice some serious red flags here.
That being said, let me point out that I'm not saying that it's a good thing to be working with nasty chemicals and infectious agents without adequate protection; clearly it's not. It's just that this sort of survey looks on the surface to be very weak and designed more for advocacy purposes than any sort of scientific look at the actual relationship between such exposures and the health problems listed and should be viewed as that and nothing more.
orac: You pointed out the reasons I did not rely on the quantitative resuls of the HCWH survey (which even they don't claim much for). Your last para. (which for public health reasons I wish had been your first para.) is pretty much where I am, plus, of course, many articles in the literature on the hazards of the health care environment, which I was merely (once again) pointing out since those outside the field think of it as particularly safe.
But Revere, why should even the qualitative results be correct? If, as you concede, the numbers are very unreliable, what's to stop them being on the other side of 0 to where the study reports them? It seems wrong to give air (brain?) space to such a poorly done study.
Mathematician: I've worked in hospitals most of my adult life. The point was to observe (once again) that they were dangerous places, just as computer clean rooms can be dangerous even though they look sterile (as the workers at IBM). The objective fact of this doesn't depend on this survey. The literature is replete with documentation and I was just taking the release of the survey as an opportunity to point it out once again. If you read the post, I wasn't touting their results (which I discounted to some extent) but highlighting their point, which seems to have gotten lost. I'll take the blame for poor execution.
The words used to make the comparison ('risk' vs. 'benefit') indicate a substantial cognitive bias towards belief in treatment effectiveness.
I suspect that the hope revere alludes to is often, maybe even generally, mistaken.
You are right in stating that ergonomics are a huge topic in healthcare. So is violence in the workplace.
http://www4.cbs.state.or.us/ex/imd/reports/rpt/index.cfm?fuseaction=ver…