Dr. Jane Lipscomb
Home care workers need federal and state workplace safety and health protection to protect them from injuries and illness on the job, according to an article in the July issue of the American Journal of Industrial Medicine.
“Occupational blood exposure among unlicensed home care workers and home care registered nurses: Are they protected?” presents the findings of a survey of nearly 1,000 personal care assistants (PCAs) who care for clients in their homes. Lead author and DCA board member Dr. Jane Lipscomb notes that little is known about the risk of blood exposure among these workers. She conducted the survey to see how often they were at risk compared to the registered nurses (RNs) who work in home care.
The PCAs in the study worked for two large home care agencies in a large Midwestern city. Eight of every 100 reported that they had contact with their client’s blood and body fluid in the course of providing care.
RNs providing home care reported 27 exposures per 100 workers. While that is a substantially higher number, it represents a substantially lower percentage of unsafe exposures, since the RNs routinely come into contact with sharps. The majority of the PCAs did not report having contact with needles or lancets on the job, but those who did were five times as likely to be exposed as the RNs. Those who reporting changing wound dressings were at between two and three times the risk of exposure to blood compared with RNs.
“Home care workers need protection from work related exposures that may lead to injuries or illnesses, just as their counterparts who work in institutional settings do,” says Lipscomb. “In fact, they may be at greater risk when exposed to blood or body fluids because the home care environment does not include certain features of an institutional work setting, including needle disposal systems and safety-engineered needles and sharps. In addition, they may not have ready access to post-exposure treatment or prophylaxis.”
Both PCAs and RNs reported exposures to sharps, blood, and body fluids in the home setting at rates that are unacceptable and indicate the need for additional training, prevention, and protection, the survey found. PCAs appear to be at increased risk of injury when they perform nursing-related activities at which they are inexperienced and/or lacking in training. To protect home care workers from blood exposure, we must ensure enforcement of the OSHA Bloodborne Pathogen Standard.
The article is free to subscribers and available to others for a fee.
Elise Nakhnikian
Communications Director
Direct Care Alliance
