October 13, 2003—The National Institute for Occupational Safety and Health (NIOSH) recently conducted an assessment at an adult care center for individuals with severe mental and developmental disabilities, which resulted in recommendations for practical measures to reduce potential risks to employees without compromising services to individuals at the center. Employee duties include assisting some of the individuals with personal care and personal hygiene needs, bringing the risk of exposure to saliva and other body materials. In addition, some individuals have challenging behaviors such as biting, scratching, or becoming verbally aggressive.
From its assessment of employees and management, existing research, and county procedures, NIOSH:
- Emphasized the importance of taking organizational steps to reduce work stress, and not dismissing stress as a “necessary evil” in a challenging job. NIOSH recommended that management engage a consultant to evaluate the extent of work stress among the employees, and pursue strategies for eliminating sources of stress and training staff in active, problem-solving coping methods.
- Recommended that the center follow Occupational Safety and Health Administration (OSHA) regulations and CDC guidelines for managing occupational exposures to bloodborne pathogens. Standard precautions should be followed to prevent occupational infections. Any employee potentially exposed to a bloodborne pathogen should be referred immediately to his or her occupational health clinic, where counseling, treatment, and post-exposure prophylaxis should be offered as appropriate.
- Addressed concerns that tearing occurred frequently in the disposable gloves provided to employees, compromising the gloves’ ability to prevent exposures to body materials. NIOSH recommended that 1) management provide different sizes of protective gloves to decrease the possibility that the glove might tear because it is too small, 2) assess the circumstances associated with tearing, to identify circumstances in which any disposable glove might tear occasionally, and 3) in those situations, provide employees with the option of wearing double gloves or thicker gloves.
The case study (conducted in 2002), “Job Stress and Infectious Disease Risks in an Adult Developmental Center,” was published in the Applied Occupational and Environmental Hygiene, 18:561-565, 2003. The hazard evaluation report is available from NIOSH (.pdf file), as is further information about the health hazard evaluation program.
