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Outreach, Community
and Home Care workers make up a growing group of employees who find,
communicate with, and serve individuals who are not part of traditional
facility based health care delivery systems. The Bureau of Labor
Statistics (BLS) reports that the industry providing nursing and
personal care in patients’ homes added jobs faster than any other
segment of the U.S. economy, with 500,000 employees in 1994.()
Looking to the future, the BLS Occupational Outlook Handbook states
that health care occupations are expected to increase more than
twice as fast as the whole economy. The increasing number of elderly
and persons recovering from surgery and other serious health conditions
is the basis for the demand in personal, home care and home health
aides.()
Along with the
demand in home care services, high risk groups for illness and disease
are the focus of outreach and community involvement and intervention
programs, such as injection drug users or special populations such
as Spanish speaking individuals. Outreach and community workers
develop special skills in learning community settings, how to approach
and communicate with individuals in the community, and how to engage
community members in activities to educate and provide care and
treatment. Public health research is being conducted to examine
program development and outcomes in community settings. Public health
departments are adding community intervention work along with traditional
disease-based case identification, education and treatment.
Parallel to
the growth in home care, community, and outreach jobs is the incidence
of work-related injuries and illnesses resulting in lost work time.
The BLS reports that the overall injury rate for home care in 1994
was 50% higher than that in hospitals and 70% higher than the national
average.(1) Home care workers are at increased risk for
injuries resulting from overexertion, highway accidents, falls at
the same elevation and from a higher elevation and body reactions.
The highest rate of injuries is due to overexertion. The greatest
difference in injury rates between home health, hospitals and the
national average is highway accidents where the rate in home care
is 25 times higher than in hospitals and 13 times higher than the
national average.(2) In addition community, outreach
and home care workers are exposed to infectious agents, hazardous
chemicals and violence.(2-)
Outreach, community
and home care workers face unique injury and illness risk factors
in their work. Workers are required to perform an ever changing
set of activities in constantly changing work settings. Patients
and clients may have multiple physical limitations which result
in increased worker risk for injury. Home care settings present
a less standardized, predictable and controlled work setting.(1)
Employers and employees may have little or no knowledge about or
control over conditions in patients’ homes and workers usually do
not have the opportunity to request assistance with particularly
difficult or dangerous activities.
The Great
Lakes Center Fact Pack (below) presents a framework to develop
knowledge and skills for a continuous evaluation for anticipating,
recognizing and controlling new or emerging hazards within the community,
outreach and home care settings. Along with the discussion from
our 1998 conference, the Fact Pack includes tools for implementing
a health and safety program at work. The Fact Pack allows the manager
to review a Health and Safety Program Report Card, which helps identify
the program’s strengths as well as determine areas of the program
that are in need of improvement. The Fact Pack addresses the essential
areas of Survey and Hazard Analysis and Safety and Health Training.
In addition, the activities and assessment tools provided in this
pack may be used for small group training sessions at the workplace.
Our goal is for both employers and employees to evaluate workplace
settings and to develop control measures at work. If you need more
information about the Fact Pack contact Joe Zanoni at jzanoni@uic.edu
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