Health and safety risks of employees in health and social services institutions

A survey conducted by the Occupational Safety Research and Educational Institute looks into the safety levels of working conditions in institutions providing health and social services. The results of the survey provide an insight into the specific working conditions of employees in these institutions and identify ways to promote a safer working environment. Based on the survey’s results, measures to improve working conditions in health and social services institutions have been proposed.

Background

In 2002, a survey by the Occupational Safety Research and Educational Institute (Výskumný a vzdelávací ústav bezpecnosti práce, VVÚBP) examined the safety levels of employees’ working conditions in health and social services institutions established according to Act No. 195/1998 on social assistance. The survey was conducted over a five-month period in 45 institutions, and included 225 participants.

According to the Statistical Office of the Slovak Republic (SO SR), approximately 18,000 employees worked in 730 health and social services institutions in 2005. The average monthly salary of employees in these institutions was SKK 13,946 (approximately €366) in the same year. Employees working in health and social services institutions include:

• medical staff;

• cleaning staff;

• social workers;

• educational staff;

• office and managerial staff;

• auxiliary workers.

Survey results

The 2002 survey revealed that employees working in health and social services institutions were being exposed to risk factors at the workplace that could endanger their health and safety. Typical risk factors included: lifting heavy physical loads and dealing with neuropsychological problems of disabled or paralysed patients; working in strained positions; working with equipment and tools that carried a risk of mechanical failure or electrical accidents. Other risk factors mentioned by the employees included shift work, the threat of infectious diseases and working with chemical substances.

Typical diseases as well as types of occupational accidents were reported by the employees surveyed. Among the most common registered occupational diseases reported by employees in this sector were infectious diseases, occupational dermatitis, upper limb disorders caused by excessive repetitive strain, and spinal injuries. The most frequent types of accidents recorded were cuts, fractures and spinal injuries. In total, some 1,092 accidents were registered during the survey period. It appears that employees working in these institutions were exposed to a high physical and psychological burden, including significant emotional stress, mainly attributed to the fact that these workers felt responsible for the health and welfare of their clients.

Unfavourable working conditions

According to the survey, the unfavourable working conditions in health and social services institutions had a direct impact on staff performance levels and on employees’ adherence to occupational health and safety guidelines. The most significant problems revealed by employees pertained to the following areas.

Inadequate equipment and buildings

• Poor technical condition of buildings and equipment;

• Construction and operational design of buildings do not meet occupational health and safety requirements, and civil protection and fire regulations;

• Lack of lifting and transport equipment for assistance with disabled or paralysed patients;

• Archaic conditions including use of barriers.

Poor compliance by employers

• Lack of suitably qualified personnel;

• Poor gender balance, as mostly women are employed in these institutions;

• Non-adherence to the specified working hours;

• Too much overtime required, with little possibility for workers to take days off or to receive adequate pay in lieu;

• Often only one employee on the premises during night shifts;

• An accumulation of functions required of one employee (auxiliary work, repair services, sanitary work);

• Non-adherence to the Labour Code;

• Low wages for employees;

• Inadequate provision of protective working tools for employees;

• Lack of personal hygiene facilities, cloakrooms, changing rooms and toilet facilities;

• Health and safety training often only formally provided by external people.

Failure of employees to adhere to obligations

• Non-observance and unfamiliarity with guidelines and regulations for occupational health and safety;

• Non-compliance with safe working practices;

• Non-participation in immunisation programmes;

• Non-observance of personal and institutional hygiene requirements.

Legal issues

• No formal system in place for on-call work (financially or organisationally);

• Cancellation of bonus for employees working in difficult conditions involved in assisting disabled or paralysed patients.

Commentary

As part of the survey, the researchers discussed with interviewees and representatives of the social services institutions various options for improving their working conditions. In this regard, all interviewees showed great interest in an immediate implementation of the measures required to improve working conditions. Management at the respective institutions are also trying to address the obvious technical and operational problems, in accordance with their financial budgets.

Note: The results of this survey have not yet been published.

Miroslava Kordošová, Institute for Labour and Family Research