As nurses we spend a great deal of time assessing for, and trying to reduce health and well-being risks that are faced by our patients. On the other hand, how often do we remember to watch out for ourselves? One study has shown that the rate of occupational injury and illness for nurses in health care settings is higher than other fields normally associated with high risks; such as, heavy construction and mining. There are some risks that we know go with the job, but on the whole do we understand the risks nurses face every day? Here are a few things to consider.
Hepatitis B (HBV)
HBV is widely recognized as an occupational risk for nurses. Prior to the initiation of wide spread immunization the rate of HBV among health care workers was 10 times higher than the general population. Currently, your risk is based on the amount of contact you have with blood in your work environment and your immunization status. Transmission may occur from a needle, or other instrument stick, or when contaminated blood invades the body through a break in the skin, ingestion, or contact with mucous membranes. Saliva, semen and feces can also carry and transmit the virus.
Without vaccination your chance of contracting HBV from a contaminated needle stick can be as high as 30%. Vaccination can reduce this number to approximately 6%.
Human Immunodeficiency Virus (HIV)
Consider that same needle stick once again. The risk of contracting HIV in this manner is approximately 0.3%. Exposing your eyes, nose, mouth or broken skin to HIV infected blood carries a 0.1% risk of infection.
Back injury is the second most common injury for all occupations. Approximately 40,000 nurses report back related injuries each year. Additional risk factors for back injury are female gender, working the evening shift, and being over-weight.
Nurses employed in emergency departments, pulmonary departments, HIV units, long term care facilities, outpatient clinics and prisons are at greatest risk for contracting tuberculosis. The patients they come in contact with are often undiagnosed.
During their lifetime, 9.6% of nurses will suffer at least one major depressive episode.
Approximately eight out of every 100 nurses are currently, or have been in the past year, involved in illicit drug use.
The average suicide rate for nurses is 0.11 deaths per 1,000. While this may not seem significant, consider that this is higher than the national average of 0.07. Overall, a female nurse is four times more likely to commit suicide than other women.
A recent study has indicated that nurses have the highest risk for work-related asthma of any occupation. While the exact causes are unclear, asthma rates were as much as 50% higher in those nurses who have high exposure levels to disinfectants, cleansers (including those commonly used for instrument sterilization), and latex.
Nurses who have worked in the field for at least 15 years have a significantly increased risk for malignant melanoma and rectal cancer.
High exposure to any type of medication causes a 14% increase in cancer rates.
Nurses exposed to high levels of radiation (at least once a week for 10 years or more) have a 20% higher rate of breast cancer.
Working as a nurse for 25 years or more increases your risk for lung cancer and breast cancer, regardless of your level of radiation exposure.
Significant exposure to cancer drugs during preparation and patient administration carries a 20% increased risk for miscarriage.
The Good News
Despite it all, there is a little good new to be had. So, we’ll end on a positive note. In general, researchers have found that nurses are 39% more likely to live longer than the general population. We also carry a lower risk for heart disease, stroke and many forms of cancer in general.
Kogevinas, M. et. al. Exposure to substances in the workplace and new-onset asthma: an international prospective population-based study (ECRHS-II). The Lancet. 370:336-341, July 28, 2007.
Office of Applied Studies. Drug Use Among U. S. Workers: Prevalence & Trends by Occupation and Industry. SAMHSA, National Household Survey on Drug Abuse, 1991-1993. Updated January 11, 2007.
Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis. Centers for Disease Control and Prevention. June 29, 2001 / 50(RR11);1-42.
Exposure to Blood: What Healthcare Personnel Need to Know. Centers for Disease Control and Prevention. July, 2003.
‘Suicide Risk’ for Doctors and Nurses. BBC News. September 27, 2000.
Reuters. Registered Nurses Have Lower Overall Mortality Risk. MedlinePlus. January 4, 2008.
The NSDUH Report: Depression among Adults Employed Full-Time, by Occupational Catergory. SAMHS. October 11, 2007.
Institute of Medicine. Nursing, Health and the Environment. Appendix B: Environmental Hazards for the Nurse as a Worker. The National Academies Press. 1995.
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