Summary - The Importance of Standards
Personal protective equipment (PPE) – and its lack thereof - has been at the forefront of discussions around healthcare worker safety throughout the pandemic. Dr. LaPuma describes the fundamentals of PPE to explain why standards in this area matter (minute 02:25) noting that not all PPE offers the wearer the same protection. N95 masks should be the minimum PPE standard for patient-facing health care workers during COVID-19, he contends. They meet stringent performance requirements and can filter out small virus particles, like that which causes COVID-19; surgical masks cannot. He adds that actions must be taken to stop the pilfering, hoarding and price gouging causing their depletion.
The situation around the physical shortage of PPE should provide all the more reason to immediately enact a national occupational safety standard that will protect health care workers, states Dr. Perry, (minute 08:25). She points to the success of the federal bloodborne pathogen standard, established during the HIV/AIDS epidemic, as an example of the kind of response that is now needed for airborne pathogens. Despite initial resistance to the standard from some employers and even health care workers, the 1991 standard resulted in a significant decrease in hepatitis B transmission and needle sticks to healthcare workers. “A standard right now would have a tremendous impact on ensuring that health care workers are getting the proper protection that they need”, states Dr. Perry. She emphasizes that OSHA had made progress in this area, until anti regulation efforts by the current administration brought it to a halt in 2017.
This lack of regulatory muscle has resulted in perilous working conditions for health care workers on the front line of the COVID-19 response, states Kelly Trautner (minute 12:10). She points to weakened infectious control guidance from the CDC and the suspension of N95 fit test requirements from OSHA as two examples. “What’s most unsettling about these changes”, Ms. Trautner points out, “is that they were made based on supply chain, not science.” She argues that when the government does not enact strong occupational standards to keep workers safe, the results are devastating, and “we’re seeing them now as health care workers increasingly take up hospital beds and spread the virus they aimed to treat.” Some workers have gone to great lengths to report these dangers to the public, even risking their jobs to do so (minute 22:30). Ms. Trautner urges the public and policy makers to pay attention to the plight of health care workers and protect their right to speak out against untenable and hazardous working conditions. She emphasizes that a collective voice is the most powerful vehicle clinicians have right now in their push for worker protections and that the need for health care worker representation has never been more critical or relevant.
Many had hoped that emergency national occupational safety standards would have materialized by this point in the COVID-19 crisis. When asked why it hasn’t, Dr. Perry notes that occupational standards have always been resisted by employers based on perceived difficulty in enforcing them and cost (minute 18:35). She argues, however, that when standards have been introduced in the past, companies do not go out of business, but instead adapted to them, again pointing to the bloodborne pathogen standard as a good example. She says she is optimistic that the attention the pandemic has shed on occupational safety and health care workers’ rights may finally result in a national standard that will protect health care, and other workers, and hold employers accountable for their safety.
Dr. Perry has a parting message for health care workers: you are not alone (minute 26:35). She urges them to continue to document their experiences to build awareness and a sense of urgency that will catalyze a national push to invoke an emergency temporary standard. “Let this be a pivotal time for occupational health and the united necessity of protecting health care workers and all workers,” she concludes. Dr LaPuma reiterates this message of solidarity, stating “The health and safety of the health care workers is paramount. We absolutely have to protect the health care workers at all costs” (minute 27:35).
The situation around the physical shortage of PPE should provide all the more reason to immediately enact a national occupational safety standard that will protect health care workers, states Dr. Perry, (minute 08:25). She points to the success of the federal bloodborne pathogen standard, established during the HIV/AIDS epidemic, as an example of the kind of response that is now needed for airborne pathogens. Despite initial resistance to the standard from some employers and even health care workers, the 1991 standard resulted in a significant decrease in hepatitis B transmission and needle sticks to healthcare workers. “A standard right now would have a tremendous impact on ensuring that health care workers are getting the proper protection that they need”, states Dr. Perry. She emphasizes that OSHA had made progress in this area, until anti regulation efforts by the current administration brought it to a halt in 2017.
This lack of regulatory muscle has resulted in perilous working conditions for health care workers on the front line of the COVID-19 response, states Kelly Trautner (minute 12:10). She points to weakened infectious control guidance from the CDC and the suspension of N95 fit test requirements from OSHA as two examples. “What’s most unsettling about these changes”, Ms. Trautner points out, “is that they were made based on supply chain, not science.” She argues that when the government does not enact strong occupational standards to keep workers safe, the results are devastating, and “we’re seeing them now as health care workers increasingly take up hospital beds and spread the virus they aimed to treat.” Some workers have gone to great lengths to report these dangers to the public, even risking their jobs to do so (minute 22:30). Ms. Trautner urges the public and policy makers to pay attention to the plight of health care workers and protect their right to speak out against untenable and hazardous working conditions. She emphasizes that a collective voice is the most powerful vehicle clinicians have right now in their push for worker protections and that the need for health care worker representation has never been more critical or relevant.
Many had hoped that emergency national occupational safety standards would have materialized by this point in the COVID-19 crisis. When asked why it hasn’t, Dr. Perry notes that occupational standards have always been resisted by employers based on perceived difficulty in enforcing them and cost (minute 18:35). She argues, however, that when standards have been introduced in the past, companies do not go out of business, but instead adapted to them, again pointing to the bloodborne pathogen standard as a good example. She says she is optimistic that the attention the pandemic has shed on occupational safety and health care workers’ rights may finally result in a national standard that will protect health care, and other workers, and hold employers accountable for their safety.
Dr. Perry has a parting message for health care workers: you are not alone (minute 26:35). She urges them to continue to document their experiences to build awareness and a sense of urgency that will catalyze a national push to invoke an emergency temporary standard. “Let this be a pivotal time for occupational health and the united necessity of protecting health care workers and all workers,” she concludes. Dr LaPuma reiterates this message of solidarity, stating “The health and safety of the health care workers is paramount. We absolutely have to protect the health care workers at all costs” (minute 27:35).