Going above and beyond hand washing

When meeting new people, I’m often asked what I do for a living. When I say I’m a chartered occupational hygienist I’m usually met with two reactions either the person’s eyes glaze over or they say, ‘oh isn’t that making sure people wash their hands properly?’
    
Occupational Hygienists are specialists in the ‘Health’ in Health and Safety. We have a broad background, often in the sciences and engineering. We recognise, evaluate and control hazards in the workplace that represent a risk to the health of employees. We help companies comply with their legal duties to asses and control exposures to chemicals, biological agents, physical agents (noise and vibration), radiation, and so on – basically anywhere exposure at work could potentially develop into a disease. These diseases could be anything from cancer through to occupational asthma, musculoskeletal disorders or noise induced hearing loss.  
    
As the UK’s largest employer, the NHS is ideally placed to benefit from the expertise of occupational hygienists to identify workplace hazards. I am one of these occupational hygienists and here is my story.

Hygiene in the NHS
Working in the NHS is very different from working with other organisations. The main difference is the sheer size and scale of the NHS and the many different people employed within it. There is significant diversity in the type of people employed: midwives, nurses, consultants, GPs, surgeons and porters to name but a few, all of whom carry out work every day that has the potential to damage their health if not controlled properly. Communicating this information and providing advice is often a challenge for the NHS due to the many different backgrounds and cultures interwoven. This makes it a particularly interesting environment to work in.

The second important point as to why the NHS is different to other organisations is that the staff are not the only people in the building we need to be mindful of. We also have a duty of care to the patients who in many respects, need to have a greater level of protection. Occupational hygienists also ensure the risks to patients are controlled. Some issues of particular relevance to patients are infection control, indoor air quality and legionella.

Occupational hazards in the NHS
Within the NHS, some occupational hazards are quite obvious, for example nurses lifting and moving patients are prone to suffering from musculoskeletal disorders, radiographers and orthopaedic surgical teams can be exposed to radiation. However, there are other hazards we encounter that are less so.  

I have seen a porter asked to drive the laundry cart to the laundry but in taking the most direct route had to drive over numerous speed bumps. This hazard was not recognised. Those of you who have seen a porter’s electric vehicle will know that it often will not have any suspension, probably a solid seat and maybe even solid rubber tyres. Whole body vibration issues have the potential to be significant.  
    
Expectant mothers and those patients in recovery after surgery often have lungs full of anaesthetic gases which they exhale and the midwives and recovery staff then need to work in an environment with potentially high levels of waste anaesthetic gases. An occupational hygienist will recognise that there may be a problem, evaluate that problem, for example measure the intensity of the vibration or the inhaled exposure of the nurse, and control the problem to stop any further potential health damage occurring.  
This ‘control’ may simply be identifying a flat route for the operator to drive on or could include recommendations for complex gas scavenging systems, efficient ventilation and air change rates and understanding cumulative exposure effects over a whole shifts exposure.

Expertise and best practice
As occupational hygienists, we have a wide and often broad range of background experiences we can rely upon in microbiology, ventilation, legionella, air quality, acoustics and measurement techniques to enable control at all levels of the hospital to help ensure both patients and staff are protected.
    
Some examples include: air quality investigations including microbiological sampling to ensure appropriate air quantity; air distribution and air quality in aseptic suites; mortuaries and operating theatres; ensuring infection control standards are met; acoustic noise surveys across the hospital; and legionella risk assessments and sampling of hot and cold water systems.
 
 We operate under several best practice guidelines that can be honed into two basic principles, the first is the Hierarchy of Control, which we use once we have identified and quantified the hazard. The second is the eight principles of control which are mainly used for control of chemicals but can be applied to other aspects of occupational hygiene.  
   
Protecting and looking after the health and wellbeing of a workforce has to be taken seriously and it is often something that does not get reported on the news. The most recent HSE statistics for 2013/14 show there were 133 deaths due to accidents at work – but over the same 12 months there were 141,000 new cases of musculoskeletal disorders, 35,000 cases of breathing/lung problems caused or made worse by work, 35,000 new cases of skin conditions, 20,000 new cases of noise induced hearing loss and around 13,500 new cases of occupational cancers diagnosed. The economic cost of £13.8 Billion is only part of the story.  
    
Seeing the benefits
An organisation that takes the health and wellbeing of their staff seriously often sees additional benefits over and above the lost time figure. Additional benefits include improved loyalty throughout the workforce, better retention rates and an improved culture and ethos in the organisation. Staff can also have an improved the level of perceived worth and this can bring an improvement to the working environment.        
    
There is a fundamental difference between occupational hygienists and most other health professionals; most of the latter try to control and cure an existing condition, whereas the occupational hygienist tries through scientific knowledge and testing to ensure the person does not get ill in the first place.

Further information
www.bohs.org