Occupational health: health workers

7 November 2022

Key facts

  • About 54% of health workers in low- and middle-income countries have latent tuberculosis, which is 25 times higher than the general population.
  • Between 44% and 83% of nurses in clinical settings in Africa have chronic lower back pain, compared to 18% among office workers.
  • Globally, 63% of health workers report experiencing any form of violence at the workplace.
  • During the coronavirus disease (COVID-19) pandemic, 23% of front-line healthcare workers worldwide suffered depression and anxiety and 39% suffered insomnia. Furthermore, medical professions are at higher risk of suicide in all parts of the world.
  • Unsafe working conditions resulting in occupational illness, injuries and absenteeism constitute a significant financial cost for the health sector (estimated at up to 2% of health spending).
  • However, so far only 26 out of the 195 Member States of WHO have in place policy instruments and national programmes for managing occupational health and safety of health workers.

 

Overview

Health workers are all people engaged in work actions whose primary intent is to improve health, including doctors, nurses, midwives, public health professionals, laboratory technicians, health technicians, medical and non-medical technicians, personal care workers, community health workers, healers and traditional medicine practitioners. The term also includes health management and support workers such as cleaners, drivers, hospital administrators, district health managers and social workers, and other occupational groups in health-related activities as defined by the International Standard Classification of Occupations (ISCO-08).

Health workers are the backbone of any functioning health system. While contributing to the enjoyment of the right to health for all, health workers should also enjoy the right to healthy and safe working conditions to maintain their own health.

Health workers face a range of occupational risks associated with infections, unsafe patient handling, hazardous chemicals, radiation, heat and noise, psychosocial hazards, violence and harassment, injuries, inadequate provision of safe water, sanitation and hygiene.

The protection of health and safety of health workers should be part of the core business of the health sector: to protect and restore health without causing harm to patients and workers.

Safeguarding the health, safety and well-being of health workers can prevent diseases and injuries caused by work, while improving the quality and safety of care, human resources for health and environmental sustainability in the health sector. 

Safeguarding the health, safety and well-being of health workers  

The protection of health and safety of health workers contributes to improving the productivity, job satisfaction and retention of health workers. It also facilitates the regulatory compliance of health facilities with national laws and regulations on occupational health and safety, bearing in mind the specific working conditions and occupational hazards in the sector. Unsafe working conditions resulting in occupational illness, injuries and absenteeism represent a significant financial cost for the health sector. For instance, in 2017 the annual costs of occupational illnesses and injuries in the health care and social services sector in Great Britain were the highest among all sectors, estimated at the equivalent of US$ 3.38 billion (1).

Globally, improving health, safety and well-being of health workers lowers the costs of occupational harm (estimated at up to 2% of health spending) and contributes to minimizing patient harm (estimated at up to 12% of health spending) (2). Furthermore, implementing key interventions to protect the health and safety of health workers contributes to increasing the resilience of health services in the face of outbreaks and public health emergencies and contribute to strengthening the performance of health systems through: 1) preventing occupational diseases and injuries; and 2) protecting and promoting the health, safety and well-being of health workers, thereby improving the quality and safety of patient care, health workforce management and environmental sustainability.

Policy actions

Only one third of countries have some national policy instrument to protect health, safety and well-being of health workers. Based on the experience of such countries, the following policy interventions have been demonstrated to be beneficial in the protection of health workers:  

  • introducing new and updating existing regulations, standards and codes of good practices for protecting health and safety of health workers;
  • making the protection of health and safety of health workers an integral part of the management of health care at all levels; 
  • creating mechanisms and building capacities for management of occupational health and safety in the healthcare sector at the national, sub-national and facility levels;
  • expanding the coverage of health workers with competent occupational health services, including for risk assessment and management, health surveillance, vaccination and psycho-social support; and
  • establishing collaboration with organizations of employers and health workers for improving working conditions.

Responsibilities and rights

While employers have the overall responsibility for ensuring that all necessary preventive and protective measures are taken to minimize occupational risks, health workers have the responsibility to cooperate with the management and participate in the measures for protecting their health, safety and well-being.

Health workers have the right to remove themselves from a work situation that they have reasonable justification to believe presents an imminent and serious danger to their lives or health. When a staff member exercises this right, he or she shall be protected from any undue consequences. 

WHO response

In 2022, with resolution WHA74.14 on protecting, safeguarding and investing in the health and care workforce, the World Health Assembly called upon Member States “to take the necessary steps to safeguard and protect health and care workers at all levels”. The global patient safety action plan 2021–2030, adopted by the 74th World Health Assembly, includes action on health worker safety as priority for patient safety. 

WHO’s work on protecting the health, safety and well-being of health workers includes:

  • development of norms and standards for prevention of occupational risks in the health sector;
  • advocacy and networking for strengthening the protection of health, safety and well-being of health workers; and
  • supporting countries to develop and implement occupational health programmes for health workers at the national, subnational and health facility levels. 

WHO and ILO have jointly issued a guide on the development and implementation of occupational health and safety programmes for health workers and work with international partners to build capacities for its implementation in countries.

WHO also provides guidelines and recommendations about prevention and management of occupational hazards in the health care sector.

 

References: 
  1. Costs to Britain of workplace fatalities and self-reported injuries and ill health, 2017/18. [Internet]. Health and Safety Executive; 2019. Available from: https://www.hse.gov.uk/statistics/pdf/cost-to-britain.pdf
  2. Bienassis De K, Slawomirski L, Klazinga N. The economics of patient safety Part IV: Safety in the workplace: Occupational safety as the bedrock of resilient health systems, OECD Health Working Papers, No. 130. [Internet]. Paris: OECD Publishing; 2021. Available from: https://econpapers.repec.org/RePEc:oec:elsaad:130-en