OSHA Guidelines for Medical Housekeeping

The Occupational Safety and Health Administration (OSHA), an agency of the United States Department of Labor, establishes guidelines and standards to protect employee health and safety. Medical facilities of all types are subject to OSHA regulations, as are all employers of one or more individuals. Medical housekeeping, a component of a safe health care environment, is one area of risk monitored by OSHA.

OSHA Background

• OSHA was established in 1970 to protect workers from harm on the job. Earlier government and union efforts had addressed job safety, but none has such influence in advising, educating, inspecting and guiding employers. OSHA can also levy penalties for non-compliance. OSHA guidelines apply to all medical facilities, from very large hospitals to small medical or dental practices.

Medical Housekeeping

• Housekeeping in a medical environment includes thorough cleaning of patient rooms and bathrooms, surgical facilities, laboratories, examination rooms, offices, waiting rooms and hallways. In addition, housekeeping staff deal with waste products, containers, bed linens, furniture, medical equipment, surgical drapes and gowns, carts and gurneys, work surfaces, chemicals and spillage. OSHA requires posted guidelines and warnings about potential hazards, but also mandates thorough employee training.

Housekeeping Hazards

• Medical housekeeping workers are exposed to health hazards during daily shifts. These hazards include work areas contaminated with airborne or bloodborne disease-causing agents, unclean medical equipment such as intravenous poles, laundry or other textiles soiled with infected blood or other bodily fluids, and improperly disposed-of waste products. Many injuries are caused by needles or other sharp instruments inadvertently left in bedding or disposed of in containers that are not leak-proof or labeled, or are over-filled. Equipment caked with dried blood or other infectious material and objects in patient areas or rooms can harbor infections including tuberculosis, the human immunodeficiency virus (HIV), hepatitis B and C, the nonovirus, methicillin-resistant staphylococcus aureus (MRSA) and other antimicrobial-resistant organisms.

Housekeeping Solutions

• OSHA requires cleaning and decontamination of rooms and other work areas with approved disinfectants. The Environmental Protection Agency (EPA) registers antimicrobial products and recommends disinfectants effective against tuberculosis and other infections. OSHA guidelines state that medical equipment, contaminated waste containers and laundry must be packaged and color-coded or labeled, and employees must be provided with gloves, goggles and splash aprons for handling hazardous chemicals. Used needles must be placed in special puncture-proof, leak-proof, closed containers. Scrupulous hand washing is always a priority.

Agency Cooperation

• In addition to OSHA, there are several organizations that monitor medical housekeeping trends and issue guidelines to counteract the hazards. Among these are the American Federation of State, County and Municipal Employees (AFSCME). AFSCME issued warnings to its 1.6 million members about needle punctures, which accounted for 62 percent of employee injuries between 1995 and 1999. The Centers for Disease Control, the Federal Facilities Environmental Stewardship and Compliance Assistance Center (FedCenter) and the EPA also cooperate with OSHA in education and information dissemination programs. Because there were more than 5,000 job-related deaths in 2008, the effort to protect medical employees is aggressive and ongoing.