International Hazard Datasheets on Occupation

Orderly, medical services

What is a Hazard Datasheet on Occupation?

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This datasheet is one of the International Datasheets on Occupations. It is intended for those professionally concerned with health and safety at work: occupational physicians and nurses, safety engineers, hygienists, education and Information specialists, inspectors, employers ' representatives, workers' representatives, safety officers and other competent persons.

This datasheet lists, in a standard format, different hazards to which orderly, medical servicess may be exposed in the course of their normal work. This datasheet is a source of information rather than advice. With the knowledge of what causes injuries and diseases, is easier to design and implement suitable measures towards prevention.

This datasheet consists of four pages:

• Page 1: Information on the most relevant hazards related to the occupation.
• Page 2: A more detailed and systematized presentation on the different hazards related to the job with indicators for preventive measures (marked as and explained on the third page).
• Page 3: Suggestions for preventive measures for selected hazards.
• Page 4: Specialized information, relevant primarily to occupational safety and health professionals and including information such as a brief job description, a list of tasks, notes and references.

Who is an orderly?

A healthcare worker who performs various tasks as directed by nurses and other medical staff. Responsible for feeding, bathing, and massaging patients, and also for transfer of hospitalized patients from one ward to another.

What is dangerous about this job?

• Orderlies are exposed to practically all of the acute hazards existing in the healthcare institutions where they work.
• Orderlies may be exposed to infectious diseases due to direct contact with patients and their body fluids.
• Orderlies may be exposed to anesthetic gases, drugs, and radiation.
• Orderlies use cleaning, disinfecting, and sterilizing agents that may damage the skin, mucous membranes and respiratory system.
• Orderlies may be injured by sharp objects (needles, blades, etc.).
• Contact with hot surfaces, faulty electric equipment, etc. may cause skin burns.
• They may suffer from musculoskeletal problems and back pain resulting from the handling of heavy patients. Continuous work while standing or walking causes fatigue and leg problems.
• Orderlies that move patient-beds and/or stretchers from place to place may slip and fall on slick surfaces.
• They may suffer from blows when colliding with the walls of narrow passages through which they move with the patients.

Hazards related to this job

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Specific preventive measures can be seen by clicking on the respective in the third column of the table.

Accident hazards	Slips, trips, and falls on wet floors, especially during emergency situations.
	Stabs and cuts from sharp objects, especially needle-sticks and cuts by blades.
	Burns and scalds from contact with hot sterilizing equipment or hot water and steam pipes.
	Electrical shock from faulty or improperly grounded equipment, or equipment with faulty insulation.
	Injuries to legs and toes caused by falling objects, e.g., medical instruments.
	Acute back pain resulting from awkward body position or overexertion when handling heavy patients.
	Acute poisoning due to accidental release of a chemical agent.
Physical hazards	Exposure to radiation from x-ray and radioisotope sources.
Chemical hazards	Exposure to chemicals during an accident (contact with scattered or spilled chemicals, leaking agents, and unidentified chemicals).
	Skin defatting, irritation, and dermatoses because of frequent use of soaps, detergents, disinfectants, etc.
	Irritation of the eyes, nose, and throat because of exposure to airborne aerosols or contact with droplets of washing and cleaning liquids.
	Chronic poisoning because of long-term exposure to medications, sterilizing fluids (e.g., glutaraldehyde), anesthetic gases, etc.
	Latex allergy caused by exposure to natural latex gloves and other latex-containing medical devices.
Biological hazards	Infections due to the exposure to blood, body fluids or tissue specimens possibly leading to blood-borne diseases such as HIV, Hepatitis B and Hepatitis C.
Ergonomic, psychosocial and organizational factors	Fatigue and lower back pain due to the handling of heavy patients and to long periods of work in a standing posture.
	Stress, strained family relations, and burnout due to shift and night work and contact with sick patients.
	Exposure to severely traumatized patients, multiple victims of a disaster or catastrophic event or severely violent patients may lead to post-traumatic stress syndrome.

Preventive measures

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	Wear shoes designed for nurses, with non-slip soles.
	Handle sharp objects with extreme care; use special safety receptacles to store used hypodermic needles until disposal. Use safety needles, if avaliable.
	Install ground fault circuit interrupters; call a qualified electrician to test and repair faulty or suspect equipment.
	Comply with all safety instructions regarding the installation and periodic inspection of electrical medical equipment.
	Consult an ergonomics specialist on the safe handling of heavy patients.
	Wear a radiation dosimeter (badge or other) when exposed to radiation; comply with all safety instructions to reduce exposure to a minimum.
	Install air conditioning with effective general ventilation where appropriate to alleviate heat stress and remove odors, gases, and vapors.
	Provide eye wash bottles or fountains.
	Personnel sensitive to natural rubber latex must use non-latex or powder-free latex gloves and avoid contact with other latex products.
	Follow established appropriate infection control precautions assuming blood, body fluids and tissue are infectious
	Routinely use barriers (such as gloves, eye protection (goggles or face shields) and gowns)
	Wash hands and other exposed skin surfaces after coming into contact with blood or body fluids
	Follow appropriate procedures in handling and disposing of sharp instruments or needles
	Provide lifting aids for the lifting and transport of heavy patients; consult an occupational safety specialist on the safe handling of heavy patients.
	Procedures and counselling services should be available to workers exposed to post-traumatic stress syndrome

Specialized information

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Synonyms	Bed-carrier; nursing-aid; sick-patient mover; sanitarian; stretcher-carrier
Definitions and/or description	Performs a variety of tasks, as directed by nursing and medical staff, to care for patients in a hospital, nursing home, or other medical facility. Bathes patient and gives alcohol rubs. Measures and records intake and output of liquids; takes and records temperature, and pulse and respiration rat. Gives enemas. Carries meal trays to patients and feeds patients unable to feed themselves. Lifts patients onto and from bed, and transports patients to other areas, such as operating and x-ray rooms, by rolling bed, or using wheelchair or wheeled stretcher. Sets up equipment, such as oxygen tents, portable x-ray machines, and overhead irrigation bottles. Makes beds and collects soiled linen. Cleans rooms and corridors. Bathes deceased patients, accompanies body to morgue, and places personal belongings in mortuary box. Administers catheterizations and bladder irrigations. Accompanies discharged patients home or to other institutions [DOT].
Related and specific occupations	Auxiliary nurse; practical nurse; other patient-care nursing occupations classified according to ward, e.g. operating-room nurse, intensive-care nurse, pediatric nurse, etc.; other nurse associate professional (e.g. anesthetic, charge, clinic, consultant, district, industrial, maternity, etc.)
Primary equipment used	Alcohol bottles; catheters; cleaning equipment and chemicals; enemas; masks; medical supplies (syringes, needles, bandages, gauze, sterile pads, scalpels, plaster dressings, etc.); monitoring equipment; overhead irrigation bottles; oxygen-tents; portable x-ray machine; sterilization equipment; stethoscope; sphygmomanometer; stretcher; thermometers; trays; watch; wheel chair; wheel stretcher
Workplaces where the occupation is common	Various wards of hospitals and other health care institutions; private homes of patients; sanitariums; industrial plants; sick-funds; nursing homes; etc.
References	Encyclopaedia of Occupational Health and Safety, 4th Ed., ILO, Geneva, 1998, p. 6.12; 97.34; 99.4. Encyclopaedia of Occupational Health and Safety, 3rd Ed., ILO, Geneva, 1983, Vol.2, p. 1480-1482. Occupational Disease - a Guide to their Prevention. DHEW- NIOSH Pub. 77-181,1977 (Multiple pages - see entry "Nurses" in index).

Production of this hazard hatasheet was sponsored by Israel Institute for Occupational Safety and Hygene