OSHA Data in New White Paper Demonstrates High Rates of Illness and Injury Among Healthcare Workers During Pandemic and Exposes the Failure by the Hospital Industry to Adequately Protect Frontline Staff

Healthcare worker injury and illness rates more than doubled in 2020 from the previous three years – from less than 200 to 413 per 10,000 full-time workers

As the healthcare industry failed on PPE and COVID-19 infection protocols in 2020, the healthcare worker injury and illness rate was 5x that of the average Massachusetts private sector worker

CANTON, Mass., May 10, 2023 /PRNewswire/ -- The Massachusetts Nurses Association Board of Directors – nurses and healthcare professionals elected by their MNA colleagues across the Commonwealth – have published a White Paper coinciding with National Nurses Week and the ending of the federal and state COVID-19 public health emergencies that uses research into OSHA illness and injury data to definitively show the disproportionate toll the pandemic took on nurses and other healthcare workers.

The COVID-19 pandemic harmed Massachusetts healthcare workers more than any other occupation, according to data reported to the Occupational Safety & Health Administration (OSHA) by hospitals and healthcare facilities. Rates of injury and illness among healthcare workers were also substantially higher in 2020 than the three preceding years, including a major jump in exposure to harmful substances – a category that contains infections such as COVID-19. Nurses in particular saw an exceptionally large increase in the number of injuries and illnesses, up from roughly 1,500 in 2017 to 3,420 in 2020.

"This White Paper validates our lived experiences of trauma and exploitation while exposing the lopsided damage inflicted on nurses and healthcare workers by the industry's failure to protect us during the height of the pandemic," said MNA President and ICU nurse Katie Murphy. "Hospital executives initially told workers not to wear masks to avoid scaring visitors, and then refused to provide N95 masks to all frontline caregivers. They told us to put contaminated masks in paper bags and use them again. Executives touted largely untested mask decontamination systems that were later rejected by the FDA."

"Nurses were often the only ones entering the rooms of contagious patients, were forced into crowded shuttle buses, and were then told by their employers that their COVID-19 infections must have come from the supermarket," Murphy said. "Patients with and without COVID-19 were mixed in the same hospital units and assigned to the same nurse. Nurses had to fight tooth and nail for sick days. We felt the shock of hospitals forcing us to return to work in ways that violated scientific common sense. This White Paper uses government data to reveal the painful effect of these decisions and healthcare executives' failure to mitigate this catastrophe."

To produce this White Paper, a group of college and university professors and an MNA Certified Occupational Health Nurse examined OSHA 300 logs of occupational injuries and OSHA 301 incident form data to evaluate changes and determine trends of worker injury and illness since the onset of the pandemic.

Highlighted Results

• The rate of injuries and illnesses among healthcare practitioners in 2020 (413 injuries and illnesses per 10,000 full-time workers) was substantially higher than rates in the three preceding years, which were all below 200 cases per 10,000 full-time workers.
• The two highest rates of illness and injury in 2020 were among healthcare support (275 illnesses per 10,000 full-time workers) and healthcare practitioners (248 illnesses per 10,000 full-time workers).
• These healthcare illness and injury rates were substantially higher than the other occupation groups with the higher rates. The average private sector occupation rate was approximately 50 per 10,000 full-time workers.
• The rate of injuries and illnesses among private sector hospital workers in 2020 (437 cases per 10,000 full-time workers) was substantially higher than rates in the three preceding years, which were consistently below 250 cases per 10,000 full-time workers.
• For private sector hospital workers, the median lost workdays more than doubled in 2020 to 14 from 6 over the previous three years.
• This lost workday difference was even more drastic for exposure to harmful substances (such as COVID-19). For that category, the median lost days in 2020 was 15, compared to 3 lost days the previous three years.
• Days away from work associated with intentional injuries (workplace violence) were also higher in 2020 compared to the preceding three years – 9 days in 2020 up from 6 days previously.

Excerpt from the White Paper's section on Implications for Health, Safety, & Nursing Practice:

"The weakening of established infections control standards coupled with decades of neglect of the public health infrastructure led to a cascade of system failures evidenced by the lack of adequate PPE resources, the delays in standing up good community and patient COVID-19 testing and diagnosis, poor data collection as well as the lack of clear consistent communication contributed to high patient morbidity and mortality despite the best efforts of frontline healthcare providers. In this period of chaos dues to the then necessary visitor restriction nurses were often left as the only means of connection between patients and families and for too many nurses were the one's holding patients' hands and providing comfort as they died alone in hospitals."

The Massachusetts hospital industry made it difficult to conduct this research. Initial requests for the data were ignored by many hospital administrators, while others forwarded incomplete or redacted information. These imposed barriers resulted in months of delays and repeated requests for information. Additional data regarding Massachusetts worker injuries and illnesses was obtained from the Bureau of Labor Statistics (BLS) Survey of Occupational Injuries and Illnesses (SOII) for the years 2017 to 2020.

Data were ultimately obtained from 29 Massachusetts acute care hospitals. There was a total of 3,531 hospital incidents reported on OSHA logs in the studied hospitals in 2020, with a rate of 53.9 incidents per 1,000 FTEs. Exposures to other substances account for the highest number of cases (1,236, 35%). Most of these were COVID-19 cases (906, 25.7%).

In the paper, the MNA makes clear its commitment to hold the hospital industry accountable for its failure to protect frontline staff, as well as its commitment to ensure similar failures are not repeated going forward.

"The evidence presented in this report demonstrates egregious failures on the part of some employers to provide vital equipment, protection, and guidance that may have mitigated losses to worker health and safety…The MNA holds healthcare organizations accountable for their lack of transparency and mismanagement of the COVID-19 crisis and the resulting consequence that contributed our lack of access and supply shortages of PPE and durable medical equipment along with their egregious failures to create a process to evaluate patient care needs and the continuity of our most vulnerable population impacted by the COVID-19 pandemic. We now need to do the work involved to stabilize our healthcare workforce and offer frontline providers the necessary protections and other tools to work in a harmless environment while providing safe patient care on the job.  It is imperative that we ensure the availability of PPE and other life-saving equipment as well as strong quality infection control standards that may be needed in the event of the development of a new COVID-19 variant or the emergence of a new contagion."

The paper was researched and written by college and university professors from UMass Boston and the Massachusetts College of Pharmacy and Health Sciences, along with an MNA Certified Occupational Health Nurse and an Industrial Hygiene Consultant. Additional project advice was provided by a group that included Northeastern University and UMass Lowell professors, and a Medical and Laboratory Consultant for the Bureau of Infectious Disease and Laboratory Sciences at the Department of Public Health. Click here to read the whole paper, citations, and authors.

MNA Guidance and Recommended Solutions

During the pandemic, the MNA was providing the administration with a weekly updates on issues that needed to be addressed in all healthcare facilities statewide. These weekly reports – shared with Gov. Charlie Baker, Health and Human Services Secretary Marylou Sudders, and other officials – included regular calls from MNA leaders describing failures and recommended solutions from frontline nurses and healthcare professionals. The MNA also sent to then incoming Gov. Maura Healey a series of recommendations for the healthcare industry.

"Our White Paper continues the legacy of MNA nurses and healthcare professionals providing experience and data to help influence how government and private sector decision-makers respond to public health crises," Murphy said. "Healthcare executives and our elected officials must work with frontline caregivers to properly prepare for the next, inevitable outbreak. As the White House recently heard from experts, there is an approximately 20 percent chance during the next two years of an outbreak rivaling the Omicron variant."

To combat the worsening problem of workplace violence that is demonstrated in the White paper, MNA nurses and healthcare professionals have proposed violence prevention legislation at the State House. Last legislative term, Massachusetts senators and representatives passed similar versions of the MNA bill  – An Act requiring health care employers to develop and implement programs to prevent workplace violence – out of committee and to Ways and Means, the final stop before a full vote by the legislative bodies.

The legislation, sponsored by Senator Joan Lovely and Representative Denise Garlick, would:

• Require healthcare employers to perform an annual safety risk assessment and, based on those findings, develop, and implement programs to minimize the danger of workplace violence to employees and patients.
• Provide time off for health care workers assaulted on the job to address legal issues.
• Allows nurses and healthcare professionals to use their health care facility address instead of their home address to handle legal issues related to an assault.
• Require semiannual reporting of assaults on health care employees to District Attorneys.

MNA nurses and healthcare professionals have also submitted to the state legislature An Act Relative to Occupational Presumption and COVID-19 (S.1176/H.1928), sponsored by Senator Paul Feeney and Representative Tram Nguyen.

• This bill would presume any frontline healthcare worker who contracts COVID-19 during the period covered by the state-of-emergency contracted the virus at work.
• It would also prohibit employers from requiring healthcare workers to use their own sick time, vacation time or other PTO to quarantine, treat or recover from COVID-19.

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Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.

SOURCE Massachusetts Nurses Association