Cleaning jobs in general have long been linked to many chemical and ergonomic risks, which increase the likelihood of occupational illness and injury. Injuries to healthcare cleaning staff can have a negative influence on service delivery, result in seeking medical care, time lost from work, and give rise to reduced patient care experience. In addition, the consequences of any injury, such as the pain, suffering, and loss of earnings for the affected workers and their families, are significant though challenging to measure.
Numerous risks are frequently present in cleaning jobs. Cleaning is a physically taxing profession with a wide range of duties. A large portion of a cleaner's workday is spent standing and moving fixtures and equipment. Their jobs necessitate bending, stooping, and stretching, such as dusting, sweeping, and cleaning bathrooms, furniture, and walls. Additionally, cleaning workers run the risk of minor burns, cuts, and bruises from hand tools, machinery, chemicals, and garbage handling. Additionally, cleaners may work outside the premises in addition to their usual indoor workspaces that are not well-lit and organised.
Healthcare industry-specific occupational hazards are likely to be present for cleaners employed in healthcare facilities. In contrast to regular office buildings, hospitals undergo continuous and vigorous cleaning for 24 hours. Cleaners must dispose of medical waste that may contain contaminated needles or sharp objects as part of their job. These can spread potentially fatal infections if improperly disposed of. Patients' expelled bodily fluids could potentially be the host of these microorganisms. Healthcare facilities might use cleaning solutions that are stronger in concentration and have a different composition than non-healthcare facilities, which puts workers handling these substances at higher risk.
According to this author's previous research, there is a very high risk of workplace injuries for cleaning staff in healthcare settings. The overall injury rate for cleaners was found to be three times higher as opposed to other healthcare workers. This research also revealed that the most vulnerable groups of healthcare cleaners to injuries were inexperienced workers, female employees, and those employed in acute care hospitals. The most frequent injury among cleaners that was reported was musculoskeletal injury, and ergonomic factors were mostly to blame for this. According to the research data, the majority of cleaning-related injury incidents result in lost work time due to their severity (especially those involving contusion and musculoskeletal injury).
According to other research, hospital cleaners had a high frequency of upper limb and neck disorders, which were correlated with physically demanding jobs. Overexertion in lifting, overexertion in pulling or pushing objects, other overexertion, falling on the same level as the floor or other surface, bending, climbing, crawling, reaching twist and struck-against stationary objects were the most common categories of injuries among these workers. The physical demands of the work appear to increase the risk of occupational injuries for cleaners.
Through similar investigation in Bangladesh, vulnerable cleaner groups may be identified and given priority for interventions. It might be possible to take preventative measures to safeguard less experienced employees. These workers may have higher injury rates due to a lack of knowledge about work procedures, a lack of awareness of potential risks, or a simple assignment to perform more dangerous tasks. It has been demonstrated before that among other healthcare workers, experience correlates with a lower risk of injury. For instance, there was a lower risk of needlestick injuries among nurses with more than five years of experience. For workers with more than ten years of experience, the overall injury risk was found to be lower. Another possible explanation for the lower injury rate among seasoned workers is the "healthy worker effect," which refers to workers who experienced injuries on the job quitting their jobs and only selected ones staying in their careers.
Risk factors that have been linked to the frequency of workplace injuries include low income, improper sharps disposal and use practices, a lack of training, and the absence or insufficient use of personal protective equipment (PPE). Other research indicates that employees who do not use PPE have a five-fold increased risk of a workplace accident. Another study from Brazil revealed that improper PPE use accounted for 32% of workers involved in accidents. It is important to note that while appropriate PPE use can help minimize risk and encourage safe practices, it cannot guarantee complete safety. Preventive factors for most jobs include using PPE, continuing education, changing professional behaviour, and modifying the job tasks.
The main reason why cleaners have such high rates of exposure to needle-stick and sharps incidents is that they frequently discover needles or sharps in trash, wrapping, or linen. All of these incidents could have been avoided with appropriate disposal of needles and sharps. Cleaning personnel might not be as aware of the risks associated with exposure to bodily fluids like blood or the urgency of promptly following up after an exposure.
Numerous hospitals in Dhaka and other areas of Bangladesh have outsourced food, laundry, and cleaning services. The growing privatization of these services points to the continued necessity of tight communication between hospital contractors and their health and safety departments.
The health and safety of hospital cleaners are generally ignored by employers in Bangladesh just like that of workers in many other high-hazard industries (e.g., construction, shipbreaking, brick-field, and transportation). The scientific community in Bangladesh has paid little attention to occupational hazards for cleaners in healthcare settings thus far. Building on research evidence is crucial to assisting in the creation of preventative regulations that lessen workplace risks and encourage cleaners to follow safer work practices.
Hasnat M. Alamgir, PhD, is Professor and Director of Career and Professional Development, Southeast University, Dhaka.
hasnat.md.alamgir@gmail.com