TABLE 1 Categories of Potential or Actual Occupational Hazards

Biologic-infectious hazards: Infectious-biologic agents, such as bacteria, viruses, fungi, or parasites, that may be transmitted via contact with infected patients or contaminated body secretions or fluids.

Chemical hazards: Various forms of chemicals that are potentially toxic or irritating to body systems, including medications, solutions, and gases.

Environmental-mechanical hazards: Factors encountered in work environments that cause or potentiate accidents, injuries, strain, or discomfort (e.g., poor equipment or lifting devices, slippery floors).

Physical hazards: Agents within work environments, such as radiation, electricity, extreme temperatures, and noise, that can cause tissue trauma.

Psychosocial hazards: Factors and situations encountered or associated with the job or work environment that create or potentiate stress, emotional strain, and interpersonal problems.

and strains, and they cited overexertion related to patient care as the primary cause.

The cost implications to health care providers of relatively high injury rates for their employees are especially troublesome down the road because, according to BLS estimates, the industry's work force is expected to grow at twice the rate for all nonfarm wage and salary workers between 1992 and 2005. In 1992, private sector health services employed 8.5 million workers, for whom nearly 700,000 work-related injuries and illnesses were reported that year.

Nursing personnel deliver care to individuals in a variety of settings including hospital-based and community-based environments. Only within recent years has any real attention been paid to the occupational risks and injuries of nurses. Also, there is evidence that stress related to work overload and staffing patterns, including shift work, can and does contribute to illness and injury in the nurse population (Jung, 1986; Phillips and Brown, 1992). Many factors such as the physical work environment, organizational and institutional characteristics, and personal work practice habits contribute to health care workers' occupational risk for hazard exposure and the resultant injury and stress that occurs (Rogers and Travers, 1991). The impact of these events is of concern not only in terms of the health risk to the worker, but also because of the effects on quality care and nursing.

In this paper, much of the research that is discussed describes the nature and severity of specific injuries of major concern in nursing and stress in nursing. The paper also provides some linkage, although less frequently, for the relationships of injury and stress to the quality of nursing care delivered and the impact of these factors on the nursing profession. Several investigations have reported



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