DEPARTMENTOFHEALTHANDHUMANSERVICESCentersforDiseaseControlandPreventionNationalInstituteforOccupationalSafetyandHealthOccupationalHazardsinHomeHealthcareNIOSHHazardrevIewNIOSHHAZARDREVIEWOccupationalHazardsinHomeHealthcareDEPARTMENTOFHEALTHANDHUMANSERVICESCentersforDiseaseControlandPreventionNationalInstituteforOccupationalSafetyandHealthiiThisdocumentisinthepublicdomainandmaybefreelycopiedorreprinted.DisclaimerMentionofanycompanyorproductdoesnotconstituteendorsementbytheNationalInstituteforOccupationalSafetyandHealth(NIOSH).Inaddition,citationstoWebsitesexternaltoNIOSHdonotconstituteNIOSHendorse-mentofthesponsoringorganizationsortheirprogramsorproducts.Further-more,NIOSHisnotresponsibleforthecontentoftheseWebsites.OrderingInformationToreceivedocumentsorotherinformationaboutoccupationalsafetyandhealthtopics,contactNIOSHatTelephone:1–800–CDC–INFO(1–800–232–4636)TTY:1–888–232–6348E-mail:cdcinfo@cdc.govorvisittheNIOSHWebsiteatwww.cdc.gov/niosh.ForamonthlyupdateonnewsatNIOSH,subscribetoNIOSHeNewsbyvisitingwww.cdc.gov/niosh/eNews.DHHS(NIOSH)PublicationNo.2010–125January2010Safer•Healthier•PeopleTMiiiForewordAnagingpopulationandrisinghospitalcostshavecreatednewandincreas-ingdemandforinnovativehealthcaredeliverysystemsintheUnitedStates.Homehealthcareprovidesvitalmedicalassistancetoill,elderly,convales-cent,ordisabledpersonswholiveintheirownhomesinsteadofahealthcarefacility,andisoneofthemostrapidlyexpandingindustriesinthiscountry.TheBureauofLaborStatisticsprojectsthathomehealthcareemploymentwillgrow55%between2006–2016,makingitthefastestgrowingoccupationofthenextdecade.Homehealthcareworkersfacilitatetherapidandsmoothtransitionofpa-tientsfromahospitaltoahomesetting.Theyofferpatientstheuniqueop-portunitytoreceivequalitymedicalcareinthecomfortoftheirownhomesratherthaninahealthcareornursingfacility.Homehealthcareworkers,whilecontributinggreatlytothewell-beingofothers,faceuniquerisksonthejobtotheirownpersonalsafetyandhealth.During2007alone,27,400recordedinjuriesoccurredamongmorethan896,800homehealthcareworkers.Homehealthcareworkersarefrequentlyexposedtoavarietyofpotentiallyseriousorevenlife-threateninghazards.Thesedangersincludeoverexertion;stress;gunsandotherweapons;illegaldrugs;verbalabuseandotherformsofviolenceinthehomeorcommunity;bloodbornepathogens;needlesticks;latexsensitivity;temperatureextremes;unhygienicconditions,includinglackofwater,uncleanorhostileanimals,andanimalwaste.Longcommutesfromworksitetoworksitealsoexposethehomehealthcareworkertotrans-portation-relatedrisks.Thisdocumentaimstoraiseawarenessandincreaseunderstandingofthesafetyandhealthrisksinvolvedinhomehealthcareandsuggestspreventionstrategiestoreducethenumberofinjuries,illnesses,andfatalitiesthattoofrequentlyoccuramongworkersinthisindustry.JohnHoward,M.D.Director,NationalInstituteforOccupationalSafetyandHealthCentersforDiseaseControlandPreventionvContentsForeword.........................................................iiiAbbreviations......................................................ixAcknowledgments.................................................xChapter1|Background..................................11.1References...............................................2Chapter2|MusculoskeletalDisordersandErgonomicInterventions.................................32.1Introduction..................................