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Whirlpool/Shower Module  


    

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Click on the area for more specific information. Ergonomics - Wheelchair Scale Physical Therapists Exposure to Bloodborne Pathogens Exposure to Legionnaire's Disease Slips/Falls - Mat Ergonomics - Whirlpool Ergonomics - Mechanical Lift Ergonomics - Shower Chair Slips/Falls - Mat Hazards in the Whirlpool/Shower area

The following topics relate to occupational safety and health hazards in whirlpools and showers: 



Ergonomics

*Note: OSHA is currently involved in rulemaking concerning employee protection against ergonomic hazards which may influence the following recommendations.

Hazard

Acute and chronic back injury caused by:

  • Lifting, reaching, or moving residents who cannot move on their own.

  • Awkward postures: pulling lifting patients from tubs, whirlpools.

Example Controls 

Good work practice recommends using the proper equipment to reduce risk of back injuries when lifting, showering, or moving residents such as:

  • Shower chairs-(residents are bathed in a shower chair with wheels, so lifting in and out of tub is eliminated).

  • Gait belts-(Provides handles to enable health care workers (HCW) to help residents walk or move, with less strain on HCW's back).

  • Wheelchair Scale-(Patients who cannot stand are weighed in their wheelchairs).

  • Mechanical lifting equipment such as a Hoyer lift for residents who cannot support their own weight.

It is also recommended that employers provide training in:

  • Proper lifting techniques-avoiding awkward postures.
  • The proper use of machinery and equipment.

The Ergonomics Module also addresses ergonomic issues.

Additional Information

 

 

Slips/Falls

Hazard

Water spills that can lead to falls and injuries. Continually wet surfaces can also create a health hazard by promoting the growth of molds and bacteria that can cause infections or allergic reactions in employees.

Example Controls

  • Floors shall be kept clean and dry [1910.22(a)(2)]. 

  • Non-slip mats and other dry standing places should be provided where practicable [1910.22(a)(2)]. In addition to being a slip hazard continually wet surfaces promote the growth of mold, fungi, and bacteria which can cause infections.  
  • The OSHA Walking/ Working Surfaces Standard requires that all places of employment shall be kept clean and orderly and in a sanitary condition [1910.22(a)(1)].
  • The OSHA Sanitation Standard requires: 

    • Where wet processes are used, drainage shall be
      maintained and false floors, platforms, mats, or other dry
      standing places shall be provided, where practicable, or
      appropriate waterproof footgear shall be provided
      [1910.141(a)(3)(ii)]. 

Other Recommended Good Practices:

  • Ensure spills are reported and cleaned up immediately. 

  • Use no skid waxes and surfaces coated with grit or waterproof
    footgear, may also help decrease slip/fall hazards. 

Additional Information

 

 

Bloodborne Pathogens

Hazard

Exposure to blood or other potentially infectious materials (OPIM) 

  • While physical therapists provide therapy to patients with bed sores or other open wounds.

Example Controls

Bloodborne Pathogens Standard 1910.1030  requires:

  • Exposure control plan in place to help reduce the risk of occupational exposure to bloodborne pathogens:
    • Communicate possible hazards to Physical Therapist.
    • Educate and train all employees with occupational exposure to blood or OPIM to recognize hazards.
    • Provide personal protective equipment (PPE), such as gloves and gowns.
    • Use safe work practices and engineering controls.
    • Provide Hepatitis B Vaccination.

For more information see the Bloodborne Pathogens Module.

Additional Information

 

 

Legionnaires' Disease

Hazard

Exposure to Legionnaires' Disease through:

  • Breathing aerosolized water that contains the legionella bacteria. This could occur in the shower or whirlpool area, or areas that have a spray nozzle. Cooling towers, evaporative condensers, fluid coolers, and domestic hot-water systems are water sources that frequently provide optimal conditions for growth of the legionella bacteria.

Example Controls

Good work practice includes appropriate maintenance of water systems, as recommended by the OSHA Technical Manual Legionnaires' Disease Chapter 7 Section III Chapter 7 - Controls:

  • Domestic hot-water systems:
    • Store hot water at 140 degrees F. To avoid scalding problems install appropriate, fail-safe scald protection equipment, such as preset thermostatic mixing valves.
    • Where building cannot be retrofitted, periodically increasing the temperature to at least 158 degrees F or chlorination followed by flushing should be considered.
    • Systems should be inspected annually to ensure equipment is functioning properly.
  • Domestic cold-water systems:
    • Maintain cold-water lines below 68 degrees F.
    • Water tanks that allow water to remain uncirculated for long periods should be eliminated or designed to reduce storage time to a day or less. They should also be covered and protected from temperature extremes.
    • Cross-contamination of the domestic cold water system with other systems shall be prevented.
    • If the cold-water lines have significant contamination, hyperchlorination can eradicate legionella.
  • Cooling towers should be cleaned and disinfected at least twice a year: 
    • Periodic use of biocides is recommended to control bacteria growth.
    • Provide visual inspection and periodic maintenance of the system, to prevent buildup of scale and sediment and bio-fouling, which support legionella growth.

The OSHA Salt Lake Technical Chapter, also provides recommendations for Source Identification of Legionnaires' disease and a employee awareness program. 

  • Employee awareness program: The purpose of an employee awareness program is to inform employees of any potential outbreak, to educate about the disease, and provide early recognition of the disease. Sample forms and questions and answers about Legionnaires' disease are provided in the technical chapter.
The Maintenance Module, also addresses Legionnaires' Disease.

 

 


 

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