Homecare Worker Health and
Safety
Laura Stock, MPH
Labor Occupational Health Program
UC Berkeley
May 2, 2011
Pop Quiz
Homecare workers have ___higher injury
rate than workers in the general
workforce.
 20%
 30%
 50%
 70%
NIOSH Homecare Worker Study:
2001 - 2004
Consumer’s Safety and Health
Safe Home
Workers’ Safety and Health
Safe Workplace
Homecare Worker and Consumer Safety and Health
Study Methods



Interviews (workers, unions, agencies,
advocacy groups, consumers)
Focus groups (English, Spahish,
Cantonese)
Data analysis
Study Results:
Stressful tasks associated with personal care
 Unassisted consumer lifting and transferring
 Bathing
 Dressing (especially putting on shoes and
lifting legs)
 Pushing/pulling/lifting wheelchair
 Supporting consumer while walking or
catching them while falling
 Using needles or sharps/wound care
Results:
Stressful tasks associated with
housekeeping chores
 Cleaning kitchen/bathroom/floors
 Carrying groceries
 Moving boxes and furniture
 Prolonged standing
Conclusions



Most workers have no training but want it
Workers unaware of simple assist devices –
gait belts, shower chairs, transfer boards
Workers have limited health information



Workers comp, blood-borne pathogens, jobrelated stress, etc.
Conflicts between consumers and workers
may pose health risks to workers
Most consumers’ homes are not wellequipped for the services they need
Challenges in Addressing
Health and Safety




Workers are employed in many
locations
Each workplace is unique
Population is very diverse (multiple
languages)
Consumers are often low income with
little access to resources
NIOSH Intervention Study


Goal: Develop interventions to improve
the safety and health of homecare
workers
Approach: Community-based
participatory research methods
Specific Aims




Stage 1: Research and develop
intervention materials (handbook and
training program)
Stage 2: Field test using peer mentors
Stage 3: Evaluate effectiveness
Stage 4: Disseminate materials (social
marketing)
Challenges of Developing
Effective Interventions




Homecare workers don’t always identify as
workers with the right to a safe workplace
Consumers don’t always identify as employers
and may lack resources/ability to take on that
role
Workers may not believe they can make
changes
Health and safety is not seen as important by
many workers and consumers
Intervention Challenges cont.




Hard to balance need to cover lots of
information and the need for simplicity
Hard to meet the needs of such a diverse
group of workers and consumers
Lack of organizational resources (no training,
no time to address safety)
Lack of easily accessible referral services
Intervention Materials: The
Homecare Workers’ Handbook
Safety Tip Example
Taking Action
Health and Safety Workshop
Designed to:
 Increase understanding/awareness of
homecare worker health and safety
 Prepare workers to use the materials to
identify and address hazards
 Promote effective communication
between homecare worker and
consumer
Where Does it Hurt?
Identifying Hazards
Hazard Stickers:
Taking Action
Social Marketing Campaign



Identifying key messages that will
resonate and promote worker health
and safety
Determining effective dissemination
strategies
Creating posters/giveaways that can
promote materials and messages
Lessons Learned



Homecare workers want and value
opportunities to share experiences with
other workers
The relationship between workers and
consumers must be respected
Involving workers and consumers is
essential to creating relevant, useful
and practical materials
Lessons, cont.


There is a need for easily accessed,
local resources – people need to know
‘who to call’
Communication and negotiation skills
are critical to addressing hazards –
people need help in advocating for their
needs
Next Steps




Conduct formal evaluation
Work with partners and worker/consumer
leaders to promote use of materials and the
recognition of importance of homecare
worker health and safety
Work with stakeholders to address
institutional barriers
Share materials and lessons learned with
others across state and nation
Other Resources on Homecare
Health and Safety

www.uic.edu/sph/homecarehealthandsa
fety/index
Discussion Questions:



How are you planning to address this
issue in your curricula?
Where can worker health and safety
information be most easily inserted?
What further resources/assistance do
you need regarding homecare worker
health and safety issues?
Thank You
Laura Stock, MPH
lstock@berkeley.edu
510-642-5056
www.lohp.org