Employee with Exposure to Chemicals

Employee with Exposure to Chemicals

Instructions/Descriptions

Employee with Exposure to Chemicals

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Leslie Johnston is a 23-year-old woman who was transferred by her employer into a job that required her to work with chemicals used in photolithography. Leslie became concerned when she noticed that the label on one of the pieces of equipment warned of possible adverse effects on reproduction. Because of her concern and related issues, she went to the on-site health clinic to talk with Peter Mitchell, the occupational health nurse.

Peter invited Leslie into his office to ask her questions and do a brief health history. Leslie reported that her health had been “excellent” until recently but that she had not felt well since transferring to her new position. She explained that she was newly married and thought she may be pregnant, but this was unconfirmed. She questioned whether her vague physical complaints (fatigue, headaches, occasional queasiness) might be related to working with chemicals, a pregnancy, or another reason.

Peter reassured Leslie that he had been employed at the company for 8 years, and he was aware that there were no restrictions in Leslie’s work area for pregnant women. He pulled up her health file from his computerized database and gave her a set of health history forms to complete. He also had her read and sign several forms related to confidentiality and assured her that none of her health information would be shared with their employer without her consent.[Order Now]

Assessment

To obtain needed information, Peter:

1. Completed general health and occupational health histories.
2. Performed a modified physical assessment and discussed the symptoms Leslie was experiencing.
3. Referred Leslie to her personal health care provider for further evaluation and to obtain a pregnancy test. (NOTE: In some cases, on-site clinics will be equipped for basic procedures such as this. If this is not a service provided by the occupational health nurse, referral must be made to the employee’s health care provider. If the employee does not have one, referral must be made to an appropriate community health resource.) Peter encouraged Leslie to inform her supervisor and himself if the pregnancy test result was positive so they could adapt her assignments to her condition.
4. Assessed Leslie’s work area with an industrial hygienist to determine whether there might be problems, such as leaking equipment or problems with ventilation.
5. Reviewed the most current industrial hygiene data appropriate to the area.

Diagnosis

Individual

1. At risk for chemical exposure
2. Vague physical complaints of unknown etiology
3. Possible pregnancy
4. At risk for possible adverse pregnancy outcomes
5. Stress related to concern regarding possible exposure to harmful chemicals

Community

1. Potential for exposure of employees to unsafe chemicals and/or working conditions

Planning

1. Peter developed a plan of care based on Leslie’s health history and concerns. Together they set the following goals:

Individual

Short-Term Goals

1. Determine pregnancy status.
2. Determine potential exposure levels and review side effects of chemicals.
3. Determine reason for her vague physical complaints.
4. Reduce stress experiences.[Order Now]

Long-Term Goals

1. Ensure that the work environment is safe for future pregnancies (if Leslie is not pregnant at present).
2. Collaborate with Leslie and her supervisor on possible work restrictions.

Community (Workplace)

Short-Term Goals

1. Company personnel (e.g., the occupational health nurse, the industrial hygienist, and all others who are directly affected) will be knowledgeable in safe handling of all hazardous chemicals.
2. All company policies regarding safety and exposure will be followed.

Long-Term Goals

1. Policies on handling of chemicals and related information will be reviewed periodically as required by law.
2. All employees who work with and around potentially hazardous chemicals will undergo periodic instruction and instruction in and confirmation of knowledge about proper procedures.
3. Work areas will be monitored per policy for compliance with safe practices.
4. There will be no incidents involving worker exposure to chemicals.

Intervention

Individual

Peter conducted a brief physical examination and did not identify any obvious physical abnormalities. Because Leslie’s chief complaints were fatigue, occasional headaches, and queasiness, he encouraged her to make an appointment with her primary care provider or gynecologist for a more extensive workup and to assess for pregnancy.

With her permission, he called the industrial hygienist to counsel Leslie regarding the policies of the company, to explain what chemicals might potentially be hazardous, and to review procedures and restrictions. The hygienist also stated that he would send a team to Leslie’s work area to take air samples, check lighting, and perform other tests to ensure there were no problems.

Community (Workplace)

The assigned industrial hygiene team sampled the environment for chemical exposure per established procedure. They also set up a plan to have the area more frequently observed pending the results of the tests. The hygienist assured Peter and Leslie that he would communicate any work restrictions or changes to the personnel department and Leslie’s supervisor if needed.

Evaluation

Individual

After the meeting with Peter and the industrial hygienist, Leslie stated that she felt reassured. She agreed to make an appointment as soon as possible with her doctor for an evaluation and pregnancy test. She also agreed to inform Peter and her direct supervisor if she learned that she was pregnant.

Community (Workplace)

The industrial hygienist and his assistants performed several tests in close proximity to Leslie’s work station; they found no abnormal readings, and all equipment was in good working order. Per agency policy and following OSHA regulations, they charted all findings and submitted reports.[Order Now]

Levels of Prevention

Primary

1. Teach about chemicals, exposures, etc.
2. Instruct about chemical avoidance.
3. Remove employee from environment through work restrictions.

Secondary

1. Assess employee for signs and symptoms.
2. Assess work environment for exposure.
3. Refer for evaluation of possible health problems as needed.

Tertiary

1. Provide reproductive counseling.

A large automobile manufacturer needs a program designed to control respiratory disease among foundry workers. Workers in different areas of ferrous foundries are exposed to different respiratory hazards. The main problems are exposures to silica and formaldehyde. The corporation would like to develop a pilot program for one of its foundries that will then be applied to its other foundries. Health and industrial hygiene data will be collected. Both the corporation and the workers support the project, and both see the project as having the following three purposes:

1. Detecting health effects in individuals who may benefit from intervention
2. Determining the relationship of health effects with environmental exposures
3. Identifying control strategies as appropriate

Outline a pilot program. Discuss the implications of discovering adverse health effects among current workers. Describe the roles of the occupational health nurse, physician, industrial hygienist, safety professional, manager, and employee.[Order Now]

Employee with Exposure to Chemicals

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