Hospitals are one of the most hazardous places to work. In 2021-2022, U.S. hospitals recorded 249,570 work-related injuries and illnesses requiring days away from work, restricted work activity, or job transfer--a rate of 3.2 work-related injuries and illnesses for every 100 full-time employees. This is nearly twice the rate of the all-industry average (U.S. Bureau of Labor Statistics).

Hazards presented in hospital environments include lifting and moving patients, needlesticks, slips, trips, and falls, exposure to infectious diseases, hazardous chemicals, and air contaminants, and the potential for agitated or combative patients or visitors. Hospitals have a dynamic, unpredictable environment and a unique culture. Hospital work often requires coping with some of the most stressful situations found in any workplace. Caregivers feel an ethical duty to "do no harm" to patients and may even put their own safety and health at risk to help a patient.

Because hospital workers and their patients share the same physical environment and organizational culture, protecting workers in hospitals can also provide benefits to patients. For example, repeated manual lifting can injure caregivers and also put patients at risk of falls, fractures, bruises, and skin tears. Moreover, some studies associate caregiver fatigue, injury, and stress with a higher risk of medication errors and patient infection. OSHA created this Hospitals eTool to help hospitals identify and assess workplace safety and health needs, implement safety and health management systems, and enhance safe patient handling and violence prevention, among other protections. This eTool* will help employers and workers identify hazards and implement effective administrative, engineering and work practice controls.

This Hospitals eTool addresses some of the hazards commonly found in various hospital areas, such as the emergency department and the surgical suite. For each hospital area, OSHA highlights some of the specific OSHA requirements, as well as recognized controls, that are likely applicable in that particular area. Recognized controls may be required by specific OSHA standards (such as requirements for the use of PPE, respirators, and/or work practice, administrative, or engineering controls), but even if they are not, these controls may be required to comply with the general duty clause of the Occupational Safety and Health Act of 1970, 29 U.S.C. 654(a)(1), which requires each employer to “furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees.”

In this Hospitals eTool, OSHA’s focus, in a given hospital area, on particular hazards, requirements and controls does not signify that they are the only applicable hazards, requirements and controls for that area. To this end, the fact that OSHA highlights particular hazards, requirements, and controls in one area, but does not highlight them in another area, does not signify that the hazards, requirements, and controls highlighted in the first area are not applicable to the second area. Employers need to conduct a thorough worksite hazard analysis to determine the full range of hazards to which employees are exposed and the full range of controls that will protect workers from those hazards.