Occupational Exposures in the Homecare Environment: Piloting an Observation Tool

A worker's health is impacted by the environment in which they work and the tasks they complete; workers who provide healthcare in the home environment are no exception. The U.S. Bureau of Labor Statistics ([BLS], 2020) reported the home health care service industry employed 1,527,400 workers in 2019 and is projected to increase by 29.9% to 1,983,400 by 2029. The dramatic growth is attributed to the growing population of persons over 65, more patients seeking care for chronic health conditions, and improvements in technology and medical advancements allowing more complex patient care to be provided at home (BLS, 2014). Dependent on the state the worker is employed in, the home care aide or patient care aide, may provide some assistance with medication and check vital signs (BLS, 2019). Licensed and professional healthcare workers who provide services within the home include nurses, advanced practices nurses, physicians, respiratory therapists, occupational therapists, speech pathologists, physical therapists, and social workers. Unlicensed workers within the industry include patient care aides who assist patients with daily activities such as bathing, feeding, housekeeping. Both licensed and unlicensed groups of workers have similar occupational exposures when entering the uncontrolled home care environment; however, some differences have been noted based on the different tasks they complete (Hittle, et al., 2016). For this study, all workers that enter the home and are employed by a home care agency are considered under the term HHCWs.