Germs and infection, such as mumps, chicken pox, or the flu, can be spread through the air when infected people cough, sneeze or speak.

How are workers and others harmed?

Workers, clients/patients and others can be exposed to infection in number of different ways, including:

• airborne infections – which are spread through the air when infected people cough, sneeze or speak. Air-conditioning can escalate the spread of infections.
• contact infections – which are transmitted through direct or indirect contact with bacteria or viruses. Direct contact can include physical contact with an infected person, or contact with blood and body fluids.
• indirect contact infections – which involve touching an object or surface that has been contaminated by an infected person.

What can you do?

First you must always eliminate the risk where you’re reasonably able to. Where you’re not reasonably able to, then you need to consider what you can do to minimise the risk. Here are some examples:

• Ensure people wash their hands regularly.
• Have processes in place to handle sharps properly.
• Clean and disinfect spills.
• Practise cough etiquette and encourage patients to do the same.
• Provide personal protective equipment (PPE), such as masks and gloves
• Ask patients to let reception workers know if they think they have an infectious illness.
• Provide vaccinations to workers.

Always ask workers for input on identifying health and safety risks, and when choosing solutions. People are more likely to take responsibility and make good choices if they’ve been involved in the conversation. Workers are the eyes and ears of your business. They could suggest practical, cost-effective solutions.

You need to select the most effective control measures that are proportionate to the risk, and appropriate to your work situation.

Poor lighting, liquid spills, uneven floor surfaces and other obstacles can put healthcare workers and clients/patients at risk of slip, trip or fall injuries.

How are workers and others harmed?

When someone falls as a result of a slip or trip, the injury can range from minor (bruises and scrapes) to more serious, including broken bones or head trauma. The severity of the injury will depend on the circumstances.

Examples of how injuries can be caused include:

• uneven or poorly maintained floor surfaces
• slippery/wet surfaces caused by water or other spilled substances
• cluttered and confined work areas
• poor lighting
• wearing footwear that does not match the environmental conditions.

What can you do?

First you must always eliminate the risk where you’re reasonably able to. Where you’re not reasonably able to, then you need to consider what you can do to minimise the risk. Here are some examples:

• Look for slip and trip hazards as part of regular workplace inspections.
• Educate workers about the importance of identifying and reporting slip and trip hazards, and involve them in identifying issues and solutions.
• Practice good housekeeping - keep rooms tidy and remove unnecessary items and clutter (for example, by providing sufficient storage and ensuring things are put away).
• Ensure floor or ground surfaces in work areas, car parks and entrances are clean, well lit, clear of obstacles and in good condition.
• Ensure floors throughout work areas are level.
• Ensure all steps and stairs have appropriate handrails.
• Develop policies on how to safely carry objects (for example, no unstable or unbalanced loads), particularly on stairs.
• Provide height access equipment (for example, mobile steps with handrails) for reaching objects or performing work above shoulder height.

Always ask workers for input on identifying health and safety risks, and when choosing solutions. People are more likely to take responsibility and make good choices if they’ve been involved in the conversation. Workers are the eyes and ears of your business. They could suggest practical, cost-effective solutions.

You need to select the most effective control measures that are proportionate to the risk, and appropriate to your work situation.

Healthcare workers often have to lift, carry or push people, putting them at risk of serious injury.

How are workers and others harmed?

Moving and handling clients/patients can put workers at risk of serious injury particularly when:

• they work in awkward postures and the physical effort is high (for example workers are visibly struggling, or say the task is difficult)
• the environment is challenging (for example, confined spaces, slippery floors, poor lighting, aggressive behaviour)
• they regularly bend, twist, reach, or hold the load away from their body
• they are rushing, have high work demands, or are understaffed
• they are young, old, new, or expectant mothers, recovering from injury, have English as a second language.

Injuries and conditions can affect muscles, ligaments, bones, tendons, blood vessels, and nerves. They may start as mild aches or pains and can develop into serious conditions, for example: 

• strains or sprains
• joint and bone injuries or degeneration
• nerve injuries
• muscular and vascular disorders resulting from vibration
• soft tissue injuries such as hernias
• chronic pain.

What can you do?

First you must eliminate the risk where you’re reasonably able to. For example:

• Eliminate manually lifting of clients/patients, except in life-threatening situations.
• Provide appropriate mechanical lifting aids and equipment (for example, overhead tracking, hoists, mobile hoists, wheeled equipment, slide sheets), and ensure they are used properly and maintained in accordance with manufacturer specifications.

Where you’re not reasonably able to, then you need to consider what you can do to minimise the risk. Here are some examples:

• Develop a patient care plan that includes information about recommended mechanical aids and equipment, plus safe handling methods (including how many people should assist with transfer). Review the plan regularly.
• Ensure workers know how to do all their work tasks and use equipment safely.
• Encourage clients/patients to provide assistance in their transfers.

Always ask workers for input on identifying health and safety risks, and when choosing solutions. People are more likely to take responsibility and make good choices if they’ve been involved in the conversation. Workers are the eyes and ears of your business. They could suggest practical, cost-effective solutions.

You need to select the most effective control measures that are proportionate to the risk, and appropriate to your work situation.

For more information, see moving and handling people in the healthcare industry.

Health and safety specialists such as vocational occupational therapists, occupational health physiotherapists, occupational health nurses, and ergonomists/human factors professionals (and others) can be used to support businesses to manage risks.

Violence can take many forms – ranging from physical assault and verbal abuse to intimidation and low-level threatening behaviour. Violence or threats of violence in the workplace are never acceptable.

How are workers and others affected?

Violence at work can include attempted or actual physical assault, verbal abuse, intimidation, and low-level threatening behaviour.

Violence or threats of violence can come from clients/patients, co-workers or even a worker’s family members or acquaintances.

Lone workers can be at greater risk.

What can you do?

First you must always eliminate the risk where you’re reasonably able to. Where you’re not reasonably able to, then you need to consider what you can do to minimise the risk.

Here are some examples of things you can consider:

• workplace layout (for example, a workplace layout must, so far as is reasonably practicable, allow people to enter, exit and move about without risks to health and safety – both under normal working conditions and in an emergency)
• workplace policies and procedures (for example, how to deal with clients/patients including what unacceptable behaviour is and what to do about it)
• what to do in an emergency (for example, you must also provide adequate first aid equipment/facilities and access to first aiders)
• training, (for example, you must provide your workers with the training/supervision they need to work safely, such as procedures for working safely)
• other security measures:
• Panic buttons/duress alarms to seek help and alert other workers to potential danger.
• CCTV with warning signs.
• Signs that set out clear expectations of the behaviour of customers (eg no bad language, no verbal abuse, no physical intimidation) and the consequences of bad behaviour.

Always ask workers for input on identifying health and safety risks, and when choosing solutions. People are more likely to take responsibility and make good choices if they’ve been involved in the conversation. Workers are the eyes and ears of your business. They could suggest practical, cost-effective solutions.

You need to select the most effective control measures that are proportionate to the risk, and appropriate to your work situation. You should also have effective ways to investigate and deal with violence when it does occur.

See violence at work for more information. 

The causes of work-related stress are numerous, including long hours, a heavy workload and conflicts with clients/patients or co-workers.

How are workers and others affected?

Awareness is increasing about the impact of work-related stress. There is often confusion between challenge and stress. While challenge at work can have positive effects on people, work-related stress is a work-related health issue that can pose risks to psychological and physical health.

The effects of work-related stress can vary from individual to individual. In general, work-related stress can cause:

• illness and disease
• low morale and engagement
• anxiety
• lower performance and productivity
• antisocial behaviours.

What can you do?

First you must always eliminate the risk where you’re reasonably able to. Where you’re not reasonably able to, then you need to consider what you can do to minimise the risk. Here are some examples:

• Set achievable expectations with your workers in relation to agreed hours of work.
• Match worker’s skills and abilities to job demands.
• Support workers to have a level of control over their pace of work.
• Engage with your workers to share ideas and perspectives on ways to address situations.
• Make sure workers know how to make suggestions, raise questions or concerns.
• Ensure managers and supervisors have the capability and knowledge to identify, understand and support workers who may be feeling stressed.
• Have agreed policies and procedures to prevent or resolve unacceptable behaviour.
• Engage and consult with workers before implementing change processes, and ensure they genuinely have the ability to influence the decisions you make.
• Provide workers with access to independent counselling services.
• Always train new workers on what the risks are and how to keep healthy and safe.

Always ask workers for input on identifying health and safety risks, and when choosing solutions. People are more likely to take responsibility and make good choices if they’ve been involved in the conversation. Workers are the eyes and ears of your business. They could suggest practical, cost-effective solutions.

You need to select the most effective control measures that are proportionate to the risk, and appropriate to your work situation.

Workers who spend their day sitting at a desk and working on a computer are at risk of experiencing discomfort, pain, or injury.

How are workers and others harmed?

Workers are at risk of discomfort, pain, or injury when they spend a lot of their workday seated at a desk, using a computer or taking phone calls.

Factors that may contribute to discomfort, pain, or injury when working with computers are:

• poor workstation set-up such as having the chair, desk, or monitor(s) set too low or high
• sitting for long periods of time without changing position or taking enough breaks to do other tasks away from the computer during the day
• poor lighting, for example, too bright or dull, or glare on the screen
• feeling rushed to get tasks done due to high work demands or being understaffed.

What can you do?

First you must eliminate the risk where you’re reasonably able to. Where you can't eliminate the risk then you need to consider what you can do to minimise the risk. Here are some examples:

• Provide adjustable furniture and equipment – one size does not fit all when it comes to chairs and work surfaces.
• Ensure workers are shown how to adjust the furniture and equipment to suit their needs.
• Take steps to control screen glare, (for example by using blinds) and make sure that the monitor is not placed in front of a window or a bright background.
• Encourage workers to take breaks away from the computer and change positions frequently, remember that ‘the best position is the next position’.
  If workers spend most of their day on the telephone, provide them with a hands-free headset or voice-activated software to reduce data entry tasks.

Always ask workers for input on identifying health and safety risks, and when choosing solutions. People are more likely to take responsibility and make good choices if they’ve been involved in the conversation. Workers are the eyes and ears of your business. They could suggest practical, cost-effective solutions.

You need to select the most effective control measures that are proportionate to the risk, and appropriate to your work situation.

For more practical information refer to:

• the Guidelines for using computers – detailed guidance on preventing and managing discomfort, pain, and injury when working with computers; and
• Setting up a healthy workstation when working from home – practical easy to follow tips on how to set up your workstation. This information applies to all workstations and not just when working at home. 

Health and safety specialists such as vocational occupational therapists, occupational health physiotherapists, occupational health nurses, and ergonomists/human factors professionals (and others) can be used to support businesses to manage risks.

Bullying harms workers and is a significant issue in New Zealand. It can affect people both physically and mentally, can disrupt workplaces, and lower work performance. Bullying can happen at any time and all levels in a business.

How are workers and others harmed?

Bullying at work is repeated and unreasonable behaviour towards a worker or group of workers that can lead to physical or psychological harm. Bullying can be physical, verbal or social.

Some of these behaviours may also fall under other types of behaviour such as discrimination or violence.

What can you do?

First you must always eliminate the risk where you’re reasonably able to. Where you’re not reasonably able to, then you need to consider what you can do to minimise the risk.

For example, building good relationships in a respectful work environment including having a ‘no-bullying tolerated’ work culture.

For more detailed information on managing bullying, see our guidance and resources on bullying prevention for workers and small businesses.

Always ask workers for input on identifying health and safety risks, and when choosing solutions. People are more likely to take responsibility and make good choices if they’ve been involved in the conversation. Workers are the eyes and ears of your business. They could suggest practical, cost-effective solutions.

You need to select the most effective control measures that are proportionate to the risk, and appropriate to your work situation.

Fatigue is an acute and/or ongoing physiological state of tiredness that leads to mental or physical exhaustion. It can impair work performance, and endanger both the worker and their patients   

How are workers and others affected?

The effects of fatigue can vary from individual to individual and can lead to negative outcomes for workers and their patients. In general, the effects of fatigue can include:

• increased risk of poor decisions
• lower levels of concentration
• increased error rates and slower reaction times
• an inability to recall events or information promptly
• more emotional responses to situations
• limitations in communicating clearly to others
• greater irritability or frequent mood changes.

What can you do?

First you must always eliminate the risk where you’re reasonably able to. Where you’re not reasonably able to, then you need to consider what you can do to minimise the risk.

Here are some examples:

• Provide workers with regular, quality rest breaks and adequate facilities for rest breaks.
• Ensure that the work schedule is reasonable for workers. This might mean limiting overtime, limiting the number of night shifts, providing minimum number of days off and/or limiting shift swaps.
• Allocate resources and funds to cover unexpected absences. This allows workers to take time off if needed to manage stress or fatigue. 

Always ask workers for input on identifying health and safety risks, and when choosing solutions. People are more likely to take responsibility and make good choices if they’ve been involved in the conversation. Workers are the eyes and ears of your business. They could suggest practical, cost-effective solutions.

You need to select the most effective control measures that are proportionate to the risk, and appropriate to your work situation.

Risks to workers and others from exposures to chemical substances including gases, cleaning agents, and sterilants are common in the health industry. They may be found in hospitals, clinics, and pathology, medical, and dental laboratories. The risks may arise from contact with skin, or from breathing in airborne mists, gases, or vapours.

How are workers and others harmed?

Many chemical substances used in health services are hazardous substances.  Many cause damage to organs and tissues, some may be carcinogenic (may cause cancer), and others may be skin or respiratory sensitisers (for example may cause dermatitis or asthma). Exposure may occur in a number of ways including:

• airborne exposures – mists, gases, or vapours being breathed in
• direct contact exposures – the chemical coming into contact with exposed skin or eyes, for example due to splashes or spills
• indirect contact exposures – surfaces or objects contaminated with the chemical coming into contact with exposed skin.

What can you do?

You must eliminate the risk where it is reasonably practicable to do so. Where it is not reasonably practicable, you need to consider what you can do to minimise the risk. Options include:

• substituting the substance for a less hazardous substance
• removing the mist, gas, or vapour at the source of generation using local exhaust ventilation
• isolating the process that uses the substance in an enclosure
• using the substance only in well-ventilated areas
• providing appropriate personal protective equipment (PPE) – and training workers in its use, storage, maintenance, and cleaning, and ensuring it is used
• cleaning up spills, while using appropriate PPE, before the substance spreads throughout the workplace.