Centers for Disease Cont And Prevention

Public awareness of the potential for healthcare to actually be the source of harm to patients through exposure to infectious agents, unintended error or known side effects of hazardous treatments has spawned a highly visible "patient safety" movement. Less visible, however, is the risk this same environment and these same hazards impose on the health of the women and men who work there. Although often thought of as clean and safe, workplaces in the Healthcare and Social Assistance (HCSA) sector are associated with many of the same types of exposures to chemicals and hazards found in "blue collar" industrial settings. The HCSA sector is burdened by the historical and entrenched belief that patient care issues supersede the personal safety and health of workers and that it is acceptable for HCSA workers to have less than optimal protections against the risks of hazardous exposures or injuries. Because patients and providers share the healthcare environment, efforts to protect patients and providers can be complimentary, even synergistic, when pursued through a comprehensive, integrated approach. In order to address occupational safety and health issues of the nation, including those of the HCSA sector, the National Institute for Occupational Safety and Health (NIOSH) is working with a range of partners to develop an updated National Occupational Research Agenda (NORA). Each industrial sector is being ad¬dressed by a group of experts and stakeholders called a NORA sector council. This publication addresses the research needs of the occupational safety and health community within the Healthcare and Social Assistance (HCSA) industrial sector. This important industrial sector represents about 11% of the U. S. workforce-approximately 17.4 million workers in 2006-of which 80% are in healthcare. The HCSA sector contains 12 of the 20 fastest growing occupations, and the projected growth of this sector through 2014 exceeds that of any other industrial sector. Workers in the HCSA sector are exposed to a wide range of health and safety hazards including infectious, chemical, and physical agents; lifting and repetitive tasks (ergonomic hazards); stress (psychological hazards); workplace violence; and risks associated with suboptimal organization of work.

Anthropometry is the study of the measurement of the human body in terms of the dimensions of bone, muscle, and adipose (fat) tissue. The word "anthropometry" is derived from the Greek word "anthropo" meaning "human" and the Greek word "metron" meaning "measure". The field of anthropometry encompasses a variety of human body measurements. Weight, stature (standing height), recumbent length, skinfold thicknesses, circumferences (head, waist, limb), limb lengths, and breadths (shoulder, wrist) are examples of anthropometric measures. Several indexes and ratios can be derived from anthropometric measurements. Perhaps the most well-known indicator of body fatness is the body mass index or "BMI." BMI values are calculated for NHANES participants using measured height and weight values as follows: weight (kilograms)/height (meters squared). BMI criteria are used to screen for weight categories: underweight (BMI values less than 18.5), normal or desirable weight (BMI values 18.5-24.9), overweight (BMI values 25.0-29.9), obese-Class I (BMI values 30.0-34.9), obese-Class II (BMI values 35.0-39.9), and extremely obese (BMI values greater than 40.0) (National Institutes of Health, 1998). The NHANES BMI results are used to track weight trends in the U. S. population. The National Institutes of Health, Centers for Disease Control and Prevention (CDC), and many other research groups have reported on the health risks associated with overweight and obesity using NHANES interview and health examination data.

In October 2008, the Federal Government issued its first-ever Physical Activity Guidelines for Americans to provide science-based guidance on the types and amounts of physical activity that provide substantial health benefits for Americans. (2008 Physical Activity Guidelines for Americans). The Guidelines state that "Being physically active is one of the most important steps that Americans of all ages can take to improve their health." It goes on to say that "Children and adolescents should do 60 minutes (1 hour) or more of physical activity daily" AND "...adults should do at least 150 minutes a week of moderate-intensity, or 75 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous intensity aerobic activity". These conclusions were based, in part, on an expanded body of scientific literature that demonstrated the relationship between physical activity and health. Namely, physical inactivity is an independent risk factor for coronary heart disease. In the United States, a significant percentage of deaths from coronary heart disease, colon cancer, and Type 2 diabetes are attributable to sedentary lifestyle. Moderate-intensity activity is even beneficial to overall health because it contributes to improved glucose tolerance and blood lipid profile levels. The American College of Sports Medicine, the Centers for Disease Control and Prevention, the American Heart Association, the National Institutes of Health, and the President's Council on Physical Fitness and Sports, recommend regular, moderate-intensity physical activity. The U. S. Surgeon General's Report on Physical Activity and Health reported that more than 60 percent of Americans do not engage in regular physical activity and that 25 percent do not engage in any activity. The report reaffirmed the importance of regular moderate or vigorous-intensity activity. Furthermore, physical activity data on children, particularly children in the 6-11 year age group are lacking. Proxy information on physical activity levels among youth are not useful because children spend large amounts of time away from home and they also engage in sporadic periods of activity that are difficult to document, let alone quantify. The results of the 2003-2006 NHANES PAM data have been analyzed and includes a minute-by-minute recording of the waking hours over 7 days in nearly 6,800 children, adolescents, and adults. The data suggested that 42 percent of children aged 6-11 years met the current 60 minutes per day recommendation, but only 8 percent of adolescents met this goal, and fewer than 5 percent of adults met the 30 minutes or more of physical activity per day.