Occupational hazards of domestic workers providing home care

Abstract

Domestic workers, as an occupational group, include a subset called homemakers who provide a variety of household and personal services for the elderly, ill and disabled. Their services obviate hospitalisation for clients who cannot maintain their homes independently. A cross-sectional survey of the San Diego membership of the United Domestic Workers of America Union was performed using a 23-item questionnaire mailed in both English and idiomatic Spanish versions to 856 union members, of whom 49% responded. Known characteristics of respondents and union membership as a whole were similar. Nearly all homemakers were women (96%) and a majority were middle aged (median age 51 years) members of an ethnic minority (58%; 31% Hispanic, 22% black). They provided a wide range of household services for clients, including cleaning (95%), laundry (95%), shopping for food (87%), meal preparation (80%) and bathing clients (50%). Forty-six percent of respondents have encountered hazards in the homes of clients, including pests (39%), flammable trash piles (19%), non-electrical safety hazards (18%), garbage (12%) and frayed electrical cords (8%). Eight point five percent reported having experienced at least one work-related injury. Verbal or physical abuse from clients was reported by 15%. Homemakers considered themselves in good overall health but 26% reported musculoskeletal disorders, principally back problems, significantly more often than expected compared to a comparison group of 52 age-matched women from a socio-economically and culturally appropriate neighbourhood. Skin but not breathing problems were reported slightly more often by homemakers. Most homemakers declared themselves satisfied with their jobs, but reported and perceived health problems are likely to be minimized in this population; for example, only 8.6% perceived common household products used as posing any hazard. These products include many with well known hazards singly or in combination, such as chlorine bleach and drain cleaner, pesticides and over cleaner. Worker education and employer supervision are needed to ensure that homemakers are adequately protected against occupational hazards.