Microsoft Word - fullpdf07022025 Georgian Scientists/ქართველი მეცნიერები ტ. 7 N 2, 2025 617 Georgian Scientists ქართველი მეცნიერები Vol. 7 Issue 2, 2025 https://doi.org/10.52340/gs.2025.07.02.56 Ensuring Occupational Safety in the Medical Sector: Key Problems, Systemic Challenges, and Strategic Recommendations Omar Lanchava1, Natalia Bulia1, Mariami Darakhvelidze 2 1Georgian Technical University, 77, Kostava Street, Tbilisi 2LEPL Labour Inspection Office, 15a Tamarashvili Street, Tbilisi Highlights • 2023 was the record year for inspections – 47 facilities were monitored. • No inspections were conducted in the medical sector during 2018–2020. • The ILO recognizes healthcare as a fundamental human right and critical service. • Medical institutions are high-risk zones, requiring constant oversight. • Occupational health and safety are not optional – it is a necessity in healthcare. Summary This article provides a detailed overview of the importance of occupational safety in the medical sector, which is one of the most high-risk professional environments. Healthcare workers face daily exposure to a variety of biological, chemical, physical, and psychosocial hazards, making the monitoring of working conditions essential. From 2015 to 2024, the frequency of inspections in Georgia’s medical institutions has been inconsistent, with some years (e.g., 2018–2020) showing no inspections at all. Despite these gaps, recent years demonstrate a clear trend toward increased state monitoring. The peak was reached in 2023 with 47 medical facilities inspected, marking a positive shift in enforcement policy. International conventions and ILO guidelines emphasize that occupational safety is vital not only for individual well-being but also for the overall efficiency and reliability of the healthcare system. Therefore, inspections must be carried out consistently, rigorously, and systematically. Such practices ensure the protection of healthcare workers’ health and lives and contribute to building a safer and more trustworthy medical sector. In conclusion, strengthening labor inspection in healthcare is not just a legal obligation—it is a strategic investment in public health infrastructure. Key words: Medical sector; Biological, Chemical, Physical risk factors; Healthcare; Inspection. Georgian Scientists/ქართველი მეცნიერები ტ. 7 N 2, 2025 618 I. Introduction The medical sector is one of the most demanding and high-risk fields globally, requiring a particularly sensitive and structured approach to occupational safety. Unlike many other industries, healthcare professionals face a combination of biological, chemical, physical, and psychosocial hazards on a daily basis. From exposure to infectious agents and toxic substances to patient-handling injuries and emotional burnout, the scope of occupational risk is vast. Internationally, organizations such as the World Health Organization (WHO) and the International Labor Organization (ILO) emphasize the necessity of implementing effective workplace safety systems in the healthcare sector. Countries with well-established safety protocols demonstrate significantly lower injury rates, higher staff satisfaction, and better patient outcomes. A proactive approach to workplace health and safety includes hazard identification, risk assessment, and continuous improvement through training, reporting, and preventive action. Developing robust risk management policies not only helps reduce workplace incidents, property damage, legal liabilities, and financial burdens — it also builds a resilient, trusted healthcare organization. Furthermore, safe working environments foster long-term employee engagement and protect public health as a whole. As healthcare continues to evolve, protecting those who care for others must remain a global priority. 2. International Labor Organization approaches. According to the International Labor Organization (ILO), healthcare is a fundamental pillar of both society and the economy. It is recognized as a basic human right essential for protecting the health and safety of populations. Without a well-supported healthcare workforce, a functioning health system is inconceivable. To ensure healthcare is high-quality and equitably accessible, it is vital to secure decent working conditions and attract and retain qualified professionals. The United Nations High-Level Commission on Health Employment and Economic Growth (HEEG) has recognized the economic significance of the healthcare sector and its capacity to generate employment. The Commission also emphasizes the urgent need to invest in healthcare as a strategy for sustainable and inclusive economic growth. The ILO envisions a future where the healthcare sector serves as a driver of economic expansion, enabling job creation and contributing to social equity. Moreover, healthcare is expected to play a key role in achieving the Sustainable Development Goals (SDGs) — including poverty reduction, quality education, gender equality, and decent work opportunities for youth. To achieve this goal, the International Labor Organization (ILO) has taken several significant steps, such as Convention No. 149 adopted in 1977. On June 1, 1977, the Governing Body of the International Labor Office convened the 63rd session of the ILO General Conference in Geneva. Recognizing the vital role of healthcare workers in protecting and improving the health and well-being of the population, the members of the Governing Body agreed that the health sector must play an active role in improving employment and working conditions for nursing personnel. It was also noted that, in addition to general standards, it was necessary to establish a standard specifically tailored for nursing staff, outlining sector-specific requirements. The Governing Body Georgian Scientists/ქართველი მეცნიერები ტ. 7 N 2, 2025 619 agreed on common proposals and decided to adopt an international convention, resulting in the adoption of Convention No. 149 in June 1977. This Convention is complemented by Recommendation No. 157 adopted in 1997, which applies to nursing personnel working in any type of institution. Furthermore, the ILO has developed various guidelines tailored for different areas of the healthcare sector. For example, the “Employment Impact Assessment in the Care Sector” guide, which includes key topics such as current evaluation approaches, employment assessment frameworks, indicators for measuring employment effects, progressive methodologies for assessing impact, and more. Fig. 1 presents the main directions of the work of the International Labor Organization. Fig. 1. ILO Focus Areas in Healthcare Sector. In both developed and developing countries, the share of individuals employed in the healthcare sector differs significantly in relation to the total population, as clearly demonstrated in the table below. The data is based on the ILO & WHO report: Working for Health: Five-Year Action Plan 2017–2021. https://www.who.int/publications/i/item/9789241511308 Table 1. Share of Employment in the Healthcare Sector by Country No Country Share of Employment in Healthcare, % 1 Georgia 6,1 2 Norway 13,5 3 USA 13,2 4 Germany 12,8 5 Japan 11,9 The table illustrates that in developed countries — such as Norway, the United States, Germany, and Japan — the level of employment in the healthcare sector is significantly higher. This suggests that successful economies are often accompanied by strategic investments in health systems. The U.S. healthcare sector stands out for both innovation and employment volume, contributing to its global strength. Georgian Scientists/ქართველი მეცნიერები ტ. 7 N 2, 2025 620 In contrast, Georgia shows a notably lower employment rate in healthcare, which indicates the need for increased investment and stronger policy focus. Such comparative analysis helps us understand how employment in healthcare correlates with a country’s economic resilience, the quality of social services, and overall population well-being. Also notable is the International Labour Organization’s (ILO) 2018 guideline titled “Occupational Safety and Health in Emergency Situations.” This guideline covers: occupational safety and health during emergencies, strategies and tools required during such situations and epidemics, risks during emergency cases, occupational safety and health in radiological incidents, natural disasters, and the management aspects of occupational safety and health under these scenarios. Occupational safety is a critical aspect for the ILO, reflected clearly in its planned strategies and practical measures. 3. Department of Labor Inspection in Georgia. Activity analysis. In Georgia, the Ministry of Labour, Health and Social Affairs introduced amendments leading to the establishment of the Labour Conditions Inspection Department by Government Resolution No. 81 in 2015. This department’s creation laid the groundwork for its full functioning. With support from the international organization, the Ministry began active work to amend existing legislation and develop new legal acts related to occupational safety and health. During this period, the functions and responsibilities of the department were redistributed, resulting in its competence being focused primarily on monitoring labor conditions and providing recommendations to employers. At that time, the department lacked the legal mandate to impose sanctions and was limited to conducting inspections on a voluntary basis. In parallel, work began on reviewing the legislative framework and proposing relevant amendments. In 2018, the Parliament of Georgia adopted the “Law on Occupational Safety,” which on February 19, 2019, was granted the status of an Organic Law. Initially, this law applied only to high-risk, harmful, and hazardous work environments. However, from September 1, 2019, its scope was expanded to cover all sectors of economic activity. In 2020, the “Law on Labour Inspection” was adopted, following which the inspection department was dissolved in 2021. In its place, the Labour Inspection Office was established as a legal entity under public law. This new body gradually increased the scale of inspections across various sectors. In particular, it actively monitored healthcare and social service institutions to supervise the working conditions and safety of employees in the medical field. The legislative history of labor safety in Georgia is summarized in Table 2. Georgian Scientists/ქართველი მეცნიერები ტ. 7 N 2, 2025 621 Table 2. Legislative History of Labour Safety in Georgia Year Law/Act Name Short Description 2018 Occupational Safety Law Law adopted to regulate occupational safety 2019 Organic Law Law officially became organic 2019 Extended to all economic sectors Labour safety requirements applied to all sectors 2020 Labour Inspection Law New law regulating labour inspection 2021 Creation of Labour Inspection Service Department abolished; Inspection Service established In 2015, a total of 24 medical facilities were inspected in Georgia, marking one of the most active years in terms of regulatory enforcement. In 2016, the number of inspections dropped significantly, with monitoring carried out in only 5 medical institutions. In 2017, the figure rose again to 24 facilities, indicating renewed regulatory engagement. In 2018, 2019, and 2020, the statistics show zero inspections in the medical sector, likely due to a shift in priorities during the COVID-19 pandemic in 2020. In 2021, only 4 healthcare facilities were inspected, reflecting minimal activity, although there were some signs of efforts to reestablish oversight. In 2022, the number of inspections increased substantially, reaching 30 medical institutions, which can be interpreted as an attempt to reinforce regulatory control in the post-pandemic period. In 2023, a record-high number of 47 medical facilities were inspected, clearly pointing to the peak activation of state supervision mechanisms. In 2024, 19 facilities were inspected—while this represents a decrease compared to the previous year, it still reflects the ongoing trend of systematic monitoring. (See Diagram on the Fig. 2). Fig. 2. Inspections carried out by the regulatory authority in the medical sector during 2015-2024 24 5 24 0 0 0 4 30 47 19 0 5 10 15 20 25 30 35 40 45 50 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Georgian Scientists/ქართველი მეცნიერები ტ. 7 N 2, 2025 622 The inspection statistics in the medical sector clearly demonstrate that monitoring intensity has been inconsistent over the years. Particularly concerning are the years in which no inspections were conducted at all, potentially indicating that certain systemic deficiencies went unaddressed during those periods. Nevertheless, the increased number of inspections in recent years should be seen as a positive trend, reflecting the state's growing commitment to strengthening labor safety in healthcare. Medical institutions are classified as high-risk workplaces, where employees are exposed daily to biological, chemical, physical, and psychosocial hazards. Staff often work with infectious patients, harmful medications, blood, and other risk factors, significantly increasing occupational risk levels. In this context, ensuring compliance with occupational safety standards is not optional but essential — both for protecting workers’ lives and health, and for guaranteeing the continuous and safe operation of healthcare services. Therefore, inspection must be a regular, strict, and effective process, providing real oversight and contributing to the overall improvement of working conditions in the medical field. 4. Conclusions. 1. Inspection trends were inconsistent: Between 2015 and 2024, the frequency of inspections in the medical sector varied significantly, indicating a lack of stable oversight policy. 2. Several years saw no inspections at all: In 2018–2020, no inspections were conducted, potentially leaving critical systemic shortcomings unaddressed. 3. Increased enforcement since 2022: Recent years have shown a positive trend toward stronger government oversight of occupational safety in healthcare. 4. The medical sector is a high-risk environment: Employees are exposed to a variety of biological, chemical, and psychosocial hazards daily, emphasizing the need for continuous monitoring. 5. Inspections must become a systemic standard: A regular, strict, and well-structured inspection process is essential to protect staff health and ensure effective functioning of healthcare institutions. Georgian Scientists/ქართველი მეცნიერები ტ. 7 N 2, 2025 623 References: 1.Health services sector | International Labour Organization [Internet]. www.ilo.org. 2024. Available from: https://www.ilo.org/industries-and-sectors/health-services-sector 2.The future of work in the health sector [Internet]. 2019. Available from: https://www.ilo.org/sites/default/files/wcmsp5/groups/public/%40ed_dialogue/%40sector/documents/publ ication/wcms_669363.pdf 3.Convention C149 - Nursing Personnel Convention, 1977 (No. 149) [Internet]. Ilo.org. 2024 [cited 2025 Jun 24]. Available from: https://normlex.ilo.org/dyn/nrmlx_en/f?p=NORMLEXPUB:12100:0::NO::P12100_INSTRUMENT_ID:3 12294 4.Assessing employment effects for the health and care workforce A guiding framework [Internet]. [cited 2025 Jun 24]. Available from: https://www.ilo.org/sites/default/files/2024- 07/Assessing%20employment%20effects%20for%20the%20health%20and%20care%20workforce%20a %20guiding%20framework.pdf 5.Occupational safety and health in public health emergencies: A manual for protecting health workers and responders Geneva, 2018 contents [Internet]. 2018 [cited 2025 Jun 24]. Available from: https://www.ilo.org/sites/default/files/wcmsp5/groups/public/%40ed_protect/%40protrav/%40safework/d ocuments/publication/wcms_633233.pdf 6.საქართველოს შრომის, ჯანმრთელობისა და სოციალური დაცვის სამინისტროს შრომის პირობების ინსპექტირების დეპარტამენტის 2015- 2017 წლების ანგარიში [Internet]. 2018. Available from: https://lio.moh.gov.ge/editor/upload/20230425042928-LCID%20Report%20_2015%20- %202017.pdf 7.საქართველოს ოკუპირებული ტერიტორიებიდან დევნილთა, შრომის, ჯანმრთელობისა და სოციალური დაცვის სამინისტროს შრომის პირობების ინსპექტირების დეპარტამენტის საქმიანობის 2018 წლის ანგარიში [Internet]. 2018. Available from: https://lio.moh.gov.ge/report/2018.pdf 8.საქართველოს ოკუპირებული ტერიტორიებიდან დევნილთა, შრომის, ჯანმრთელობისა და სოციალური დაცვის სამინისტროს შრომის პირობების ინსპექტირების დეპარტამენტის 2019 წლის საქმიანობის ანგარიში [Internet]. 2019. Available from: https://lio.moh.gov.ge/editor/upload/20230425042732-LCID-Report-2019-GEO.pdf 9. შრომის პირობების ინსპექტირების დეპარტამენტის 2020 წლის საქმიანობის ანგარიში. https://lio.moh.gov.ge/report/2020.pdf 10. შრომის პირობების ინსპექტირების დეპარტამენტის 2021 წლის საქმიანობის ანგარიში. https://lio.moh.gov.ge/report/2021.pdf 11. სსიპ-შრომის ინსპექციის სამსახურის 2022 წლის საქმიანობის ანგარიში [Internet]. 2022. Available from: https://shorturl.at/EYGni 12. სსიპ-შრომის ინსპექციის სამსახურის 2023 წლის საქმიანობის ანგარიში, https://lio.moh.gov.ge/editor/upload/20240606033109-FINAL%20REPORT_2023_GEO.pdf Georgian Scientists/ქართველი მეცნიერები ტ. 7 N 2, 2025 624 შრომის უსაფრთხოების განუხრელი დაცვის აუცილებლობა სამედიცინო სექტორში: არსებული პრობლემები, სისტემური გამოწვევები და სტრატეგიული რეკომენდაციები ომარ ლანჩავა 1, ნატალია ბულია 1, მარიამი დარახველიძე 2 1საქართველოს ტექნიკური უნივერსიტეტი, კოსტავას 77, თბილისი 2 სსიპ შრომის ინსპექციის სამსახური, თამარაშვილის 15ა, თბილისი მნიშვნელოვანი მომენტები • 2023 წელი იყო ინსპექტირების რეკორდული წელი – შემოწმდა 47 ობიექტი. • 2018–2020 წლებში სამედიცინო სფეროში ინსპექტირება არ ჩატარებულა. • შრომის საერთაშორისო ორგანიზაცია (ILO) აღიარებს ჯანდაცვას როგორც ადამიანის ფუნდამენტურ უფლებას. • სამედიცინო დაწესებულებები ითვლება მაღალი რისკის მქონე ობიექტებად, რაც საჭიროებს რეგულარულ ზედამხედველობას. • შრომის უსაფრთხოება და ჯანმრთელობა არის არა არჩევითი, არამედ აუცილებელი მოთხოვნა ამ სფეროში. რეზიუმე სტატია დეტალურად განიხილავს შრომის უსაფრთხოების მნიშვნელობას სამედიცინო სექტორში, რომელიც ერთ-ერთი ყველაზე მაღალი რისკის შემცველი სფეროა. პერსონალი ყოველდღიურად ექვემდებარება სხვადასხვა სახის საფრთხეს – ბიოლოგიურს, ქიმიურს, ფიზიკურსა და ფსიქო-სოციალურს, რაც შრომის პირობების მონიტორინგის აუცილებლობას განაპირობებს. 2015–2024 წლების პერიოდში ინსპექტირების ინტენსიურობა არაერთგვაროვანი იყო, რაც განსაკუთრებით თვალშისაცემია იმ წლებში, როდესაც საერთოდ არ განხორციელდა ზედამხედველობა. მიუხედავად გარკვეული ჩავარდნებისა, ბოლო წლებიდან მოყოლებული ინსპექტირების მაჩვენებელი მატულობს. 2023 წელს დაფიქსირდა ყველაზე მაღალი მაჩვენებელი – შემოწმებულია 47 სამედიცინო დაწესებულება. ეს ტენდენცია პოზიტიურად უნდა შეფასდეს და სახელმწიფო პოლიტიკის გაძლიერებაზე მიუთითებს. საერთაშორისო კონვენციები, რეკომენდაციები და სახელმძღვანელოები ხაზს უსვამენ შრომის უსაფრთხოების მნიშვნელობას არა მხოლოდ ინდივიდუალური კეთილდღეობისთვის, არამედ ჯანდაცვის სისტემის გამართულად ფუნქციონირებისთვის. ამდენად, აუცილებელია ინსპექტირების პროცესის მუდმივი, მკაცრი და სისტემური განხორციელება, რაც უზრუნველყოფს ჯანდაცვის სექტორში დასაქმებულთა ჯანმრთელობისა და სიცოცხლის დაცვას და ხელს უწყობს სექტორის სანდოობასა და ეფექტიანობას. საკვანძო სიტყვები: სამედიცინო სექტორი; ბიოლოგიური, ქიმიური, ფიზიკური რისკ ფაქტორები; ჯანდაცვა; ინსპექტირება.