Friday, 25 March 2011 06:15

Health Effects and Disease Patterns

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Hotels and restaurants constitute a large, diversified, labour-intensive service industry made up predominantly of small enterprises. While there are a number of giant corporations, some of which attempt to standardize procedures and working rules, their hotels and restaurants are usually operated individually, often on a franchise rather than a directly owned basis. Frequently, the eating and drinking establishments in hotels are leased to franchise operators.

There is a high degree of failure among the enterprises in this industry, with many being very close to the edge of financial insolvency for some time before closing their doors. This often dictates economies in staffing, in the purchase and maintenance of equipment and in the provision of necessary supplies. It also often forces neglect of employee training programmes and a reluctance to spend scarce resources on measures to promote and protect employee safety and health.

The majority of the jobs are unskilled and provide low or minimal wages (in some of the jobs, these may be supplemented by gratuities that depend on the largesse of the patrons). Consequently, they attract only workers with minimal education and experience, and because minimal language and literacy skills are required, many of the jobs are filled by immigrants and ethnic minorities. Many are entry-level positions with little or no opportunities for advancement. Shift work is required in hotels because they operate around the clock; in restaurants, the flurries of activity at meal times are often covered by part-time workers. Because their patronage is seasonal, many establishments curtail their operations or shut down entirely during the off-season, and, as a result, there may be little or no job security. The end result of all of this is a high rate of turnover in the workforce.

Job Stress

Because of the periods of intense activity and the necessity of pleasing the patrons on whose gratuities their livelihoods often depend, many of the workers in this industry are subject to high levels of job stress. They must often comply with seemingly unreasonable or even impossible requests and may be subjected to abusive behaviour on the part of supervisors as well as customers. Many of the jobs, particularly those in kitchens and laundries, must be carried out in stressful environments featuring high heat and humidity, poor ventilation, poor lighting and noise (Ulfvarson, Janbell and Rosen 1976).


Hotels and restaurants rank high on the lists of workplaces with the greatest incidence of occupational violent crime. According to one survey, over 50% of such incidents involving hotel and restaurant workers resulted in death (Hales et al. 1988). These workers are exposed to many of the risk factors for workplace homicide: exchange of money with the public, working alone or in small numbers, working late night or early morning hours and guarding valuable property or possessions (Warshaw and Messite 1996).

Types of Injuries and Diseases

According to the US Bureau of Labor Statistics, food and beverage preparation and housekeeping departments accounted for 76% of all work injuries and accidents in hotels (US Bureau of Labor Statistics 1967), while a Danish survey found that these were predominantly skin and musculoskeletal problems (Direktoratet for Arbejdstilsynet 1993). Most of the skin problems may be traced to exposure to soap and hot water, to the chemicals in detergents and other cleaning/polishing materials and, in some instances, to pesticides. Except for the special problems noted below, the majority of musculoskeletal injuries result from slips and falls and from lifting and handling heavy and/or bulky objects.

Sprains, strains and repetitive motion injuries

Back injuries and other sprains and strains commonly occur among doormen, porters and bellmen lifting and carrying luggage (a particular problem when large tour groups arrive and depart); kitchen workers and others receiving and storing bulk supplies; and housekeeping workers lifting mattresses, making beds and handling bundles of laundry. A unique type of injury is carpal tunnel syndrome among food service workers who use scoops to prepare servings of hard ice cream and other frozen desserts.

Cuts and lacerations

Cuts and lacerations are common among restaurant workers and dishwashers who deal with broken glass and crockery, and who handle or clean sharp knives and slicing machines. They are also common among chambermaids who encounter broken glasses and discarded razor blades in cleaning out waste baskets; they may be protected by lining the baskets with plastic bags which can be removed en masse.

Burns and scalds

Burns and scalds are common among chefs, dishwashers and other kitchen workers and laundry workers. Grease burns occur from splatters during cooking or as food is dropped into deep-fat fryers, when hot grease is added, filtered or removed, and when grills and fryers are cleaned while hot. Many result when workers slip on wet or slippery floors and fall on or against hot grills and open flames. A unique type of burn occurs in restaurants where flaming desserts, entrees and drinks are served (Achauer, Bartlett and Allyn 1982).

Industrial chemicals

Hotel and restaurant establishments share with other small enterprises a propensity for improper storage, handling and disposal of industrial chemicals. All too frequently cleaning supplies, disinfectants, pesticides and other “household” poisons are stored in unlabelled containers, are placed above open food containers or food preparation areas or, when used in spray form, are excessively inhaled.

The fast food industry

The fast food industry, one of the most rapidly growing in the United States and becoming increasingly popular in other countries, is one of the largest employers of young people. Lacerations and burns are common hazards in these establishments. It has also been noted that the home delivery of pizzas and other prepared food is often extremely hazardous because of policies which encourage reckless driving on bicycles as well as in motor vehicles (Landrigan et al. 1992).

Preventive Measures

Standardized work processes, adequate training and proper supervision are key elements in the prevention of work-related injuries and illnesses among workers in the hotel and restaurant industry. It is essential that, because of their generally low educational levels and language difficulties, the educational materials and training exercises be readily understood (they may have to be conducted in several languages). Also, because of the high turnover, training must be repeated at frequent intervals. The training exercises should be supplemented by frequent inspections to assure that the basic principles of good housekeeping and elimination of accident hazards are observed.

Emergency drills

In addition to regular inspections to verify that firefighting equipment (e.g., smoke alarms, sprinkler systems, fire extinguishers and hoses and emergency lighting equipment) is in good working order and that emergency exits are clearly marked and not blocked, frequent drills are necessary to train the workers in how to prevent themselves and the patrons from being trapped and overcome in the event of a fire or an explosion. It is desirable to hold at least some of these drills in concert with the community fire, rescue and police organizations.


Apropriately designed and diligently practised preventive measures will do much to lower the frequency of occupational injuries and illnesses among hotel and restaurant workers. Language barriers and relatively low educational levels often represent formidable challenges to the effectiveness of training and indoctrination programmes, while the high rate of turnover dictates the frequent repetition of these programmes. It is important to remember that the health and safety of the workers in this industry is an essential element in the enjoyment and satisfaction of the patrons, upon whose good will the success - and even the survival - of the enterprise depends.



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Hotels and Restaurants References

Achauer, BM, RH Bartlett, and PA Allyn. 1982. Face flambe. JAMA. 247:2271.

Direktoratet for Arbejdstilsynet. 1993 Hotel og restauration Copenhagen: Direktoratet for Arbejdstilsynet.

Hales, T, PJ Seligman, SC Newman, and CL Timbrook. 1988 Occupational injuries due to violence. J Occup Med. 30:483-487.

Landrigan, PJ, SH Pollack, R Belleville, and JG Godbold. 1992. Child labor in the United States: Historical background and current crisis. Mount Sinai Journal of Medicine 59:498-503.

Ulfvarson, U, H Janbell, and G Rosen. 1976. Fyskaliska och kemiska faktorer i hotell - och restauranganställdas arbetsmiljö. Arbete och hälsa - Vetenskaplig skriftserie. Stockholm: Arbetarskyddsverket.

US Bureau of Labor Statistics. 1967. Work Injuries and Accident Causes in Hotels, BLS Report No. 329. Washington, DC: US Department of Labor.

Warshaw, LJ and J Messite. 1996. Workplace violence: Preventive and interventive strategies. Journal of Occupational and Environmental Medicine 38:993-1006.