Category Archives: Health & Safety

Workers’ compensation costs for healthcare caregivers: Home healthcare, long‐term care, and hospital nurses and nursing aides

Source: Kermit G. Davis, Andrew M. Freeman, Jun Ying, Jeffrey R. Huth, American Journal of Industrial Medicine, Volume 64 Issue 5, May 2021
(subscription required)

From the abstract:
Background: Healthcare workers (nurses and nursing aides) often have different exposures and injury risk factors depending on their occupational subsector and location (hospital, long‐term care, or home health care).

Methods: A total of 5234 compensation claims for nurses and nursing aides who suffered injuries to their lower back, knee, and/or shoulder over a 5‐year period were obtained from the Ohio Bureau of Workers’ Compensation and analyzed. Injury causation data was also collected for each claim. The outcome variables included indemnity costs, medical costs, total costs, and the number of lost work days. The highest prescribed morphine equivalent dose for opioid medications was also calculated for each claim.

Results: Home healthcare nurses and nursing aides had the highest average total costs per claim. Hospital nurses and nursing aides had the highest total claim costs, of $5 million/year. Shoulder injuries for home healthcare nursing aides (HHNAs) had the highest average total claim costs ($20,600/injury) for all occupation, setting, and body area combinations. Opioids were most frequently prescribed for home healthcare nurses (HHNs) and nursing aides (18.9% and 17.7% having been prescribed opioids, respectively). Overexertion was the most common cause for HHN and nursing aide claims.

Conclusions: With the rapidly expanding workforce in the home healthcare sector, there is a potential health crisis from the continued expansion of home healthcare worker injuries and their associated costs. In addition, the potential for opioid drug usage places these workers at risk for future dependence, overdose, and prolonged disability. Future research is needed to investigate the specific and ideally reversible causes of injury in claims categorized as caused by overexertion.

Participatory survey design of a workforce health needs assessment for correctional supervisors

Source: Alicia G. Dugan, Sara Namazi, Jennifer M. Cavallari, Robert D. Rinker, Julius C. Preston, Vincent L. Steele, Martin G. Cherniack, American Journal of Industrial Medicine, Volume 64 Issue 5, May 2021
(subscription required)

From the abstract:
Introduction
The correctional workforce experiences persistent health problems, and interventions designed with worker participation show favorable outcomes. However, participatory intervention research often leaves workers out of the health needs assessment, the basis of interventions subsequently developed. This omission risks failure to detect factors contributing to the health and is less likely to result in primary prevention interventions.

Methods
Partnering with a correctional supervisors’ union, we followed Schulz and colleagues’ community‐based participatory research (CBPR) methods for participatory survey design and used Healthy Workplace Participatory Program (HWPP) tools to develop a tailored survey to assess workforce health and contributing factors. Utilizing the HWPP Focus Group Guide, we generated key themes to adapt the HWPP All Employee Survey, a generic workforce health assessment, to become thorough and contextually‐relevant for correctional supervisors.

Results
Content analysis of focus group data revealed 12 priority health concerns and contributors, including organizational culture, masculinity, work‐family conflict, family support, trauma, positive job aspects, health literacy and efficacy, health/risk behaviors, sleep, obesity, and prioritizing work and income over health. Twenty‐six measures were added to the generic survey, mainly health‐related antecedents including knowledge, attitudes, norms, and motivation.

Conclusion
Findings yielded new insights about supervisors’ lived experiences of work and health, and resulted in a customized workforce survey. CBPR methods and HWPP tools allowed us to identify health issues that we would not have detected with conventional methods, and provide opportunities for interventions that address root causes of poor health. We share challenges faced and lessons learned using CBPR with the correctional workforce.

New York’s Nursing Homes Were on the Brink. Then Covid Hit. Covid was a nightmare — but it was a nightmare years in the making, workers say.

Source: Bridget Read, The Cut, April 2021

….But the blame for what happened in New York’s nursing homes extends far beyond the Cuomo administration. It is a huge crisis of neglect, decades in the making. Care workers who survived the pandemic say that the virus exposed preexisting gaps in funding and attention, compounding deficiencies that created the conditions for absolute disaster. Horrifying images of nurses dressed in black trash bags begging for PPE were shocking, but they were not a surprise to workers.

Though nursing homes are funded by billions of government dollars from Medicare and Medicaid, a majority in the United States are now owned by for-profit companies — in New York, it’s 60 percent of facilities. They’ve become cash cows for executives and owners, snapped up at alarming rates by huge conglomerates or private-equity firms. For staff and residents, the consequences have been dire. For-profit homes statistically have leaner staffing, bad food, substandard conditions, and higher chances of abuse, though they are intended to service residents that need intensive levels of care. Some patients are in relatively good health, but others require help with almost every aspect of life. Many have little or no family visiting them, which can lead to behavioral issues. Residents with dementia can be a danger to themselves. These are the people living in New York’s for-profit facilities, one in four of which have the state’s lowest-star-quality ratings….

A policy manifesto for paying, protecting, and empowering essential workers

Source: Molly Kinder and Laura Stateler, Brookings Institution, Metropolitan Policy Program, March 18, 2021

….Powell and his fellow frontline employees at the hospital are strenuously working to do jobs like cleaning, taking vital signs, and spending time with patients—but without the decent pay and respect that nurses and doctors earn. “These are people who work very, very, very hard, and who make very, very, very little,” he said.

With the country on track for mass vaccinations in the coming months, the worst of the pandemic may be over. But the risks facing frontline essential workers like Powell have not ended. Many of the underlining inequities they face—including low wages, structural racism, and inadequate protections—remain.

It is long past time that we treat essential workers as truly essential. Lawmakers in Washington and around the country have the opportunity to turn their policy rhetoric into real change. The recommendations in this report lay out how federal, state, and local policymakers can—finally—give essential workers what they have always deserved: the dignity of a living wage, lifesaving protections, and power in their workplaces…..

Prevention of Hand Eczema among Nurse Apprentice (PREVEDERM): An Interventional Study

Source: Horatiu Remus Moldovan, Ionela Manole, Alina Suru, Alexandra-Irina Butacu, Alin Laurentiu Tatu, Adriana Lupu, Mihai Dascalu, George-Sorin Tiplica, Carmen Maria Salavastru, Annals of Work Exposures and Health, Volume 65, Issue 2, March 2021
(subscription required)

From the abstract:
Background
Workers in the healthcare sector are at high risk of developing occupational hand eczema mainly due to frequent exposure to irritants and/or allergens. Amongst workers in healthcare, nurses are at higher risk of developing hand dermatitis.

Objectives
To evaluate the effectiveness of a short educational intervention program in preventing occupational hand eczema in nurse apprentices, using two objective tools, namely TEWL and EH, and the HECSI score.

Methods
Data regarding professions, wet work exposure, activities performed during working hours, self-reported eczema were collected from 230 nurse students, divided in two study groups: the intervention and the control group (CG). The intervention group (IG) was given education about risks and proper skin care and was provided with cosmeceuticals to be used for skin care during hospital activity. The evaluation of skin properties was performed using questionnaires, HECSI score, measurement of transepidermal water loss (TEWL) and epidermal hydration (EH).

Results
A number of 139 apprentice nurses completed the study. Of those participants who completed the study, 19.1% from CG and 19.6% from IG reported, at T1, hand eczema in the last 3 months, while at T2 (3 months later), 59.52 % of the CG and only 11.34 % from the IG stated having eczema in the last 3 months. In the IG, results showed an improvement of CM with 17% and of TEWL with 16%, with only a 0.5% improvement of CM in CG and a marked impairment of TEWL by 33%.

Conclusion
Hand eczema is a common occupational dermatosis affecting the medical staff, even during apprenticeship. Early preventive training programs are effective in reducing the burden of occupational contact dermatitis.

Inside a Long, Messy Year of Reopening Schools

Source: Rachel M. Cohen, New Republic, March 8, 2021

Teachers unions were accused of being obstinate and compromising education. The real story is a lot more complex.

Last month in Chicago, after months of heated negotiations, the teachers union and Chicago Public Schools emerged with one of the most detailed school reopening agreements in the nation. Brad Marianno, an education policy professor at the University of Nevada, Las Vegas, who has been studying these agreements since last spring, called it the most comprehensive he’s seen, citing its inclusion of things like testing protocols, measures that might lead to reclosing schools, and vaccination commitments. Among other things, the union succeeded in negotiating accommodations for hundreds more members at higher risk of Covid-19 complications, or who serve as the primary caregiver for someone at higher risk, than the district had originally agreed to accommodate.

Stacy Davis Gates, the vice president of the Chicago Teachers Union, said one of the most important components of the agreement was the so-called “school safety committees” a demand the union put forward in December to hold leadership accountable to the health and safety promises it’s made. The school-based committees include up to four CTU members, the principal, the building engineer, and a “reasonable” number of other employees like janitors, lunchroom staff, and security guards. On a regular basis, they will flag to the principal any issues that arise and can hold the school liable if they go ignored. ….

Medical claims paid by workers’ compensation insurance among US Medicare beneficiaries, 1999–2016

Source: Laura Kurth, Megan Casey, Brian Chin, Jacek M. Mazurek, Patricia Schleiff, Cara Halldin, David J. Blackley, American Journal of Industrial Medicine, Early View, First published: January 11, 2021
(subscription required)

From the abstract:
Background
Workers’ compensation claims among Medicare beneficiaries have not been described previously. To examine the healthcare burden of work‐related injury and illness among Medicare beneficiaries, we assessed the characteristics, healthcare utilization, and financial costs among Medicare beneficiaries with claims for which workers’ compensation was the primary payer.

Methods
We extracted final action fee‐for‐service Medicare claims from 1999 to 2016 where workers’ compensation had primary responsibility for claim payment and beneficiary, claim type, diagnoses, and cost information from these claims.

Results
During 1999–2016, workers’ compensation was the primary payer for 2,010,200 claims among 330,491 Medicare beneficiaries, and 58.7% of these beneficiaries had more than one claim. Carrier claims submitted by noninstitutional providers constituted the majority (94.5%) of claims. Diagnosis codes indicated 19.4% of claims were related to diseases of the musculoskeletal system and connective tissue and 12.9% were related to disease of the circulatory system. Workers’ compensation insurance paid $880.4 million for these claims while Medicare paid $269.7 million and beneficiaries paid $37.4 million.

Conclusions
Workers’ compensation paid 74% of the total amount to providers for these work‐related medical claims among Medicare beneficiaries. Claim diagnoses were similar to those of all workers’ compensation claims in the United States. Describing these work‐related claims helps identify the healthcare burden due to occupational injury and illness among Medicare beneficiaries resulting from employment and identifies a need for more comprehensive collection and surveillance of work‐related medical claims.

COVID‐19 as an occupational disease

Source: Christopher Carlsten, Mridu Gulati, Stella Hines, Cecile Rose, Kenneth Scott, Susan M. Tarlo, Kjell Torén, Akshay Sood, Rafael E. de la Hoz, American Journal of Industrial Medicine, Early View, First published: January 24, 2021

From the abstract:
The impact of coronavirus disease 2019 (COVID‐19) caused by the severe acute respiratory syndrome coronavirus 2 permeates all aspects of society worldwide. Initial medical reports and media coverage have increased awareness of the risk imposed on healthcare workers in particular, during this pandemic. However, the health implications of COVID‐19 for the global workforce are multifaceted and complex, warranting careful reflection and consideration to mitigate the adverse effects on workers worldwide. Accordingly, our review offers a framework for considering this topic, highlighting key issues, with the aim to prompt and inform action, including research, to minimize the occupational hazards imposed by this ongoing challenge. We address respiratory disease as a primary concern, while recognizing the multisystem spectrum of COVID‐19‐related disease and how clinical aspects are interwoven with broader socioeconomic forces.

COVID‐19 deaths by occupation, Massachusetts, March 1–July 31, 2020

Source: Devan Hawkins, Letitia Davis, David Kriebel, American Journal of Industrial Medicine, Early View, February 1, 2021

From the abstract:
Background
Exposure to COVID‐19 is more likely among certain occupations compared with others. This descriptive study seeks to explore occupational differences in mortality due to COVID‐19 among workers in Massachusetts.

Methods
Death certificates of those who died from COVID‐19 in Massachusetts between March 1 and July 31, 2020 were collected. Occupational information was coded and age‐adjusted mortality rates were calculated according to occupation.

Results
There were 555 deaths among MA residents of age 16–64, with usable occupation information, resulting in an age‐adjusted mortality rate of 16.4 per 100,000 workers. Workers in 11 occupational groups including healthcare support and transportation and material moving had mortality rates higher than that for workers overall. Hispanic and Black workers had age‐adjusted mortality rates more than four times higher than that for White workers overall and also had higher rates than Whites within high‐risk occupation groups.

Conclusion
Efforts should be made to protect workers in high‐risk occupations identified in this report from COVID‐19 exposure.

Voices of Strength: A Survey of Librarians Working with Chronic Illnesses or Conditions

Source: Susan Rathbun-Grubb, Journal of Library Administration, Volume 61 no. 1, 2021
(subscription required)

From the abstract:
This research attempts to understand the ways that librarians overcome the challenges associated with a chronic condition in the workplace. Six hundred sixteen respondents completed a survey about type of workplace, type of chronic condition, longevity of the condition, disclosure, accommodations, level of support, career mobility and advancement, work challenges, coping strategies, and perceptions on disability. Respondents report chronic illness and conditions of all sorts, both visible and invisible, with 46% having more than one type of illness. They cope by using creative strategies to supplement or replace formal accommodations, however 39% believe that their condition has negatively impacted their career advancement.