Category Archives: Health & Safety

After The Fall: Safeguarding Employees’ Mental Health After Workplace Injuries

Source: Maureen Minehan, Employment Alert, Volume 36, Issue 18, September 4, 2019
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An employee trips and falls at work and sustains a significant knee injury. She needs surgery and misses months of work while recovering. You know she’s receiving good care for her physical injuries, but do you need to also be concerned about her mental health?

Related:
Suicide and drug‐related mortality following occupational injury
Source: Katie M. Applebaum, Abay Asfaw, Paul K. O’Leary, Andrew Busey, Yorghos Tripodis, Leslie I. Boden, American Journal of Industrial Medicine, Volume 62 Issue 9, September 2019
(subscription required)

From the abstract:
Background:
Drug overdoses and suicides have been rising since 2000 and are major contributors to a 3‐year decline in US life expectancy. Studies suggest that injured workers have elevated rates of depression and opioid use, but no studies have measured excess mortality related to these risks.

Materials and methods:
We linked New Mexico workers’ compensation data for 100 806 workers injured in 1994 through 2000 with Social Security Administration earnings and mortality data through 2013 and National Death Index cause of death data. We then estimated the association between receiving lost‐time workers’ compensation benefits and mortality hazard ratios (HRs) and 95% confidence intervals (CIs) based on Fine and Gray cause‐specific subdistribution hazards for common causes of death and for drug‐related, suicide, and alcohol‐related mortality.

Results:
There was almost a 3‐fold increase in combined drug‐related and suicide mortality hazard among women (HR = 2.63, 95% CI = 1.91‐3.64) and a substantial increase among men (HR = 1.42, 95% CI = 1.13‐1.79). Circulatory disease mortality hazard was elevated for men (HR = 1.25, 95% CI = 1.05‐1.50).

Conclusion:
Workplace injuries severe enough to require more than a week off work may impair workers’ long‐term health and well‐being. Drug‐related deaths and suicides may be important contributors to the long‐term excess mortality of injured workers. Improved workplace conditions, improved pain treatment, better treatment of substance use disorders, and treatment of postinjury depression may substantially reduce mortality consequent to workplace injuries.

Artificial intelligence: Implications for the future of work

Source: John Howard, American Journal of Industrial Medicine, Early View, August 22, 2019

From the abstract:
Artificial intelligence (AI) is a broad transdisciplinary field with roots in logic, statistics, cognitive psychology, decision theory, neuroscience, linguistics, cybernetics, and computer engineering. The modern field of AI began at a small summer workshop at Dartmouth College in 1956. Since then, AI applications made possible by machine learning (ML), an AI subdiscipline, include Internet searches, e‐commerce sites, goods and services recommender systems, image and speech recognition, sensor technologies, robotic devices, and cognitive decision support systems (DSSs). As more applications are integrated into everyday life, AI is predicted to have a globally transformative influence on economic and social structures similar to the effect that other general‐purpose technologies, such as steam engines, railroads, electricity, electronics, and the Internet, have had. Novel AI applications in the workplace of the future raise important issues for occupational safety and health. This commentary reviews the origins of AI, use of ML methods, and emerging AI applications embedded in physical objects like sensor technologies, robotic devices, or operationalized in intelligent DSSs. Selected implications on the future of work arising from the use of AI applications, including job displacement from automation and management of human‐machine interactions, are also reviewed. Engaging in strategic foresight about AI workplace applications will shift occupational research and practice from a reactive posture to a proactive one. Understanding the possibilities and challenges of AI for the future of work will help mitigate the unfavorable effects of AI on worker safety, health, and well‐being.

Survey: What Employees Want Most from Their Workspaces

Source: Jeanne C. Meister, Harvard Business Review, August 26, 2019

…. Surprisingly, we found employees want the basics first: better air quality, access to natural light, and the ability to personalize their workspace. Half of the employees we surveyed said poor air quality makes them sleepier during the day, and more than a third reported up to an hour in lost productivity as a result. In fact, air quality and light were the biggest influencers of employee performance, happiness, and wellbeing, while fitness facilities and technology-based health tools were the most trivial.

Organizations have the power to make improvements in these areas, and they need to, both for their workers and themselves. A high-quality workplace — one with natural light, good ventilation, and comfortable temperatures — can reduce absenteeism up to four days a year.  With unscheduled absenteeism costing companies an estimated $3,600 annually per hourly worker and $2,650 each year for salaried workers, this can have a major impact on your bottom line. ….

“Felony assault should stick:” Assaulted EMS responders’ frustration and dissatisfaction with the legal system

Source: Jasmine Y. Wright, Andrea L. Davis, Sherry Brandt‐Rauf, Jennifer A. Taylor, American Journal of Industrial Medicine, Early View, First published: August 16, 2019
(subscription required)

From the abstract:
Introduction:
The prevalence of violence to first responders is reported in ranges of approximately 40% to 90%. Pennsylvania has a felonious assault statute to address such violence, but the prosecutorial process has been noted to cause first‐responder dissatisfaction.

Methods:
An exploratory qualitative study using individual interviews with snowball sampling was conducted with the Philadelphia District Attorney’s office to understand the prosecutorial process when a first responder is assaulted and injured in a line of duty. The Philadelphia Fire Department provided a list of first responders who sustained a work‐related injury from a patient or bystander assault so that particular cases could be discussed during the interviews.

Results:
Emergent themes fell into two categories: factors that lead to a charge (prosecutorial merit, intent, and victim investment), and the judge’s discretion in sentencing (“part of the job” mentality, concern for the defendant, and the justice system’s offender focus). Immediately actionable tertiary prevention recommendations for fire departments, labor unions, and district attorney’s offices were developed.

Conclusion:
Violence against fire‐based emergency medical service (EMS) responders is a persistent and preventable workplace hazard. While felonious assault statutes express society’s value that it is unacceptable to harm a first responder, this study found that such statutes failed to provide satisfaction to victims and that support when going through the court process is lacking. Assaulted EMS responders, their employers, and labor unions would benefit from the recommendations provided herein to help them extract a stronger sense of procedural justice from the legal process.

Assessing the impact of health and safety training: Increased behavioral change and organizational performance

Source: Ruth Ruttenberg, Carol Rice, American Journal of Industrial Medicine, Early View, August 5, 2019
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From the abstract:
Background:
Annual health and safety refresher training is mandated for workers in a number of employment sectors and also is used to maintain and enhance skills when not legally required.

Methods:
One year following training, hazardous waste worker training participants were asked if the training had been applied at their work or in the community, corresponding to Kirkpatrick levels of training evaluation. Likely response themes were drafted by the authors using qualitative data coding.

Results:
Of the 1,726 refresher participants, 1,094 (63%) provided an entry. Eight theme categories were adapted from the originals, spanning the activities trainees reported as applications of their training: events, actions, awareness, emergency response, equipment, planning and standard operating procedures, training, and use of written resources.

Conclusions:
Asking participants to reflect on how training has been applied provides an opportunity to describe workplace changes made during the past year. Participants documented that training resulted in actions to protect them from hazardous exposures. Specific events where training was used and where actions were taken to improve health and safety represent Kirkpatrick Levels III and IV applications of training. Collecting similar data may be useful to others wishing to identify impacts of training and can be integrated into routine program assessment.

Decline in the rate of occupational injuries and illnesses following the implementation of a paid sick leave law in Connecticut

Source: Devan Hawkins, Junli Zhu, American Journal of Industrial Medicine, Early View, July 22, 2019
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From the abstract:

Background:
Workers with paid sick leave may have a lower rate of occupational injuries compared with other workers. This study sought to determine whether there was a decline in the rate of occupational injuries and illnesses following the implementation of a paid sick leave law in Connecticut (CT).

Methods:
Data from the Bureau of Labor Statistics was used to calculate the rate of occupational injuries and illnesses in CT in the 3 years before (2009‐11) and after (2012‐14) the law was implemented. These numbers were compared with New York (NY) and the United States, and between the occupations specified by the CT law and other occupations.

Results:
Among service occupations addressed by the CT paid‐sick‐leave law, the rate of occupational injuries declined more in CT compared to rates for those same occupations in NY and the United States. Within CT, injury and illness rates showed a greater decline in occupations specified by the law (−17.8%; 95% confidence interval [CI] = −15.6‐−19.9) compared with other occupations (−6.8%; 95% CI = −6.6%‐−7.0%) between the two periods.

Conclusions:
A paid sick leave law was associated with an increased decline in occupational injuries and illnesses in affected service workers in the period after implementation. Further research should examine the possible reasons for the associations seen here.

Associations between daily‐on‐the job hassles with perceived mental exertion and depression symptoms in taxi drivers

Source: Barbara J. Burgel, Rami A. Elshatarat, American Journal of Industrial Medicine, Early View, July 22, 2019
(subscription required)

From the abstract:

Introduction:
Taxi drivers experience frequent hassles that may contribute to mental exertion and depression symptoms.

Aim:
Mental exertion and depression symptoms in taxi drivers are explored in association with hassles, effort‐reward imbalance, job strain, and iso‐strain.

Methods:
Personal interviews were conducted with 130 drivers in San Francisco.

Results:
Mental exertion averaged 4.5 (±2.68) and physical exertion averaged 3.71 (±2.1) on 0 to 10 Borg scales. Based on the Center for Epidemiological Studies‐Depression scale, 38% had depression symptoms. Mental exertion and depression symptoms correlated with job strain, iso‐strain and effort‐reward imbalance in anticipated directions, lending construct validity to the Borg mental exertion scale. Physical exertion, night shift, stressful personal events, and being uninsured for healthcare predicted mental exertion. Lack of respect by dispatchers and stressful personal events predicted depression symptoms.

Conclusion:
Selected hassles may be remedied by communication trainings, emphasizing mutual respect. Recognition and treatment of depression in taxi drivers are important.

Opioid‐related overdose deaths by industry and occupation—Massachusetts, 2011‐2015

Source: Devan Hawkins, Cora Roelofs, James Laing, Letitia Davis, American Journal of Industrial Medicine, Early View, July 26, 2019
(subscription required)

From the abstract:

Background:
Thousands of people in the United States continue to die from opioid overdoses every year. Work‐related injuries and other factors associated with work may increase exposure to opioids and, subsequently, opioid‐related overdose deaths (OROD). This study sought to determine whether OROD rates differed by industry and occupation and explored work‐related factors that might contribute to these differences.

Methods:
We coded industry and occupation information on death certificates for all OROD among Massachusetts residents from 2011 to 2015. We estimated rates of OROD by industry and occupation using Massachusetts employment data. National survey data were used to explore whether work‐related factors known to vary by occupation (occupational injury and illness, job insecurity, and paid sick leave) correlate to observed differences in OROD.

Results:
Several industries and occupation groups had rates of OROD that were significantly higher than the rates for other workers. Construction workers and fishing workers stood out for having OROD rates many times higher than the average for all workers. Occupation groups with high rates of occupational injuries and illnesses, high job insecurity, and low availability of paid sick leave had higher rates of OROD.

Conclusions:
These findings underscore the need for policy and educational interventions to reduce OROD tailored to the needs of high rate worker populations. Interventions should address workplace hazards that cause injuries for which opioids are prescribed, as well as best practices in medical management and return to work following injury, safer prescribing, enhanced access to treatment for opioid use disorders, and overdose prevention education.

Environmental and Personal Protective Equipment Contamination during Simulated Healthcare Activities

Source: Rachel T Weber, Linh T Phan, Charissa Fritzen-Pedicini, Rachael M Jones, Annals of Work Exposures and Health, Advance Articles, June 4, 2019
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From the abstract:
Providing care to patients with an infectious disease can result in the exposure of healthcare workers (HCWs) to pathogen-containing bodily fluids. We performed a series of experiments to characterize the magnitude of environmental contamination—in air, on surfaces and on participants—associated with seven common healthcare activities. The seven activities studied were bathing, central venous access, intravenous access, intubation, physical examination, suctioning and vital signs assessment. HCWs with experience in one or more activities were recruited to participate and performed one to two activities in the laboratory using task trainers that contained or were contaminated with fluorescein-containing simulated bodily fluid. Fluorescein was quantitatively measured in the air and on seven environmental surfaces. Fluorescein was quantitatively and qualitatively measured on the personal protective equipment (PPE) worn by participants. A total of 39 participants performed 74 experiments, involving 10–12 experimental trials for each healthcare activity. Healthcare activities resulted in diverse patterns and levels of contamination in the environment and on PPE that are consistent with the nature of the activity. Glove and gown contamination were ubiquitous, affirming the value of wearing these pieces of PPE to protect HCW’s clothing and skin. Though intubation and suctioning are considered aerosol-generating procedures, fluorescein was detected less frequently in air and at lower levels on face shields and facemasks than other activities, which suggests that the definition of aerosol-generating procedure may need to be revised. Face shields may protect the face and facemask from splashes and sprays of bodily fluids and should be used for more healthcare activities.

Peaks, Means, and Determinants of Real-Time TVOC Exposures Associated with Cleaning and Disinfecting Tasks in Healthcare Settings

Source: M Abbas Virji Xiaoming Liang Feng-Chiao Su Ryan F LeBouf Aleksandr B Stefaniak Marcia L Stanton Paul K Henneberger E Andres Houseman, Annals of Work Exposures and Health, Advance Articles, June 4, 2019
(subscription required)

From the abstract:
Cleaning and disinfecting tasks and product use are associated with elevated prevalence of asthma and respiratory symptoms among healthcare workers; however, the levels of exposure that pose a health risk remain unclear. The objective of this study was to estimate the peak, average, and determinants of real-time total volatile organic compound (TVOC) exposure associated with cleaning tasks and product-use. TVOC exposures were measured using monitors equipped with a photoionization detector (PID). A simple correction factor was applied to the real-time measurements, calculated as a ratio of the full-shift average TVOC concentrations from a time-integrated canister and the PID sample, for each sample pair. During sampling, auxiliary information, e.g. tasks, products used, engineering controls, was recorded on standardized data collection forms at 5-min intervals. Five-minute averaged air measurements (n = 10 276) from 129 time-series comprising 92 workers and four hospitals were used to model the determinants of exposures. The statistical model simultaneously accounted for censored data and non-stationary autocorrelation and was fit using Markov-Chain Monte Carlo within a Bayesian context. Log-transformed corrected concentrations (cTVOC) were modeled, with the fixed-effects of tasks and covariates, that were systematically gathered during sampling, and random effect of person-day. The model-predicted geometric mean (GM) cTVOC concentrations ranged from 387 parts per billion (ppb) for the task of using a product containing formaldehyde in laboratories to 2091 ppb for the task of using skin wipes containing quaternary ammonium compounds, with a GM of 925 ppb when no products were used. Peak exposures quantified as the 95th percentile of 15-min averages for these tasks ranged from 3172 to 17 360 ppb. Peak and GM task exposures varied by occupation and hospital unit. In the multiple regression model, use of sprays was associated with increasing exposures, while presence of local exhaust ventilation, large room volume, and automatic sterilizer use were associated with decreasing exposures. A detailed understanding of factors affecting TVOC exposure can inform targeted interventions to reduce exposures and can be used in epidemiologic studies as metrics of short-duration peak exposures.