Category Archives: Health & Safety

Trends of occupational fatalities involving machines, United States, 1992–2010

Source: Suzanne M. Marsh and David E. Fosbroke, American Journal of Industrial Medicine, Early View, Article first published online: September 11, 2015
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From the abstract:
Background: This paper describes trends of occupational machine-related fatalities from 1992–2010. We examine temporal patterns by worker demographics, machine types (e.g., stationary, mobile), and industries.

Methods: We analyzed fatalities from Census of Fatal Occupational Injuries data provided by the Bureau of Labor Statistics to the National Institute for Occupational Safety and Health. We used injury source to identify machine-related incidents and Poisson regression to assess trends over the 19-year period.

Results: There was an average annual decrease of 2.8% in overall machine-related fatality rates from 1992 through 2010. Mobile machine-related fatality rates decreased an average of 2.6% annually and stationary machine-related rates decreased an average of 3.5% annually. Groups that continued to be at high risk included older workers; self-employed; and workers in agriculture/forestry/fishing, construction, and mining.

Conclusion: Addressing dangers posed by tractors, excavators, and other mobile machines needs to continue. High-risk worker groups should receive targeted information on machine safety

Workplace stressors & health outcomes: Health policy for the workplace

Source: Joel Goh, Jeffrey Pfeffer, & Stefanos A. Zenios, Behavioral Science & Policy, Vol. 1 no. 1, Spring 2015

From the summary:
Extensive research focuses on the causes of workplace-induced stress. However, policy efforts to tackle the ever-increasing health costs and poor health outcomes in the United States have largely ignored the health effects of psychosocial workplace stressors such as high job demands, economic insecurity, and long work hours. Using meta-analysis, we summarize 228 studies assessing the effects of ten workplace stressors on four health outcomes. We find that job insecurity increases the odds of reporting poor health by about 50%, high job demands raise the odds of having a physician-diagnosed illness by 35%, and long work hours increase mortality by almost 20%. Therefore, policies designed to reduce health costs and improve health outcomes should account for the health effects of the workplace environment.

The association between weekly work hours, crew familiarity, and occupational injury and illness in emergency medical services workers

Source: Matthew D. Weaver, P. Daniel Patterson, Anthony Fabio, Charity G. Moore, Matthew S. Freiberg and Thomas J. Songer, American Journal of Industrial Medicine, Early View, Article first published online August 25, 2015
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From the abstract:
Objective: Emergency Medical Services (EMS) workers are shift workers in a high-risk, uncontrolled occupational environment. EMS-worker fatigue has been associated with self-reported injury, but the influence of extended weekly work hours is unknown.

Methods: A retrospective cohort study was designed using historical shift schedules and occupational injury and illness reports. Using multilevel models, we examined the association between weekly work hours, crew familiarity, and injury or illness.

Results: In total, 966,082 shifts and 950 reports across 14 EMS agencies were obtained over a 1–3 year period. Weekly work hours were not associated with occupational injury or illness. Schedule characteristics that yield decreased exposure to occupational hazards, such as part-time work and night work, conferred reduced risk of injury or illness.

Conclusions: Extended weekly work hours were not associated with occupational injury or illness. Future work should focus on transient exposures and agency-level characteristics that may contribute to adverse work events

Personal protective equipment for the Ebola virus disease: A comparison of 2 training programs

Source: Enrique Casalino, Eugenio Astocondor, Juan Carlos Sanchez, David Enrique Díaz-Santana, Carlos del Aguila, Juan Pablo Carrillo, American Journal of Infection Control, Article In Press, August 12, 2015
(subscription required)

From the abstract:
Background: Personal protective equipment (PPE) for preventing Ebola virus disease (EVD) includes basic PPE (B-PPE) and enhanced PPE (E-PPE). Our aim was to compare conventional training programs (CTPs) and reinforced training programs (RTPs) on the use of B-PPE and E-PPE.

Methods: Four groups were created, designated CTP-B, CTP-E, RTP-B, and RTP-E. All groups received the same theoretical training, followed by 3 practical training sessions.

Results: A total of 120 students were included (30 per group). In all 4 groups, the frequency and number of total errors and critical errors decreased significantly over the course of the training sessions. The RTP was associated with a greater reduction in the number of total errors and critical errors. During the third training session, we noted an error frequency of 7%-43%, a critical error frequency of 3%-40%, 0.3-1.5 total errors, and 0.1-0.8 critical errors per student. The B-PPE groups had the fewest errors and critical errors.

Conclusion: Our results indicate that both training methods improved the student’s proficiency, that B-PPE appears to be easier to use than E-PPE, that the RTP achieved better proficiency for both PPE types, and that a number of students are still potentially at risk for EVD contamination despite the improvements observed during the training.

• Despite current recommendations, training courses for Ebola virus disease personal protective equipment (PPE) have not been evaluated to date.
• We evaluated basic and enhanced PPE with conventional and reinforced training programs.
• Critical error frequency was between 3% and 40% at the third training session.
• Basic PPE appears to be easier to use than enhanced PPE.
• The reinforced training program achieved better proficiency for both PPE types.

Budget reductions vs. loss of security training

Source: John M. White, Journal of Healthcare Protection Management, Vol. 31 no. 2, 2015
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During the past few years many healthcare security budgets have been cut, and with that, budget lines for ongoing training of officers and other employees have been reduced, the author reports. Stressing that such training is essential to a hospitals protection, he presents in this article ways to achieve cost savings that will keep your training program alive and well despite budget cuts.

Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603 838 individuals

Source: Mika Kivimäki, Markus Jokela, Solja T Nyberg, et al., Lancet, August 19, 2015

From the abstract:
Background: Long working hours might increase the risk of cardiovascular disease, but prospective evidence is scarce, imprecise, and mostly limited to coronary heart disease. We aimed to assess long working hours as a risk factor for incident coronary heart disease and stroke.

Methods: We identified published studies through a systematic review of PubMed and Embase from inception to Aug 20, 2014. We obtained unpublished data for 20 cohort studies from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium and open-access data archives. We used cumulative random-effects meta-analysis to combine effect estimates from published and unpublished data.

Findings: We included 25 studies from 24 cohorts in Europe, the USA, and Australia. The meta-analysis of coronary heart disease comprised data for 603 838 men and women who were free from coronary heart disease at baseline; the meta-analysis of stroke comprised data for 528 908 men and women who were free from stroke at baseline. Follow-up for coronary heart disease was 5·1 million person-years (mean 8·5 years), in which 4768 events were recorded, and for stroke was 3·8 million person-years (mean 7·2 years), in which 1722 events were recorded. In cumulative meta-analysis adjusted for age, sex, and socioeconomic status, compared with standard hours (35–40 h per week), working long hours (≥55 h per week) was associated with an increase in risk of incident coronary heart disease and incident stroke. The excess risk of stroke remained unchanged in analyses that addressed reverse causation, multivariable adjustments for other risk factors, and different methods of stroke ascertainment. We recorded a dose–response association for stroke, with RR estimates of 1·10 for 41–48 working hours, 1·27 for 49–54 working hours, and 1·33 for 55 working hours or more per week compared with standard working hours.

Interpretation: Employees who work long hours have a higher risk of stroke than those working standard hours; the association with coronary heart disease is weaker. These findings suggest that more attention should be paid to the management of vascular risk factors in individuals who work long hours.


Source: French Institute for Public Health Surveillance and Bordeaux University, 2015

[editor’s note: the default language is French, but a button will translate the page to English.]

Ev@lutil is a database consisting of document databases containing description and measures of existing occupational exposure situations and job-exposure matrices giving average exposure estimates for all possible jobs.

The Evalutil program is based on a set of databases accessible via Internet and related to the assessment of occupational exposures to fibres and nanometric particles. The fibres are targeted asbestos and man-made mineral fibres (MMMF). MMMF are defined as mineral wools (glass, rock, slag), refractory ceramic fibres (RCF), continuous filaments of glass and special-purpose glass fibres (or Microfibres®). The nanometric particles (NP) are defined by solid particles with dimensions less than 100 nm, aggregates and agglomerates are included if their constitutent particles are in this size range. The NP studied have an anthropogenic origin, unintentionally emitted by work processes (UNP) and manufactured for commercial purposes (MNP).

The Evalutil databases provide assistance for assessing occupational exposures in order to: (i) guide decisions about preventive measures and medical surveillance of exposed workers; and (ii) facilitate exposure assessment in epidemiological studies about the health effects of such exposures.

The searchable fields include: 1- Source (author, laboratory ….), 2- Year published, 3- Country (includes USA), 4- Worker’s occupation (ISCO 1968), 5- Industrial sector of the site cheked (ISIC 1975), 6- Asbestos containing materials (ACM), 7- Operation on ACM

NASA Controller Fatigue Assessment Report

Source: Federal Aviation Administration, Memorandum, July 18, 2015

From the Q&A press release:
What steps has the FAA taken to relieve the problem of controller fatigue?
In 2012, the FAA implemented a comprehensive Fatigue Risk Management System to manage controller fatigue. This Fatigue Risk Management System includes policy and practice changes, along with fatigue education to raise awareness about the personal responsibilities associated with managing fatigue. Some of the changes the FAA has made as part of the Fatigue Risk Management System include:
• Allowing for recuperative breaks when no duties are assigned
• Requiring nine hours off duty where a day shift follows an evening shift
• Requiring positive confirmation of air traffic hand-offs during midnight operations
• Restricting consecutive midnight shifts
• Restricting 10-hour midnight shifts
• Restricting the start time of early morning day shifts that precede a midnight shift
• Allowing controllers to self-declare fatigue and take time off if needed to recuperate

The Role of Occupations in Differentiating Health Trajectories in Later Life

Source: Michal Engelman, Heide Jackson, Boston College Center for Retirement Research Working Paper No. 2015-15, July 1, 2015

From the abstract:
This study characterizes heterogeneous trajectories of health among older Americans and investigates how employment histories differentiate them. Using the 1998-2010 waves of the Health and Retirement Study, we examine the impact of longest-held occupations on patterns of limitations in activities of daily living. We use latent class growth analysis to identify distinct health trajectory classes and linear growth curve analysis to model the pattern of limitation accumulation for individuals. All analyses are stratified by sex and race, to account for differential labor markets and health experiences of these demographic groups. A limitation of this analysis is its reliance on broad occupational categories rather than specific measures of working conditions. In future work, we plan to incorporate data on specific occupations and merge them with detailed information on occupational characteristics available in the O*NET database (an online repository that has updated the Dictionary of Occupational Titles used in previous research on aging and retirement and occupational epidemiology).

The paper found that: White respondents (both male and female) are substantially more likely to be in the healthiest class compared to black respondents. Certain occupations are protective against membership in poor health classes, but the list of protective occupational categories differs substantially by sex and race. The impact of occupations on health trajectories was diminished when we controlled for educational attainment and smoking, suggesting the important role of education in sorting individuals into occupations that differ in physical and cognitive demands that likely influence health.

The policy implications of the findings are: Life expectancy alone does not capture all the health information that would be relevant for assessing the capacity of American workers to stay on the job beyond traditional retirement ages. Legislators should consider differences in health and in the trajectories of functional decline across demographic groups defined by sex, race, and occupational exposures when debating further increases in the Social Security retirement age.

Enforcement Procedures and Scheduling for Occupational Exposure to Tuberculosis

Source: U.S. Department of Labor, Occupational Safety and Health Administration (OSHA), Directive Number: CPL 02-02-078, June 30, 2015

This Instruction provides general enforcement policies and procedures to be followed when conducting inspections and issuing citations related to occupational exposure to tuberculosis (TB).

This Instruction supersedes CPL 02-00-106, Enforcement Procedures and Scheduling for Occupational Exposure to Tuberculosis (February 9, 1996), which reflected guidance from a 1994 report of the Centers for Disease Control and Prevention (CDC), “Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in HealthCare Facilities (1994).” This Instruction reflects guidance from the updated CDC report: “Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in HealthCare Settings, 2005.” And this Instruction provides information concerning OSHA’s general enforcement policy and procedures for conducting inspections and issuing citations related to occupational tuberculosis (TB) hazards.

Significant Changes:
This Instruction explicitly covers additional workplaces regarded as healthcare settings, e.g., settings in which emergency medical services are provided, and laboratories handling clinical specimens that may contain M. tuberculosis. This Instruction uses the term “tuberculin skin test” (TST) instead of “purified protein derivative test” (PPD). This Instruction also introduces a newer screening method: the blood analysis for M. tuberculosis (BAMT). This Instruction uses the following risk classifications for healthcare settings: low, medium, and potential ongoing transmission. Also, in some scenarios this Instruction calls for less frequent TB screening for workers.