Category Archives: Health & Safety

Under What Circumstances Can an Acute Myocardial Infarction Be Regarded as a Work-Related Accident?, Multi-Causal Diseases as Work Accidents

Source: Mervyn S. Gotsman, and Stephen Adler, International Social Security and Workers Compensation Journal, Volume 1 Issue 1, 2009
(registration required)

Workers compensation systems compensate for work accidents and occupational diseases. Multi-causal diseases, such as heart disease, are not accidents and are not occupational diseases. They are an ordinary part of life, and heart attacks, for example, may occur without a precipitating event. However, coronary heart disease may be aggravated by unusual physical exertion or mental stress, resulting in a myocardial infarct (heart attack). If such strain or stress occurs at work, it is often compensated for by the workers compensation system. This paper asks whether the legal theories that are used to determine if a heart attack should be recognised as a work accident are consistent with modern medical knowledge on the subject. To answer this question, we must first examine the medical theory relating to the effect of an event at work on a latent illness, such as pre-existing heart disease, which must be present to produce a heart attack.

We describe events at work as ‘triggers’ of acute myocardial infarction. However, most of these triggers are not connected to the workplace. Triggers occasionally occur during an unusual, sudden and acute emotional event, such as stress or unusual physical effort at work, which, therefore, are work-related. This work-related event results in ruptured plaque in a diseased coronary artery. Intimal (the inner layer of the artery) disruption initiates a thromboembolic clot of the coronary artery involved. Thrombus forms, obstructs the artery, coronary fow is impeded, and the distal myocardium undergoes necrosis and infarcts (an acute myocardial infarction or heart attack). Thus, the sudden acute emotional event or physical effort at work has caused a heart attack, which should be compensated by the workers compensation system.

The medical and legal basis for recognising the relationship between the trigger and the heart attack are not precise. We suggest that an unusual acute stressor, or trigger, which occurs in the workplace, should be the basis for recognising the infarct as a work accident. In Israel, when it has been determined that a work-related trigger event contributed to the occurrence of a heart attack, the attack is recognised as a work accident.

This paper describes the importance of risk factors which can cause a heart attack, the experimental, pathological, and clinical evidence of plaque rupture as a cause of heart attacks, clinical examples, and legal theories for recognising a heart attack as a work accident, with particular reference to Israeli and American sources.

Building a Safer Workplace

Source: Towers Watson, 2010

From the summary:
Every year around the globe, millions of workers are injured, thousands of lives are lost, and the impact of workplace safety is felt by businesses, employees and their families. Recent studies estimate that workplace injuries cost as much as 4% of the world’s gross domestic product. It is the responsibility of all employers to take a strong, proactive stance to ensure their employees’ safety. Towers Watson partners with the world’s largest companies to improve their safety culture, gathering feedback through custom-tailored employee surveys designed to identify potential critical problem areas.

Our experts analyze the data, identify high-risk areas, and help clients develop concrete plans for improved occupational and process safety performance. Our work is focused on using employee insights to prevent costly and potentially deadly accidents before they occur. Employee culture is as much an element of a safe workplace as mandatory training sessions and regulatory policies. Our safety surveys aim to create a safer workplace by taking into account both the environment in which employees work and the culture that drives their daily work experience.

Is Job-Related Stress the Link Between Cardiovascular Disease and the Law Enforcement Profession?

Source: Warren D. Franke, Marian L. Kohut, Daniel W. Russell, Hye Lim Yoo, Panteleimon Ekkekakis, Sandra P. Ramey, Journal of Occupational and Environmental Medicine, Vol 52 no. 5, May 2010
(subscription required)

From the abstract:
Objective: To determine whether job-related stress is associated with alterations in pro- and anti-atherogenic inflammatory mediators among law enforcement officers.

Conclusions: Law enforcement officers may be at an increased risk for cardiovascular disease due to a relatively greater pro-inflammatory vascular environment. However, this increased risk cannot be attributed to either chronic stress or the work-related stress measures assessed here.

OSHA to Make Only Tiny Dent in Huge Health Standard Backlog

Source: Public Employees for Environmental Responsibility, Press release, May 6, 2010

The new regulatory agenda for the U.S. Occupational Safety and Health Administration (OSHA) will result in new worker protections against at most a small handful of health hazards by the end of the presidential term, leaving untouched the absence of standards for thousands of chemicals and hundreds of existing standards that are much weaker than needed to protect workers, according to Public Employees for Environmental Responsibility (PEER). While OSHA is beginning some new initiatives, it is also pushing back the deadlines for completing some ongoing health standards.
See also:
Look at the OSHA regulatory agenda
Compare the yawning regulatory backlog in exposure limits
Read David Michaels’ explanation via web-chat
See the PEER plan for Putting the “H” Back in OSHA

Overtime Work And Incident Coronary Heart Disease: The Whitehall II Prospective Cohort Study

Source: Marianna Virtanen, Jane E. Ferrie, Archana Singh-Manoux, Martin J. Shipley, Jussi Vahtera, Michael G. Marmot, and Mika Kivimäki, # European Heart Journal, published online May 11, 2010
(subscription required)

From the abstract:
Aims: To examine the association between overtime work and incident coronary heart disease (CHD) among middle-aged employees.

Conclusion: Overtime work is related to increased risk of incident CHD independently of conventional risk factors. These findings suggest that overtime work adversely affects coronary health.
See also:
Memo to boss: 11-hour days may be bad for you
Source: Ben Hirschler, Reuters, May 11, 2010

Chemical Exposure Health Data

Source: Occupational Safety and Health Administration, 2010

From the press release:
In keeping with the president’s memorandum on open government, the U.S. Labor Department’s Occupational Safety and Health Administration is releasing 15 years of data providing details of workplace exposure to toxic chemicals.

The data is comprised of measurements taken by OSHA compliance officers during the course of inspections. It includes exposure levels to hazardous chemicals including asbestos, benzene, beryllium, cadmium, lead, nickel, silica, and others. The data offers insights into the levels of toxic chemicals commonly found in workplaces, as well as insights into how chemical exposure levels to specific chemicals are distributed across industries, geographical areas and time.

Death on the Job: The Toll of Neglect

Source: AFL-CIO Safety and Health Department, April 2010

Each workday, it’s likely that 14 workers won’t come home because they will be killed on the job, according to the most recent statistics. The AFL-CIO’s 19th annual workplace safety report, “Death on the Job: The Toll of Neglect,” also reports that in 2008, along with the 5,214, workers killed, another 50,000 workers died from occupational diseases, while at least 4.6 million workers were reported injured, unreported injuries could push that total to as many as 14 million workers.

Increase in Sharps Injuries in Surgical Settings Versus Nonsurgical Settings after Passage of National Needlestick Legislation

Source: Janine Jagger, Ramon Berguer, Elayne Kornblatt Phillips, Ginger Parker, Ahmed E. Gomaa, Journal of the American College of Surgeons, Vol. 210 Issue 4, April 2010
(subscription required)

From the abstract:
The operating room is a high-risk setting for occupational sharps injuries and bloodborne pathogen exposure. The requirement to provide safety-engineered devices, mandated by the Needlestick Safety and Prevention Act of 2000, has received scant attention in surgical settings.

Despite legislation and advances in sharps safety technology, surgical injuries continued to increase during the period that nonsurgical injuries decreased significantly. Hospitals should comply with requirements for the adoption of safer surgical technologies, and promote policies and practices shown to substantially reduce blood exposures to surgeons, their coworkers, and patients. Although decisions affecting the safety of the surgical team lie primarily in the surgeon’s hands, there are also roles for administrators, educators, and policy makers.

Provision and Use of Safety-Engineered Medical Devices Among Home Care and Hospice Nurses in North Carolina

Source: Jack K. Leiss, American Journal of Infection Control, published online 26 April 2010
(subscription required)

From the abstract:
Nurses who provide care in the home are at risk of blood exposure from needlesticks. Using safety-engineered medical devices reduces the risk of needlestick. The objectives of this study were to assess provision of safety devices by home care and hospice agencies as well as the use of these devices by home care and hospice nurses in North Carolina, and to examine the association between provision and use.

The percentage of nurses who were always provided with safety devices ranged from 51% (blood tube holders) to 83% (winged steel needles). Ninety-five percent of nurses who were always provided with safety devices, but only 15%-50% of nurses who were not always provided with safety devices, used a safety device the last time they used that general type of device. Among nurses who did not use a safety device on that occasion, 60%-80% did not use it because it was not provided by the agency.

This study suggests that limited access is the primary reason for home care/hospice nurses’ failure to use safety devices. The policy goal of providing safety devices to health care workers in all situations in which such devices could reduce their risk of needlestick is not being achieved for home care nurses in North Carolina.

Role Of Nasal Methicillin-Resistant Staphylococcus Aureus Screening In The Management Of Skin And Soft Tissue Infections

Source: Anneliese M. Schleyer, Kenneth M. Jarman, Jeannie D. Chan, Timothy H. Dellit, American Journal of Infection Control, published online 26 April 2010
(subscription required)

From the abstract:
We set out to determine whether nasal swab isolates can identify methicillin-resistant Staphylococcus aureus (MRSA) colonization and guide therapy in skin and soft tissue infections (SSTI). Among hospitalized patients admitted to a general medicine service with SSTI, specificity and positive predictive value for MRSA in nasal swab isolates were 100%; sensitivity was 55%. Thus, positive nasal swab cultures may help identify MRSA colonization and guide antimicrobial therapy for SSTI when wound cultures cannot be obtained.