Category Archives: Health & Safety

Report Offers Resources for Home Health Care Response During a Flu Pandemic

Source: Agency for Healthcare Research and Quality (HHS), AHRQ Publication No. 08-0018, July 2008

From the press release:
Home Health Care During an Influenza Pandemic: Issues and Resources, a report identifying home health care as a critical component in providing care during a pandemic influenza event and offering resources to home health care providers and community planners to prepare for such an event, was released today by the U.S. Department of Health and Human Services’ (HHS) Agency for Healthcare Research and Quality (AHRQ) in collaboration with the Office of the Assistant Secretary for Preparedness and Response (ASPR).

Home health care agencies already provide routine care for acute and chronically ill, permanently disabled and terminally ill patients. In fact, on any given day, there are three times as many patients in home health care settings as there are in hospitals.

The report emphasizes the home health care sector’s potential to help handle a surge in patients during a biologic event and stresses the need for involvement of home health care agencies in advance planning and coordination at the local level. It offers resources and suggestions on addressing key elements of home health care preparedness and includes lists of existing tools and models throughout.

Virus Transfer from Personal Protective Equipment to Healthcare Employees’ Skin and Clothing

Source: Lisa Casanova, Edie Alfano-Sobsey, William A. Rutala, David J. Weber, and Mark Sobsey, Emerging Infectious Diseases, August 2008

We evaluated a personal protective equipment removal protocol designed to minimize wearer contamination with pathogens. Following this protocol often resulted in virus transfer to hands and clothing. An altered protocol or other measures are needed to prevent healthcare worker contamination.

Fatal Workplace Injuries in 2004: A collection of Data and Analysis

Source: Bureau of Labor Statistics, June 16, 2008

The Census of Fatal Occupational Injuries (CFOI), administered by the Bureau of Labor Statistics (BLS, the Bureau) in conjunction with the 50 States , the District of Columbia, and New York City, compiles detailed information on all work-related fatal injuries occurring in the United States. In an effort to compile counts that are as complete as possible, the fatality census uses diverse sources to identify, verify, and profile fatal work injuries. Source documents such as death certificates, news accounts, workers’ compensation reports, and Federal and State agency administrative records are cross-referenced to gather key information about each workplace fatality.

The annual CFOI report provides detailed tabulations of data from the fatality census, as well as analytical articles on various topics related to fatal workplace injuries. Although the format differs, this report for 2004 provides the same information as in previous years. The report has two sections, the first section contains charts and text highlighting fatality data from the Census of Fatal Occupational Injuries, including charts derived from the five analytical articles using CFOI data. The second section presents detailed data tables and appendices that describe the scope, methodology, and outputs of the program, along with the full text of the five analytical articles.

HIDDEN TRAGEDY: Underreporting of Workplace Injuries and Illnesses

Source: Majority Staff Report By the Committee on Education and Labor
U.S. House of Representatives, June 2008

The Occupational Safety and Health Act of 1970 requires the Department of Labor to
collect and compile accurate statistics on the extent of occupational injuries, illnesses and fatalities in the United States. Employers are also required to keep accurate records of workplace injuries, illnesses and deaths. Top officials at the Department of Labor (DOL) and Occupational Safety and Health Administration (OSHA) often cite declining injury, illness and fatality numbers to demonstrate the effectiveness of their programs and to fight off criticism that OSHA has abandoned its original mission of setting and enforcing workplace safety and health standards.

But extensive evidence from academic studies, media reports and worker testimony shows that work-related injuries and illnesses in the United States are chronically and
even grossly underreported. As much as 69 percent of injuries and illnesses may never
make it into the Survey of Occupational Injuries and Illnesses (SOII), the nation’s
workplace safety and health “report card” generated by the Bureau of Labor Statistics
(BLS). If these estimates are accurate, the nation’s workers may be suffering three times
as many injuries and illnesses as official reports indicate. Despite these reports, OSHA
has failed to address the problem, relying on ineffective audits to argue that the numbers
are accurate.

Experts have identified many reasons for underreporting. Twenty percent of workers– including public employees and those who are self-employed–are not even counted by BLS. Work-related illnesses are difficult to identify, especially when there are long periods between exposure and illness, or when work-related illnesses are similar to other non-work-related illnesses. In addition, recent changes in OSHA’s recordkeeping
procedures have affected the accuracy of the count of musculoskeletal disorders (MSDs). Finally, some employers are confused about reporting criteria and OSHA staff is often not well-trained to provide accurate advice.

But a major cause of underreporting, according to experts, is OSHA’s reliance on self-reporting by employers. Employers have strong incentives to underreport injuries and illnesses that occur on the job. Businesses with fewer injuries and illnesses are less likely to be inspected by OSHA; they have lower workers’ compensation insurance premiums; and they have a better chance of winning government contracts and bonuses. Self-reporting allows employers to use a variety of strategies that result in underreporting of injuries and illnesses.

Capture-Recapture Estimates of Nonfatal Workplace Injuries and Illnesses

Source: Leslie I. Boden, and Al Ozonoff, Annals of Epidemiology, Volume 18, Issue 6, June 2008
(subscription required)

From the abstract:
We examine reporting of nonfatal injury and illness reporting for the two most important sources of such data in the United States: workers’ compensation data and the Bureau of Labor Statistics’ (BLS) annual Survey of Occupational Injuries and Illnesses.

We linked individual case records from establishments reporting to the BLS with individual cases reported to workers’ compensation systems in six states for 1998-2002 and used capture-recapture analysis to estimate the proportion of injuries reported. Data are for private sector workers and exclude mining, railroad and water transportation, temporary employment agencies, membership organizations, and small agricultural establishments.

For injuries and illnesses eligible for income benefits, using conservative assumptions, we estimate that workers’ compensation systems in the six states missed over 180,000 lost-time injuries in the sampled industries, that the BLS survey missed almost 340,000, and that about 69,000 injuries were unreported to either system.

Underreporting of nonfatal occupational injury and illness is substantial in both systems, but particularly in the Survey of Occupational Injuries and Illnesses. Using both sources improves coverage but falls far short of an accurate count for four of the six states. Reporting rates vary widely, so we cannot infer them for the entire United States.

Government, Industry Play the Numbers Game on Worker Safety in Meatpacking Plants

Source: Roger Horowitz, Labor Notes, #351, June 2008

… But today the figures make beef and pork processing look far safer than it is. In the 1990s companies began keeping injured workers on the job, which reduced their reported injury rates and their worker’s compensation claims.

They were aided in 2002 by the Bureau of Labor Statistics (BLS), which changed its recording methods so that the most common injuries in meatpacking are now exiled from official statistics. The result is that today’s government data seriously under-report injury levels in the meatpacking industry….

Emergency Response Guidebook 2008

Source: Pipeline and Hazardous Materials Safety Administration (U.S. Department of Transportation)

The Emergency Response Guidebook (ERG2008) was developed jointly by the US Department of Transportation, Transport Canada, and the Secretariat of Communications and Transportation of Mexico (SCT) for use by firefighters, police, and other emergency services personnel who may be the first to arrive at the scene of a transportation incident involving a hazardous material. It is primarily a guide to aid first responders in (1) quickly identifying the specific or generic classification of the material(s) involved in the incident, and (2) protecting themselves and the general public during this initial response phase of the incident. The ERG is updated every three to four years to accommodate new products and technology. The next version is scheduled for 2012.

DOT’s goal is to place one ERG2008 in each emergency service vehicle, nationwide, through distribution to state and local public safety authorities. To date, nearly eleven million copies have been distributed without charge to the emergency response community.

Full Version (PDF; 2.6 MB)

Enduring Mental Health Morbidity and Social Function Impairment in World Trade Center Rescue, Recovery and Cleanup Workers: The Psychological Dimension of an Environmental Health Disaster

Source: Environmental Health Perspectives

Workers’ service in 9/11 recovery operations is associated with chronic impairment of mental health and social functioning. Psychological distress and psychopathology in WTC workers greatly exceed population norms. Surveillance and treatment programs continue to be needed.

Full text (526 KB)

Health-Care-Associated Infections in Hospitals: Leadership Needed from HHS to Prioritize Prevention Practices and Improve Data on These Infections

Source: Governmental Accountability Office, March 31, 2008

According to the Centers for Disease Control and Prevention (CDC), health-care-associated infections (HAI) are estimated to be 1 of the top 10 causes of death in the United States. HAIs are infections that patients acquire while receiving treatment for other conditions. GAO was asked to examine (1) CDC’s guidelines for hospitals to reduce or prevent HAIs and what the Department of Health and Human Services (HHS) does to promote their implementation, (2) Centers for Medicare & Medicaid Services’ (CMS) and hospital accrediting organizations’ required standards for hospitals to reduce or prevent HAIs and how compliance is assessed, and (3) HHS programs that collect data related to HAIs and integration of the data across HHS. GAO reviewed documents and interviewed officials from CDC, CMS, the Agency for Healthcare Research and Quality (AHRQ), and accrediting organizations.

Full report
Testimony