Category: Safety & Health
I recently spoke at the American College of Occupational and Environmental Medicine (ACOEM) which is a think tank for occupational medicine. Here are some random notes I gathered from that conference:
- State workers’ compensation typically pays the physician for their billed services at a higher rate than Blue Cross or Medicaid.
- The number of occupational medicine practice physician jobs coming open each year far exceeds the supply of occupational medicine physicians to fill them.
- When any of your employees are traveling to a foreign country it is important to understand all the necessary preventative healthcare measures that should be taken.
- The best marketing tool for an independent medical exam practice is the physician’s written report.
- Single site chronic pain is uncommon – only 13% of those with chronic low back pain have isolated pain.
- Workplace injuries have increased incidence and severity due to obesity, sleep deprivation, smoking, drug and alcohol abuse, impairment from certain medicines, diabetes, depression, and workplace conflict.
- An employee’s health behaviors are influenced by their work environment.
- The most common reasons for medical examination disqualification in a study of New Hampshire drivers presenting for a DOT medical exam was neurological conditions and substance abuse.
- Occupational medicine practice can include pre-hire medical examinations, risk analysis, return to work, and job accommodation.
- A driver with sleep apnea cannot be qualified to operate a commercial vehicle.
- Pesticide exposures can include complaints such as skin rashes, headaches, respiratory problems, itchiness, eye irritation and dizziness. There are also serious concerns over the potential threat of long-term health impacts. Farm workers have the highest rate of chemically-related illnesses of any occupational group.
- Deficiencies seen in occupational health nursing include an increase in the average age of nurses, the fact new nurses often do not receive orientation and there is no formal process of validating their competence in the role.
- 30% of the US population sleeps less and six hours per night.
- On-site support and employer size can include the following:
- In-person patient care for acute care and primary care
- Minor acute care via telemedicine tools such as kiosks, web videos, and telephone
- Health coaching with and on-site nurse or coach
- Biometric screening to identify and motivate people with health risks.
- The key elements of a well-designed wellness program include
- Strategic planning
- Cultural support
- Programs for assessment and screening
- Behavior change interventions
- Measurement and evaluation
- Four modifiable risk factors: weight, smoking, exercise, and nutrition/healthy eating drive most chronic conditions in the U.S.
- Some 60 to 90% of low back pain has an unclear etiology.
- An integrated view of health-related costs for a company include medical, pharmacy, wage replacement costs, and lost productivity due to absence and presenteeism.
- The time-frame of the impact of marijuana on driving appears to be 90 minutes.
- Urine drug testing in most settings fails to detect the drugs that factor into accidents at work.
- The prolonged absence from one’s normal role is detrimental to physical, mental, and social well-being. Long-term unemployment post-injury is itself a health problem.
- It is estimated that there are approximately 20,000 cancer deaths per year that can be attributed to the workplace. Historical carcinogens include asbestos, benzene, and chromium.
- In conducting an IME, the physician may not ask a patient for their family medical history, tell the company if a patient has cancer, or asked the patient undergo genetic testing for specific diseases. All of these activities are prevented by GINA.
- Under HIPAA you may not look up laboratory results on a family member, let a mother know her 21-year-old daughter is pregnant, or that her 20-year-old son is in the ER. You can however ask a patient if he wants family to be present during the evaluation.
To learn more about the ACOEM please go to www.ACOEM.org.
Here’s the deal: Since 1996 seventeen states and Washington D.C. have passed marijuana laws for medical/personal use. To date all the courts have ruled that on the job use or intoxication is not protected. California, Oregon and Washington State court rulings have said use itself, even if legal, does not prevent an employer from have a no drug policy for hiring or employment. Statutes like Michigan’s explicitly say “nothing in this act shall be construed to require an employer to accommodate the ingestion of marijuana in any workplace or any employee working while under the influence of marijuana.”
Of course, as with a prescription drug where health and safety concerns govern it can be treated like the use of other prescription drugs. I doubt any court will require employers to hire stoner surgeons or crane operators. At least let’s hope not! It appears only the Maryland and Arizona statute specifically allows for use at works. Employers cannot discriminate against patients and caregivers and a positive test for marijuana metabolites is not cause for disciplining or terminating a patient. In a sense you have to catch them intoxicated in the moment, not just in their blood stream. Every one of these laws will be tested in court to find out where their workplace boundaries lie.
To the extent Federal laws such as DOT provisions and government contract drug-free workplace laws apply, they control. The Feds are still reviewing the situation as these laws impact on their ability to control illegal use and sale nationwide.
To keep abreast of these legislation trends here are two great resources:
Of course there are those who wonder what all the fuss is about. Here’s an interesting blog on the smokers view of drug testing for the weed.
Note: Just the millionth reason why employers should have their employee handbooks reviewed by an attorney on an annual basis.
Holiday Party Best Practices
Eggnog, latkes, old friends, parties – and a whole lot of beveraging! The holiday season is here! On behalf of everyone at HR That Works, let us be the first to wish you a safe and happy holiday!
To protect yourself and others follow these best practices:
- Make sure that attendance at the party is voluntary.
- Hire bartenders who are trained to spot intoxicated revelers and how to handle them.
- Provide non-alcoholic beverage options.
- Provide each guest with a limited number of drink tickets instead of an open bar.
- Have real food – not just chips and pretzels – served whenever alcohol is available.
- Stop alcohol service at least an hour before ending the function.
- Confront intoxicated guests immediately and cut them off; don’t wait until they are ready to leave the party.
- Don’t inquire of an apparently impaired guest whether they think they’re able to drive home. They can’t.
- Have a taxi service available for any guest who requires one.
- Call a friend or family member to pick up intoxicated guests.
- Arrange for discounted rooms at the event location (if possible) or a nearby hotel.
Don’t forget to have a fun party. Think Mr. Fezziwig!
Accommodating Religious Needs
The holiday season makes an ideal time to focus on the law regarding religion in the workplace. It’s also a great time to celebrate our religious differences! Title 7 of the Civil Rights Act of 1964 prohibits discrimination based on religion. There has been an increasing trends in these claims over the past years with over 4,000 claims being filed in 2011. Not surprisingly, many of these claims are combined with national origin discrimination allegations (i.e. someone alleges discrimination because they’re of Arab origin, as well as Muslim).
The EEOC makes this point about what a religion is:
“In most cases, whether or not a practice or a belief is religious is not an issue. However, the EEOC defines religious practices to include moral or ethical beliefs as to what’s right and wrong, which are sincerely held with the strength of traditional, religious views. The fact that no religious group espouses such beliefs, or that the religious group to which the individual professes to belong might not accept such belief, will not determine whether the belief is a religious belief of the employee or prospective employee. The phrase ‘religious practices’ includes both religious observances and practices.” Also, bear in mind that:
- It’s unlawful for an employer to fail to accommodate reasonably the religious practices of an employee or prospective employee, unless the employer demonstrates that accommodation will mean undue hardship in conducting its business.
- An employer may not ask about an employee’s religious background unless justified by business necessity.
Here’s an EEOC memo on accommodating religious expression.
Lastly, here’s a great link to the religious accommodation practices at the University of Missouri.
Each June, the National Safety Council encourages organizations to get involved and participate in National Safety Month. NSM is an annual observance to educate and influence behaviors around the leading causes of preventable injuries and deaths. Each week carries a theme that brings attention to critical safety issues.
The live webinars are only $119 and come with a great deal of information! The recorded webinars are free! Check them out yourself and I know you will to use some of the excellent tools. Great job NSC!
Employer Relies on Hearsay Evidence to Support an the Issuance of a Restraining Order Against an Employee in Order to Prevent Workplace Violence
This case represents one of the scariest scenarios related to workplace safety. Apparently, after being terminated, the former nurse employee and her husband returned to the hospital where she worked to visit some former patients. When told she was not to be in the nurses’ area, her husband made threats to the managing nurses. The court eventually upheld a three-year “stay away” injunction over the plaintiffs’ complaint that the Court relied on hearsay statements to issue the injunction. The statute involved, which is similar to that found in many states, allows an employer to seek a temporary restraining order and an injunction on the behalf of an employee who has already suffered violence or a credible threat of violence carried out in the workplace. The employer may obtain a temporary restraining order if the affected employee files an affidavit that, to the satisfaction of the court, shows reasonable proof that an employee has suffered unlawful violence or a credible threat of violence by the defendant, and that greater irreparable harm would result to an employee.
The question in this case is whether typical rules of evidence (like those related to hearsay) apply to this type of procedure. The court ruled that due to the unique and expedited context pertaining to a workplace violence injunctions that the typical rules of evidence do not apply. Kaiser Foundation Hospital v. Jeff Wilson, 4th Appellate District http://www.courtinfo.ca.gov/opinions/documents/D058491.PDF
Lesson to employers: You have an obligation to seek these types of injunctions should you catch wind of a credible threat. Remember, the last thing you want is to have any regret afterward because you did not make every effort possible to prevent violence, even if based on hearsay statements.
Heat illness can be deadly. Every year, thousands of workers become sick from exposure to heat, and some even die. These illnesses and deaths are preventable.
This webpage is part of OSHA’s nationwide outreach campaign to raise awareness among workers and employers about the hazards of working outdoors in hot weather. The educational resources on this website give workers and employers information about heat illnesses and how to prevent them. There are also training tools for employers to use and posters to display at their worksites. Many of the new resources target vulnerable workers with limited reading skills or who do not speak English as a first language. OSHA will continue to add information and tools to this page throughout the summer.
The U.S. Department of Labor (DOL) announced a new Web tool to help employers understand their responsibilities to report and record work-related injuries and illnesses under Occupational Safety and Health Administration (OSHA) regulations.
The OSHA Recordkeeping Advisor helps employers and others responsible for organizational safety and health quickly determine whether an injury or illness is work-related; whether a work-related injury or illness needs to be recorded; and which provisions of the regulations apply when recording a work-related injury or illness. To help employers in making these determinations, the OSHA Recordkeeping Advisor relies on their responses to a series of pre-set questions.
Here is some helpful info from OSHA on keeping workers safe during flood and tornado recovery operations: