First Aid for Dealing with Stress

Encourage your employees to take the following measures when they feel stress taking over—

• Make the most of workday breaks. Even ten minutes of “personal time” will refresh your mental outlook.
• Take a brief walk, chat with a coworker about a non-job topic, or simply sit quietly with your eyes closed and breathe.
• If you feel angry, walk away. Mentally regroup by counting to 10, then look at the situation again
• Walking and other physical activities can help you work off steam. Don’t expect perfection of yourself. Talk to your boss about your job description. The responsibilities and criteria for measuring your effectiveness may not accurately reflect what you are doing.
• Work with other employees to make needed changes. This will not only benefit your emotional and physical health, but also improve the organization’s overall productivity.

Source: American Psychological Association

Take Care of Your New Employees

Take care of your newest employees—and you will save mightily on your work-related injuries and health problems.

For every ten new employees hired this year, four will end up with a work-related injury by the end of the year.

The main reason your newest employees have the greatest risk of work-related injuries is that they are not familiar with tools or procedures at your business.

Complicating matters, many new employees try too hard to do everything right the first time and are reluctant to ask for help. Result: a high rate of injuries by workers who
have been on the job less than a year. Temporary workers have an equally high rate of work-related injuries.

Here are some steps you can take to smooth the path for your new employees as they begin working for your business:

1. Monitor your safety training programs during employee orientationto be sure that the new workers are paying close attention.
2. Vary your job training with free materials (without advertising) tomotivate your new workers to put safety first. For example, “New Employee Orientation” by LiftTruck.com, is an attractive slide show with narration describing what should be included in a safety program for new employees.
3. Allow extra time for more experienced workers to track with the new hires in difficult or high-risk tasks. Take time to listen to new workers express their frustration in mastering physical challenges unique to your workplace and take steps to recommend action based on their observations.

For supervisors who are responsible month after month for safety training, the information you are required to deliver to new employees can become boring even to the presenter. Don’t let that happen. Bolster your talk with examples (disguised to protect privacy). Involve employees in demonstrating safety measures. Inject a touch of humor as circumstances allow.

Safety training doesn’t end at the conclusion of your safety orientation program. Your new employees need time to absorb the principles and apply them to their work. You need time to observe how the new workers are adjusting to the job and to listen to their comments related to their personal safety at work. It also takes time to evaluate your own effectiveness in motivating new workers to prevent work-related injuries.

Time is the biggest culprit in new employee injuries. Give your newest workers the time they need to master their tasks so they won’t cut themselves, fall, twist their backs, or otherwise suffer from an injury on the job.

A marked improvement in your safety record for new employees will be your reward for your investment in time and caring.

Show the way to Safety

Take another look at the safety signs at your workplace. Be honest...

• Are the signs clumped together in one disorderly display?
• Are key signs getting faded and dented?
• Is there a small storm of safety sign clutter at your business?

A sign not seen is a sign not heeded. Sit down with your safety crew and set up a sign evaluation tour and replacement routine for your business.

But first, take advantage of the latest (Dec '07) online edition of Occupational Health & Safety and its helpful article on safety signage at work.

A decrepit board causes death

The other day we ran across a report of a worker who fell three stories to his death from a scaffold that was loose and, in the words of the reporter, “dilapidated.”

How many times do our workers scramble to find a board or a used scaffold to stand on to do work on the outside of a building without giving the durability of the supporting materials a thought? They want to do the job now and get it done. They don’t want to bother the foreman. They may not even notice that the board is split at one end or that nails holding the scaffold together are wobbly.

After the fact, we know. Local authorities and the work site’s management staff can pinpoint exactly why that worker fell to his death.

Someone has said that “all accidents are preventable,” and this one certainly was. That is not the same as saying that the people at that business, including the worker who fell, intended for the board to twist and send the worker to the concrete surface below. Neglect leading to injury is never intentional.

Safety on the job is never an accident. Constant, persistent, and sometimes annoying attention to safety-related issues by all employees is the only way to maintain a safe workplace for all.

Healthy Workers Only...

in the last printed edition of HealthWorks we presented the strategy of a major health care company to levy steep fines on employees who don’t comply with health standards.

Another approach to cut health-related costs is being followed by a major retail chain, according to online reports. They’re looking for young, healthy employees, and those
who are overweight, smoke, or have other high-risk life factors go to the bottom of the prospect list.

If you’ve ever dreamed of having a workforce consisting only of healthy, highly motivated workers, this scenario may be attractive. But when you think about it, it becomes apparent that trying to keep worker’s comp and health insurance costs down by hiring only healthy workers is a bad idea.

Here’s why:

In the first place, it won’t work. In Southwest Idaho we’re running at about 2.0 percent unemployment, and when the job market is that open, businesses can’t afford to be
so selective about their workforce that anyone with a health problem will be turned away.

Another reason it’s a bad idea is that costly legal issues, including the whole privacy arena, come into play when employers try to eliminate applicants who may not
follow totally healthful lifestyles when they’re not at work.

The most important reason that prehire health discrimination shouldn’t be considered is that it undermines the concept of shared risk that makes health insurance possible in the first place. Some companies are following the healthy employee model so far that they are going the self-insured route, taking people less likely to be sick out of the insurance pool.

Recognizing the negative consequences of hiring only “healthy” workers, some businesses are offering cash bonuses and other incentives for losing weight, exercising, eating right, and not using tobacco or alcohol.

But will extra cash discriminate unfairly against workers who don’t quite make the hit? Do they require managers to be judge, jury, watchman, and awards manager for activities that aren’t job related?

The most sensible way to deal with employees in an imperfect world is to stick to the workplace and the job in evaluating an employee’s fitness to work. Job descriptions need to spell out the requirements of specific tasks that are involved in each position.

Pre-employment testing or checking of references to be sure the employee can perform these tasks are also appropriate.

But let’s stay out of the worker’s life off the job. If he or she comes to work drug free and capable of handling specific work assignments, we have an acceptable worker on our team.

The shocking reality

An electrician with ten years of experience and a Class A rating was electrocuted while replacing a switch on a sampling tool at a coal fired power plant.

A 26-year-old male construction worker was helping install sewer lines in a new residential development. He attached a section of pipe to a hook on the bucket of the track hoe and held one hand on the wire rope as the pipe was being moved into the trench. The boom of the track hoe made contact with a 7200-volt overhead power line. The electric current traveled through the boom and down the wire rope choker to the victim, who was electrocuted.

These are two extreme examples of the sinister power of electricity when it comes in contact with the human body. From light tingling to instant death, the effects of all of these factors in combination cannot be predicted with 100 percent accuracy.

The path the current takes through the body and the body’s resistance to it affect the impact of the electricity on a person as well as the three primary characteristics of electricity—amperage, voltage, and type of current (alternating or direct). Voltage is the most important factor, but people have been killed by shocks of 50 volts.

Factors involved in electrical burn injuries—

• People with thin or wet skin may experience deep burning of internal organs and tissues while leaving the surface skin unaffected.
• Thick or tough skin may burn from contact with electricity but prevent the current from damaging internal organs.
• Neurological problems may be immediately obvious or not noticeable for up to three years after the shock.
• The respiratory system may be paralyzed by the shocks, causing death.
• Smaller veins and arteries dissipate heat less easily than larger blood vessels and may develop blood clots as a result.
• Amputation is often required after severe high-voltage injuries.

Side effects of an incident involving electric shock can be horrific as well.

An electric arc may set flammable objects on fire, and the victim’s muscles may undergo shocks so violent that the resulting muscle spasms can break and dislocate bones.

Cutting Hearing Loss at the Construction Site

When it comes to construction noise, there is action on the front lines. Efforts to reduce on-site construction noise are the key focus of the Construction Noise Control Partnership, a voluntary group of contractors, union representatives, equipment manufacturers, insurance executives, and others.

The organization is working on a comprehensive data base on equipment noise and is developing protocols that will enable a firm to consider noise factors when purchasing construction equipment.

The partnership is also developing methods for reducing noise with existing equipment, a best practices guide, and information tools. The University of Washington has conducted research on construction related hearing loss, including a five-year study of noise and hearing loss in the industry. This study found that workers wear hearing protection devices less than 20 percent of the time even when noise levels were above 85 decibels.

An 85 decibel sound level is equivalent to an average factory, while a jackhammer, subway train and diesel truck register about 100 decibels. Exposure to levels above 90 decibels can cause permanent hearing loss within a short period of time. Some permanent hearing loss occurs when a person is exposed to 85 decibels of noise for up to eight hours. The numbers are exponential, meaning that increasing the noise level by three decibels cuts the maximum safe exposure time from eight to four hours.

Education about the medical risk of continued exposure to loud noise is one of the ways to motivate workers to wear hearing protective devices in construction work.

Not having the noise in the first place is an even better idea, but until the day when heavy equipment purrs like a kitten and jackhammers dissolve concrete and bricks, hearing protection devices are the best way to preserve hearing even on a construction job.

Why Construction Workers Go Deaf

“Huh?”may be the word construction workers say most often

A jackhammer biting into concrete creates a heavy banging sound that can give a headache to people standing a hundred feet away. The roar of heavy equipment, pounding, beeping, clanging, and other sounds at a construction site inspire local laws that restrict the hours when construction workers can ply their trade.

But what about the workers nearest the equipment that is making all this noise? Are our construction workers at risk of learning first-hand about noise-induced hearing loss?

Construction workers in our neighboring state of Washington are five times as likely as other workers to file claims for work-related hearing loss. On a national level, OSHA reports that hearing loss claims related to construction noise have risen 40 percent over the past ten years. Hearing loss is now the second most common self-reported occupational disease.

Statistics collected by NIOSH, the National Institute for Occupational Safety and Health, indicate that nearly half a million construction workers in the U.S. are exposed to “hazardous” noise that could interfere with hearing.

The road construction industry spends about $50 million a year for work-related hearing loss. Hearing protection devices for all construction workers would cost about $36 million a year. The conclusion is that the road-building industry would save $14 million a year by insisting that their workers wear hearing protection devices when they’re on the job.

There’s a flaw in this logic, since handing out hearing devices doesn’t guarantee that the workers will wear them all the time. A study in 1998 found that while two out of three construction workers believed they had hearing loss, only half of all of the workers in the study used hearing protection on a regular basis.

Experts at NIOSH are now putting more emphasis on the source of noise rather than its final destination. Modifying the equipment and tools that shatter the quiet of the neighborhood would do more to reduce noise than merely requiring workers to wear devices that, if worn properly, protect the ears from excessive noise.

There are plenty of noise control regulations on the books but not much enforcement because the industry is vast and on-site inspections are costly. Even if citations are issued, a concerted effort to reduce noise at the construction site is rare. Since most construction contractors make only about one to five cents out of every dollar they receive in construction fees, it’s hard to convince them that they should be spending money on upgrading their equipment to make it quieter.

As with other health problems associated with a specific type of work, the hazards of construction noise are best contained at its source.

Let's Hire Healthy Workers

Apparently Walmart managers and other employers are looking for a quick, easy way to cut their health-related costs, according to an online report by the Rochester, N.Y. City News. They're looking for young, healthy employees, and those who are overweight, smoke, or have other high-risk life factors go to the bottom of the prospect list.

Trying to keep worker's comp and health insurance costs down by hiring only health workers is a bad idea. Here's why:

• In the first place, it won't work. In Southwest Idaho we're running at about 2.0 percent unemployment, and when the job market is that open, businesses can't afford to be so selective about their workforce that anyone with a health problem will be turned away
• Another reason it's a bad idea is that costly legal issues, including the whole privacy arena, come into play when employers try to eliminate applicants who may not follow totally healthful lifestyles when they're not at work.
• The most important reason that pre-hire health discrimination shouldn't be considered is that it undermines the concept of shared risk that makes health insurance possible in the first place. Some companies are following the healthy employee model so far that they going the self-insured route, taking people less likely to be sick out of the insurance pool.
  

Recognizing the negative consequences of hiring only "healthy" workers, some businesses are offering cash bonuses and other incentives for losing weight, exercising, eating right, and not using tobacco or alcohol. But will extra cash discriminate unfairly against workers who don't quite make the hit? Do they require managers to be judge, jury, watchman, and awards manager for activities that aren't job related?

Think about it.

Big brother will keep you healthy

A while ago I included a report (see 06 in this series) about the penalties Clarian Health plans to impose on its 13,000 employees if they don't follow the hospital chain's lifestyle expectation. I had no idea that a niche industry had been born.

Now I have learned from Tim Jones, reporter for the Chicago Tribune, that The Cleveland Clinic has started testing for nicotine in pre-employment physicals and won't hire anyone who tests positive. Weyco, Inc., fired four employees in 2005 for using tobacco and now penalizes employees with spouses who smoke or chew tobacco.

Don't stumble over this, thinking it's a campaign to motivate employees to lay off bad habits that could shorten their lives or sentence them to a sickroom. It's not that at all. It's simply a trend by business owners and managers to save money.

The harsh reality is that businesses are paying too much for health insurance for their employees and will do anything they can to pay less. The ideal would be to have a workforce that never gets sick, and they're working on this day by day.

They have a lot of support. Insurance companies want to cover only the healthiest of the healthy so they can invest the premiums in ventures more appealing than health care.

One employee, Anita Epolita, is still steaming after Weyco fired her in 2005 when she refused to stop smoking. "They're trying to change behavior after 5 o'clock," Epolito said. "What's next? No McDonalds? No caffeine? No Krispy Kreme?"

Indeed. Build huge hostels and require employees to live in them so their every move can be monitored. Invent devices for employees to wear that alert company officials when the calorie load is exceeded. Require a loyalty oath when hiring new employees with the penalty of surrendering all earthly goods to the company if the health rules are violated.

Here's how Tim Jones covered the story in the Chicago Tribune.

Tendon or bone injury: what's worse?

Tendons attach to bones, taking the force of the muscle and applying it to bone. Bones are hard, consisting mostly of minerals such as calcium, and provide structure and protection to the human body.

Nobody wants an employee with either a broken bone or a damaged tendon, but too often we assume that a fractured bone is more serious, causes more pain, and takes longer to heal than “just” a torn or detached tendon.

In some cases this is true, but the reality is that a tendon injury can cause longer lasting problems than a broken bone. Here are some reasons why.

At the point where the bone inserts itself into the bone, the tissues of the tendon change in composition so they can attach to the bone. The attachment is so strong that an injury isn’t likely to dislodge the tendon. However, when the tendon is ripped from its moorings, it can be a serious challenge even for a skilled orthopedic surgeon to sew the fragmented tissues it back together again and re-attach them to the bone. Recovery from tendon repair surgery can take ten weeks or longer, and for a significant number of persons, the damage can never be eliminated.

Whether your worker suffers from a fracture or a tendon injury—or both—be sure to support the advice of your provider team regarding lifting, moving, or other actions that can put strain on the injury and make it difficult for the worker to achieve a full recovery.

Move materials to avoid injuries

Moving tools and materials them incorrectly can result in injuries

The human body is made to move, but moving fingers, knees, or other body parts too much or putting too much strain on a body part such as the elbow or neck can cause injury and even permanent disability.

Here are some common workplace movements that can lead to work-related injuries.

Excessive repetition can lead to pain, numbness, and inflammation in any joint, including wrist, knee, and elbow. Carpal Tunnel Syndrome, Raynaud’s Syndrome, tendinitis, tennis elbow, ganglion cysts (a lump forming on the wrist), and rotator cuff problems can result or be aggravated.

Forceful gripping can lead to or worsen symptoms of Raynaud’s Syndrome (“white finger”), tennis elbow (epicondylitis), trigger finger.

Awkward posture is associated with a variety of injuries, including tendinitis and rotator cuff problems as well as back and neck pain.

Overhead work can cause or aggravate rotator cuff injuries as well as tendinitis and strains on muscles of the back, shoulders, and neck.

Working with wrists bent can increase the risk of Carpal Tunnel Syndrome and ganglion cysts.

Hand, arm, or full body vibration from operating heavy equipment or power tools can cause Raynaud’s Syndrome (“white finger”) and other symptoms such as numbness, and reduced sensitivity to heat, cold, and pain.

Tips for reducing musculoskeletal injuries at work

The Centers for Disease Control recommends the following steps to prevent or reduce the risk of injuries from excessive or incorrect handling of tools and materials at work:

1. Substitution. Machines, such as hoists, cranes, and dollies, may be able to substitute for workers in some tasks.
2. Improved equipment design. Research has shown that improved design of some vibrating tools virtually eliminates hazardous vibration; suspension or isolation systems may be added to vehicles to greatly reduce whole-body vibration.
3. Task design. Manual tasks can be altered to minimize physical stress to the worker.
4. Worker education. Injuries due to musculoskeletal stresses may be reduced by strength testing, training in proper ways to do a task, and on-site programs of exercise and physical therapy.
5. Variation of work practices. Periodic rotation of workers into jobs with different physical demands may help reduce the number of work-related injury claims.
   

Back pain—exercise works, devices don't

Employees are more likely to give back pain as the reason for filing a worker’s comp than any other cause, and only the common cold results in more days off work.

Training programs have mushroomed to teach proper lifting techniques. Devices such as hoists have been introduced in hospitals and other businesses around the country.

Now there is a report based on data from 18,000 employees in eleven studies with the conclusion that they don’t work. Neither training nor assistive devices were shown in the review of the studies to prevent back pain or reduce disability claims or sick leave.

Some of the studies examined the impact of training on back pain. Others looked at the association between using hoists or other lifting devices and back pain. Still others compared employees with both types of programs in place or no preventive programs at all. There was no significant difference in the number of back pain claims for any of the employee groups.

Christopher Maher, associate professor of physiotherapy at the University of Sydney in Australia did not participate in the study but had this to say to Science Daily:
“...[G]overnment bodies and employers concentrate on things that do not work, [such as] back belts, education, lifting devices, workplace redesign and no-lift policies, and ignore the only known effective intervention—exercise.”

The study referred to above was conducted by the Finnish Institute of Occupational Health in Helsinki, Finland, and was reported in the latest issue of The Cochrane Library, a publication of an international organization that draws evidence-based conclusions from medical research.

If they’re not healthy—fine them

Everybody's talking about the bold move at an Indianapolis-based hospital to reduce its healthcare costs. Next year Clarian Hospital in Indianapolis will begin charging employees who don’t meet minimum standards in five areas of health: body mass index, cholesterol, blood glucose, blood pressure and non use of tobacco.

The fees will be minimal at first—only $5 deducted from each paycheck per “infraction,”— but will rise to $30 every two weeks in 2009. Company-sponsored screening will also be required for all employees.

Employees must show that they are working to decrease a specific health risk to avoid the fine. Clarian, which operates five hospitals in the Midwest, is the first major employer to take advantage of changes in federal rules that went into effect in July of this year. The rules do not allow a business to discriminate against any of its employees by cutting health care benefits, but it is legal to use financial incentives to encourage healthier lifestyles.

The interpretation of new HIPAA (privacy act) regulations to allow this type of a financial penalty for lifestyle choices is too lengthy to explain here, but for more information about HIPAA and employer-sponsored wellness programs, try this link.

Drug abusers like to work where you do

While you are reading this, approximately 16.4 million illicit drug users and 15 million heavy alcohol users are holding full-time jobs and showing up for work almost every day. They may be working for you.

A new study just released by the Substance Abuse and Mental Health Services Administration reveals startling facts about workers who mix mind-altering substances and full-time jobs.

Twice as many illicit drug users miss work at least one day a month as other workers. Drug users are also much more likely to miss two or more workdays per month from illness or injury.

Nearly one out of three illicit drug users in the study said they would probably work for businesses that do not conduct drug or alcohol testing programs. Substance users also had far higher job turnover rates. Among full-time workers who reported current illicit drug use, 12.3 percent said they had worked for three or more employers in the past year, compared with 5.1 percent of non abusing workers.

Should safety be a moral obligaiton?

Many feel that maximizing safety in the workplace is a moral obligation. Managers and owners should work with employees to create a safe working environment just because it's the right thing to do. The government should stay out of it.

Others argue that depending on high morals for workplace safety is not enough. Too many managers and owners ignore safety and don't care much about its impact on human life. Safety laws can deal with decision makers who show a willful disregard for their workers’ well-being by subjecting them to penalties in line with their crimes.

Here in the quiet state of Idaho we occasionally hear rumblings that safety is a luxury. We also hear local business people say that the cost of work-related injuries is just another “cost of business” to be factored in with pavement upgrading and roof repair.

Finally, we hear loud cries from a few about the audacity of government to dare to impose safety regulations on America, the land of the free.

The reality is that competition, pricing, availability of materials, productivity, and quality do not need to wipe out a deep and abiding concern for the health and welfare of employees.

You don’t have to choose between good work and a safe workplace. Your employees will work together if you give them a chance to identify the safety quirks at your business and take steps to correct them.

Instead of trying to get by without getting caught or brushing off the impact of any penalties, you’ll meet and exceed OSHA and industry safety standards. Why? Because you know that nothing works better for you than a safe, healthy employee.

* Are you getting tired of safety regulations at your business?

* What can employees do to raise the standard for safety?

* How can you get the attention of top management to pay more attention to worker health and safety?

jg

Ignoring safety rules--how should it be punished?

Every year about 100 workers die because of injuries resulting from willful indifference to workplace danger such as a safety device that was removed to speed up production or a worker who was denied protective gear.

Over the two decades ending in 2002, a total of 1,242 deaths or injuries were investigated by OSHA and found to be the result of willful violation of safety requirements. However, for 93 percent of these cases, OSHA decided not to seek prosecution. These cases included repeat offenders, violations that caused multiple deaths, and safety lapses that resulted in the death of teenagers.

At the corporate level, the ten largest businesses in the country accounted for 3,800 violations of safety regulations from 1982 to 2002, with an average fine of less than $500. Only 74 employers were prosecuted at the federal level, and only one employer spent jail time for an offense—for forty-five days.

OSHA’s budget has been cut, staff has been reduced, and the will to penalize employers for dangerous practices in the workplace seems to grow weaker year by year.

This is not an advocacy organization. We do not support legislation or urge readers to vote for or against political candidates or to call office holders to a greater level of accountability.

Is there anything we can do? What are your thoughts about prosecuting businesses that ignore safety regulations? Or do you see a problem at all?

Human life not always valued

Example #1:

OSHA reports that they're going to seek a $2.78 million penalty against a dry-cleaning company that was apparently indifferent to the possible danger of the conveyor belt carrying heavy, wet clothing from the washer to the industrial-sized dryer. The clothing jammed. The worker who was asked to clear the jam was killed when he fell into the dryer.

Four employees at the plant are responsible for clearing jams on the conveyor belt. Apparently none of them received any safety training for how to do the job. Lockout-tagout standards were repeatedly ignored, and the company had been cited for 42 instances of willful violation of these rules. Read about it.

Example #2

Behind a high metal fence surrounding a pipe foundry in Texas, a man climbs into a deep pit to shut off heavy equipment, as ordered, while it is running. His mangled body is found the next day. The national company that employed him has been cited for more safety violations than their six major competitors combined. In court, executives for the firm admitted that they don’t worry about safety until an injury or death occurs. Company profits matter more.

Example #3

He was just 22 years old and a plumber’s apprentice when he was ordered into a trench ten feet deep to work on a sewer line. No safety provisions were made, such as a large metal box placed in the trench to provide a safe area to work. Thousands of pounds of mud and sludge collapsed on the man. He died struggling, and his body was pulled from the trench hours later. The worker had reported numerous safety violations to authorities, and the company had been cited recently for unsafe trenches, but nothing had been done to correct the condition.

Do reports like this trouble you?

Indifference kills

Listen to the rumbling of an approaching presence. You sense that the presence is getting closer but you see nothing. Just before you scream you feel a clammy hand on your mouth...You have just been engulfed in the sea of indifference to worker safety and health.

Every year about 100 workers die because of injuries resulting from willful indifference to workplace danger such as a safety device that was removed to speed up production or a worker who was denied protective gear.

Over the two decades ending in 2002, a total of 1,242 deaths or injuries were investigated by OSHA and found to be the result of wilful violation of safety requirements. However, for 93 percent of these cases, OSHA decided not to seek prosecution. These cases included repeat offenders, violations that caused multiple deaths, and safety lapses that resulted in the death of teenagers.

At the corporate level, the ten largest businesses in the country accounted for 3,800 violations of safety regulations from 1982 to 2002, with an average fine of less than $500. Only 74 employers were prosecuted at the federal level, and only one employer spent jail time for an offense—for forty-five days.