According to the Bureau of Labor Statistics, almost a quarter of all 65- to 74-year-olds are active in the workforce, representing the highest percentage of workers in this age group since 1970. As older adults return to work after retirement, whether due to financial need or the desire to continue working, health and safety professionals must address this population’s needs.

Gregory Petty, professor of health and safety programs at the University of Tennessee, discussed the aging workforce’s special safety concerns at the National Safety Council’s (NSC) 2007 Congress and Expo in Chicago. He explained the phenomenon of so many older employees returning to the workforce after retirement can be attributed to better health, insufficient retirement funds or the desire to gain new experiences.

“Though many older people will need to work, at least part time, many others will want to,” Petty said. “[Some] older workers want the potential for new adventures or experiences.”

Petty said that while many business and industry leaders are overlooking the increasingly older workforce, he predicted the expectations of this population’s work ability will change “with the realization that ‘old’ does not have to mean tired, sick, cautious or quiet.”

“There are reasons why you should care about the value of these older workers,” Petty said.

He explained the older working population generally is highly educated, experienced and reliable. These employees typically have held established careers, have the wisdom of maturity and often have lower injury rates. Petty acknowledged that the benefits of hiring older employees, however, are accompanied by risks.

“You have a fall when you’re 20, you have a bruise,” he said. “You have a fall when you’re 50, 60 or 70, you have a broken hip.”

Common on-the-job injuries experienced by the older working population often are caused by falls, which can be attributed to poor balance, slowed reaction time, visual deficits, lack of concentration or complacency. Sprain or strain injuries also are common, and may be brought on by loss of strength, endurance or flexibility. Additionally, older workers may be more sensitive to overexertion, heat, cold, lighting, noise and ergonomic issues.

Employers and health and safety professionals may need to make accommodations for their older workers to keep them safe. Petty suggested wellness programs, job analyses and ergonomic evaluations to protect the aging workforce. He added that restructured job duties and work hours might also be beneficial to this population. Providing behavior-based feedback and giving more positive than negative consequences are also beneficial for the older workforce.

“For employers intent on recapturing talents of older workers, more interesting, varied jobs will make a difference,” Petty said.

He stressed that older workers should be aware of their current functioning ability. Forgetting glasses or hearing aides, for example, could prove dangerous for an older worker. “You have to know your limitations,” he warned.

Do you think a health hazard exists in your workplace? Do any of the following stories resemble situations at your workplace?

• A factory worker was feeling numbness and tingling in her fingers. She learned that three coworkers had the same problem, and two had headaches while at work but not over the weekend. Some workers said the air at work smelled bad. Their supervisor noticed the smell but didn’t think it was anything to worry about.
• A manager noticed that employees in one work area had more skin rashes in the past year than the year before. He wanted to know why, but didn’t know what to do.
• A work crew was putting cement tiles on a roof. They were working outside, but the air seemed dusty. The saws used to cut the tiles were noisy. Someone told them that this work was dangerous and they should have it checked out.

At no cost to employers or employees, or their representatives, the NIOSH Health Hazard Evaluation (HHE) program may be able to help with problems like these. This site lets you know about the program and how to ask for NIOSH help. It also has links to reports from thousands of HHEs done by NIOSH.

What is a Health Hazard Evaluation?

An HHE is a study of a workplace. It is done to learn whether workers are exposed to hazardous materials or harmful conditions. On the basis of the information you provide, NIOSH responds to an HHE request in one of the following ways:

• NIOSH staff responds in writing with helpful information or a referral to a more appropriate agency.
• NIOSH staff calls to discuss the problems and how they might be solved.

NIOSH staff visits the workplace. When this happens, they will meet with the employer and the employee representatives to discuss the issues. They will tour the workplace. They may review records about exposure and health, interview or survey employees, measure exposures, and do medical testing. These activities may happen during one or more visits. At the end of this evaluation, NIOSH will provide a written report to the employer and to the employee representatives. This can take from a few months to a few years, depending on the type of evaluation.

Who Can Request an HHE?

Private sector and Federal workplaces

An employee can request an HHE if he or she is currently an employee at the workplace of concern and has the signatures of two other employees. If the workplace has three or fewer employees, the signature of only one employee is enough.

An officer of a labor union that represents employees for collective bargaining can request an HHE.

Any management official may request an HHE on behalf of the employer.

For anyone who submits a request, NIOSH will not reveal to the employer the names of the persons who made the request if they indicate this on the request form

State or local government workplaces

When the workplace is part of a State or local government, NIOSH authority is more limited than for the private and Federal sectors. The cooperation of the employer may be necessary before NIOSH can do an evaluation.

Should you request an HHE?

When there is concern about a health hazard in a workplace, you can request an HHE, file a complaint with the Occupational Safety and Health Administration (OSHA), or request help from the OSHA Consultative Service. Some things to consider for each of these options are listed below.

1. When to request an HHE from NIOSH

You are an employee, employee representative, or employer and the following apply:

• Employees have an illness from an unknown cause.
• Employees are exposed to an agent or working condition that is not regulated by OSHA.
• Employees experience adverse health effects from exposure to a regulated or unregulated agent or working condition, even though the permissible exposure limit is not being exceeded.
• Medical or epidemiological investigations are needed to evaluate the hazard.
• The incidence of a particular disease or injury is higher than expected in a group of employees.
• The exposure is to a new or previously unrecognized hazard.
• The hazard seems to result from the combined effects of several agents.

2. When to request help from the OSHA Consultation Program (http://www.osha.gov/dcsp/smallbusiness/consult.html):

You are a small business owner and you want:

• assistance in recognizing hazards in your workplace.
• suggestions or options for correcting safety and health issues.
• assistance in developing or maintaining an effective safety and health program.
• to reduce workers compensation cost and improve employee morale..

The OSHA On-site Consultation Program:

• is a free service.
• is delivered by state (and territorial) governments using well-trained safety and health professionals.
• is separate from enforcement.
• is confidential. The company’s name, and any other identifying information provided about the workplace, plus any unsafe or unhealthful working conditions that the consultant uncovers, will not routinely be reported to OSHA enforcement personnel.
• does not issue and citations, penalties, or fines.
• will provide you a confidential, written report that summarizes the consultant’s findings.
• requires the correction of hazards identified by the consultant(s).
• under specific circumstances, employers with exemplary safety and health programs can be recommend for recognition and provided with an exclusion from general schedule inspections.

3. When to file a complaint with OSHA (www.osha.gov/as/opa/worker/index.html):

You are an employee and the following situations apply*:

• Immediate enforcement by a regulatory agency is needed.
• Employees want the employer to comply with existing health and safety standards.
• The hazard is well recognized.
• An OSHA standard is known to adequately protect employees from the hazard.

* [Employers in the Federal sector may wish to explore the services available through the Division of Federal Occupational Health (DFOH), which maintains an office in each Federal region. State and local government employers may be eligible for help under the OSHA Consultation Program operating in their State. The State or local health department may also be able to help with occupational safety and health issues.]

How Does NIOSH Respond to an HHE Request?

NIOSH logs in each request for an HHE and generally sends a letter to the person making the request. Most often this happens within a few weeks.When NIOSH decides to send information or make a referral to another agency, usually a letter is sent within 4–6 weeks.

When NIOSH decides that telephone consultation or a workplace visit is needed, a project officer is assigned. Usually, within 4–6 weeks, the project officer contacts the person who sent in the request. When the request is made by an employee or union, NIOSH also contacts the employer to let them know about the request and to arrange for a site visit. Typically, NIOSH does not conduct surprise visits.

What protections are provided for employees who request and participate in HHE investigations?

Confidentiality

If desired and noted on the HHE request form, NIOSH will not reveal to the employer the names of the persons who made the request. Personal information from records, questionnaires, interviews with NIOSH investigators, and individual medical results will be safeguarded in accordance with provisions of the Privacy Act.

Anti-discrimination Provisions

The Occupational Safety and Health Act and the Federal Mine Safety and Health Act forbid employers from retaliating or punishing employees for making HHE requests or cooperating with NIOSH investigators (see Section 11(c) of the Occupational Safety and Health Act or Section 105(c) of the Mine Safety and Health Act). The enforcement of these anti-discrimination provisions is the responsibility of the U.S. Department of Labor. If discrimination is suspected, contact the nearest OSHA or MSHA office immediately.

Procedural Rights of NIOSH and Employee or Employee Representatives

There are 7 legal rights of NIOSH and employees or employee representatives that NIOSH considers non-negotiable:

• NIOSH and its representatives have the right to enter the workplace to conduct HHE investigations.
• NIOSH and its representatives have the right to access information and records maintained by the employer that are pertinent to the HHE investigation.
• NIOSH and employees (including management employees) have the right to private and confidential interviews.
• Employee representatives, including an employee requestor and a representative of any union representing the affected employees, have the right to accompany NIOSH investigators during the initial inspection of any workplace to be evaluated.(NIOSH investigators may have additional employee representatives accompany them if necessary to aid in the investigation.)
• Employee representatives have the right to participate in an opening and closing conference with NIOSH investigators at the start and conclusion of a NIOSH investigation at the workplace.
• Employees have the right to wear NIOSH sampling devices and participate in medical tests when offered or requested by NIOSH. (This also applies to management employees.)
• Employees have the right to read or obtain copies of all HHE interim and final reports. (The employer is required to post the final report in the workplace for 30 days, or supply a list of names and addresses of affected employees so that NIOSH can mail the report directly to them.)

Procedural Rights of the Employer

Regardless of who submitted the request for an HHE, employers have the following rights during HHE investigations:

• To obtain a copy of the HHE request (excluding the identity of confidential requestors and any accompanying information of a personal nature.)
• To obtain verbal accounts from NIOSH investigators concerning plans, procedures, and findings at conferences at the beginning and conclusion of NIOSH visits to the workplace.
• To accompany NIOSH investigators during the initial inspection of the workplace to be investigated.
• To observe NIOSH investigative procedures during the HHE, except for certain confidential NIOSH-employee interactions, such as private interviews and medical test procedures.
• To identify, at the start of the investigation, information that is considered trade secret, and to have that information safeguarded by NIOSH unless NIOSH follows procedures outlined in 42 CFR 85.7(b) to remove the trade secret designation from such information. (These procedures provide an opportunity for the employer to defend the trade secret designation.)
• To require that NIOSH officers comply with all safety and health rules in the workplace, and conduct the investigations in a manner that does not unreasonably disrupt operations.

Role of the Employee Representative

The local, national, or international union may submit an HHE request on behalf of employees it represents. Two employees may authorize a third employee to submit an HHE request on their behalf.

The employee representative has the following rights:

• To accompany NIOSH investigators on the initial inspection of the workplace.
• To convey to the NIOSH investigators, privately if requested, additional information related to the HHE request.
• To participate in the opening and closing conferences.
• To receive copies of all interim and final reports

How Are HHE Results Reported?

NIOSH reports its findings and recommendations to employers, employees, and employee representatives. Verbal reports are normally provided to employer and employee representatives during a closing conference at the conclusion of a site visit, and by telephone. Often, results are only preliminary or incomplete at that time. Written interim reports are sometimes provided while an investigation is still in progress.

When all the information and data have been analyzed, NIOSH issues a report of its final determination, giving findings and recommendations. Copies of this report are sent to the requestor, the employer, employee representatives, OSHA, and other appropriate agencies.

The employer is required to post the final report in a place accessible to employees from all areas evaluated (alternatively, the employer may give NIOSH names and addresses of affected employees to permit NIOSH to mail the report to each affected employee.) Although NIOSH has no authority to force the employer to adopt its recommendations, experience has shown that most employers attempt to address any problems identified in the HHE report.

By What Authority Does NIOSH Conduct HHEs?

In private sector workplaces, NIOSH is supported by the following:

• The Law

Section 20(a)(6) of the Occupational Safety and Health Act (Public Law 91-596, 91st Congress, S.2193, December 29, 1970), 29 USC 669 (a)(6), authorizes the Secretary of Health and Human Services (delegated to NIOSH), “following a written request by any employer or authorized representative of employees, to determine whether any substance normally found in the place of employment has potentially toxic effects in such concentrations as used or found.” Section 501(a) of the Federal Mine Safety Act of 1977 authorizes NIOSH, “upon the written request of any mine operator or authorized representative of miners, to evaluate potentially hazardous or toxic effects of substances, physical agents, or equipment found or used in mines.”

• Federal Regulations

The regulations governing NIOSH procedures for conducting HHEs are published in Title 42, Code of Federal Regulations, Part 85; Requests for Health Hazard Evaluations (42 CFR 85).

In Federal agency workplaces, NIOSH is supported by the following:

• The Law

Section 19 of the Occupational Safety and Health Act (29 USC 668) requires the head of each Federal agency to “establish and maintain an effective and comprehensive occupational safety and health program.”

• Executive Order

Executive Order 12196 of February 26, 1980, “Occupational Safety and Health Programs for Federal Employees.”

• Federal Regulations

Title 29, Code of Federal Regulations, Part 1960; Basic Program Elements for Federal Employees Occupational Safety and Health

Programs and Related Matters (29 CFR 1960). Section 1960.35 of these regulations describes the procedures for requesting HHEs in Federal agency workplaces.  NIOSH follows the procedures outlined in the regulations governing HHEs (42 CFR 85) when evaluating Federal agency workplaces.

In other government agency workplaces, NIOSH is supported by the following:

• The Law

Section 18 of the Occupational Safety and Health Act (29 USC 667) permits OSHA to approve a plan under which the State assumes responsibility for developing and enforcing occupational safety and health standards. Section 18(c)(6) requires that such a plan, to be approved, must contain satisfactory assurances that the State will “establish and maintain an effective and comprehensive occupational safety and health program applicable to all employees of public agencies of the State and its political subdivisions.” Although approved State plans do not ordinarily extend the right to request HHEs to State employees and employers, the State agency charged with carrying out this plan has right-of-access to State and local government workplaces, and could request technical assistance from NIOSH in evaluating the workplaces.

• Federal Regulations

In cases where NIOSH responds to requests to evaluate State or local government workplaces, the procedures outlined in 42 CFR 85 are followed.

Occupational Medicine Rotation Program

The NIOSH Health Hazard Evaluation and Technical Assistance Branch provides hands-on, one- and two-month workplace training opportunities to Medical Residents. Residents join staff on a combination of workplace and epidemiologic investigations, public inquiries, health and safety assessments on today’s health and safety topics and learn to plan and conduct worksite health evaluations. Residents gain understanding of the role and function of CDC/NIOSH regarding occupational health research and service.

On April 6, 2010, EPA took an important step toward providing communities with additional information about toxic chemicals being released to the environment. The Agency announced that it is proposing to add 16 chemicals to the TRI list of reportable chemicals. The Agency’s proposal is part of its ongoing efforts to examine the scope of TRI chemical coverage and provide communities with more complete information on toxic chemical releases, and is the first TRI program chemical expansion in over a decade.

The chemicals that EPA is proposing to add have been classified as “reasonably anticipated to be a human carcinogen” by the National Toxicology Program (NTP) in their Report on Carcinogens (RoC) document. Based on a review of the NTP RoC data, EPA believes that these 16 chemicals meet the EPCRA section 313(d)(2)(B)statutory listing criteria because they can reasonably be anticipated to cause cancer in humans. Additionally, four of the chemicals are being proposed for addition to the polycyclic aromatic compounds (PACs) category. The PACs category is a category of special concern, because PACs are persistent, bioaccumulative, toxic (PBT) chemicals, and as such, they are likely to remain in the environment for a very long time, are not readily destroyed, and may build up or accumulate in body

1-Amino-2,4-dibromoanthraquinone

2,2-bis(Bromomethyl)-1,3-propanediol

Furan

Glycido

Isoprene

Methyleugenol

o-Nitroanisole

Nitromethane

Phenolphthalein

Tetrafluoroethylene

Tetranitromethane

Vinyl Fluoride

Additions to the Polycyclic Aromatic Compounds (PACs) category:

1,6-Dinitropyrene1,

8-Dinitropyrene,

6-Nitrochrysene,

4-Nitropyrene

Every year since 1996 the Occupational Safety and Health Administration (OSHA) has collected work-related injury and illness data from more than 80,000 employers. For the first time, the agency has made the data from 1996 to 2007 available in a searchable online database, allowing the public to look at establishment or industry-specific injury and illness data. The workplace injury and illness data is available at http://www.osha.gov/pls/odi/establishment_search.htmlas well as Data.gov.

OSHA recently solidified leadership for the agency and has provided a clearer picture of the regulatory horizon.

NIOSH Update: Aging Workers at Higher Risk of Death, Severe Injury, Conference Report Suggests Ways to Keep Workers Healthy and Productive

Policy Shifts on Work Environment, Health Promotion, Continued Research Needed to Maintain Healthy U.S. Workforce

A report of conference presentations and discussions among participants from the National Academies of Science, universities and research institutions, and representatives of professional associations, industry and labor, recommends attention to workplace environments to maintain “work ability” as workers age, along with legislative fixes and research to fill in knowledge gaps for keeping workers healthy and productive.

According to researchers using U.S. Bureau of Labor Statistics (BLS) data, older workers are more severely injured and die with greater frequency from work-related injuries than younger workers. Older workers also have longer recovery periods than younger workers. These findings raise health care delivery and economic issues for the nation, as more workers are choosing to delay retirement due to collapsed 401(k) plans and savings. BLS uses workers age 55 and older in its calculations, although the rates rise sharply for those workers over age 65. Other agencies and organizations define the term as age 50 or 55 and up. The Department of Labor uses age 40 as a starting point for “older worker.”

“The issue of healthy aging is critically important as the U.S. economy is revitalized. As we go forward in time, the demand for workers will grow but fewer workers will be entering the workforce and a larger proportion of the workforce will be older. This is a simple reality of demographics,” said National Institute for Occupational Safety and Health (NIOSH) Director John Howard, M.D. “Having a healthy, productive workforce will help sustain economic growth in the decades ahead. We must take steps now to help all workers stay safe and healthy at work as they age. We must also take steps to address the special needs of older workers who, more and more, will be staying on the job past traditional retirement age.”

The conference, held Feb. 17-18, 2009, at the National Labor College in Silver Spring, Md., paid particular attention to workers in physically demanding jobs, such as construction and health care. Health care cost-containment has meant longer work hours and increased stress among health care workers, which has led to a shortage of nurses. Thirty-nine percent of RNs were 45 years or older in 2002.

Construction workers already suffer the highest number of fatalities in any U.S. industry.  But the death rate among construction workers 55 years and older was nearly 80% higher than that of construction workers under 35 in 2007. And like the rest of the workforce, the average age of a construction worker is rising; it was 40.4 in 2008, which is 4.4 years older than in 1985. The average retirement age among construction workers is 61.

“Our nation loses an average of four construction workers every workday to a job-related incident – and that’s been consistent for more than a decade,” said Pete Stafford, executive director of CPWR – The Center for Construction Research and Training, one of the conference’s co-sponsors. “As we start to rebuild our nation’s crumbling infrastructure and venture into green jobs, we want to make sure jobsites do not become a source of pain and death for older workers who have so much to contribute, especially in mentoring younger workers.”

Howard believes the conference confirms and expands on a 2004 report from the National Academies of Science that recognized the deteriorating conditions facing an aging workforce, to the detriment of workers, their families, and businesses. “Health and Safety Needs of Older Workers” made clear recommendations to increase research efforts toward preventing work-related injury, illness and fatality among aging workers.   These recommendations have yet to be adopted.

“The discussions and recommendations from the conference point to steps that can be taken to address needs identified in the 2004 report  that were never acted upon,” said Jordan Barab, acting Assistant Secretary of Labor for  the Occupational Safety and Health Administration (OSHA). “As those discussions make clear, a sustainable workforce will be a critical component of a secure and prosperous 21st century economy. The work we do now is an investment in a stronger workforce for tomorrow.”

The Healthy Aging for Workers conference was funded through grants from NIOSH and CPWR. The Association of Occupational and Environmental Clinics and the Society for Occupational and Environmental Health were conference sponsors. Additional co-sponsors were AARP, OSHA, the American Public Health Association, the Veterans Administration, and the University of Maryland Work and Health Research Center.

The full conference report and presentations from national and international researchers on occupational health and safety issues can be found on the Society for Occupational and Environmental Health’s Web site.

Nonfatal workplace injuries and illnesses among private industry employers in 2008 occurred at a rate of 3.9 cases per 100 equivalent full-time workers — a decline from 4.2 cases in 2007, the Bureau of Labor Statistics reported Oct. 29th. Similarly, the number of nonfatal occupational injuries and illnesses reported in 2008 declined to 3.7 million cases, compared to 4 million cases in 2007. The total recordable case (TRC) injury and illness incidence rate among private industry employers has declined significantly each year since 2003, when estimates from the Survey of Occupational Injuries and Illnesses (SOII) were first published using the 2002 North American Industry Classification System (NAICS).

National public sector estimates covering nearly 19 million State and local government workers — for example, police protection and fire protection — are available for the first time from the SOII for reference year 2008.  Nonfatal workplace injuries and illnesses among state and local government workers combined occurred at a higher rate (6.3 cases per 100 full-time workers) than among private industry workers in 2008.

Key findings of the 2008 Survey of Occupational Injuries and Illnesses:

• Incidence rates for injuries and illnesses combined among private industry establishments declined significantly in 2008 for all case types, with the exception of job transfer or restriction cases whose rate remained unchanged from 2007.  The number of cases of injuries and illnesses combined declined significantly in 2008 for all case types.
• For injuries only, both the incidence rate and the number of cases in private industry establishments declined significantly in 2008 compared to 2007 — each falling 8 percent from the year earlier.
• Looking at illnesses, both the incidence rate and the number of cases declined significantly in 2008 compared to 2007 — mainly the result of a decline among the ‘All other illnesses’ category, which accounted for nearly 84 percent of the decline in illness cases among private industry establishments.
• Manufacturing was the only private industry sector in 2008 in which the rate of job transfer or restriction cases exceeded the rate of cases with days away from work, continuing an 11 year trend.
• The total recordable case injury and illness incidence rate was highest in 2008 among mid-size private industry establishments (those employing between 50 and 249 workers) and lowest among small establishments (those employing fewer than 11 workers) compared to establishments of other sizes.

Slightly more than one-half of the 3.7 million private industry injury and illnesses cases reported nationally in 2008 were of a more serious nature that involved days away from work, job transfer, or restriction — commonly referred to as DART cases.  These occurred at a rate of 2.0 cases per 100 workers, declining from 2.1 cases in 2007.   Among the two components of DART cases, the rate of cases involving days away from work fell from 1.2 to 1.1 cases per 100 workers, while the rate for cases resulting in job transfer or restriction remained unchanged at 0.9 cases in 2008. Other recordable cases — those not involving days away from work, job transfer, or restriction–accounted for the remaining injury and illness cases nationally and occurred at a lower rate in 2008 (1.9 cases per 100 workers) compared to 2007 (2.1 cases per 100 workers).

Private Industry Injuries and Illnesses

Injuries. Approximately 3.5 million (94.9 percent) of the 3.7 million nonfatal occupational injuries and illnesses in 2008 were injuries — of which 2.5 million (71.2 percent) occurred in service-providing industries, which employed 80.1 percent of the private industry workforce covered by this survey.  The remaining 1.0 million injuries (28.8 percent) occurred in goods-producing industries, which accounted for 19.9 percent of private industry employment in 2008.

Illnesses. Workplace illnesses accounted for slightly more than 5 percent of the 3.7 million injury and illness cases in 2008. Private industry employers reported 18,900 fewer illness cases in 2008 — down to 187,400 cases compared to 206,300 in 2007. This resulted in a decline in the rate of workplace illnesses in 2008 from 21.8 to 19.7 cases per 10,000 full-time workers.

Goods-producing industries as a whole accounted for approximately 38 percent of all occupational illness cases and were responsible for more than two-thirds of the decline in illnesses reported among private industry workplaces in 2008. Consequently, both the number and rate of illnesses declined significantly for goods-producing industries as a whole in 2008. The manufacturing sector accounted for 31.5 percent of all occupational illnesses cases and reported 12,000 fewer illnesses in 2008 compared to 2007. Both the number and rate of illness cases among service-providing industries as a whole remained statistically unchanged in 2008, compared to 2007.

National Public Sector Estimates

National public sector estimates covering nearly 19 million State and local government workers — for example, Police protection (NAICS 922120) and Fire protection (NAICS 922160) — are available from the SOII for the first time for 2008.

Nearly 940,000 injury and illness cases were reported among State and local government workers combined in 2008, resulting in a rate of 6.3 cases per 100 workers — significantly higher than the rate among private industry workers (3.9 cases per 100 workers). Approximately 4 in 5 injuries and illnesses reported in the public sector occurred among local government workers, resulting in an injury and illness rate of 7.0 cases per 100 workers — significantly higher than the 4.7 cases per 100 workers in State government.

In addition to the industry-level estimates available for the first time with this release, more detailed national public sector estimates will be available in the future covering case and worker demographics for cases that involved days away from work.

The risk of influenza to healthcare workers is not a new concern, but the ongoing experience with novel influenza A (nH1N1) makes this issue even more urgent. Among the many considerations for the health and well-being of healthcare workers is the question about what types of personal protective equipment (PPE) (respiratory protection, gloves, gowns, eye protection, and other equipment) are needed to protect these frontline workers. PPE needs to be regarded one part of a set of infection control strategies to reduce the potential for infection in healthcare workers. At the request of the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA) the Institute of Medicine convened the Committee on Respiratory Protection for Healthcare Workers in the Workplace Against Novel H1N1 Influenza A to provide recommendations regarding the necessary respiratory protection for healthcare workers in their workplace against novel H1N1 influenza A.

RESPIRATORY PROTECTION

The committee focused solely on the scientific and empirical evidence regarding the efficacy of various types of personal respiratory protective equipment (e.g., medical masks and respirators). Studies on influenza transmission show that airborne (inhalation) transmission is one of the potential routes of transmission. N95 respirators are documented to filter out 95 to 99 percent of relevant particles and have maximum effectiveness when properly fitted to the face of users. Research results on the filtration and fit of medical masks show wide variation in penetration of aerosol particles and inadequate fit suggesting that the use of medical masks is unlikely to be effective against airborne transmission.

Recommendationation 1: Use Fit -Teste d N95 Respirators espirators

Healthcare workers (including those in non-hospital settings) who are in close contact with individuals with nH1N1 influenza or influenza-like illnesses should use fit-tested N95 respirators or respirators that are demonstrably more effective as one measure in the continuum of safety and infection control efforts to reduce the risk of infection.

• The committee endorses the current CDC guidelines and recommends that these guidelines should be continued until or unless further evidence can be provided to the effect that other forms of protection or other guidelines are equally or more effective.

• Employers should ensure that the use and fit testing of N95 respirators be conducted in accordance with OSHA regulations, and healthcare workers should use the equipment as required by regulations and employer policies.

It is important to note that controversy exists regarding clinical guideline decision making as many factors besides efficacy may affect policy decisions for PPE guidance including economics, equipment supplies, vaccine availability, immunization status, extent of worker compliance, and logistical considerations in the implementation of such guidance. The committee was not charged to address these other issues.

AUGUST 19, 2009

CDC is releasing new guidance that recommends actions that non-healthcare employers should take now to decrease the spread of seasonal flu and 2009 H1N1 flu in the workplace and to help maintain business continuity during the 2009–2010 flu season. The guidance includes additional strategies to use if flu conditions become more severe and some new recommendations regarding when a worker who is ill with influenza may return to work. The guidance in this document may change as additional information about the severity of the 2009-2010 influenza season and the impact of 2009 H1N1 influenza become known. Please check www.flu.gov periodically for updated guidance

Introduction

The U.S. Department of Health and Human Services’ (HHS) Centers for Disease Control and Prevention (CDC), with input from the U.S. Department of Homeland Security (DHS), has developed updated guidance for employers of all sizes to use as they develop or review and update plans to respond to 2009 H1N1 influenza now and during the upcoming fall and winter influenza season. Businesses and employers, in general, play a key role in protecting employees’ health and safety, as well as in limiting the negative impact of influenza outbreaks on the individual, the community, and the nation’s economy. Employers who have developed pandemic plans should review and revise their plans in light of the current 2009 H1N1 influenza outbreak to take into account the extent and severity of disease in their community as outlined in this guidance.

Planning for Fall and Winter Influenza Season

Businesses may have already been impacted by the spring and summer outbreaks of 2009 H1N1 influenza affecting their employees. CDC anticipates that more communities may be affected than were in the spring/summer 2009, and/or more severely affected reflecting wider transmission and possibly greater impact. In addition, seasonal influenza viruses may cause illness at the same time as 2009 H1N1 this fall and winter. In response to the anticipated spread of 2009 H1N1 influenza, the CDC has revised its recommendations to assist businesses and other employers of all sizes.

The severity of illness that 2009 H1N1 influenza flu will cause (including hospitalizations and deaths) or the amount of illness that may occur as a result of seasonal influenza during the 2009–2010 influenza season cannot be predicted with a high degree of certainty. Therefore, employers should plan to be able to respond in a flexible way to varying levels of severity and be prepared to refine their pandemic influenza response plans if a potentially more serious outbreak of influenza evolves during the fall and winter. More people and communities are likely to be affected as influenza is more widely transmitted. The CDC and its partners will continuously monitor national and international data on the severity of illness caused by influenza, will disseminate the results of these ongoing surveillance and will make additional recommendations as needed.

FOR THE COMPLETE GUIDE GO TO http://www.flu.gov/plan/workplaceplanning/guidance.html

There is an old saying, “haste makes waste.”  But to safety professionals haste makes incidents.  Today, companies are getting leaner and meaner.  They want more productivity with less expense, meaning less people.   A job that was performed by 3 people, is now done by 2, or maybe 1 person.   As a safety person, this presents new challenges to our job.  Not only does haste make waste, it cause injuries.  To work faster and be more productive you often have to use unsafe work behaviors.

Look around you, how many people are gone?  Are you working more hours and being asked to do more?  Most people are.  Talking to other safety people, we are now starting to see more unsafe work practices and more injuries than previously experienced in the past few years.  Statistics may not show this trend for a couple of years, and one reason is the decline in the number of workers in the workforce.   But just ask a safety manager what they are experiencing, and they will tell you they are seeing more injuries than every before and more serious injuries.

I believe there are 2 main causes of incidents in the current workplace or at home, HASTE (speed) and NOT BEING AWARE OF YOUR SURROUNDINGS.  As we work faster, we tend to think less of our surroundings and more about getting the job done.

When people try to do their job in a hurry, they tend to make mistakes.  Often these mistakes can cause a near miss and at other times it can cause an injury.  Most workers today do not report a near miss, which give us less opportunity to do a root cause analysis.  We have to wait until the near miss becomes an incident. 

We hurry or speed because we are required more things today.  When I teach defensive driving, speed is still the #1 cause of motor vehicle incidents.  Speed also keeps people from focusing on the task at hand.  Remember the I Love Lucy episode where the candy was coming down the conveyor belt?  The candy was coming down at a rate that made it impossible for Lucy and Ethel to pack it properly in the boxes.  Haste not only made waste, but look closely and you will also see possible near misses.

Think of your last few Slip, Trip or Fall incidents.  Our workplace had more than we wanted in the past few months.  Many were caused when someone wanting to get somewhere a little faster.  How about you, Mr./Ms safety professional?   It is finally time to leave work and go home.  What are you concentrating on:
· How fast you get out of the building
· Picking up your kids
· Making that one stop to get dinner
· Meeting someone someplace

 Whatever the case, you are probably not thinking of the ground around you, even if there is sow, ice or an uneven surface, and all of a sudden you slip and fall.
 As I stated above, haste keeps us from not being aware of our surroundings.  At home you need a box off a high shelf, so you pull up a nearby chair and stand on it.  Do you think about how unsafe this act is?  Probably not.  You cutting your lawn wear your flip-flops.  An unsafe act?  Your probably not thinking about this act either.  The company sales rep is trying to place and order and get to the next appointment at the same time.  Do you think they are thinking about their surroundings?  Bet not, until they have an vehicle incident. 

In today’s environment, safety people are dealing with these actions more and more.  What can we do to prevent more incidents?  The message has to start at the top with senior leadership.  While every CEO wants their company to be more efficient and leaner, they cannot proceed to a point where it promotes unsafe behaviors to be more productive.  The CEO must be the leader to make sure everyone is aware that safety is high priority.   The message should state that behaving in an unsafe manner is not acceptable and actually costs the company more when an incident occurs.

Managers and supervisors have to be held accountable that their employees are working safer and smarter.  The workers should understand to report if part of their job creates an unsafe work behavior.  In other words, EVERYONE has to be responsible for having a safe workplace.  Safety people have to make sure that workers are acting in a safe manner.  Slowing down enough to make their job safe and giving the worker an opportunity to focus on being aware of their surrounding.  Through training, reminders and other forms of communication, the message must be constant and often.

Hopefully as workers slow down and become more aware of their surroundings, we can eliminate the phase HASTE MAKES WASTE and replace it with SLOW, STEADY AND SAFE MAKES YOU MORE PRODUCTIVE.