“Injury and illness prevention programs are a better approach than safety incentive programs,” said OSHA Assistant Secretary David Michaels in his American Society of Safety Engineers webinar in May. “Already, workers have lots of incentives to work safely. We don’t need incentives. We need strong safety and health programs.”

Given this perspective, OSHA’s accelerated effort to adopt an Injury and Illness Prevention Program (I2P2) standard makes sense. Once adopted, the standard would require all U.S. employers to have company I2P2s, something that, incredibly, is not required under current regulations. Michaels said he wants the standard in place within three years, a lightning pace if judged by OSHA’s past standard adoption performance.

Through its effort to require injury and illness prevention programs at all work sites, OSHA hopes to bring much added focus to the question of what constitutes an effective safety and health program. The basic purpose of an I2P2 is identification and assessment of hazards and the institution of prevention measures. Good data collection is one aspect; so is worker involvement and top-management attention. Training is also critical.

“Safe work is more important than reporting,” said Michaels, who stressed that employers’ drive for low, reported injury and illness rates has corrupted the data and masked the extent of the nation’s workplace safety and health problems. “We want programs that reward workers for working safely, identifying hazards and abating them. A good I2P2 is a better approach than an incentive program.”

During June, OSHA convened three sessions to receive public comment on its proposed I2P2 standard. The LHSFNA participated and is working with the Building and Construction Trades Department of the AFL-CIO to develop an I2P2 rule specific to the construction industry. Eventually, the key components of a solid safety program will be codified in the new standard.

Michaels also urged companies to use government safety consultation services that are provided at the state level, and he praised Voluntary Protection Program (VPP) companies that strongly pursue safety programs and safe workplaces. He advised all companies to develop I2P2s and to engage their workers and supervisors in the process.

The LHSFNA’s Occupational Health and Safety Division provides support to LIUNA signatory employers who want help developing company- and site-specific safety programs. It can be reached at 202-628-5465

OSHA defines I2P2 programs as management systems that are designed to help employers reduce workplace injuries and illnesses “through a systematic process that proactively addresses workplace safety and health hazards.” In 1989, OSHA implemented an I2P2 program that encouraged employers to voluntarily implement a safety and health protocol and programs. During the Clinton administration, OSHA attempted to promulgate a regulatory requirement that employers implement I2P2 programs, but the effort stalled due to opposition from employers. OSHA dropped the effort from its agenda in 2002, but the Obama administration has indicated that an I2P2 rule is a high priority. Current OSHA Assistant Secretary David Michaels has spoken frequently of his determination to implement a final rule on I2P2 in the near future.

Stakeholders at the June 29 meeting discussed four general topic areas: possible regulatory approaches, the scope and application of the rule, organization of the rule, and the economic impacts of the rule. Organized labor was bullish on the notion of implementing an I2P2 requirement, while employers were mostly opposed to a new mandate. In general, employers expressed concern over requiring firms to implement an I2P2 system rather than relying upon a voluntary system. Small business representatives were particularly vocal about the burden of an I2P2 requirement and urged that any such rule permit flexibility or carve out exemptions based upon size or injury rate. Additionally, many employers requested that an I2P2 rule should consider employees’ behavior and overall wellness and the impact of those factors on risk and injury. During the meeting, a recommendation was made that the proposed rule contain a section on employee duties to complement the employer duties. Finally, employers in attendance urged OSHA to ensure that any I2P2 regulation would not be overly prescriptive and that it address only those areas of workplace safety that have been proven quantitatively to benefit from specific health and safety management protocols.

Several steps remain before an I2P2 rule could be finalized; indeed, a proposed rule has not even been drafted. The June 29 meeting marked the third of five I2P2 stakeholder meetings scheduled for 2010; previous meetings took place on June 3 in East Brunswick, N.J., and on June 10 in Dallas, Tex. The remaining meetings will be held on July 20 in Washington, D.C., and on August 3 in Sacramento, Calif.

Once the stakeholder meetings have been completed, OSHA must proceed through the regular rulemaking process, which involves drafting a proposed rule, publishing it in the Federal Register, permitting public comment, and responding to public comment before a Final Rule is issued. Since the regulation impacts small businesses, OSHA must include one additional step as part of the review process: In coordination with the Small Business Administration (SBA), OSHA must also establish a Small Business Regulatory Enforcement Fairness Act (SBREFA) panel that includes small business representatives impacted by the proposed rule. The panel will review the regulatory language and preliminary government analysis of the regulation’s impact before producing a report that will be published along with the rule. SBREFA also requires that all rules reviewed by a panel are subject to Congressional review.

OSHA requires you to train employees to prevent lockout/tagout (LO/TO) accidents in the workplace (1910.147). This standard covers the servicing and maintenance of machines and equipment in which the unexpected energization or start up of the machines or equipment, or release of stored energy could cause injury to employees. This standard establishes minimum performance requirements for the control of such hazardous energy.

Employees must be trained in accordance with 1910.147(c)(7) . Here are 5 areas which are considered a must part of any Lockout/Tagout training program.

1. Failure to stop equipment. Sure, this sounds like common sense, but there’s much more involved. Some workers value productivity above safety and others feel that their age or experience with equipment make them immune from risk. “Taking the trouble” to properly safeguard energized equipment is essential in all cases.

2. Failure to disconnect from the power source. When working with and around electric equipment, some workers believe that simply operating the on/off switch will ensure their safety. They ignore the fact that the switch may be defective or that power may find its way through a short circuit or other source.

3. Failure to drain residual energy. There’s a reason that televisions carry warnings about trying to open the case even if the set is disconnected. That’s because many electrical devices store power in a capacitor or battery. Even unplugged, the risk remains. A compressed spring, hot pipe, pressurized tank, or heavy object hanging overhead can store energy even when the initial source of power is disconnected.

4. Accidental restart of machinery. Even if an employee knows how to shut down equipment before working on it, his or her co-workers may not. In too many instances, unknowing employees cause injury to their co-workers.

5. Failure to clear work areas before restarting. Restarting machinery must be performed as carefully as shutting it down and locking it out. A repair tool left in the works can fly out, or a restart while a co-worker remains in the path of danger represents as great a hazard as not locking out the machine at all.

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.

What is VPP?

The Voluntary Protection Programs (VPP) promote effective worksite-based safety and health. In the VPP, management, labor, and OSHA establish cooperative relationships at workplaces that have implemented a comprehensive safety and health management system. Approval into VPP is OSHA’s official recognition of the outstanding efforts of employers and employees who have achieved exemplary occupational safety and health.

What Is the Authority for VPP?

The legislative underpinning for VPP is Section (2)(b)(1) of the Occupational Safety and Health Act of 1970, which declares the Congress’s intent “to assure so far as possible every working man and woman in the Nation safe and healthful working conditions and to preserve our human resources - (1) by encouraging employers and employees in their efforts to reduce the number of occupational safety and health hazards at their places of employment, and to stimulate employers and employees to institute new and to perfect existing programs for providing safe and healthful working conditions.”

How Does VPP Work?

In practice, VPP sets performance-based criteria for a managed safety and health system, invites sites to apply, and then assesses applicants against these criteria. OSHA’s verification includes an application review and a rigorous onsite evaluation by a team of OSHA safety and health experts.

OSHA approves qualified sites to one of three programs:

• Star
• Merit
• Star Demonstration: Recognition for worksites that address unique safety and health issues.
  Sites that make the grade must submit annual self-evaluations and undergo periodic onsite reevaluations to remain in the programs.

When Did VPP Begin?

• 1979 - California began experimental program
• 1982 - OSHA formally announced the VPP and approved the first site.
• 1998 - Federal worksites became eligible for VPP.

How Has VPP Improved Worker Safety & Health?

Statistical evidence for VPP’s success is impressive. The average VPP worksite has a Days Away Restricted or Transferred (DART) case rate of 52% below the average for its industry⁽¹⁾. These sites typically do not start out with such low rates. Reductions in injuries and illnesses begin when the site commits to the VPP approach to safety and health management and the challenging VPP application process.

How Does VPP Benefit Employers?

Fewer injuries and illnesses mean greater profits as workers’ compensation premiums and other costs plummet. Entire industries benefit as VPP sites evolve into models of excellence and influence practices industry-wide.

How Does VPP Benefit OSHA?

OSHA gains a corps of ambassadors enthusiastically spreading the message of safety and health system management. These partners also provide OSHA with valuable input and augment its limited resources.

Another benefit to OSHA is a safety and health advocacy group that came into existence as a result of the VPP, the Voluntary Protection Program Participants’ Association (VPPPA). The VPPPA is a nonprofit organization founded in 1985. As part of its efforts to share the benefits of cooperative programs, the VPPPA works closely with OSHA and State Plan States in the development and implementation of cooperative programs. The VPPPA also provides expertise to these groups in the form of comments and stakeholder feedback on agency rulemaking and policies. Additionally, the Association provides comments and testimony to members of Congress regarding legislative bills on health and safety issues.

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.

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.

In general, health care management emphasizes the prevention of impairment and disability through early detection, prompt treatment, and timely recovery. Medical management responsibilities fall on employers, employees, and health care professionals (HCPs). A medical management program can help to either eliminate or substantially reduce the risk of development of ergonomics-related problems and symptoms through early identification and treatment.

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