worker health

Worth reading: Unequal risk and hospital infections

lborkowski — Mon, 13 Jul 2015 17:08:14 +0000

Worth reading: Unequal risk and hospital infections

A few of the recent pieces I've liked:

The excellent "Unequal Risk" series by the Center for Public Integrity's Jim Morris, Jamie Smith Hopkins, and Maryam Jameel ("Workers in America face risks from toxic exposures that would be considered unacceptable outside the job — and in many cases are perfectly legal.")

Sarah Kliff at Vox: Do no harm ("There's an infection hospitals can nearly always prevent. Why don't they?")

Ta-Nehisi Coates in The Atlantic: Letter to My Son ("Here is what I would like for you to know: In America, it is traditional to destroy the black body -- it is heritage.")

Charles Ornstein at ProPublica: Transparency Program Obscures Pharma Payments to Nurses, Physician Assistants

Anna Diamond at Slate: The EACH Woman Act is Reasonable, Necessary, and Doesn't Have Much of a Chance

And if you haven't seen it, Maryn McKenna's TED Talk "What do we do when antibiotics don't work anymore?" is well worth checking out.

lborkowski Mon, 07/13/2015 - 13:08

Tags

Public Health - General

EACH Woman Act

hospital infections

pharmaceutical marketing

racism

Toxics

worker health

Sequestration claims another public health program: The Adult Blood Lead Epidemiology and Surveillance program

kkrisberg — Fri, 19 Jul 2013 13:50:55 +0000

Sequestration claims another public health program: The Adult Blood Lead Epidemiology and Surveillance program

When I asked Teresa Schnorr why we should be worried about the loss of a little-known occupational health data gathering program, she quoted a popular saying in the field of surveillance: "What gets counted, gets done."

Schnorr, who serves as director of the Division of Surveillance, Hazard Evaluations and Field Studies at CDC's National Institute for Occupational Safety and Health (NIOSH), was referring to the Adult Blood Lead Epidemiology and Surveillance program (ABLES), a state-based effort that collects and analyzes data on adult lead exposure. For more than two decades, NIOSH has been partnering with states to collect such data, which guides local health officials in shaping effective outreach and prevention strategies and helps pinpoint workplaces in need of regulatory intervention. According to the latest CDC data, the prevalence of elevated blood lead levels among adults — which are work-related in 95 percent of cases — declined from 14 per 100,000 employed adults in 1994 to about 6 per 100,000 in 2009.

Unfortunately, those gains could now be in jeopardy. As of August and due to sequestration, there will be no more federal funding for ABLES, Schnorr told me. What that means for the 40 states that receive federal ABLES funds will vary according to each state's budget and funding constraints; however, many states do depend on the NIOSH funds to keep the program afloat. As of 2010, more than 31,000 U.S. adults had blood lead levels higher than 10 micrograms per deciliter, the recently updated definition of elevated blood lead level. Lead exposure can result in cognitive dysfunction, adverse reproductive outcomes, and cardiovascular and kidney damage, with both acute and chronic health effects.

"Obviously, we're saddened that we're losing the opportunity to continue to track this...we're now looking at other alternatives to address occupational lead exposure, but at this point it's unclear what those might be," Schnorr said. "We're all still sorting it out and we're hopeful that we can do something so we can continue to track what's happening with lead."

ABLES is one of those relatively inexpensive public health programs with the potential to yield significant health outcomes and reduce medical expenditures. NIOSH provided a total of $812,500 to 40 state ABLES programs annually, with each state receiving funds based on its needs. Schnorr said it wasn't much, but it was enough to allow states to conduct follow-up and build their occupational health capacity. In fact she said for many state health departments, ABLES was the primary occupational health activity.

In Pennsylvania, federal ABLES funds meant that until very recently the state health department had one staff person dedicated to the effort who could do follow-up and intervention into lead exposure cases. But with the sequestration-mandated cut, there's only enough money for one part-time staff person — and that position may only last for the next one to two years, said James Logue, director of the Division of Environmental Health Epidemiology at the Pennsylvania Department of Health.

"But when that money is gone, I don't know what the future will bring," Logue told me.

Pennsylvania's been involved in ABLES since 1992, and Logue described it as a "priority program in environmental health." He said the state is a leader in adult blood lead level testing, with about 20,000 tests conducted every year that yield about 1,000 new cases of potentially hazardous blood lead levels. Pennsylvania workers particularly at risk of lead exposure include those in the battery manufacturing industry, smelters and construction workers. (According to NIOSH, occupational lead exposure mainly occurs among battery manufacturing, lead and zinc ore mining, and painting and paper hanging.)

Like many state ABLES program, Logue said Pennsylvania's effort works closely with the health department's childhood lead poisoning program as well as with OSHA — "we're the advisors, but the real regulatory group here is OSHA. So it's possible that if we do see an unusual trend in a group of workers, part of the intervention could be alerting OSHA," he noted.

"But if you don't have the program to follow these trends...it can have a serious impact on public health," Logue said. "This is a national situation and it's not good in terms of follow-up on adult excess elevated blood lead levels. I don't know how the states will continue to do it."

Rick Rabin called the ABLES data "invaluable." For about 20 years, Rabin served as the Lead Registry coordinator with the Massachusetts Division of Occupational Safety. He told me that he and his colleagues used ABLES data to conduct follow-up with workers and employers and to help companies reduce their lead exposure risks. Over the years, he noted, the state saw declines in adult blood lead levels among construction workers and particularly among larger construction companies. (Unfortunately, he said due to minimal OSHA enforcement measures, the same declines didn't appear among residential painters.)

"The research over the last 20 years shows that lead is harmful at just about any level we can measure and not just for kids, but for adults as well," said Rabin, who now works as a trainer and technical consultant at the Massachusetts Coalition for Occupational Safety and Health. "It's real bad news."

Rabin said he suspects that without ABLES funding and the data collection it facilitated, it will get much harder to enforce safe workplace standards.

"I would expect that OSHA and other programs that assist workers, particularly those in construction, are going to be much less able to target companies and industries that have high lead exposure," he said. "That might not happen immediately because we have good data for now...but an immediate problem would be if a company is poisoning workers now or next year nobody will know about it."

Sharon Watkins, a member of the Council of State and Territorial Epidemiologists' Executive Board and the organization's lead on occupational health, injury and environmental health, said she's also worried that lead exposure-related referrals to OSHA will decrease in some states or disappear all together. She told me that for many states, federal ABLES money is the only source of funding for adult blood lead surveillance.

And while occupational lead exposure doesn't come with the morbidity and mortality of other workplace hazards, such as falls and motor vehicle crashes, Watkins noted that "it's entirely preventable."

"I think (ABLES) has been critical," said Watkins, who also serves as chief of the Bureau of Epidemiology at the Florida Department of Health. "It started more than 20 years ago to fill a gap and over the years it's grown to include most states and is generating reliable and consistent data. I think the program has strengthened what states are able to do, has initiated interventions and has really affected worker health."

In Florida, federal ABLES funding meant the state could dedicate one part-time worker to the effort, Watkins said. Without the funding, she said it'll be a struggle to continue.

"When we're not consistently looking at the data, it's hard to say what the true numbers are or what the trend is," Watkins told me. "There's always emerging industries and as we grow our manufacturing sector in the U.S. new things are always popping up, so I don't think we should just breathe a sigh of relief and think that the days of adult blood lead poisoning are over."

To learn more about the ABLES program and its impact on worker health, visit NIOSH.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.

kkrisberg Fri, 07/19/2013 - 09:50

Tags

Occupational Health & Safety

OSHA

Public Health - General

regulation

Research

safety

adult blood lead levels

You know the expression "What's Cheap is Expensive?" This is a cost-cutting measure that will reap costs vastly in excess of savings, by any reasonable cost-benefit assessment. But applying a values assessment to this action should result in a recognition of truly tragic developments in our national priorities.

New study sheds light on the health effects of job insecurity

lborkowski — Fri, 28 Sep 2012 10:21:01 +0000

New study sheds light on the health effects of job insecurity

by Kim Krisberg

It's not news that unemployment is bad for a person's health. But it turns out that just the threat of unemployment is bad as well.

A recent study, published in the September issue of the Journal of Occupational and Environmental Medicine, found that perceived job insecurity is also linked to poor health outcomes, even among those who had jobs during the recession. Researchers found that perceived job insecurity was linked with "significantly higher odds" of fair or poor self-reported health as well as recent symptoms suggesting depression and anxiety attacks. The findings persisted even after researchers adjusted for sociodemographic characteristics, previous health problems, whether a person was a temporary worker and recent job loss.

"It's an invisible problem — these people might not look like they need help," Sarah Burgard, a professor at the University of Michigan and co-author of the study along with Lucie Kalousova and Kristin Seefeldt, told me. "It's a growing problem in the United States over the last several decades because a lot of job creation has been in insecure jobs and jobs without benefits. It's hard to care about people who are still employed when you're in a recession."

Based on data from about 440 adults older than 25 working in southeastern Michigan in 2009–2010, the study found that about 17.5 percent felt their employment situation was insecure — in other words, they felt they'd lose their job or get laid off in the next year (workers were asked to rate the chance of losing their jobs as very likely, fairly likely, not too likely or leaving the labor force). About 19 percent of these job-insecure respondents reported fair or poor health; only about 7 percent of job-secure respondents reported similar health statuses. More than 40 percent of job-insecure respondents reported symptoms of depression and 30 percent reported an anxiety attack in the previous month, versus about 7 percent and 10 percent, respectively, of those not reporting job insecurity. Those reporting that they were fairly or very likely to lose their jobs were more likely to be black, have a chronic illness, be a temporary worker, have experienced recent unemployment and were less likely to have a college degree.

The study also notes this interesting comparison: While this recent study found that almost 18 percent of 25- to 64-year-old workers in southeastern Michigan were insecure, a 2007 study found that between 1977 and 2002, only about 11 percent of respondents in a nationwide survey perceived job insecurity, "suggesting that insecurity is elevated in the postrecession period."

"A worker perceiving job insecurity may experience stress due to anticipation about the problems associated with a job loss, the mental strain of being in a powerless position and ambiguity about the future," the study stated. "This research has become increasingly salient in the wake of the Great Recession that began in December 2007; historically high unemployment rates followed by an unusually slow and 'jobless' economic recovery may have population health consequences."

No easy answers for job insecurity

Burgard told me that workers who persistently and chronically experience job insecurity are sometimes, in fact, in worse health than the unemployed — "even though it's really terrible to lose a job, it ends the serious gnawing and uncertainty about it." And the impact of unemployment and diminished assets, though hardly an ideal situation, can be tempered through a variety of assistance programs. Addressing the health risks of job insecurity, however, is much less clear and straightforward.

Many readers of this study might think unions are the answer — and there's no doubt that collective bargaining has improved worker status and conditions and empowered workers with a sense that they too have a say in their futures. But while Burgard agrees that "unions are designed to help with these type of matters," they've also experienced sizable setbacks, old union jobs are disappearing and new jobs aren't likely union jobs. The balance of power "between unions and corporations and businesses has shifted shockingly in a way that doesn't benefit unions," she said.

"We have enough trouble trying to help people who've actually lost their jobs, so I've never heard about an intervention program (that addresses the health effects of job insecurity)," Burgard said. "In the larger scope of things, it's hard to convince people to address this...but this is a growing and more common problem in the workplace."

Burgard stressed that it's not really a problem that can be effectively addressed case by case — "people often hear 'don't blame yourself' or 'don't worry,' but that's not a lot comfort to people with families to support...it puts all of the work and blame on the individual, who is usually in a situation they have no control over."

"As a social scientist, we want people to think about this as a policy problem," she told me. "Telling people to take better care of themselves...that won't solve anything. This is a structural issue."

So, what exactly to do? Of course, it would be helpful if employers could provide more information so that workers can plan ahead, "exercise a bit of agency," she said. And workers who have job benefits that could help them cope with such stress should take advantage of them, she advised. But unfortunately, at the end of the day, "there aren't a lot of great (current) options," Burgard said.

"At least, I hope more people pay attention to this as a potential risk factor," she said, noting that it's an issue health care providers should ideally be aware of when treating people with stress-related problems. "It's important to put on people's radar, to have a conversation about it and see if any practical steps can be taken. It's really about recognition more than anything else."

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for the last decade.

lborkowski Fri, 09/28/2012 - 06:21

Tags

labor rights

mental health

Occupational Health & Safety

Public Health - General

Since I live in DC, I know a lot of federal employees are in their own special category of job insecurity -- they know they're likely to still have a job, but fear being shifted to a paper-pushing position if their office falls victim to budget cuts. They're not as badly off as workers who fear being left entirely without a paycheck, of course, but it's still got to be stressful. I'm guessing that Congress's game of sequestration chicken is contributing to a lot of health problems among federal workers.

Was there any test to determine whether this is a chicken or an egg situation? Or the extent to which it might be. Eg Does chronic ill health cause a respondent to think their job is insecure or does job insecurity cause chronic ill health?

Hi Sou, Great question. The study notes: "Pre-existing health problems could increase perceptions of job insecurity or select respondents into insecure jobs and also predict subsequent poor health." In response, the researchers created a measure of chronic health conditions diagnosed at least three years prior to the study interview "to address the possibility that earlier health status influenced perceptions of job insecurity or limited individuals to jobs that were insecure." Here's another study Burgard conducted on job security published a couple years ago: midus.wisc.edu/findings/pdfs/701.pdf

Rather more on the topic, including news and resources from across the globe, here: www.hazards.org/insecure

Rory-
The website you posted is fascinating. I would like to clarify a difference in definitions here. Who the website seems to reference as "insecure workers", are temps and people doing "precarious" work. The people in Burgard's study are full-time workers with permanent jobs, who are simply worried about loosing their jobs, that, in my mind, makes her results even more striking.

Job Insecurity, Anxiety, or Grief?

In 2003, the Wall Street Journal published the results of our Grief Index, in which we established a minimum of $75 billion annual loss to US businesses based on the impact of grief and unresolved grief in the workplace.

Needless to say, the annual amount of loss is significantly higher now, nearly 10 years later.

Here’s a link to a short, but excellent article about the Grief Index: http://suite101.com/article/the-impact-of-grief-and-loss-on-the-workpla…

If you’d like a complimentary copy of the Index, send me an email request at: rfriedman@griefrecoverymethod.com

I have worked as a union carpenter.in spite of the union the workplace was very stressful.I think fine home building cited carpentry as very low in job satisfaction,just below garbage collector.I think that the 800 pound gorilla in the room is that we need to begin to seriously question the entire way we structure our lives in this society.This cannot be achieved thru violent revolution.It has been my experience that the unions as they were were inadequate to this task.WE face some serious resource constraints in this world,and the status quo will not believe it"Anybody who thinks exponential economic growth can continue forever on a finite planet is either a madman or an economist"Well the unions believe in endless growth as job providers.It(endless growth)has never been achieved,and never will be.Yet both right wing corporate bosses,and union bosses continue to believe in this fantasy.What we need is an honest discussion that is REALITY based.It is unlikely to happen.I think Mother Nature is just going to correct,whether we like it or not

The Hands that Feed Us: Most food industry workers earn low or poverty-level wages

lborkowski — Wed, 29 Aug 2012 11:16:00 +0000

The Hands that Feed Us: Most food industry workers earn low or poverty-level wages

by Elizabeth Grossman

What industry employs approximately 20 million Americans, or one out of five US private-sector workers, but whose median wage has workers taking home less than $20,000 a year? Clue: It’s the same industry in which it’s actually legal to pay $2.13 an hour, for workers who qualify as “tipped” employees. Answer: The food service industry, which includes agricultural and farmworkers, food processing and slaughterhouse employees, as well as those working in food distribution, retail, restaurants, and other food service businesses.

In a survey for a report released earlier this summer, the Food Chain Workers Alliance – a coalition of non-governmental organizations advocating on behalf of these workers – found that 86 percent of the workers surveyed earned low or poverty wages, with many earning the bare federal minimum of about $15,080 a year. Only 17 percent of these workers receive health insurance through their employers, and 58 percent were without any healthcare coverage. Wages in this industry are so low that, according to the Bureau of Labor Statistics, workers in the food service industry use food stamps at twice the rate of Americans employed elsewhere.

A large proportion of food industry workers, whether farm, slaughterhouse, food-processing or restaurant workers, also suffer from inadequate health and safety training and inadequate policies and/or practices regarding job-related illness and injury. Many also work extended hours that go beyond 40 and in some cases 60 hours a week. More than 40 percent of the workers surveyed worked for two or more employers each week. More than half the workers surveyed by the Food Chain Workers Alliance also reported picking, processing, selling, cooking, and serving food while sick, an average of at least three days per year. Almost two-thirds of these workers said they did this because they lacked paid sick days; 43 percent said they thought they’d lose their job if they stayed home.

In some segments of the food industry, piece-work is still common. One farm worker reported being paid $20 for each box filled with cucumbers – but that $20 had to be split with the entire work team of 18 people. Workers in retail food distribution, including one Wal-Mart warehouse worker, also reported being paid by the piece – often by number of boxes moved. Across the industry, workers reported inadequate lunch and break times and ethnic discrimination.

Wage theft is also common: More than one-third of the workers surveyed reported problems with being paid properly for the previous week, by not being paid for all hours worked, not receiving overtime payments, or not receiving their share of tips. The Restaurant Opportunities Center, part of the team that produced this new report, has been documenting these wage issues, as Liz Borkowski and Celeste Monforton have reported for The Pump Handle. Almost one-quarter of the workers in the Food Chain Workers Alliance survey said they were not paid the minimum wage. Payment problems are exacerbated throughout the food industry by the recent notable increase in use of temporary and part-time workers.

In 2010, more than 27 percent of all US jobs created were temporary, while staffing at employment agencies specializing in temp jobs accounted for 91 percent of the country’s non-farm job growth between 2009 and 2011. Agricultural jobs have traditionally been seasonal, but the current trend in temporary and part-time hiring also extends to food distribution warehouses and restaurants, particularly fast-food outlets, which in 2012 employed more than 4 million workers, up more than 100,000 since 2011.

Pushing for a higher minimum wage
A great many things need fixing to improve the working conditions and outlook for those in the food industry – including for the many young people and children who are employed throughout the food production and retail supply chain. High on this list – #1 for the Food Chain Workers Alliance – is the need for a living wage, which the federal minimum clearly does not offer. A bill now under consideration by Congress would raise the federal minimum wage from its current $7.25/hour to $10/hour, tie future annual increases to the Consumer Price Index, and increase the federal minimum for tipped employees from $2.13 to $5.50 an hour. Its success, however, is uncertain without bipartisan support, which it currently lacks, and given business groups’ ongoing opposition.

Across the country state Farm Bureaus have been opposing minimum wage increases, arguing that they would harm business and hurt job growth. The National Restaurant Association also firmly opposes any state or federal minimum wage increases, arguing that “Wage mandates are an ineffective way to reduce poverty” and that they prevent hiring and cause staff and work-hour cutbacks. The American Enterprise Institute goes farther, saying that raising the minimum wage would increase poverty, fail to help the unemployed poor who lack jobs, and impact only the “tiny fraction” of people currently paid the minimum wage.

Yet a report just released by the Massachusetts Budget and Policy Center analyzing the state’s job growth over almost two decades shows that increases in the minimum wage have not impeded job growth. The report, which looked at wage and job patterns since 1995, found that while the state’s minimum wage increased six times during that period, “employment growth in industry sectors with high concentrations of minimum wage workers has been more than total employment growth.”

Even during the 2007 to 2009 recession across the six New England states, “states with a larger minimum wage increases actually had smaller drops in employment during this period,” according to the Massachusetts report. New Hampshire, which raised its minimum wage several times during these two years, had the smallest decline in employment of all New England states. Rhode Island, with no minimum wage increases during this time, saw New England’s largest drop in employment. The report acknowledges a variety of factors contributing to these statistics, but also finds that since the end of the most recent recession in 2009, there continues to be no evidence that increasing the minimum wage hinders job growth.

The Massachusetts report also cites academic studies that looked at relationship between minimum wage increases and employment in the restaurant industry – including the fast-food industry – and with regard to teen employment. Both found that increases in minimum wage had no significant effect on employment levels. Similarly, an analysis of small business hiring and minimum wage rates found that “minimum wage increases are unlikely to have a negative economic impact on small businesses in the long term.”

When Congress reconvenes after Labor Day, it’s expected that the minimum wage will be on the agenda. The Food Chain Workers Alliance will be there to make their case.

Elizabeth Grossman is the author of Chasing Molecules: Poisonous Products, Human Health, and the Promise of Green Chemistry, High Tech Trash: Digital Devices, Hidden Toxics, and Human Health, and other books. Her work has appeared in a variety of publications including Scientific American, Salon, The Washington Post, The Nation, Mother Jones, Grist, and the Huffington Post. Chasing Molecules was chosen by Booklist as one of the Top 10 Science & Technology Books of 2009 and won a 2010 Gold Nautilus Award for investigative journalism.

lborkowski Wed, 08/29/2012 - 07:16

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food

Occupational Health & Safety

Occupational Health News Roundup

lborkowski — Fri, 08 Apr 2011 09:46:26 +0000

Occupational Health News Roundup

Last year, psychiatric technician Donna Gross was killed on the job at Napa State Hospital, allegedly by a patient who had a pass that gave him unsupervised access to the grounds. In a two-part series, NPR's Ina Jaffe talks with staff, directors, and patients from two psychiatric hospitals, Napa State Hospital and Atascadero State Hospital, about patient violence.

Both hospitals treat mentally ill patients who arrive through the criminal justice system; Atascadero was designed from the start to treat mentally ill criminal offenders, while Napa had hardly any criminal commitments 20 years ago. Recently, Napa has eliminated the grounds passes like the one Grossman's alleged killer had, and California's Department of Mental Health has called a summit on safety issues at the state's psychiatric hospitals. But a scheduled meeting isn't enough for Napa employees, who recently held a demonstration demanding better safety measures. Jaffe interviewed several workers who were attack, and found statistics demonstrating why these employees are concerned:

According to a report mandated by the federal government, patients at Napa committed 75 physically aggressive acts against staff in a single six-month period ending in early 2009. In the same period one year later, there were nearly four times as many assaults. The report also shows that patient-on-patient aggression more than doubled during that same time.

She also spoke by phone with a patient who told her that the hospital environment isn't therapeutic - he stays in his room for fear of fights with one of the patients who make violence and intimidation the norm.

At Atascadero, the increase in violence seems linked to a 2006 state agreement on treatment plans, which resulted from a civil rights investigation that found abuse and neglect of patients. While Jaffe found some hospital staffers who think the plan has made things better, others are skeptical about its appropriateness for hospitals treating people who've committed violent crimes. One employee who had to quit after being attacked by patient and suffering serious neck damage says it creates security risks because it's led to employees "spending more time on paperwork than you are treating the patient." Several measures spending in California's legislature would address hospital safety.

In other news:

Washington Post: At TEPCO's damaged plant in Fukushima, multiple highly radioactive areas make working conditions dangerous. An outcry greeted a TEPCO statement that the company didn't have enough radiation-monitoring equipment to give each worker a dosimeter, so the company then announced it would slow work so each worker can wear one.

Charleston Gazette: At an international symposium on mining health and safety, recommendations include more effective dust-control measures, comprehensive monitoring for explosive gases, and changes to criminal statutes and investigation procedures.

EHS Today: The Bureau of Labor Statistics has released a report that finds workplace violence has declined over the last 16 years.

New York Times: When new doctors choose jobs, a growing number are opting for positions that require fewer hours of work and less time on call.

Reuters: A study of working arthritis sufferers found that their arthritis-related difficulties at work are periodic rather than constant and can often be alleviated by simple changes in the workplace.

lborkowski Fri, 04/08/2011 - 05:46

Tags

Confined Space @ TPH

Occup Health News Roundup

Occupational Health & Safety