SUMMER 2012 issue 19

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Welcome to WorkCare’s digital newsletter! In this edition, we focused on topics that we hope will shed new light on issues related to occupational health.

In the opening story, we highlight the U.S. Food and Drug Administration’s updated regulations on sunscreen. This new information will help employers and employees understand which products offer the best protection from the harmful rays of the sun.

Safety concerns in the mining industry are the focus of the story on page 2. This piece provides an overview of a study presented by A.M. Donoghue titled Occupational Health Hazards in Mining, which details the physical, psychosocial, biological, chemical and ergonomic risks associated with mine work.The State of Maryland recently made updates to their drug and alcohol testing regulations. Page 6 provides information on what employers need to know and what action is required.

As the world rapidly changes, transformations of life at work emerge as a consequence. In a story titled Emerging Hazards

in Occupational Health, we provide an overview of a study that illustrates the present and future trends of relevance to occupational health, the main workplace risks and their prevention.

Based on a 2012 study published in the March issue of Journal of Occupational and Environmental Medicine, we help answer the question — what costs more, smoking or obesity? Found on page 6, this piece also provides highlights of my talk presented at the recent American Society of Safety Engineer’s conference in Denver, Colorado. Enjoy!

Peter P. Greaney, M.D.Chief Executive Officer/Chief Medical Officer

Doctor’s Desk

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The modern world wouldn’t have cellular phones, light bulbs or toothpaste without mining. The minerals that mining generates are essential components for today’s economies and are integral to contemporary society.

Oil, gas and coal are common elements that come to mind when thinking of mined organic matter. But what about copper, iron, steel and limestone? Many of the products contemporary culture deems necessary, such as the car, require an enormous amount of these materials. Yet along with the acquiring of these minerals comes a great deal of risk.

According to the Bureau of Labor Statistics, mining continues to be the second most dangerous occupation in the United States, if not the world.1 Physical and psychosocial hazards, as well as biological, chemical and ergonomic hazards, remain at the forefront of what threaten miners on the job. This includes traumatic injuries, hearing loss and respiratory diseases, among other related health issues.

Because minerals are traditionally excavated underground or at surface level, occupational risks are generally related to metallurgical processes and coal mining. Additionally, there are concerns in connection with the development and operation of these mine sites that pose safety issues to workers. In the study presented by A.M. Donoghue, Occupational health hazards in mining: an overview, even though major corporations have assimilated sound sustainability practices and environmentally-friendly methods in association with mining, occupational health needs to become an integral part of each company’s best practices.2

Physical RisksOne of the biggest disadvantages of being a miner is the risk of physical injury. Injuries are not uncommon when working in a mine, particularly an underground coal mine. Common causes of such injuries include falling rocks, fires, explosions, equipment accidents, entrapment and electrocution. Although they are not as common today as they were in previous years, collapsed coal mines are also still a risk to many coal workers. Technological progress has reduced the degree of fatal injuries; however, human intervention is required for multiple manual tasks, which means that mine workers are still exposed to high risks of injury.

Hearing loss is one of the most dominant occupational hazards for miners. The most common cause is overexposure to hazardous noise levels, such as drilling, blasting and cutting materials. A worker can also lose some hearing from exposure to certain

chemicals or handling particular elements. An analysis by the National Institute for Occupational Safety and Health (NIOSH) states that “a large sample of audiograms showed that at age 50 approximately 90 percent of coal miners and 49 percent of metal/nonmetal miners have a hearing impairment”.3 NIOSH concludes by asserting that most mine workers will retire with some form of hearing loss caused by the high levels of noise exposure to which they are subjected.

Heat stress and exposure to radiation and excessive pressure also remain problematic for mine workers. They can be exposed to such high levels of heat that they may suffer from heat illness. Working in extraordinary temperatures may not only cause sickness and even death, but also loss of concentration leading to lowered productivity and mistakes, which can result in accidents. Where humidity is relatively high, the hazard is increased. Exposure to radiation such as solar ultraviolet and infra-red also contribute to heat illness as well as forms of cancer and cataracts. High intensities of barometric pressure have been linked to such illnesses as altitude sickness and various other physical issues.

Psychosocial RisksMining is associated with long and arduous hours and as a result, mine workers experience psychosocial consequences. Many workers travel long distances and may be away from their families for countless days or even weeks. Loneliness and isolation are common feelings suffered by many workers. These conditions cause anxiety in many employees and their personal lives are adversely affected. Mining activities are also accompanied by relocation, owing to the great distances between workers’ homes and the mines. This results in dangerous sexual behavior, alcohol and drug abuse, and malnourishment. Violence in the workplace is not infrequent in the mines. This arises from different circumstances, including harassment and bullying. Moreover, post-traumatic stress disorders are common due to the various injuries that occur on a regular basis to other workers.

Biological RisksMining is also linked with poor working conditions with the extremities exposed to biological hazards. Among the various dangers involved are the threats of insect bites, minor wounds and critical injuries. In the case of some remote mining locations, there are also risks of tropical diseases such as malaria. Exposure to certain bacteria also raises significant health concerns. Neurological syndromes and elevated birth defects have been found among mine workers contaminated by these toxic bacteria, sometimes ending in death.

SALUS

Occupational Safety in Mining

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Chemical Risks  Crystalline silica has always been a serious danger in mining and still remains a great difficulty. Prolonged exposure can lead to chronic obstructive pulmonary disease, rheumatoid arthritis, renal disease and an increased risk of lung cancer. Another serious hazard is coal dust which causes black lung or pneumoconiosis, as well as chronic obstructive pulmonary disease in mine workers. Other chemical hazards related to mining include asbestos, exposure to diesel particles as an effect of underground equipment, cyanide (which is used as a solvent in hydro metallurgical processes), exposure to mercury used in certain mining operations, sulfur dioxide gas from smelting of sulfide ore, and many others. The effects are numerous and also include arthritis, a multitude of respiratory diseases and skin disorders.

Ergonomic Hazards Musculoskeletal disorders are a substantial problem for the mining industry. The main risk factors of difficult postures, extraordinary forces, repetition and vibration are common in mining, and often the degrees of exposure are extreme. The tools and machines used in mines have evolved to ease the physical labor of the mine worker. However, manual handling is still required for many tasks. Consequently, physical disorders and prolonged disability remain at the top of the list of health concerns for the mining industry. In a study by the National Institute for Occupational Safety and Health (NIOSH), severe knee injuries continue to be one of the common hazards of mine workers. Postures that pose high impacts, such as kneeling or crawling, may have detrimental effects on “the knee’s external and internal anatomy such as the kneecap, ligaments, cartilage, and meniscus”.4

Safety and Preventive MeasuresMany of the aforementioned health hazards can be avoided with proper education and training. These educational activities aimed at reducing the risk of injury for mine workers are needed to raise awareness and to promote behavioral change.

Mining is similar to any other occupation and it requires appropriate orientation and induction. Corporations can use information campaigns, instruction and training to accomplish occupational safety goals.

Various preventative methods have proven to lessen work-related risks of miners throughout the years, such as the use of protective equipment, the application of proper ventilation, the employment of other security devices and medical surveillance. Companies can cultivate advantageous work environments by formulating health promotion policies and procedures. Management should use the results to establish a comprehensive safety culture approach and provide workers with appropriate safety training. The benefits will be numerous, including improved health, well-being, comfort and productivity, which will benefit the company overall and support a positive bottom line.

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A number of U.S. states and municipalities have laws that regulate work-related testing for substance abuse. Recently, the state of Maryland made changes to their drug and alcohol testing regulations that will require Maryland-based employers to update their protocols.

Here is what you need to know:

• All drug and alcohol testing required by employers of non-DOT job applicants, employees or contractors must meet comprehensive legal requirements pursuant to Maryland’s general drug and alcohol tasting statute.

• The only permitted specimens for current employees or contractors are blood, urine and saliva. Breath testing is no longer allowed.

• Hair samples may only be used to test for alcohol for pre-employment circumstances.

• Under the current law, employers in the state of Maryland cannot require or request that a non-DOT job applicant submit for a breath alcohol test — regardless of the employer’s intent.

• Other drug testing options are urine screening, blood screening or hair testing.

• WorkCare’s Maryland-based employers are encouraged to contact our medical surveillance department at (800) 455-6155 with updated protocols.

REFERO

Changes to the State of Maryland’s Drug and Alcohol Testing Regulations

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SITUS

Emerging Hazards in Occupational Health

As the world rapidly changes, transformations of life at work emerge as a consequence. Impacting the health and safety of workers globally are fluctuations in employment and demographic structures, the introduction of new technologies, and the current worldwide financial crisis. These changes are generating new challenges in occupational health systems for successfully managing work-related health hazards and supporting the health of workers in different working conditions.

In a study by the European Risk Observatory titled New and Emerging Risks in Occupational Safety and Health at Work, an overview of these hazards are illustrated to describe the “present and future trends of relevance to occupational health, the main workplace risks and their prevention”.1 The report finds changes principally in the areas of physical, psychosocial, biological and chemical risks.

The workplace is a precarious environment. In many economic regions, there are universal occupational health and safety hazards that affect large amounts of employees. Common reports are those of risky chemical or biological contact or an excess of immoderate weight required to perform physical work that may be dangerous to health and safety. Many working people relate psychological burdens at work resulting in stress symptoms. Several individuals spend a majority of their adult life in such

hazardous work environments. In addition to avoidable distress for the employee, the costs stemming from these health risks are immense.

Enhanced access to occupational health services needs to be a result of these situations and the growing attention derived from comprehensive risk management analyses at the workplace. The following provides an overview of the top emerging health risks facing workers.

Physical Risk FactorsHeading the list of occupational health hazards is hearing impairment. Numerous workers around the globe report being exposed to this risk factor at their workplace. It is a common threat to workplace safety and has been for many years in the mining, manufacturing and agriculture industries. However, as the ERO states, “there has been a sharp increase in the proportion of exposed workers in the construction sector in recent years”.2 Similar findings were reported in such positions in the fields of education and entertainment. Although noise has never been typically an issue in these sectors, current results conclude that they are increasingly becoming an area of concern regarding occupational health.

Similarly, exposure to UV radiation and solar radiation is a tremendous problem in the workplace. Numerous diverse occupational sectors face the challenges of contact with radiation, including dentists, farmers, physical education instructors, aircraft pilots and painters. A great proportion of these workers are men. Health conditions reported by over-exposure to radiation, whether by outdoor or indoor contact, are an impairment to the eyes, skin damage and weakening of the immune system.

Work-related accidents are also a growing concern. Gender and age are predominantly

the causes associated with occupational injuries in this new environment of change. Even though men account for higher rates of accidents on the work site, the number of injuries that are reported by women relate to the use of equipment specifically tailored to men. The study further demonstrates that older and younger workers lead the way when it comes to accidents on the job. Because the Baby Boomer population — those in their 50s and 60s — are remaining in the workforce as they grow older, they pose a greater risk for injury. Likewise, younger employees make up a substantial amount of work-related accidents because of poorer working conditions and highly demanding manual labor. The fact that younger employees have less access to benefits only exacerbates the issue. These accidents on the work site contribute to many physical ailments such as back injuries, limb damage and skin disorders.

Psychosocial HazardsThe ERO defines psychosocial risks as stress “experienced when the demands of the work environment exceed the employee’s ability to cope with (or control) them.”3 It is especially noteworthy that many employees report that they experience some form of pressure from work. Time pressure is the most common psychosocial risk factor in the workplace. Considerably fewer employees are exposed to harassment or bullying, violence or the threat of violence, or other psychosocial health hazards at their place of work.

Working under stress is more common among high level employees including legislators, senior officials, managers and professionals. The study found that “between 50 percent and 60 percent of all lost working days are related to stress.”4 Predictions indicate that levels of depression related to stress will increase radically due to the expansion of new technologies and the rush of globalization. Also, the workload will surge as many of

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the older population of employees cannot keep up with the rise of technology; with the gradual decrease of workers, those left to handle production will develop stress as a consequence.

ChemicalA multitude of workers report handling hazardous chemicals for a good amount of the time they spend at work. Many work-related illnesses are linked to toxic substances encountered in the workplace. Nanoparticles rank at the top of the list of chemicals from which workers need protection. Nanotechnology is described by ERO as “technologies that involve the creation and manipulation of materials to develop materials and products of the nanometre size to exploit their new physicochemical properties.”5 This technology is used currently for the manufacturing of cosmetics and IT products and is expected to develop quickly into a lucrative worldwide market. Research is still in process regarding the effects of nanoparticles; however, certain results show negative influences on the digestive system, respiratory tract and skin.

In several emerging professions, employees’ skin is exposed to chemicals leading to a rise in the amount of workers affected by allergic diseases. Musculoskeletal disorders and skin diseases are the consequences of exposure to chemicals at the work place. Positions that cause the greatest concern, where employees face the challenge of coming into contact with risky substances, include waste management, construction and service activities, such as cleaning or home nursing.

The growing issue is that on a daily basis, new chemicals and new forms of substances are being synthesized. While some compounds are harmless, others pose a serious risk to workers. Substances such as very acidic or basic compounds are dangerous and threaten the safety and well-being of employees.

Biological ThreatsBiological health risks may be the greatest and most intricate hazard there is as

diseases, viruses, bacteria and anything organic falls under this heading. Workplace health is seriously endangered by biological hazards since the most common areas of transmitting diseases are on the job. Due to the nature of transmittal, every work site is vulnerable and increasingly so as a result of globalization.

Occupational biological risks stem from organic substances handled in the workplace that present a threat to the health of humans. Biological hazards include pathogenic micro-organisms, viruses, toxins, spores, fungi and bio-active substances. Biological vectors or transmitters of disease are also considered biological risk factors. Positions in the manufacturing and agriculture industries face the biggest concern of hazards associated with biological risks. However, occupations in growing sectors, such as community, social and personal services where diseases are easily communicable, are being threatened as well.

Exposures to biological toxins produce risks for numerous employees in a wide variety of ways. Healthcare professionals come into contact with biological hazards via bodily matter, including blood, tissue, saliva, mucous, urine and feces. These substances have a high risk of containing viral or bacterial diseases. Similarly, people who work with live animals or animal products are exposed to particular diseases and infections that correlate only to animals; nevertheless, some have the potential to infect humans or cause serious allergies. Another issue is when workers are exposed to laboratory cell cultures, certain organic matter, wastewater or sewerage; these biological hazards in the work environment present many health concerns. In the industrial industries, as well as the field of construction, contact with molds and yeasts is common.

All of these exposures create a number of illnesses and health threats worldwide. Some of the most common are pandemics, such as HIV, malaria, SARS and the bird flu. According to the ERO, “social, technological and environmental factors

encourage the emergence of new diseases and the return of old diseases.”6 The study also states that these infections cross the borders of age, occupation, socio-economics and gender.

Conclusions There are several important challenges that companies need to address regarding the future occupational health of their organizations. Some of the significant issues are connected with new information of technologies and automation, new chemical substances and physical energies, new biotechnologies, the transfer of hazardous technologies, aging of working populations and problems related to the growing mobility of worker populations.

Corporations need to establish a further improvement of occupational health and safety gauges where trends in occupational health and safety are growing. The development of necessary resources and company cultures should be implemented to make positive outcomes possible. Companies must apply a progressive expansion of occupational health services with the ultimate objective of covering all workers with such services irrespective of the sector of economy, size of company, occupation, mode of employment or nature of employment.

The most valuable assets of individuals, communities and corporations are health at work and healthy work environments. Occupational health is an essential approach to ensure the well-being of employees and it is also a method to influence productivity, work motivation, and job satisfaction in a positive manner; and in so doing, it contributes to the quality of life of individuals and society as a whole.

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New research published in Occupational and Environmental Medicine reveals a startling fact — workers who combat obesity have greater health issues and more medical expenses associated with these problems than smokers.

James P. Moriarty, MSc, and colleagues of the Mayo Clinic, Rochester, Minnesota analyzed the incremental (additional) costs of smoking and obesity among more than 30,000 Mayo Clinic employees and retirees. All had continuous health insurance coverage between 2001 and 2007. The study provides new insights into the long-term costs of obesity and smoking, showing that both risk factors lead to persistently higher health costs throughout a seven-year follow-up period.

Smoking and obesity place a growing strain on an already stretched healthcare system. Employers are evaluating wellness programs, such as quit-smoking and fitness programs, in an attempt to lower costs by reducing health risk factors.

At the recent American Society of Safety Engineer’s conference in Denver, Colorado, WorkCare’s President and Chief Medical Officer Peter Greaney, M.D., delivered a presentation titled Employee Health Risks and Health Promotion: A Roadmap for Prevention.

The talk was successful in providing employers with insight into the top health risks facing today’s workforce and tips for launching a wellness program. The presentation highlighted:

• CEO’s top financial worries.• The state of the =U.S. healthcare

system. • The top health risks facing U.S.

workers.• Stages of change. • 10 steps for wellness program success.

For a copy of the complete presentation overview, email info@workcare.com.

SITUS

Study Reveals Obese Workers have Higher Healthcare Costs than Smokers

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In June, the Food and Drug Administration (FDA) unveiled several new rules for sunscreen labels, which will go into effect in 2012. Years in the making, these rules aim to better protect consumers from the harmful effects of the sun’s ultraviolet-A and ultraviolet-B radiation and prevent sunscreen manufacturers from using words like “sunblock” and “waterproof” on their products.

Under the new FDA guidelines: Sunscreens may only be labeled “broad spectrum” if they protect the skin from both UVA and UVB rays.

Any sunscreen with a sun protection factor (SPF) of less than 15 must have a warning label that the product does not protect the skin from sunburn, premature aging, and skin cancer

Consumers will no longer see the familiar labels sunblock, waterproof, and sweat proof. Instead, manufacturers may only call their products water-resistant and must indicate how often they must be reapplied.

Lastly (and perhaps most surprising to the extra sun-cautious), sunscreens can no longer carry an SPF label greater than 50.1

New FDA Rules on Sunscreen

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Search for us on YouTube!

“WorkCare1”

OCCUPATIONAL SAFETY IN MINING1. U.S. Bureau of Labor Statistics http://stats.bls.gov/iif/oshwc/

cfoi/cfch0005.pdf2. Donoghue, AM, Occupational health hazards in mining,

Occupational Medicine 2004; 54:283-289.3-4. National Institute for Occupational Safety and Health (NIOSH)

Mining Division. http://www.cdc.gov/niosh/mining/pubs/pubreference/outputid2642.htm

EMERGING HAZARDS IN OCCUPATIONAL HEALTH 1-6. European Risk Observatory: OUTL OOK 1, New and emerging

risks in occupational safety and health.

NEW FDA RULES ON SUNSCREEN1. http://www.washingtonpost.com/blogs/capital-weather-

gang/post/new-sunscreen-regulations-seek-to-block-out-misconceptions/2011/06/17/AGKoD7YH_blog.html

CONMEMORATIO

References in Vita Opus

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CONTACT US

EXECUTIVE EDITOR & CONTRIBUTING WRITERStephanie harriS-UyidiCreative DirectorCommunications and Multimediastephanie.harris-uyidi@workcare.com

MANAGING EDITOR & CONTRIBUTING WRITERdeirdre MathiSCommunications Coordinatordeirdre.mathis@workcare.com

ART DIRECTORKriSta MccorMicKGraphic Design Specialistkristamccormick@gmail.com

EDITORIAL ADVISORY BOARDpeter p. Greaney, MdPresident/CEOpeter.greaney@workcare.com

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ARTICLE REPRODUCTIONCopyright © WorkCare Inc. 2012. Vita Opus is a quarterly publication produced by WorkCare™. Duplication in any form, including photocopying or electronic reproduction without permission is strictly prohibited and is subject to legal action. Permission to recopy articles printed in Vita Opus can be requested by e-mailing: info@workcare.com

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STRETCH OF THE QUARTER

Shoulder Blade StretchINSTRUCTIONS:

• Place arm in front of body – elbow bent.

• Rotate hand inward.

• Pull hand across body with opposite hand.

• Hold for 10 seconds.

• Repeat 3-5 times.

• Switch sides.