All I Want for Christmas is a Chemical Hazards Pocket Guide?

The NIOSH Pocket Guide to Chemical Hazard disc image
Stay safe; take this "pocket" guide for a spin

Anything that will help you and your employees have a safe and healthy New Year!

The NIOSH Pocket Guide to Chemical Hazards (NPG) is intended as a source of general industrial hygiene information on several hundred chemicals/classes for workers, employers, and occupational health professionals. The NPG does not contain an analysis of all pertinent data, rather it presents key information and data in abbreviated or tabular form for chemicals or substance groupings (e.g. cyanides, fluorides, manganese compounds) that are found in the work environment. The information found in the NPG should help users recognize and control occupational chemical hazards. Instructions for Downloading: Download the NPG CD-Rom as a ISO image file and create a disc with CD-ROM authoring software. The NPG ZIP file contains a condensed version of the NPG. All non-Pocket Guide links were removed so that this set of files acts as a “stand-alone” database. These files can be used with a standard web browser or on some mobile devices.

  • 2010-168c.zip (245 MB) (requires WinZip or other unzipping software)
  • 2010-168c.exe(181 MB) (Self-extracting zip file for Windows)
  • 2010-168c.isoNIOSH publication number 2010-168c (ISO Requires CD-Rom Authoring Software)

Preventing and Treating Winter Colds

The signs don’t lie: scratchy throat, nasal congestion, watery eyes. It is, indeed, the start of another cold. If your first thought is to reach for the Airborne, that over-the-counter herbal cold remedy invented by a teacher, think again. It probably won’t make a dent.

But other herbal and natural approaches do prevent colds—and if you do end up catching a cold, natural treatments can spare you considerable misery.

Colds are humanity’s most prevalent illness. Caused by more than 200 viruses, each one technically causes a “different” cold. But because all colds produce similar symptoms, the malady is considered a single illness.

Most colds start with a scratchy throat, and progress through nasal congestion, watery eyes and runny nose to a dry, hacking cough that may become bronchitis. Childhood colds may cause fever, but adult colds rarely do.

Medically, colds are minor and clear up by themselves in a week or so. But this minor illness causes major misery and is quite costly. Americans suffer 500 million colds annually and spend $17 billion a year treating them. Most of that money is wasted on over-the-counter cold formulas that suppress symptoms without spurring healing. Herbal and natural approaches are preferable because they provide real protection and/or speed healing.

Prevention: Boost Immunity

When researchers infect people’s noses with a live virus, some test subjects—those with the most robust immune systems—don’t catch the cold. These three immune-boosting herbs have shown value in cold prevention:

• Echinacea (Echinacea spp.). Studies from the 1990s showed scant preventive value. But in 2007, University of Connecticut scientists analyzed 14 studies and found that echinacea reduced cold risk by 58 percent. Echinacea’s preventive value remains controversial, but if anyone close to you catches a cold, there’s no harm in taking it. Recommended dose: 20 drops of tincture three times a day, or follow package directions.

• Ginseng. (Panax quinquefolius, P. ginseng). Canadian researchers gave 279 adults a daily placebo or ginseng (400 mg a day). Four months later, the ginseng group developed significantly fewer colds. University of Connecticut researchers repeated this study and came to the same conclusion, calling ginseng “a safe, natural means for preventing acute respiratory illness.” Recommended dose: 400 mg a day.

• Green tea (Camellia sinensis). University of Florida researchers gave healthy adults either a placebo or green tea capsules twice a day. Three months later, the tea group reported significantly fewer colds.

No other herbs have been shown to prevent colds. However, several boost immune function against viruses, so it’s a good bet they help prevent colds.

• Ashwaganda (Withania somnifera). For centuries, Indians have used this immune-enhancing Ayurvedic herb to prevent illness. Recommended dose: 1 to 6 grams daily (2 to 12 teaspoons) in capsules or tea. In tincture or liquid extract, use 2 to 4 ml three times daily. Or follow package directions.

• Eleuthero (Eleutherococcus senticosus). Also known as Siberian ginseng, this herb is unrelated to ginseng but has similar effects, including immune-boosting antiviral action. A German study shows that it produces a “drastic increase” in immune responses, notably, more T-cells and natural killer cells. Recommended dose: 400 mg daily of standardized extract containing 0.3 percent eleutheroside E. Or follow package directions.

• Maitake mushroom (Grifola frondosa). Maitake contains beta-glucan that activates germ-devouring T-cells, natural killer cells and macrophages. Recommended dose: 3 to 7 grams a day. Or use this delicious mushroom in cooking.

• Reishi mushroom (Ganoderma lucidum). Like maitake, reishi contains beta-glucan, and revs up the immune system against various viruses, notably herpes. Recommended dose: 1.5 to 9 grams daily of dried mushroom; 1 to 1.5 grams a day of powder; or 1 ml a day of tincture. Reishi is nasty-tasting and is not used as a food.

• Shiitake mushroom (Lentinula edodes). These tasty Asian mushrooms are immune-boosters, notably against the viruses that cause hepatitis B and genital warts. Recommended dose: 6 to 16 grams a day of dried mushrooms or 4 ounces fresh. Or use in cooking.

• Vitamin C. Since 1970, when the late Nobel laureate Linus Pauling published Vitamin C and the Common Cold, this nutrient has ranked among the nation’s most popular—and controversial—cold remedies. Finnish researchers analyzed 30 trials, and found no preventive benefit—except in those under substantial physical stress (soldiers, marathon runners). However, this analysis considered studies using about 200 mg a day—too little, according to some reports, to show benefit. Most studies showing cold prevention use 2,000 mg a day or more. The jury is still out. But if those around you have colds, there’s no harm in taking vitamin C. Recommended dose: 2,000 mg a day in divided doses.

• Forget Airborne. This bestselling supplement contains some echinacea, but not enough to help. Otherwise, it’s simply a multivitamin. Last August, as part of a false-advertising settlement with the Federal Trade Commission, Airborne’s maker agreed to stop claiming that it prevents or treats colds.

More Cold-Fighting Strategies

• Exercise boosts immune function. University of Washington researchers enrolled 115 women in weekly 45-minute stretching sessions or 45 minutes of moderate exercise five days a week. After 12 months, the exercisers contracted significantly fewer colds than the stretchers did.

• Manage stress. Ever catch a cold studying for finals?  Blame stress. Carnegie Mellon researchers gauged stress levels in 400 volunteers, then subjected their noses to live cold viruses. As the volunteers’ stress increased, so did their likelihood of catching the cold. Stress impairs immune function. Effective ways to reduce it include meditation, music, yoga and other moderate exercise.

• Socialize. Colds spread from person to person, so you’d think social butterflies would catch the most colds. Actually, as social connections increase, risk of colds decreases. That’s what the Carnegie Mellon group discovered in a study of 334 volunteers who completed surveys of social ties before exposure to cold virus. Social connections boost immune function. Apparently, the benefit gained from socializing more than compensates for the risk of spending time around cold sufferers.

• Make love. Researchers at Wilkes-Barre University in Pennsylvania surveyed 112 college students about their sexual frequency, then analyzed their saliva for immunoglobulin A (IgA), one of the body’s first defenses against colds. Those who reported sex once or twice a week had the highest IgA levels.

Treating Colds Herbally

If all your prevention measures fail—and they sometimes do—you still can take steps to lessen the cold’s impact.

• Echinacea. Some studies show no treatment benefit, but most support the use of echinacea. University of Wisconsin researchers analyzed eight studies of echinacea for treating colds. Every one showed that compared with untreated cold sufferers, those taking the herb had shorter, less severe colds. The University of Connecticut analysis of 14 studies, mentioned earlier, showed that in addition to preventing colds, echinacea reduces cold duration by 1.4 days.

• Ginseng. The University of Connecticut study showed that ginseng cut severity of cold symptoms in half.

• Green tea. In the University of Florida study, mentioned earlier, green tea significantly reduced the duration of colds.

• Andrographis (Andrographis paniculata). This traditional Chinese and Ayurvedic medicine has recently become a popular cold treatment. At the University of Chile in Santiago, researchers gave 158 adults coming down with colds either a placebo or andrographis (1,200 mg a day). The andrographis group reported faster relief of all symptoms, with no side effects. British researchers analyzed seven studies of andrographis for colds. They found significant benefit. Recommended dose: 400 mg three times a day.

• South African geranium (Pelargonium sidoides). Ukrainian scientists gave 103 adult cold sufferers a placebo or pelargonium (30 drops three times a day). After 10 days, 31 percent of the placebo group was cured. In the pelargonium group, the figure was 79 percent. This herb also treats the bronchitis that may develop at the tail end of a cold. Recommended dose: 30 drops three times a day.

• Slippery elm (Ulmus rubra) and licorice (Glycyrrhiza glabra). For cold-related sore throat, these herbs provide remarkable relief. University of Wisconsin researchers gave 60 sore throat sufferers a placebo or Throat Coat, a tea (from Traditional Medicinals) containing slippery elm bark and licorice root. The tea provided significantly greater relief.

• Ashwaganda, eleuthero, maitake, reishi and shiitake. While no studies have investigated these herbs as cold treatments, their immune-enhancing effects against viral infections suggest they may help.

Other Natural Treatments

• Hot drinks. Grandma was right when she said to drink hot liquids. Cold viruses reproduce best at temperatures below normal body temperature. Any hot drink warms the throat, impairing viral replication. Hot liquids also help soothe a sore throat and suppress cough.

• Chicken—or vegetable—soup. For centuries, chicken soup has been used to treat colds. Florida researchers showed that it does, indeed, relieve nasal congestion better than plain hot water. In a laboratory study, University of Nebraska researchers showed that chicken soup significantly reduced throat-cell inflammation. However, the Nebraska group’s soup worked even before the chicken was added, when it was simply onion- and garlic-rich vegetable soup. Many studies have shown that vegetables, notably onions, have anti-inflammatory action.

• Take vitamin C. The analysis, mentioned earlier, showing that vitamin C provides no preventive benefit for the general population also showed that it offers consistent, modest benefit as a cold treatment—14 percent shorter colds in children, and 8 percent in adults. Again, this analysis was based on studies using 200 mg a day. Better results have been observed in studies using larger doses, for example a University of Helsinki report showing that 2,000 mg a day reduces cold duration 26 percent.

• Zinc lozenges. A dozen studies have tested zinc lozenges against colds. Most have shown that the mineral relieves symptoms and significantly shortens colds.

• Honey. Recently, the Food and Drug Administration ruled that cold and cough remedies should not be given to children younger than 2. What’s a parent with suffering kids to do? If your child is older than 1 year, give a teaspoon of honey. Penn State researchers tested honey against the standard over-the-counter cough suppressant dextromethorphan in 105 children. Parents said honey worked better. (Do not give honey to infants younger than 1 year.)

San Francisco health writer Michael Castleman is the author of 11 consumer health books. Visit www.mcastleman.com

Poinzner Pounces on Proposal for WC Rate Increase

CA IC Rejects Request For Increase In WC Cost Benchmark

Graphic of "Rejected" rubber stamp Sacramento, CA (CompNewsNetwork) – Commissioner Poizner announced today his Order (see link below) to reject – for the third consecutive time – a filing submitted on behalf of insurers by the Workers’ Compensation Insurance Rating Bureau (WCIRB) seeking a rate increase of almost 28%.

“I will not approve a rate that passes avoidable costs through to California employers,” Commissioner Poizner said. “Once again, workers’ compensation insurers have failed to demonstrate that they have adopted procedures to control costs or that they are operating efficiently. That is unacceptable. Our nation and our state are in the midst of a recession and unemployment rates are sky high – this is the absolutely wrong time for workers’ compensation rates to increase. Even in a better economy, I still wouldn’t budge on a rate increase without the industry first implementing the efficiencies we have recommended.”

The Benchmark is purely advisory and the California Department of Insurance (CDI) does not set workers’ compensation insurance rates.

Following a hearing on workers’ compensation rates in June 2009, Commissioner Poizner released a report detailing 27 available but underused efficiencies (see link below) insurers should use to control costs. Commissioner Poizner has consistently instructed insurers that until they demonstrate that they are implementing these changes, he would not consider a rate increase.

Since 2008, the actual premium paid by California employers increased by a modest 3%. During that same period, insurer filings with CDI claimed a 36% average increase in claims costs. Widespread discounting based on employer experience and other market factors has negated that increase, stabilizing employer costs. Poizner characterized this development as positive and as an indication that California’s competitive market is keeping workers’ compensation rates under control.

Commissioner Poizner also announced his decision to implement three reforms that will significantly improve and inject transparency into the review process. The reforms require the WCIRB to:

  • Calculate future advisory pure premiums based on insurers’ actual filed rates rather than on theoretical previous Benchmark numbers. Commissioner Poizner noted that under this approach, the current filling would actually have sought a rate decrease.
  • In addition to industry average numbers, include in each future rate filing a table showing the proposed change for each individual worker classification, allowing employers to better understand the specific impact the filing could have on them;
  • Use Department filing information and data from the WCIRB to evaluate overall workers’ compensation insurer profitability. This will enhance regulators’ ability to monitor the health of the workers’ compensation system and make it easier for consumers to understand insurance pricing.

“The workers’ compensation rate-making system is long overdue for some much-needed reforms,” Commissioner Poizner said. “The benchmark rate is only theoretical, and this has enabled insurers to file for and pass on rate increases to businesses. I will not allow this broken rate-making process to serve as cover for the insurance industry in its justification for higher rates that are simply not justified.”

CDPH DIRECTOR URGES CALIFORNIANS TO GET SMART ABOUT ANTIBIOTICS

Get Smart About Antibiotcis Week, logoAs part of “Get Smart About Antibiotics Week,” California Department of Public Health (CDPH) Director Dr. Mark Horton is reminding health care professionals and patients this week about the importance of proper antibiotic use. Antibiotics are used to treat bacterial infections. They are often prescribed, yet do not work, for viral infections such as the flu or common cold.  Overuse of antibiotics can lead to severe antibiotic-resistant, life-threatening infections by “super bugs” that are more difficult to treat.

The Centers for Disease Control and Prevention (CDC) reports that half of all antibiotics prescribed are unnecessary or inappropriate.

“In the United States, antibiotic-resistant infections cause $20 billion in excess health care cost,” said Horton. “California has the nation’s only statewide initiative focused on the safe and effective use of antibiotics in hospitals.

“California Senate Bill 739 requires all acute care hospitals to develop a process for evaluating the use of antibiotics,” Horton explained. “We’re encouraging all health care facilities to implement similar practices that have been proven to improve patient care decrease the inappropriate use of antibiotics, decrease antibiotic resistance and save health care dollars.”

Horton added that people should not share unused prescription medicine with others and they should not save unused prescriptions for future illnesses.

November 15-21 is Get Smart About Antibiotics Week, a collaborative effort with CDC, CDPH and other professional organizations. The campaign’s goal is to educate consumers and health care providers about appropriate use of antibiotics.

Methods for Designing a Wellness Incentive Program

chart showing Best Wellness Incentives by Age
Best Wellness Incentives by Age

According to Dr. Robert H. Haveman of the University of Wisconsin-Madison, the following basic principles should guide the development of any incentive arrangement:
1. Identify the desired outcome.
2. Identify the behavior change that will lead to the outcome.
3. Determine the potential effectiveness of the incentive in achieving the behavior change.
4. Link a financial incentive directly to this outcome or behavior.
5. Identify the possible adverse effects of the incentive.
6. Evaluate and report changes in the behavior or outcome in response to the incentive.

Similar steps are recommended by the Wellness Councils of America:

1. Determine what actions or behaviors you want to increase or decrease.
2. Research the values that would hinder adoption of the desired actions or behaviors.
3. Research and select formal and informal rewards that are feasible for inclusion in the incentive design while producing the largest behavioral change effect.
4. Develop incentive rules and examine them for unintended consequences.
5. Use focus groups of randomly selected employees picked to test the incentive system.
6. Develop a communications plan for the incentive program.
7. Field-test the incentive system.
8. Evaluate the field test, modify the design and implement organization-wide.
9. Follow-through as planned in implementation of the incentive program.
10. Periodically, at least annually, evaluate the effects of the incentive system and revise it.

Popular Rewards
In terms of the most commonly used incentives, the types of wellness programs or activities being offered plays an influential role:

1. Completion of a health risk assessment (HRA): The trend is moving away from a voluntary, non-rewarded approach to HRA completion and toward continued health benefit eligibility or use of a differential premium contribution for health plan coverage and modest cash rewards for completion.
2. On-site Activities: Participation in on-site wellness activities typically features rewards involving material goods or merchandise coupons.
3. Long-term Involvement: Overall program participation, completion of biometric and/or preventive screening tests, attainment of particular health goals, seat belt use and other personal health and safety measures are related to satisfying certain criteria. In turn, these criteria are associated with a point system linked to reduced health plan premiums and/or deposits in health savings accounts.

Medical Billing and Coding — A Work Comp Cost Cutting Tool

graphic for medical billing
Break the code instead of the bank

Medical Billing and Coding — A Work Comp Cost Cutting Tool

06 November, 2010

Employers need every edge in reducing their costs of workers compensation, given our stagnant economy. Medical billing and coding is perhaps an overlooked area of cost control. One tiny error can lead to a very big problem in a medical bill — i.e., kicking the bill back for re-processing thus delaying payment.

An employer can do one of two things: rely on an outside source,– billing departments of doctors, nurses, therapists, hospitals, etc.– to produce correct, timely medical invoicing with accurate coding and risk paying more, paying for the wrong procedure, or waiting longer for a work comp claim to close. However, an employer still need to provide oversight, will be one of many other clients, must be sure the staff understands workers comp issues – in other words, you’ll be bird-dogging.

Another and better way is to have your own in-house staff whose job is to review and analyze all medical bills submitted by health care providers before they are approved for payment. Either hire or train a person to vet all medical bills. Training a current employee has the advantage having someone already familiar with the company’s workers comp procedures and works only for the employer.

Whether you hire or train, there is a high demand for workers who are medical billers and coder, a field described as “recession proof.”
Look for a person with a: Continue reading Medical Billing and Coding — A Work Comp Cost Cutting Tool

Cal/OSHA Implements Updated Heat Safety Regulations

the heat is on graphic

Oakland, CA (CompNewsNetwork) – As a national leader in workplace safety, Cal/OSHA today implements updated safety standards for employees working in outdoor heat.  The revisions to the Heat Illness Prevention Standard, approved by the Occupational Safety and Health Standards Board on Aug. 19, became effective today. The revised standards provide clarification of the shade requirement, including temperature triggers and address high-heat requirements. “Today we continue as a national safety leader in strengthening the standards that safeguard outdoor workers,” said Department of Industrial Relations Director John C. Duncan.  “Fostering behavior change is a key step to ensure a safer work environment. Our practice of measuring those behavioral changes is one that should be viewed by other states and OSHA as a useful method for gauging the impact of our efforts.”

Shade Requirements

  • Must be present to accommodate 25% of the employees on the shift at any time when temperatures exceed 85 degrees, and located as close as practicable to the areas where employees are working.  When temperatures are below 85 degrees, employers shall provide timely access to shade upon an employee’s request.
  • Shade must be located as close as practicable to the areas where employees are working.
  • Where the employer can demonstrate that it is infeasible or unsafe to have a shade structure, or otherwise to have shade present on a continuous basis, the employer may utilize alternative procedures for providing access to shade if the alternative procedures provide equivalent protection.
  • Except for employers in the agriculture industry, cooling measures other than shade may be provided in lieu of shade if the employer can demonstrate that these measures are at least as effective as shade in allowing employees to cool.

High-Heat Rules

  • High-heat procedures are now required for five industries when temperatures reach 95 degrees or above.  These procedures include observing employees, closely supervising new employees and reminding all workers to drink water.  The industries specified under this modification are:
    1. Agriculture
    2. Construction
    3. Landscaping
    4. Oil and gas extraction
    5. Transportation or delivery of agricultural products, construction material or other heavy materials

“The amendments that became effective today represent important measures to clarify and strengthen the heat illness prevention standard,” said Cal/OSHA Chief Len Welsh. “Our efforts in enforcement, outreach and educational partnerships over the last five years have paid off. We have seen significant behavior change resulting in a compliance increase among employers inspected from 35 to 85 percent.”

Under the leadership of Governor Schwarzenegger, in 2005, California became the first state in the nation to develop a safety and health regulation to protect workers from heat illness. Labor Code Section 3395 became effective in 2006.  The regulations include providing employees with water, shade and rest as well as heat illness training for employees and supervisors.

Cal/OSHA is the employee health and safety division of the Department of Industrial Relations.  For more information on heat illness prevention and training materials visit the Cal/OSHA Web site at http://www.dir.ca.gov/heatillness. Educational materials including a safety DVD on heat illness prevention are also available in English, Spanish, Hmong, Punjabi and Mixteco on the Calor Web site, at http://www.99calor.org/english.html.