Cal/OSHA Reminds Employers of Heat Illness Risks

Summer heat safety patchThe heatwave is headline news today here on the Central Coast, so it never hurts to have a handy list of the risks faced by  those who work in the heat.

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Cal/OSHA reminds all employers with outdoor workers to protect their workers as temperatures are expected to reach record levels, rising to the triple digits in both Northern and Southern California over the next six days.

“With temperatures expected to be from 10-20 degrees above average across the entire state through July 2nd, workers and employers alike are reminded to take extra precautions. Rest, water and shade are absolutely essential in high heat conditions,” said Christine Baker, Director of the Department of Industrial Relations (DIR). Cal/OSHA is a division of DIR.

“Cal/OSHA will be out in force throughout the state, reviewing outdoor worksites to ensure that employers are following heat illness prevention regulations,” said Cal/OSHA Chief Ellen Widess. “Employers should be especially aware of the need for workers to be acclimatized to the very high heat conditions.”

California’s heat regulations require all employers with outdoor workers take basic steps to protect their workers:

• Train all employees and supervisors about heat illness prevention before work begins.

• Provide plenty of cool, fresh water and encourage employees to drink water frequently.

• Provide a readily accessible shaded area for workers to take a cool down recovery break, and provide rest breaks when workers request them.

• Ensure that workers are given enough time to adjust, or “acclimatize” to the heat. This is especially important for new workers and for all workers during a sudden heat wave. This step can mean the difference between life and death.

• Prepare an emergency heat illness prevention plan for the worksite, with training for supervisors and workers on the steps to take if a worker shows signs or symptoms of heat illness.

Special “High Heat” procedures are also required when temperatures reach 95 degrees – supervisors must take extra precautions:

• Observe workers for signs and symptoms of heat illness.

• Remind workers to drink water frequently.

• Provide close supervision of workers in the first 14 days of their employment (to ensure acclimatization).

• Have effective communication systems in place to be able to summon emergency assistance if necessary.

• Ensure effective emergency procedures are in place in case workers become ill.

• Employers may want to adjust work schedules to avoid the peak heat times of the day. In all cases, employers need to be extremely vigilant.

Visit Cal/OSHA’s Heat Illness web page or the Water. Rest. Shade. campaign site for online information on the heat illness prevention requirements, training materials in multiple languages, and bilingual training sessions for employers and workers. A Heat Illness Prevention e-tool is available on Cal/OSHA’s website, and more information can be found on DIR’s Facebook and Twitter pages.

Cal/OSHA’s Consultation Program provides free and voluntary assistance to employers and employee organizations to improve their health and safety programs. For assistance from the Cal/OSHA Consultation Program, employers can call (800) 963-9424.

Employees with workplace safety questions or complaints, including heat illness, can contact the Cal/OSHA district office in their region to file a confidential report. Recorded messages in English and Spanish detailing resources for California workers are also available toll free at 1-866-924-9757.

For media inquiries, contact Erika Monterroza at (510) 286-1164 or Peter Melton at (510) 286-7046.

ADA: Targeted Phone Calls May Help Control Diabetes

diabetes app for iPhoneBy Charlene Laino, Senior Writer, Gupta Guide

Published: June 24, 2013
Reviewed by F. Perry Wilson, MD, MSCE; Instructor of Medicine, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner

CHICAGO — HbA1c levels dropped by a “startling” 0.6% in people with diabetes in a poor, underserved, urban area who received telephone counseling from trained health educators who lived in their neighborhood and “spoke their language,” a researcher reported here at the American Diabetes Association 2013 Scientific Sessions.

In the 1-year study of nearly 1,000 people, HbA1c levels fell from 9.3% to 8.4% in those who received written and phone counseling (P<0.01), compared with a nonsignificant drop from 9.1% to 8.6% in those who received only print materials.

“The [reduction] in HbA1c in the telephone intervention group was comparable to that produced by some pharmaceuticals,” said study author Elizabeth A. Walker PhD, RN, CDE, of Albert Einstein College of Medicine in New York City. She added that people with higher HbA1c levels at baseline did best.

The key to the program’s success, she said, was behavioral counseling that stressed the importance of medication adherence, exercise, and diet, delivered in “in a voice that sounded familiar, like their neighbor’s.”

Importantly, “this is something that could be done out of [any physician’s] office or clinic. It’s a low-cost intervention — and it does not have to be delivered by a healthcare professional,” Walker said.

“We trained people who had bachelor’s degrees over a 2-week period. But really you can train anyone to perform the telephone intervention,” she said.

Study participants, all of whom lived in the South Bronx, were “some of the hardest-to-reach people,” Walker said. “They were very poor, 70% were foreign born, and 56% were Spanish speaking. That’s why the finding is so significant,” she said.

When the study began in 2009, the prevalence of diabetes in the South Bronx was among the highest in the nation: 14.2%, she said.

For the study, the researchers recruited 941 adult patients with diabetes from the New York City Health Department’s HbA1c registry, a mandatory reporting system that tracks HbA1c test results for all city residents.

Continue reading ADA: Targeted Phone Calls May Help Control Diabetes

State Gearing Up for Public Education Campaign Targeting Latinos

by Angela Hart, California Healthline Contributing Reporter

Covered California (health exchange) logo
Meet your local promotores!

Eager to maintain the state’s reputation as a leader in implementing the Affordable Care Act, California officials are putting the finishing touches on a plan to send thousands of newly hired emissaries to spread the word about health care reform.

Officials hope their massive public education and outreach campaign starting next month will reach deep into hidden pockets of the state and attract a large pool of newly insured individuals into Covered California, the state’s health insurance exchange. Exchange officials hope to enroll 1.4 million next year from a pool of about 5.3 million who will be eligible.

A new army of outreach workers — part of an estimated 21,000 new employees working directly and indirectly for Covered California — will be knocking on doors, holding informational gatherings likened to Tupperware parties and visiting hundreds of schools throughout the state.

Covered California officials said it is critical to reach the uninsured and inform them about new health law provisions taking effect in six months. The goal of the outreach campaign is to increase awareness about new benefits available to consumers, educate “targeted” audiences about subsidies available under Covered California and to motivate people to enroll.

The state’s biggest target? Latinos.

In awarding 48 community groups, schools and health clinics $37 million in federal outreach and education grants last month, Covered California officials underscored the importance of reaching the largest uninsured populations.

Latinos make up 42% of the population in California but account for a disproportionate share of its uninsured residents. According to a 2012 report by the California HealthCare Foundation, Latinos constitute nearly 60% of the state’s uninsured population. CHCF publishes California Healthline.

“Latino outreach is going to be very important,” said Shannon McConville, a researcher at the Public Policy Institute of California specializing in issues surrounding health policy and racial and ethnic health disparities. “When you look at who is currently uninsured and who will become eligible for coverage, it’s impossible to ignore the Latino population. Based on current numbers, they are the largest uninsured group in California.”

McConville pointed to a January 2013 PPIC opinion poll that gauged public opinion about the new health law. According to the statewide survey, 32% of Latinos said they would be better off under the new health care law, compared with 21% among whites. Conversely, the poll showed that 37% of whites said they would be worse off, compared with 11% of Latinos.

L.A. Group’s Far-Reaching Plans for ‘Promotores’

Vision y Compromiso, a Los Angeles-based advocacy group that focuses on issues effecting the Latino community, won a $1 million grant from Covered California for education and outreach in late May. Continue reading State Gearing Up for Public Education Campaign Targeting Latinos

Distracted Walking More Dangerous Than Distracted Driving?

road sign that reads, "distracted driving injuries quadrupled in last 7 years"Distracted Walking: Injuries Soar for Pedestrians On Phones

More than 1,500 pedestrians were estimated to be treated in emergency rooms in 2010 for injuries related to using a cell phone while walking, according to a new nationwide study.

The number of such injuries has more than doubled since 2005, even though the total number of pedestrian injuries dropped during that time. And researchers believe that the actual number of injured pedestrians is actually much higher than these results suggest.

“If current trends continue, I wouldn’t be surprised if the number of injuries to pedestrians caused by cell phones doubles again between 2010 and 2015,” said Jack Nasar, co-author of the study and professor of city and regional planning at The Ohio State University.

“The role of cell phones in distracted driving injuries and deaths gets a lot of attention and rightly so, but we need to also consider the danger cell phone use poses to pedestrians.”

The study found that young people aged 16 to 25 were most likely to be injured as distracted pedestrians, and most were hurt while talking rather than texting.

Nasar conducted the study with Derek Troyer, a former graduate student at Ohio State. It appears in the August 2013 issue of the journal Accident Analysis and Prevention.

The researchers used data from the National Electronic Injury Surveillance System, a database maintained by the U.S. Consumer Products Safety Commission (CPSC), which samples injury reports from 100 hospitals around the country. These reports are used to estimate total injury occurrences at emergency rooms across the country.

They examined data for seven years (from 2004 to 2010) involving injuries related to cell phone use for pedestrians in public areas (in other words, not at home).

Continue reading Distracted Walking More Dangerous Than Distracted Driving?

The Art of Written Communication in Workers Compensation

June 10, 2013 by 

Throughout the workers compensation process you will frequently need to write letters requesting information from health care professionals, your claims adjuster, your broker, employees and others.
Make sure that your communication spells out in sufficient detail exactly what kind of information you want in response. For example, if you ask a treating physician for “a statement about whether the employee can return to work” you are likely to get back a vague statement like “the employee cannot return to work until seen by this office.”

Workers' Compensation Claim form with stethoscope

This document does not contain sufficient information to indicate if the worker is able to return to work in a transitional duty capacity, nor does it contain any information
that is useful to the employer. To be useful, ask that the physician’s note include:
  • Estimated return to work date
  • Diagnosis
  • Prognosis
  • Treatment plan
  • Follow up care information
  • Medical abilities and restrictions detailing what the employee can do in a transitional duty job
  • Next appointment
  • Doctor’s phone number
One important use of clear letter writing is internal company communication. Written internal communication can set the tone of your company’s safety culture. For example, a CEO Roll-Out Letter is a good tool for transitioning your company into the implementation phase of workers compensation management. The CEO highlights the main features of your improvement plan program, such as return to work and a description of the general expectations for participation in the program.
Another good use of letter writing is to network and establish good working relationships. For example, if you have your injury coordinator write a letter to your insurance adjuster thanking them for their help in developing your workers comp program, you have set the tone for a future positive working relationship. See our sample at
A few basics:
  • Consider using a form.  Tables with “to,” “from,” “subject” and “date,” for example, look professional and keep information crystal clear. 
  • Use professional language at all times. This is not the time for emotions or personal references.
  • Spell out abbreviations on the first reference, even when you are sure your recipient knows them. You never know who else may handle your letter, including new employees, interns or temps.
  • Always include the time, date, your title, name and contact information including phone numbers and email address.
  • While emailing an attachment of your letter is the conventional method these days, sending a hard copy in the mail is a good idea, especially when requesting sensitive information or documents.
Communication in workers compensation is critical. Writing letters and documents require care and professionalism. Contact us for assistance in writing letters and setting up your workers comp management program.
Author Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  Contact:
©2013 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law

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Stay Home if You Are Sick. Really.

If you're sick stay homeRespiratory Virus Shedding in a Cohort of On-Duty Healthcare Workers Undergoing Prospective Surveillance

Esbenshade JC, Edwards KM, Esbenshade AJ, et al Infect Control Hosp Epidemiol. 2013;34:373-378

Study Summary

Two recent publications serve as yet another reminder that healthcare workers (HCWs) should avoid patient care duties when feeling ill.

Esbenshade and colleagues performed prospective biweekly surveillance to assess influenza and other respiratory virus shedding in a cohort of hospital-based HCWs between November 2009 and April 2010. During the 20-week study period, 1404 nasal swab specimens were collected from 159 physicians, nurses, and ancillary staff working in patient care areas. Multiplex respiratory virus polymerase chain reaction was also performed on 119 specimens from 83 ill HCWs and 200 specimens from 106 randomly selected asymptomatic HCWs.

Forty-two specimens were positive: 35 (29.4%) obtained from ill HCWs and 7 (3.5%) from asymptomatic HCWs. Human rhinovirus was the most commonly identified virus (n = 33), followed by coronavirus and parainfluenza virus (n = 4 each) and human metapneumovirus (n = 1). No influenza was detected, which was believed to be related to the atypical influenza season in 2009-2010 as well as the high level of vaccination among participants (74.2%).

Multivariate analysis demonstrated that viral shedding was strongly associated with report of any symptoms (odds ratio [OR],13.06; 95% confidence interval [CI], 5.45-31.28; P < .001) and less strongly associated with younger age (OR 0.96; 95% CI, 0.92-0.99; P = .23). In a postsurveillance survey, 46% of study participants reported working with an influenza-like illness.

Agricultural Giant Takes Lead in Keeping Workers Healthy

bushel basket of clementines from Californiaby Alice Daniel, California Healthline Regional Correspondent

DELANO — Paramount Agribusinesses comprises the largest farming operation of tree crops in the world: almonds, pistachios and clementines. Now its companies are betting on a different kind of productivity: keeping a workforce healthy in California’s Central Valley by offering free on-site medical care.

“We’re backing up the healthy products we create by offering our employees much better than standard coverage,” said Danny Garcia, director of human resources at Paramount Citrus.

In return, the company benefits from fewer sick days, better productivity and improved morale. Paramount companies also offer employees health insurance.

“If people feel like they’re part of a company, invested in the company, that pays off. We have a lot higher retention rate, better, more consistent work,” said Garcia. While the company can’t know yet whether the venture saves money in the long run, it is already making gains in terms of its employee base, he added.

“I think this is a great idea,” said Kevin Hamilton, deputy chief of programs at Clinica Sierra Vista, a health care organization for underserved populations. “I love to see employers taking responsibility for the health care of employees especially if they’re not eligible for the Affordable Care Act.” He said community health centers in California have long been interested in partnering with agricultural providers.

Farmworker advocates said a few other agriculture-related companies in California offer similar programs. Western Growers Assurance Trust has a low-cost clinic in Salinas for its employees. The Reiter Affiliated Companies, growers of Driscoll’s Berries, fund three low-cost clinics that serve workers and their family members in Watsonville, Santa Maria and Oxnard. Continue reading Agricultural Giant Takes Lead in Keeping Workers Healthy

A Drug-Free Workplace Helps Your Company And Your Workers’ Comp

June 3, 2013 by 

Part of our services to businesses in the Santa Maria Valley include fast, accurate D.O.T. screenings and pre-employment testing services at Central Coast Industrial Care.

We Conduct Drug Testing yellow and black signHaving a drug-free workplace is an important step in reducing workers comp costs. Employees using drugs or under the influence of alcohol are more likely to have accidents and make mistakes. They also have higher rates of absenteeism and are less productive. In addition, some states and insurers offer a workers comp premium reduction for employers that have a drug-free workplace program.
The Department of Labor Data
The Department of Labor (DOL) has significant data on drugs and alcohol in the workplace. Some of the findings are that
·         75% of the nation’s current illegal drug users are employed
·         3.1% say they have used illegal drugs before or during work hours
·         79% of the nation’s heavy alcohol users are employed
·         7.1% say they have consumed alcohol during the workday
It is important for employers to encourage workers with substance abuse issues to seek help. This encourages employees not to hide their problem, which can make the risk of accidents more likely. Also, employees who have a status as being a drug addict or alcoholic may be protected under disability discrimination laws.
Drug-Free Written Policy
The first step in establishing a drug-free workplace is to have a written policy that is distributed to all employees at all levels. The policy should:
·         Tell employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the workplace
·         Specifies the actions that will be taken against employees for violating that prohibition
·         Tells employees that they must notify you in writing if convicted for violating a criminal drug statute occurring in the workplace and must do so no more than five calendar days after the conviction
Drug-Free Awareness Program
Employers should establish an ongoing drug-free awareness program to inform employees about
·         The dangers of drug abuse in the workplace
·         The policy of maintaining a drug-free workplace
·         Any available drug counseling, rehabilitation, and employee assistance programs
·         The penalties for drug abuse violations occurring in the workplace