Promising Practices for Total Worker Health

Chia-Chia Chang, MPH, MBA, NIOSH Office for Total Worker Health
Deborah Roy, MPH, RN, COHN-S, CSP, L.L.Bean

A Safety Redesign Jump-Starts Health and Well-Being for L.L.Bean’s Aging Workforce

vaccuum assisted lifting for ageing worker at L.L. Bean
A materials-handling worker demonstrates using a vacuum-driven lift-assist device in an L.L.Bean warehouse

At L.L.Bean, Maine’s quintessential outdoor clothing and equipment company, the workforce is growing older. Although advancing age improves problem-solving and teamwork skills, it also adds risk, especially for older workers with physically demanding tasks.

Acknowledging this truth helped L.L.Bean look beyond its established safety and health infrastructure, says Deborah Roy, MPH, RN, COHN-S, CSP, Corporate Director for Health, Safety, and Wellness. The company began taking decisive steps to optimize work processes and prevent injury and illness for all their workers, not only their older ones.

Unique Workforce Considerations

When people come to work at L.L.Bean, many become lifelong staff members because they know the company values its workers and embraces active living. However, low turnover means that employees who were hired in their 20s still have physically demanding jobs 25 or 30 years later.

With an average employee age of 50, L.L.Bean’s team shares many of the age-related challenges common in workplaces nationwide. Reduced flexibility of the neck and spine, lower grip and lifting strength, and limits to range of motion all become more likely as workers age. Older workers are also more likely to have one or more chronic diseases such as arthritis, diabetes, and obesity. These issues make a focus on injury and illness prevention an absolute necessity.

Integration of Prevention

A materials handling worker at L.L.Bean demonstrates lifting techniques that resulted in L.L.Beans purchase and installation of robotic and vacuum-driven lift-assist devices.
Continue reading Promising Practices for Total Worker Health

Medication Sharing App Wants to Prevent Waste of Unused Medications

Paul Cerrato, Iltifat Husain, MD | August 19, 2016

Dr. Iltifat Husain’s physician take is at the end of this article

screen shot of prescription medicine sharing appA bold Greek experiment for donating unused medications to others in need may be worth emulating in other countries. The GIVMED app allows users to register their excess medicines by scanning the barcode on the package and choosing where they want to donate their medication.

The medical app developers explain “according to the Panhellenic Pharmaceutical Association, 57,000,000 boxes of medicine expire every year in Greece, while social pharmacies cannot accommodate their 15,000 daily requests.

The mobile application extracts all medical information from the barcodes found on medical packaging, and links users with organizations that could redistribute this medication to individuals in need of them, like social pharmacies and NGOs. Social pharmacies are responsible for collecting and distributing medicines to people with financial problems, free of charge.”

The medication sharing app lets donors decide which medications to donate now and which ones to donate before their expiration date. It also gives users updates on how many are in the community’s network, the drugs that have been donated, and their total worth.
Continue reading Medication Sharing App Wants to Prevent Waste of Unused Medications

Advancing Pain Treatment

By Safety National 08/24/2016 10:59:00

Chroni Pain signStartling statistics, trends and illustrations reveal an undeniable prescription drug problem in the United States.

This session at WCI’s 2016 Workers’ Compensation Educational Conference focused on chronic pain management, including alternative and advanced treatment methods being used to alleviate pain and restore quality of life among those who have become ill or have been injured on the job.

Speakers included:
•  Dr. Teresa Bartlett, Senior Vice President, Medical Quality, Sedgwick
•  Michael Gavin, CEO, Prium
•  Dr. Eric Won, President, Brain Research Laboratory

Opioids and other powerful narcotics are often the first line of defense in addressing chronic pain among injured or ill workers today. Far too often, these lead to the more severe problems of long-term use and addiction. The lives of workers and those around them can quickly be destroyed.

There are several ways to intervene when an addiction occurs:

•  PBM-assisted triage and collaborative clinical intervention. Offer provider education on CDC guidelines and follow best practices related to opioid risk assessments and drug screening.
•  Pain coaching and behavioral support.
•  Mandatory utilization review, when applicable. If you can stop the prescription at the point of sale, you have the best chance of avoiding potential problems later on.
Continue reading Advancing Pain Treatment

As States Legalize Medical Marijuana, Doctors Struggle With Knowledge Gap

August 15, 2016 | Kaiser Health News –

caduceus with marijuana leafMedical marijuana has been legal in Maine for almost 20 years. But Farmington physician Jean Antonucci says she continues to feel unprepared when counseling sick patients about whether the drug could benefit them.

Will it help my glaucoma? Or my chronic pain? My chemotherapy’s making me nauseous, and nothing’s helped. Is cannabis the solution? Patients hope Antonucci, 62, can answer those questions. But she said she is still “completely in the dark.”

Antonucci doesn’t know whether marijuana is the right way to treat an ailment, what amount is an appropriate dose, or whether a patient should smoke it, eat it, rub it through an oil or vaporize it. Like most doctors, she was never trained to have these discussions. And, because the topic still is not usually covered in medical school, seasoned doctors, as well as younger ones, often consider themselves ill-equipped.

Even though she tries to keep up with the scientific literature, Antonucci said, “it’s very difficult to support patients but not know what you’re saying.” Continue reading As States Legalize Medical Marijuana, Doctors Struggle With Knowledge Gap

A New Opioid … Really?

By Mark Pew 08/09/2016

cereal bowl full of multi-colored prescription pillsAccording to the Philadelphia’s “The Inquirer”, Medical advisers to the FDA have recommended approval of a new abuse-deterrent formulation (ADF) opioid named Arymo ER by Egalet Corp.

In fact, the vote was overwhelming; 18-1. This new painkiller is an extended-release morphine that comes in 15mg, 30mg and 60mg doses. A final decision by the FDA on that recommendation is expected by mid-October.

When compared to MS-Contin, a pharmacologist with the FDA reportedly said …

The numerical difference or outcome in the data was less than 5 percent, raising a question about Arymo’s “clinical relevance”
I applaud the concept of abuse-deterrence formulations of opioids and other dangerous drugs that can be abused. I appreciate the fact there truly are some people that need opioids for “before/during/immediately after surgery, cancer, AIDS/HIV, end-of-life care” (my broadbrush interpretation of appropriate use of opioids). I agree abuse (non-medical use) is rampant with opioids (and other dangerous drugs). I am an “all of the above” (all options on the table) kind of person when it comes to resolving our painkiller epidemic, and I do think ADF has a part to play.

But to me the bigger problem is … legitimate prescriptions by legitimate prescribers used legitimately by patients that are clinically inappropriate. Especially for the mostly inappropriate treatment of chronic pain.


Fired Worker Says Adderall Was Part Of The Job

By Cameron Langford

negatibe side effect of Adderall, info graphcSherman, TX ( – A finance manager for a Texas car dealership claims in court that his boss gave employees prescription Adderall to boost production, which hospitalized him with “heart-attack conditions,” and the boss fired him after he spent a month in rehab.

Brandon Davis sued Berkshire Hathaway Automotive dba Crest Nissan of Frisco on Aug. 8 in Federal Court. The dealership is the only defendant.

Davis says in the lawsuit he was the dealership’s top-producing finance manager and had the highest customer-service rating among his peers, which was not lost on his bosses, who noted those accomplishments in a letter of recommendation.

But Davis says when the dealership hired a new finance director, Justin Hamaker, in the summer of 2015, the workplace abruptly changed.

“Plaintiff noticed that his fellow finance managers did not seem as tired as plaintiff on long working days and nights,” he says in the complaint.

”During a discussion with Hamaker, Hamaker indicated to plaintiff that he had provided Adderall to the other finance managers and would do the same for plaintiff. Hamaker indicated the Adderall was necessary to work long hours and achieve high numbers.”
Continue reading Fired Worker Says Adderall Was Part Of The Job

Wearable Technology May Be Employee Health “Game Changer”


Wearable_Technology consumer preferencesSacramento, CA – Wearable technology is a category of technology devices that can be worn by an individual to collect tracking information related to health and fitness.

Some wearables have small motion sensors to report data back to the user. Today, many wearable devices are embedded in jewelry, clothing, shoes, bionic suits and smart helmets. These wearables use sophisticated biosensors to track metrics such as physical activity, heart rate, fatigue, stress and mood.

Wearables may be one of the fastest growing technology sectors, predicted to hit $10 billion annually within the next three years. And according to an article in Property Casualty 360, they’re poised to become a trend in the management of injured workers. And the workers’ compensation industry is staking a claim in wearable technology.

Employers and payers already are adopting wearable technology in the workplace to reduce costs and improve safety and productivity through injury prevention and recovery. Applications can range from tracking locations to reduce the risk of injury in unsafe areas, to monitoring posture and compliance with ergonomic use of equipment, to using smart wheelchairs and exoskeletons to improve and restore mobility.

The RIMS 2016 presentation, “The New Game Changer in Managing Worksite Health: Wearable Technology,” identified four main categories of wearable technology with significant potential for workers’ compensation.

1) Postural Devices: The use of postural devices in the workplace is intended to positively remind employees to be aware of their posture throughout the day. Workers are sent an alert if they repeatedly slouch or deviate from an ergonomically correct position. This assistive technology benefits employees by reminding them to stretch or adjust periodically while also helping to prevent ergonomic-related workers’ compensation claims.

2) Activity Trackers: If a physical therapist has recommended physical activities such as daily walks to rebuild muscle strength, the case manager can track the degree of activity of that injured worker. If the tracking device records lower physical activity levels than prescribed, intervention and counseling can take place to improve compliance or develop a different treatment plan.

 Continue reading Wearable Technology May Be Employee Health “Game Changer”

New FCC Tool Shows How Broadband Access Impacts Health

By Jeremy Snow  – August 2, 2016






The Federal Communications Commission’s Connect2Health Task Force unveiled a new data-driven map Tuesday to help illustrate how health care and broadband issues correlate across America.

With the new online mapping tool, users can explore every American county’s health statistics and broadband strength, connecting the benefits of stronger broadband to the health of citizens in certain areas. Users can see percentages of Americans with obesity, preventable hospitalization or diabetes. States with issues in both categories turn a different color, making easy to identify the most troublesome states.

Users can download all of the tool’s underlying data to use for other applications.

FCC Chairman Tom Wheeler, who spoke at the tool’s launch event at the Microsoft Innovation and Policy Center, believes it will showcase how health technology dependent on broadband, like teleheath or online diagnoses, will improve lives.

“This map can coordinate those kind of life-saving activities,” Wheeler said. “The map can help us focus on areas that need help. The map can direct resources.”

The data will allow experts to make fact-based decisions on broadband issues in health care, such as figuring out the best area to deploy new tech services or seeing which locations could take better advantage of its broadband, said FCC Commissioner Mignon Clyburn, who led the project. Continue reading New FCC Tool Shows How Broadband Access Impacts Health

CDC Says Zika Unlikely To Spread Far

August 01, 2016 | Jessica Davis – Associate Editor, Healthcare IT News

Zika-chain-coloredCDC Director Tom Frieden, MD said that the Centers for Disease Control and Prevention expected Zika to reach the U.S. and that individual cases and small clusters of infections are possible in the U.S. but widespread infections are unlikely.

American Medical Association President Andrew Gurman, however, urged members of Congress to resolve the difference and provide funding necessary to fight the virus.

“As we have anticipated, Zika is now here,” Frieden said.

Frieden explained that the population should not become alarmed if more cases are reported because many of the infected are asymptomatic. And the four Miami Zika victims were bit by a mosquito that had already bit someone with the virus.

The source of the recent cases is a reported 1-mile radius in Miami; two of the victims worked in neighboring worksites in the Winwood neighborhood. As it was sprayed directly after the source of the virus became known, there’s no real cause for alarm, he explained.
Continue reading CDC Says Zika Unlikely To Spread Far

Medical Marijuana – Beyond the Obvious

By Safety National 07/29/2016

Medical Marijuana logoAt the 2016 SAWCA Annual Conference, a panel discussed a variety of issues associated with medical marijuana. The panel was:

•  Dr. Robert Howell – Georgia GHSE
•  Eric Haines – Chief Deputy – Escambia County Sheriff’s Office
•  Michael Minardi – Chairman – Regulate Florida
•  Reggie Garcia – United for Care
•  Tom Glasson – Government Affairs Officer – AIG
•  Paul Tauriello – Colorado Division of Workers’ Compensation

Recreational marijuana has been legal in Colorado for 3 years now. Last year the marijuana industry in Colorado generated $996 million in revenue. This resulted in around $200 million in tax revenues for the state. While this may seem like a large number, it is really a very small percentage of the state budget. With tobacco, for every $1 in taxes collected there is $10 in costs to the system including healthcare and regulatory costs. Is marijuana producing a better ratio or is the costs of regulating legalized marijuana higher than taxes collected from its sale?

Alternative to Opioids?

The issue with considering marijuana as an alternative to opioids is that there is no science to support this. Since marijuana is a Schedule 1 drug, there has been no credible testing and studies about its effectiveness for different conditions. Any other prescription medication has to go through extensive testing to be approved. Published articles on this topic are very unscientific and tend to be more driven by personal opinion rather than actual scientific fact.

The question becomes can we stop the opioid epidemic by substituting medical marijuana?  The answer is that this is doubtful. Test subjects report a 30% reduction in pain with marijuana. It is likely that instead of replacing opioids, medical marijuana would be used in addition to it. Continue reading Medical Marijuana – Beyond the Obvious