Tip of the Week Archive
August 24th, 2009
Intermittent Leave
"An understanding of where the Family and Medical Leave Act, The Americans with Disabilities Act and state regulations intersect is required when determining whether an employee is "entitled" to be intermittently absent from work because of a medical condition. Individualized assessment is necessary to determine if intermittent leave is required as a "reasonable accommodation" under the ADA, in part because repeated absences from work most likely mean the person is unable to perform "essential job functions." ADA evaluations must be job-related and consistent with business necessity. The FMLA, on the other hand , entitles employees to intermittent leave when "medically necessary," a determination made through completion of the certification form DOL WH 380. An FMLA-qualified medical condition may or may not be work-related. Under the FMLA, employees must provide advance notice of their need for intermittent leave, but only as much as is practical under the circumstances. Practicality remains open to legal interpretation. An evaluating occupational medicine physician may consult with an employee's personal physician about an employee's medical condition - such as depression or migraine headaches that may cause intermittent absences - but only after getting the employee's permission."
Courtesy of:
Francis P. Alvarez, J.D.
Jackson/Lewis, LLP
White Plains, NY
August 14th, 2009
Tips to Help Workers in Cold Environments
Prolonged exposure to freezing or cold temperatures may cause serious health problems such as trench foot, frostbite and hypothermia. In extreme cases, including cold water immersion, exposure can lead to death. Danger signs include uncontrolled shivering, slurred speech, clumsy movements, fatigue and confused behavior. If these signs are observed, call for emergency help.
OSHA's Cold Stress Card provides a reference guide and recommendations to combat and prevent many illnesses and injuries. Available in English and Spanish, this laminated fold-up card is free to employers, workers and the public. Tips include:
- Recognize the environmental and workplace conditions that may be dangerous.
- Learn the signs and symptoms of cold-induced illnesses and injuries and what to do to help workers.
- Train workers about cold-induced illnesses and injuries.
- Encourage workers to wear proper clothing for cold, wet and windy conditions, including layers that can be adjusted to changing conditions.
- Be sure workers in extreme conditions take a frequent short break in warm dry shelters to allow their bodies to warm up.
- Try to schedule work for the warmest part of the day.
- Avoid exhaustion or fatigue because energy is needed to keep muscles warm.
- Use the buddy system - work in pairs so that one worker can recognize danger signs.
- Drink warm, sweet beverages (sugar water, sports-type drinks) and avoid drinks with caffeine (coffee, tea, sodas or hot chocolate) or alcohol.
- Eat warm, high-calorie foods such as hot pasta dishes.
- Remember, workers face increased risks when they take certain medications, are in poor physical condition or suffer from illnesses such as diabetes, hypertension or cardiovascular disease.
August 17th, 2009
National Alcohol and Drug Addition Recovery Month in September
Employers are being encouraged by the U.S. Department of Labor to recognize National Alcohol and Drug Addiction Recovery Month in September. The campaign highlights the strides made in substance abuse treatment and explains that addiction to alcohol and other drugs is a chronic, but treatable, public health problem that impacts all segments of society, including the workplace. Recovery Month provides opportunities for occupational health professionals to work with businesses to focus on drug and alcohol testing services, create or enhance their drug-free workplace programs and improve educational outreach efforts. Resources are available at: www.recoverymonth.gov.
August 10th, 2009
August is typically the hottest month of the year, so stay cool!
Heat is a serious hazard in construction. Your body builds up heat when you work and sweats to get rid of extra heat. But sometimes your body may not cool off fast enough. This can happen, say, if you are up on a roof pouring hot asphalt or you are lifting heavy loads.Too much heat can make you tired, hurt your job performance, and increase your chance of injury. You can get skin rash. You can also get:
- Dehydration. When your body loses water, you can't cool off fast enough. You feel thirsty and weak.
- Cramps. You can get muscle cramps from the heat even after you leave work.
- Heat exhaustion. You feel tired, nauseous, headachy, and giddy (dizzy and silly). Your skin is damp and looks muddy or flushed. You may faint.
- Heat stroke. You may have hot dry skin and a high temperature. Or you may feel confused. You may have convulsions or become unconscious. Heat stroke can kill you unless you get emergency medical help.
The Risk of Heat Stress
Your risk of heat stress depends on many things. These include:
- Your physical condition
- The weather (temperature, humidity)
- How much clothing you have on
- How fast you must move or how much weight you must lift
- If you are near a fan or there is a breeze
- If you are in the sun.
If there is an industrial hygienist on your work site, ask the hygienist about the Wet-Bulb Globe Temperature Index. It is a more precise way to estimate the risk of heat stress.
Protect Yourself
Try to do these things:
- Drink when you are thirsty.
- Keep taking rest breaks. Rest in a cool, shady spot. Use fans.
- Wear light-colored clothing made of cotton.
- Do the heaviest work in the coolest time of the day.
- Work in the shade.
- For heavy work in hot areas, take turns with other workers, so some can rest.
- If you travel to a warm area for a new job, you need time for your body to get used to the heat. Be extra careful the first 2 weeks on the job.
- If you work in protective clothing, you need more rest breaks. You may also need to check your temperature and heart rate. On a Superfund site where the temperature is 70 degrees or more, the U.S. Environmental Protection Agency (EPA) writes that while on the job you should be monitored for heat-stress related symptoms, including changes in body temperature and heart rate.
- If you think someone has heat stroke, call emergency services (or 911). Immediately move the victim to the shade. Loosen his/her clothes. Wipe or spray his/her skin with cool water and fan him/her. You can use a piece of cardboard or other material as a fan.
OSHA does not have a special rule for heat. But because heat stress is known as a serious hazard, workers are protected under the General Duty Clause of the Occupational Safety and Health Act. The clause says employers must provide "employment free from recognized hazards...causing or...likely to cause physical harm."
For more information, call your local union, CPWR - Center for Construction Research and Training (CPWR) (301-578-8500 or www.cpwr.com), the National Institute for Occupational Safety and Health (1-800-35-NIOSH or www.cdc.gov/niosh), or OSHA (1-800-321-OSHA or www.osha.gov). Or check the website www.elcosh.org
August 3rd, 2009
If you have an employee who is traveling overseas, whether for business or pleasure, be sure to have him or her contact our own travel medicine expert, Dr. Rodney Dodge, M.D., anchor physician of the Tualatin Clinic.
"Be sure employees are up to date on their vaccinations such as Hep A, Tetanus, etc. Allow plenty of time before traveling to schedule these vaccinations as some require a series of injections over a period of time. Check with the destination region for specific vaccinations and medications that may be recommended or required to enter a specific country. Another good rule of thumb is don't drink the water, either while brushing your teeth, taking a shower, or even the ice cubes in your drink. Waterborne illness is the most common cause of sickness and inconvenience among travelers."
Dr. Rodney Dodge, M.D.
Staff Physician
Tualatin Clinic
Cascade Occupational Medicine
(503) 885.8793
July 27th, 2009
When used for decision making, functional job descriptions (FJD) must be legally defensible. Recent ADA and EEOC decisions have used "essential functions of the job" as central criteria. A good FJD invariably serves as the core of a legal case, on either side. OSHA injury logs (300) call for identification of modified duty, compared to the original FJD. Workers' compensation looks for actual return to work when an injured worker can do a specific job-based either on the description of the original job or a different job. In developing a job description, measurement and qualitative assessment should take place on-site to ensure "real world" accuracy. Then, written worker validation of the FJD enhances its legal defensibility. In sum, FJD's can be strengthened by including on-site measurement and worker validation."
Courtesy of - NAOHP, as submitted by:
Susan Isernhagen
Founder, Isernhagen Work Systems
Duluth, MN
July 20th, 2009
Focus on Weight Management
Advice from a Medical Professional: "If I had to choose just one work place wellness
intervention, it would be a weight-management program. The benefits of proper nutrition
and regular exercies - such as lowering blood pressure, glucose, fasting total cholesterol,
low-density lipoprotein and triglyceride levels while increasing HDL - and reducing
the need for medications have been shown to lower cost and enhance health. Medical
providers can provide client companies and their employees with valuable insights
on medical morbidity and disease manifestations associated with obesity, and they
are well equipped to discuss ways to break a cycle of destructive habits and establish
healthier, more constructive lifestyles."
Courtesy of - NAOHP, as submitted by:
Phillip Zinni, D.O.
Medical Director
Harrah's Health and Wellness Center
Las Vegas, NV