National Return to Work Week - Part 2

The first group of webinar sessions for National Return to Work Week were a great introduction into the why a company should make the effort, perhaps even amid lay-offs, to returning an employee to some sort of productive work.

Annually, 1.1 million employees lose and average of 7 days due to their work injury. When looking at the significant costs of those injuries, one finds that according to the National Safety Council's Accident Facts ® injuries cost US employers $160.4 billion each year in medical and other direct costs, lost productivity and wages. This expense does not count the additional expenses related to adding to the social security systems.

Now not all injuries are workplace injuries. A return to work program can also be effective to keep short-term and long-term disability claims down. Disabling injuries happen off the job as well as on the job. Every 1.3 seconds someone suffers a disabling injury. That's 63,000 people total people injured daily. Almost half of the 6.8 million people who collect Social Security benefits are under the age of 50.

In the current economic downturn both company employers and the insurance industry are showing huge losses. These staggering statistics make an excellent case for an effective return to work programs for employees injured both on and off the job. The new amendments to the ADA and updates to the FMLA that went into effect this year may also substantially affect companies who do not have a progressive return to work program.

Allowing or forcing an employee to stay at home rather than working a modified duty does nothing more than create an end settlement that does one of two things:

1. Either it rewards those workers who have a tendency to play the system, encouraging them to repeat the actions at their next job.

2. For those workers with a legitimate injury the settlement is rarely enough to survive on, thus creating an additional burden to society though welfare and social security systems.
   

An employer must effectively manage the workers compensation process from the date of injury through return to work or settlement. The insurance adjuster is not the employer. The employer has a far better handle on the issues related to the injury. However, a well managed return to work program doesn't have to be a daunting task, as Dennis Chandler – Director of Return to Work Programs with Company Nurse shows.

Attorney Michael Moebes, who has the unique position to have worked on both the employer and worker sides of the workers compensation issues, discussed the mistakes employers make. Attorney Moebes also talked about the current economy and the success of return to work programs.

To learn more a, please review yesterday's webinars and sign up for others happening this week. The webinars will be stored and the recording available for you to watch on-demand.

http://nationalreturntoworkweek.org/register-for-national-return-to-work-week-sessions/

National Return to Work Week – Part 1

May 10 – 16th is National Return to Work Week. This week is an opportunity for safety professionals and others involved in workers compensation and disability management to demonstrate their commitment to helping injured, disabled or ill employees stay-at-work or return-to-work. By doing so, one of the largest business expenses for a company can also be significantly lowered.

Annually 1.2 million employees loose work days due to workplace injury or illness. Unfortunately once an employee is injured, too many employers feel that person has become a liability. Often the company does not offer light duty, or only for a very short time. When that happens the employee is forced onto workers compensation. Often times the employee is also laid off.

Statistics have shown that 40% of the employees who are off work for over 12 weeks (FMLA time) have serious trouble finding other work. If an employee is out for more than sixteen weeks, there is a good chance that individual will never return to employment. Even if an employee finds a job, it is frequently at a much lower position than held previous to the injury or illness. Employees begin to lose contact with fellow workers and feel shut out.

Unless returned to work as soon as possible, some employees begin to feel that that a workers compensation benefit is better than looking for another job. Workers compensation essentially “rewards” employees for not working. An employee sitting at home is exposed to advertisements from lawyers offering to help them continue to collect workers compensation. This begins to look good as a way to get even with the employer that seemed to discard them as easily as yesterdays trash.

Unfortunately in this system, both employers and injured employees lose. Beyond the initial injury, employees may suffer depression Entire whole families may suffer emotionally and financially if the major bread-winner is injured and off work for any length of time.

The longer an employee is off work, the more expensive a workers compensation (or long-term disability) case becomes. Insurance rates or direct expenses skyrocket. Employers may set themselves up for additional discrimination claims and expensive settlements. Employers lose employee loyalty, and may have under-reporting issues especially if the employee feel their jobs are likely to be lost if they claim a workers compensation injury.

This week's blog will continue the theme of establishing an effective return to work program.

Links:

National Return To Work Week was founded by Margaret Spence, CWC, RMPE - President of Douglas Claims & Risk Consultants, Inc. author of “From Workers’ Comp Claimant to Valued Employee - Employer’s Guide to Implementing a Proactive Return to Work Program - Florida Edition”. - http://margaretspence.com/

National Return to Work Week - http://NationalReturnToWorkWeek.org/.

Free webcasts as part of NRTWW - http://nationalreturntoworkweek.org/register-for-national-return-to-work-week-sessions/.

More about Margaret Spence - http://workcompseminars.com/about/about-margaret-spence/

Job Hazard Analysis - Introduction

The job hazard analysis is an important safety tool. A job hazard analysis (JHA) or job safety analysis (JSA) breaks down a worker's job into specific tasks. From there each task is broken into specific steps. Each step is then analyzed for hazards that may be present.

Since a job hazard analysis takes time, priorities must be set to determine which jobs should take precedence. Review incident and accident logs to see if certain areas come up more frequently. Employee surveys are another way to track areas of greater concern. A job hazard analysis should be performed as part of setting up a new task, or when the area or task is changed. JHA's should be done after a near miss, or accident.

Video taping the employee at work is an excellent way to determine hazards as each specific task can be viewed multiple times. However, one must be sure that workers being video taped understand this is to make their jobs safer and not a critique of the employee. In fact, employees should be included in the entire process of the JHA. Who better knows the job and the tasks that cause pain or awkward positions? Employees have a better understanding of the task, and may offer clues to hazards. Employees should also be encouraged to offer suggested solutions as they may have found “work-arounds” to minimize the hazard. Include supervisors in the JHA as their input may also be valuable.

While each job task must be broken into steps, an overview of the area must also be analyzed. Is lighting adequate? Are there issues with employee or material handling traffic in the area? Once the overview is complete and any hazards noted, the specific task and each step must be analyzed. Writing down each step is important. Note any hazards for each step. Then work on the recommended solutions. Recommendations should:

1. Eliminate the hazard if at all possible (add guards, add a hydraulic table, use a non-hazardous alternative to a current chemical, etc.).

2. Provide administrative controls if the hazard cannot be eliminated (job rotations, changes in the way the tasks are performed, etc.).

3. Provide proper PPE if engineering and administrative controls aren't adequate to eliminate or control the hazard.
   

Once the solutions are found and the hazards eliminated or controlled, all employees and supervisors will need to be trained in the new procedures. The task should also be revisited to see if the solutions are working, and reviewed yearly.

Here is an excellent video on job hazard analysis: http://revver.com/video/1385172/introduction-to-the-job-hazard-analysis-process

Links:

http://www.safetyworksmaine.com/safe_workplace/safety_management/hazard_analysis.html

http://www.ccohs.ca/oshanswers/hsprograms/job-haz.html

http://www.forensicmag.com/articles.asp?pid=243

http://tinyurl.com/o9lnjw

http://www.osha.gov/Publications/osha3071.html

http://www.the-osha-advisor.com/JHA.html

More on Overexertion Injuries: Repetitive Motion Injuries

Repetitive motion injuries (RMI), are gradually developing injuries of soft-tissue structures such as tendons, nerves, and muscles. Repetitive motion injuries are most common in fingers, wrists, elbows, arms and shoulders. Characterized by pain and discomfort, repetitive motion injuries tend to become progressively worse over time if not treated, and may result in a disabling loss of function of the affected area.

While Tennis Elbow (tendinitis) is a well known as a sports related injury, most RMI's have occupational stressers as the major contributing cause. Unlike other injuries, RMI's do not have a single definitive date of injury. Repeated motion of a body part without time for recovery causes micro-tears in the tissues and nerve. These micro-tears accumulate to cause a permanent cumulative trauma to the area. Repetitive motion injuries are also known as Cumulative Trauma Disorder (CTD). Symptoms include chronic aches, stiffness, sore muscles, decreased coordination, tingling or numbness especially upon waking, and trouble sleeping because of the pain.

Carpal tunnel syndrome (impingement of the nerves in the wrist) may be the best know work related RMI. However, hand-arm vibration syndrome (wrist), radial tunnel syndrome, cubital tunnel syndrome, tenosynovitis of the forearm extensor and flexor muscles (elbow and forearm), tension neck syndrome, thoracic outlet syndrome (shoulders and neck), are also examples of repetitive motion injuries. Repetitive motion injuries are often tough to diagnose and treat. However, once diagnosed, OSHA considers this to be a recordable occupational illness. Due to the difficulty in diagnosis and treatment, RMI's are among the most costly occupational injuries. Preventing these injuries can result in significant cost savings for a company.

The first step in prevention is determining which tasks are at risk. A job hazard analysis with a focus of which tasks are frequently repetitive or tasks that very little throughout the workweek, awkward positions and posture, excessive pinching, frequently raising the arm or shoulder and excessive force needed in the job task. Employee surveys, reviewing incident records, and noting areas where employees leave or bid out to other areas are great ways to pinpoint which areas may need the most attention.

Educate employees to the risks of repetitive motions injuries. Encourage employees to promptly report all concerns with repetitive tasks and aches or pain. Repetitive motion injuries can often be healed quickly if promptly reported.

Train supervisors to be aware repetitive motion tasks and issues employees may have. Supervisors should help evaluate workstations. Encourage and allow supervisors to cross train employees, and vary their tasks through-out the day or week. Supervisors must continually monitor work areas for proper ergonomic work practices.

Once an employee reports a repetitive motion injury or pain and swelling, take them off the task to allow the injury to heal. Before allowing the employee back on the task, adjust the workstation or task to control the hazard. Merely allowing a healed employee back on the same task that caused the issue, doesn't fix the problem. Inevitably the repetitive motion injury will return.

An untreated repetitive motion injury can be disabling for the employee. Controlling repetitive motion injuries can result in a significant cost savings in workers compensation rates, reduced absence rates, and increased productivity. One study estimated that each controlled or eliminated repetitive motion injury saves a company $27700.

Additional Links:

http://www.cdc.gov/niosh/docs/97-141/ergotxt1.html

http://www.cdc.gov/niosh/docs/2006-119/pdfs/2006-119a.pdf

http://www.cdc.gov/nchs/data/series/sr_03/sr03_031.pdf

http://www.cdc.gov/nchs/data/series/sr_03/sr03_031.pdf

https://www.hrtools.com/insights/jennifer_blanchard/dont_let_repetitive_motion_injuries_damage_your_workplace.aspx

http://www.scif.com/safety/safetymeeting/Article.asp?ArticleID=99

http://ehstoday.com/news/ehs_imp_37502/

http://www.cdc.gov/niosh/docs/2007-122/glossary.html

Eye Injuries and Protection

Approximately 2000 eye injuries occur everyday in the workplace (in the US). The construction Industry has one of the highest rates of injury. Common sources of injuries are from dust, metal, wood, slag, drywall, cement and other fine particles. Rebounding nails are also one of the most common causes of vision loss for construction workers. Wet or powdered cement in the eyes may cause chemical burns. Improper or non-existent eye protection when handling chemicals can also lead to chemical burns if splashes reach the eyes. Improper eye protection can lead to weld flash burns to eyes for welders, helpers and bystanders. Laser burns from cutting machines or surveying equipment can be another source of eye burns.

All injuries must be taken seriously, as even minor injuries can cause life-long vision problems. Suffering a simple scratch from sawdust, cement, or drywall could cause painful corneal erosion. Everyone working in or passing by a construction site must be aware of the risk, as dusty or windy conditions may lead to particles in the eyes. Coworkers may generate hazardous conditions that could cause eye injuries to others.

Even passing through an area where work is being performed may lead to eye injuries if the hazard isn't controlled. Machine guarding may prevent particles from becoming airborne. Weld curtains can protect bystanders from weld flash burns to the eyes. All workers in an area that may contain eye hazards must wear proper eye protection. The most common injuries to the eyes are from those who didn't think they needed eye protection.

All eye protection must have a “Z87” or “Z87+” mark along the frame or lens. Safe eye protection includes safety glasses (prescription or no-prescription), clear or tinted goggles, faceshields, welding helmets, and some full-face type respirators that meet the ANSI Z87.1 Eye and Face Protection Standard.

Safety glasses are the most common type of eye protection. Safety glasses are used as protection against impact. Side protection is required when hazards from flying objects are present. Most safety glasses include wrap around side shielding. Some safety glasses are made in different sizes to fit different shape faces. Some styles fit better than others. Safety glasses should fit snug against the face to provide the best protection. Face shields provide protection from impact to the face, but not the eyes. Safety glasses must be worn underneath a face shield.

Goggles provide more protection than safety glasses. Goggles are used for higher impact protection, greater particle protection, chemical splashes, and welding light protection. Goggles with direct venting (small holes around the sides) tend to fog less, but should not be used with liquid or fine dust hazards. Goggles for splash or high dust protection should have indirect venting.

Tinted safety glasses used in torch soldering must have a shade number (1.5-3) on the lens, but do not provide adequate protection for gas or arc welding which need shades 4 or higher (the shade number is marked on the lens and shows how dark the lens is). Welding goggles with shade numbers 4-8, must be used for gas welding or cutting. Welding helmets are needed for all arc welding requiring shade numbers 10-14. Safety glasses must be worn underneath welding helmets.

More information can be found here:

http://www.cdc.gov/niosh/topics/eye/default.html

http://www.cdc.gov/niosh/topics/eye/eyechecklist.html

http://www.safetyequipment.org/eyeface.htm

http://www.elcosh.org/docs/d0100/d000018/d000018.html

http://www.elcosh.org/docs/d0500/d000553/d000553.html

http://www.osha.gov/SLTC/eyefaceprotection/index.html

The Four Day Work Week and Overexertion Injuries

High gasoline prices last year and the economic down-turn this year are affecting both employees and businesses. Doing more with less in an already Lean environment as well as the rising costs of material and general overhead has number of businesses considering going to a four day work week. As part of this consideration, the effect on employee safety must be considered.

While survey results so far show that generally employees are more satisfied with the 4 day schedule, the long term effects of near miss accidents, reportable and lost time injury rates have yet to be assessed. Keep in mind that lengthening the time employees perform heavy labor contributes to muscle fatigue. Granted employees will generally have an extra day to recuperate. However, the length of time between the day to day labor may not be enough to properly remove lactic acid build up – one cause of overexertion injuries.

Many manufacturing companies' demands are also cyclical. What happens when the demand increases and the needs of 4 ten hour days are not enough to meet those demands? Generally companies will offer over-time during these periods. If you add another hour or two to the beginning or end of the shift, the lactic acid buildup will be greater. Extending the week to include overtime on Friday may not leave enough time for recuperation, especially if your employees tend to be active on their other days off.

Some progressive companies have hired ergonomic professionals in the past to help them determine recommended lifting requirements of specific jobs. Adding an extra two hours to a shift may lower those recommended weight limits. See yesterday's post for more on lifting requirements.

I would be the first to appreciate a four day work week and the last to tell you not to do it. However, the possible detrimental costs of increased injuries, must be assessed along with economic considerations.

Overexertion Injuries and Lifting Requirements

According to Liberty Mutual's "Most Disabling Injury Report", overexertion ranks first as the leading cause of workers compensation claims costs in the workplace. The report goes on to state, "This event category, which includes injuries related to lifting, pushing, pulling, holding, carrying, or throwing, accounted for more than one-quarter of the overall national burden at 25.7 percent. In the latest data year (2006), these injuries cost businesses $12.4 billion in direct cost." Given that, if your company has injuries related to this category, revisiting the manual materials movement requirements may save a significant amount of money, either as a significant decrease in the Experience Modification Rates (EMR) or as direct costs for those self-insured companies. In this post, we'll concentrate on lifting.

Do you know how your company came up with its current lifting requirement? Too many companies base their lifting requirements on the weight of the item to be lifted. As an example, the item to be lifted weighs 65 pounds. The employee is capable of lifting it from the floor to waist height, so the lifting requirement was set at 65 pounds. There was no consideration given to the demographics of the workforce, the frequency of the lift, any twisting that needed done, etc.

At the time of writing OSHA does not have an ergonomic standard, though that may change with the new administration. Currently, OSHA is able to cite employers under its General Duty Clause when a workforce is found to have lifting requirements well above that which is safe. Given the direct cost of injuries attributed to lifting and the possibility of additional costs in possible fines, a company would be well served to take a long hard look at their current lifting requirements.

OSHA uses a Lifting Guide issued by the National Institute for Occupational Safety and Health (NIOSH) to help determine a recommended safe lifting weight. NIOSH recommends lifting a maximum of 51 pounds and that is only under very controlled conditions (lifts from knee level to waste level, no twisting, proper hand-holds, etc.). If an employee must start a lift below knee level, twist as part of that lift, reach above shoulder level, lift more frequently, etc. the maximum recommended weight for the lift goes down – in some cases drastically.

NIOSH has published an “Applications Manual for the Revised NIOSH Lifting Equation” (See links). My suggestion would be to read it throughly and then use one of the on-line calculators to determine the maximum recommended lifting weight for the task (See links). A lifting requirements must be assigned for each task, or in cases where employees change tasks often, must be determined by the lowest recommended weight limit of all of the tasks performed.

There are things that can be done to increase the recommended weight limits, while still reducing the instances of overexertion injuries related to lifting. Engineering controls include:

• Reduce the size and /or weight of the object to be lifted.
• Adjust the starting and ending height of the lift by installing pneumatic lifts, or lowering the height of shelves.
• Adjust work stations to reduce twisting, or obstructions.
• Use conveyors to eliminate of reduce lifting frequencies.

Administrative controls could include:

• Train employees to lift properly.
• Use two hand lifts where necessary.
• Strength test potential employees to make sure they are capable of handling the lifts.
• Where possible, include passing a strength test as a condition of accepting transfer to a new position.

Whether there will be a revised OSHA ergonomic standard or not, it makes good financial sense to adjust tasks and lifting requirements to help reduce the costs associated with employee overexertion injuries from lifting.

Useful Links:

Applications Manual for the Revised NIOSH Lifting Equation

• http://www.cdc.gov/niosh/docs/94-110/

On-line Lifting Calculators

• http://www.emcins.com/lc/niosh.htm
• http://www.ccohs.ca/oshanswers/ergonomics/niosh/calculating_rwl.html
• http://www.lni.wa.gov/Safety/Topics/Ergonomics/ServicesResources/Tools/LiftingCalculator3/ergo_worksheetIE.htm
• http://www.cdc.gov/niosh/docs/94-110/
• http://www.ohiobwc.com/employer/programs/safety/liftguide/liftguide.asp - Includes lifting limits for injured workers.

Other Useful Links

• http://www.libertymutualgroup.com/omapps/ContentServer?cid=1138365240689&pagename=LMGResearchInstitute/cms_document/ShowDoc&c=cms_document
• http://www.cdc.gov/niosh/docs/2001-111/thumb.html
  
• http://www.lni.wa.gov/Safety/Topics/Ergonomics/ServicesResources/WhatsNew/PDFs/LiftingFAQrevised.pdf
• http://libertymmhtables.libertymutual.com/CM_LMTablesWeb/taskSelection.do?action=initTaskSelection
• http://www2.worksafebc.com/Topics/Ergonomics/Home.asp