Archive for: OSHA – General

CDC study: Excessive noise can contribute to high blood pressure and cholesterol

By: April 3rd, 2018 Email This Post Print This Post

Door alarms, heart monitors, surgical equipment, and Ted Nugent? Yes, Ted Nugent.

As I wrote in this month’s Medical Environment Update newsletter, excessive noise is an issue in the OR, where the eardrums of surgical team members are often bombarded by a bunch of different sources. Believe it or not, that sometimes includes classic rockers like the aforementioned Mr. Nugent, a popular playlist pick among surgeons.

Excessive noise in the OR can affect auditory processing among surgical team members, leading to miscommunication in critical moments and, subsequently, medical mistakes that affect patients plus needlestick injuries and slip-ups with a surgical knife.

I also focused on how it can expose surgical team members to hearing damage, too.

“[The surgical team is] like a construction crew,” Matthew Bush, MD, of the University of Kentucky, told me in a phone conversation. “Perhaps there are some people who have to use jackhammers and there’s other people who are using paintbrushes.” But in any case, that noise can add up, and “we need to be very conscious of that.”

Another thing to be wary of, according to a recent CDC study published in the American Journal of Industrial Medicine, is high blood pressure and high cholesterol.

“A significant percentage of the workers we studied have hearing difficulty, high blood pressure, and high cholesterol that could be attributed to noise at work,” Liz Masterson, MD, one of the study’s authors, said in a CDC press release. “This study provides further evidence of an association of occupational noise exposure with high blood pressure and high cholesterol, and the potential to prevent these conditions if noise is reduced.”

While the healthcare was not mentioned in that press release as an industry “with the highest prevalence of occupational noise exposure,” OR staff members often must work through loud bursts of noise that occur throughout many surgeries.

This is a concern that Lisa Spruce of the Association of periOperative Registered Nurses brought up during our recent chat about excessive noise, saying it “has been linked to impaired sleep, increased stress, physical discomfort, increase in blood pressure, heart rate, and breathing. And that all just has an effect on a person’s well-being.”

Spruce says some healthcare facilities have noise-related policies. And if yours doesn’t, she recommends forming an interdisciplinary team to evaluate noise in facilities and by individual types of surgery, and then determining what actions you can take to decrease noise levels, including exploring quieter alternatives for surgical equipment.

“I think we’re bringing more attention to [noise] as a problem where we haven’t in the past,” she said. “So, I think we are going to see more and more hospitals having policies and looking at it from a patient safety, and also a staff safety standpoint.”

Our expert answers a couple of reader questions related to waste disposal

By: February 19th, 2018 Email This Post Print This Post

When you’ve got healthcare safety or standards questions, we’ve got answers. More specifically, we’ve got a stable of industry experts who are only an email away and are willing and able to give you the guidance you are seeking.

This time, we turned to Dan Scungio, MT(ASCP), SLS, the laboratory safety officer for Sentara Healthcare in Virginia, to answer a pair of waste disposal questions recently posed by our readers. Scungio, aka “Dan, the Lab Safety Man,” writes a monthly column for our monthly Medical Environment Update newsletter.

Question No. 1, from a blog commenter named Sarah Winters: “I am the nursing supervisor for a school district. At the end of every year, the nurses at the schools close and seal their full sharps boxes and transport them in their vehicles to [our] central office, where I then take them to EMS for disposal. A safety/health inspector has told us this is unsafe and violates the OSHA standard. I cannot find how that violates any OSHA regulation. Suggestions? Resources? Thanks.”

Answer from Dan, the Lab Safety Man: “OSHA does not directly regulate the transport of hazardous waste, but the U.S. Department of Transportation does. The DOT states that if you are not in the business of transporting hazardous materials, the process of sharps transport for the schools falls under the DOT’s Materials of Trade exemption. That means it is acceptable to transport used sharps in your private vehicle provided they are packaged in containers constructed of a rigid material that is resistant to punctures and securely closed to prevent leaks. That said, individual state regulations may supersede federal DOT rules, so it is important to know what the transport laws are in your specific state.”

Question No. 2, submitted anonymously via email: “Can we dispose of irrigation fluid from the anterior chamber of the eye in the regular garbage if not visibly contaminated with blood and is self-contained in a sealed bag?”

Answer from Dan, the Lab Safety Man: “Eye irrigation fluid may not be considered an infectious waste if it does not contain blood, but it is probably not a good idea to place it into the regular (non-hazardous) waste stream. It is important to consider those who handle the trash after it leaves your site. If there is breakage of a sealed container or bag that creates an exposure, that would create a scenario that will raise questions for the person exposed and a situation that should be avoided.”

Got a question you’d like answered? Shoot us a note at mvensel@hcpro.com.

How would Trump’s proposed 2019 budget affect OSHA? Barab weighs in

By: February 15th, 2018 Email This Post Print This Post

Jordan Barab, the former OSHA official under Barack Obama who still champions worker safety on his personal blog, has gone through the 2019 budget proposal that the Trump Administration unveiled earlier this week, the one that aims to slash by $18 billion the budget for the Department of Health and Human Services.

While OSHA’s overall budget is not among the ones President Trump is proposing to cut, Barab is still concerned, writing that, like last year, Trump “once again proposes to slash or eliminate important safety and health programs and agencies.”

Per Barab, if approved, the 2019 budget proposal would eliminate the Susan Harwood Training Grant Program and the Chemical Safety Board. However, given how Congress reacted to proposed cuts of those programs last time around — as Barab put it, they “had about as much lift as a Butterball Turkey when the administration floated these ideas” in his 2018 budget — he isn’t too worried it will actually happen.

“There’s a saying that there’s no education from the second kick of a mule. With a little lobbying and common sense, we can only hope that the Trump administration will get to witness that phenomenon” with these proposed cuts, Barab wrote.

Additionally, the 2019 budget proposal looks to eliminate two advisory committees dealing with whistleblower protections and federal employee safety and health, Barab wrote. They would be the Federal Advisory Council on Occupational Safety and Health and the Whistleblower Protections Advisory Committee.

As far as OSHA’s overall budget is concerned, Barab said it would, if approved, remain “mostly level,” with a $5.1 million increase from 2017 in enforcement and a $3 million increase in compliance assistance, mostly, Barab wrote, “to add Compliance Assistance Specialists who had been cut in previous years due to budget limitations” plus “eight staff to work exclusively on the Voluntary Protection Programs.”

OSHA, in its budget justification, says it has set a goal of 30,840 inspections for 2019, which is 5% less than the 2017 fiscal year, the most recent data available.

OSHA says it plans to focus on “the highest-impact and most complex inspections at the highest-risk workplaces.” One would think that list includes healthcare facilities. But in a recent article of our Medical Environment Update newsletter, Barab and industry safety experts expressed concern about how the loss of dozens of OSHA inspectors under Trump might affect healthcare workers.

We’ll circle back on this in greater detail, with original reporting on how it could affect you, in the event these cuts actually get pushed through this fall.

Group sues Trump administration, OSHA for failing to share 300A summary reports

By: February 14th, 2018 Email This Post Print This Post

One advocacy group is suing the Trump administration, claiming the Department of Labor (DOL) and OSHA are illegally withholding records about workplace injuries and illnesses, our colleagues over at OSHA Compliance Advisor wrote this week.

In each of the final three months of 2017, advocacy group Public Citizen submitted Freedom of Information Act (FOIA) requests for records submitted by employers under OSHA’s electronic injury and illness recordkeeping rule. The group says it intended to use the info to conduct research on job safety and health. Public Citizen claims its October and November requests were inappropriately denied.

That recordkeeping rule, finalized in May 2016, required employers with 250 or more employees and employers in some high-risk industries that have 20 or more workers to electronically submit their 2016 300A summary report to OSHA by December 31, 2017. OSHA was then supposed to make the data public to encourage employers to prevent injuries and illnesses and to advance research into workplace safety.

OSHA issued a response explaining why Public Citizen’s FOIA request was denied.

That response, via our colleagues writing for OSHA Compliance Advisor: “As stated in the preamble to the Improve Tracking of Workplace Injuries and Illnesses final rule (see 81 FR 29624), OSHA plans to use the establishment-specific data for enforcement targeting purposes. Disclosure of the data before and while it is being used to select establishments for inspection would in turn disclose OSHA’s techniques for law enforcement investigations. Thus, OSHA has determined the data submitted under the electronic reporting requirements are exempt from disclosure while they are being used for enforcement targeting purposes.”

Public Citizen appealed, arguing that the records are not exempt from FOIA because they were not compiled for law enforcement purposes, and that OSHA in its final rule in 2016 stated that it would publicly disclose these records to encourage workplace safety. The advocacy organization’s suit asks the court to find that failure to provide the records is unlawful and to order the DOL and OSHA to provide them.

A rundown of new, increased OSHA penalties

By: January 16th, 2018 Email This Post Print This Post

In case you missed it, new, increased civil penalties for violations of workplace safety and health standards went into effect two weeks ago today.

Effective January 2, OSHA increased its penalties by 2% to adjust for inflation, as required by the Federal Civil Penalties Inflation Adjustment Act of 2015, with a max fine of nearly $130,000. The new fines apply to all violations that occurred after November 2, 2015, with penalties assessed after January 2, 2018.

Employers that violate OSHA standards are now subject to the following fines, as reported in the latest edition of BLR’s OSHA Compliance Advisor newsletter:

  • Willful violations: between $9,239 and $129,336 per violation (previously between $9,054 and $126,749)
  • Repeat violations: up to $129,336 per violation (previously up to $126,749)
  • Serious violations: up to $12,934 per violation (previously up to $12,675)
  • Other-than-serious violations: up to $12,934 (previously up to $12,675)
  • Failure to correct a violation: up to $12,934 for each day the condition continues (previously up to $12,675 for each day it continued)
  • Violation of posting requirements: up to $12,934 per violation (previously up to $12,675 per violation)

Report: OSHA losing inspectors under Trump

By: January 8th, 2018 Email This Post Print This Post

Before taking office, President Donald Trump expressed a desire to trim the federal workforce, something he has taken action on since getting sworn in last year.

OSHA is reportedly one of the federal agencies that have been impacted.

According to data obtained by NBC News through a Freedom of Information Act request, OSHA has lost 40 inspectors through attrition since Trump took office last January, and as of October 2, the federal agency had made no new hires to replace them. The 40 vacant positions represent 4% of the OSHA’s total federal inspection force, which fell below 1,000 in early October, according to the NBC News report.

A Labor Department spokesman told NBC News that OSHA has hired “several additional inspectors” since early October and is currently recruiting at least two dozen more. Still, even if OSHA is allowed to fill some of those open positions in the coming months, last year’s hiring lull could affect the agency’s future performance, argued Jordan Barab, an OSHA official under former President Barack Obama.

“Even after OSHA hires someone, they can’t just send them out to do an inspection by themselves,” Barab told NBC News. “This will have an impact for years.”

Meanwhile, due to limited resources and manpower, OSHA is prioritizing high-risk workplaces — such as construction sites and manufacturing plants — with increased rates of fatal accidents, serious injuries, and illnesses, the report said. It is not yet clear how much impact the loss of inspectors has had on the healthcare industry.

Back in May 2017, when the White House released its budget request for 2018 that sought to slash, among other things, the Labor Department’s budget, a cut of about 2% of OSHA’s budget was proposed. We noted at the time that even a modest cut could significantly impair OSHA’s ability to enforce workplace safety regulations.

According to the Labor Department, OSHA from October 2016 to September 2017 actually increased its number of inspections for the first time in five years, NBC News reported. But some activists, politicians, and former OHSA officials argue the loss of on-the-ground inspectors in specific regions expose workers to greater risk.

“OSHA is far too understaffed to fulfill its mandate of reducing workplace injuries,” U.S. Representative Rosa DeLauro, a Democrat from Connecticut, told NBC News. “Under the Trump administration, OSHA has suffered a troubling decline in both staff and work-place inspections in key areas of the country.”

Fact sheet unveiled to protect lab workers from Zika virus

By: October 3rd, 2017 Email This Post Print This Post

A new OSHA Fact Sheet has been published to help employers protect biomedical laboratory workers from the Zika virus, which has been blamed for infants being born with Microcephaly and other brain and eye abnormalities.

For lab workers, the most likely sources of exposure to Zika include needlesticks and similar cuts or puncture wounds, as well as areas of compromised skin that come into contact with contaminated materials, according to the four-page fact sheet. Workers also face risks of exposure through the eyes, nose, and mouth; mosquito bites; and coming into contact with blood or other body fluids.

“Employers and workers in laboratories should follow required and recommended infection prevention and biosafety practices to minimize the risk of infection,” the document states, noting that employers must comply with relevant regulations and standards, such as OSHA’s Bloodborne Pathogens standard.

“In all cases, employers should assess and control their workers’ Zika virus exposure risk, consider relevant advisory documents, and review new information as it becomes available, including from the Centers for Disease Control and Prevention (CDC),” the document states.

For more, download the fact sheet from OSHA’s website.

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List of OSHA standards cited most frequently in 2017 released

By: September 28th, 2017 Email This Post Print This Post

Fall protection training requirement makes debut on annual top 10 list

The annual list of most-frequently cited OSHA standards was released this week at the National Safety Center (NSC) Congress & Expo in Indianapolis. Although the list looks pretty similar to years past, there has been some movement.

The general requirements of fall protection (1926.501) ranked first on the list again this year, as it did last year and the year before that. The top five categories, in fact, have held their positions for the past three years.

The hazard communication requirements (1910.1200)—which are especially pertinent to healthcare employers and other industries where workers handle hazardous substances—have held steady as the second-most-frequently cited set of OSHA standards.

Citations related to electrical wiring (1910.305) have continued their downward trend relative to the other top standards, moving from eighth place to 10th in two years. This year’s ninth-place finisher, fall protection training requirements (1926.503), jumped onto the list for the first time in recent memory.

For more detail on the OSHA standards for the past three years, review the chart below. (Or click here for the PDF version.) The numbers associated with each category indicate the number of violations cited under each set of standards. These numbers are based on each fiscal year, and they are considered preliminary. A final report will be published in the December edition of NSC’s Safety+Health magazine.

NSC President and CEO Deborah A.P. Hersman said in a statement that the list of top OSHA violations is “a blueprint for keeping workers safe.”

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Bipartisan bill passes Senate Appropriations Committee, could preserve OSHA funding

By: September 8th, 2017 Email This Post Print This Post

Democrats and Republicans on the Senate Appropriations Committee came together this week to pass a budget plan that would keep federal OSHA funding at the same level in fiscal year (FY) 2018 as is today.

The bill, which addresses spending by Labor, HHS, Education and related agencies, calls for the Labor Department to be funded by $12 billion overall—that’s a slight cut of $61.5 million or about 0.5% from the funding level in FY 2017—according to a summary released by the committee’s Republican members. It passed by a vote of 29-2.

“For the second year in a row, the committee has worked together in a tough fiscal environment to pass a bipartisan bill that reflects Americans’ priorities,” said Sen. Roy Blunt (R-Mo.), chairperson for the subcommittee on Labor and HHS appropriations, in a statement.

Sen. Patty Murray (D-Wash.), ranking member of the subcommittee on Labor, HHS, Education, and related agencies, said in a separate statement that she’s pleased to see bipartisanship at work, though there’s more to be done.

“While I support this bill as a compromise and the best we can do given the inadequate investment levels we’ve been given, it underscores the need for us to keep working toward another budget deal to increase investments in people, communities, and economic growth,” Murray said. “But this bill is a good first step and a strong foundation for continued bipartisan work.”

Labor agencies would fare far better under this Senate appropriations bill than the version under consideration by the House, which proposed even deeper cuts for OSHA’s enforcement budget than President Trump had requested, as Bloomberg BNA’s Bruce Rolfsen reported in July.

Jordan Barab, a former OSHA official and an outspoken critic of the Trump administration, said a flat budget (i.e., no increase in funding) could be the best-case scenario “considering who controls the White House and Congress.”

“Although we’ll end up with strikingly different bills in the Senate and the House, the expectation is that, because the Senate bill is a bi-partisan measure that both parties have agreed on, the current funding is likely to be maintained if there is a final bill,” Barab wrote on his blog, Confined Space. If, he added, Congress were to resort to a continuing resolution rather than passing a final bill, that too would keep funding at about the same levels as they stand today.

California hospital where worker was murdered still an example of violence plaguing healthcare

By: August 31st, 2017 Email This Post Print This Post

Six years after a psychiatric technician at Napa State Hospital was murdered by a patient, regulators within the California Division of Occupational Safety and Health (Cal/OSHA) approved a new rule last fall to protect healthcare workers from on-the-job violence.

The rule took effect in April, and I covered the story in our May edition of Briefings on Hospital Safety, noting that federal OSHA officials were asking whether drafting a similar nationwide standard would be appropriate and worthwhile. Since then, the Trump administration has pared back OSHA’s regulatory agenda and classified the initiative to prevent workplace violence in healthcare settings as among the agency’s “long-term actions,” with no date set for the initiative’s next action item.

Meanwhile, the workers at Napa State Hospital continue to report frequent assaults against employees and patients alike. Cal/OSHA is investigating an attack on May 9, 2017, that left one worker with serious bodily injuries, the Napa Valley Register reported this month. Officials did not specify the circumstances of the attack, but a 26-year-old man arrested the following day had reportedly punched a staff member multiple times in the head and face, with a closed fist, before lifting a medical table above his head in an effort to use it as a weapon against the worker.

A judge ordered the hospital to release unredacted documents about the incident to Cal/OSHA after complaints that previously released documents “were so heavily redacted that they provided no meaningful information” to state investigators, the Register reported.

There were 886 assaults on staff reported at Napa State Hospital in 2015, according to the California Department of State Hospitals violence report for 2016. That figure was about the same in 2014 and 2013, but it was higher in 2012, when 1,048 assaults on staff were reported.

The 886 assaults on staff in 2015 are in addition to the 1,053 reported assaults on patients.

“That’s 1,939 reported assaults and who knows what wasn’t reported,” Michael Bartos, MD, former medical chief of staff for Napa State Hospital, wrote in a letter to the Register editor last week.

“A facility with 1,200 patients that reports over 1,000 patient assaults in a single year could be considered somewhat less than a healing environment and with almost 900 staff assaults might not be the best place to work, even with generous state benefits,” Bartos added. “Despite the problems, the majority of front line staff including nurses, psychiatry technicians, social workers, rehabilitation therapists, psychologists and psychiatrists, are dedicated professionals doing their best under difficult circumstances.”

OSHA buries worker fatalities list

By: August 25th, 2017 Email This Post Print This Post

What had been featured prominently on the agency’s homepage is now shorter and harder to find

Earlier this week, if you had navigated to OSHA.gov in search of information about the U.S. Department of Labor’s (DOL) agency committed to improving the safety of American workers, you would have been greeted by a prominent ticker listing recent workplace fatalities. Each entry had a date, state, name, and brief explanation of how the worker died.

That item was removed Friday from the OSHA website, however, in an effort to make the public data more “accurate and useful,” Politico reported, citing a DOL spokesperson.

“The previous listings included fatal incidents that were outside federal OSHA jurisdiction, not work-related, or the employer was not cited for a violation related to the incident,” Mandy Kraft said in a release. “We are continuing to review all of the data to ensure it is accurate and useful to our stakeholders.”

Critics were quick to blast the change. Jordan Barab, a former OSHA official under the Obama administration, called it a “brazen attempt to hide from the American public the extent of workplace fatalities in this country.”

In place of the workplace fatalities ticker, the updated OSHA site now lists information on training, compliance assistance, and cooperative and recognition programs. Then there’s an introduction to a new ticker praising specific companies by name: “Below are just a few examples of our cooperative programs that work with and recognize employers who create safe workplaces,” it says.

“This list will soon get pretty stale,” Barab wrote. “There are a lot more workers killed on the job every month than new VPP, SHARP or Alliance participants in an entire year.”

Representatives with DOL and OSHA did not immediately respond Friday to requests for comment.

Update (8/28/17): An OSHA spokesperson responded in an email Friday with the same comments reported by Politico. “Previous entries [in OSHA’s fatalities data set] remain available in the original format on OSHA’s data and statistics page,” the spokesperson noted. The Wall Street Journal reported Sunday that the U.S. Chamber of Commerce had asked OSHA to revise its fatalities-reporting practices.

Potential security breach prompts suspension of OSHA’s new injury-tracking portal [UPDATED]

By: August 17th, 2017 Email This Post Print This Post

[Editor’s note: Access to OSHA’s data portal has been restored. See updates below.]

Just two weeks after its already-delayed launch, an online portal designed to collect data on worksite injuries has been suspended amid information security concerns.

Use of the portal, OSHA’s Injury Tracking Application (ITA), was supposed to become mandatory for certain employers on July 1, 2017, pursuant to the controversial electronic recordkeeping rule. But officials signaled back in May that they would be postponing the deadline, and they formally did so in June—giving the approximately 466,000 affected employers five additional months, until December, to begin using the application.

The ITA finally went live August 1, a full month after its original implementation date, as labor attorney Tressi L. Cordaro with Jackson Lewis P.C. noted Monday in a blog post. The ITA was suspended, however, on Tuesday after the Department of Homeland Security (DHS) notified the Department of Labor (DOL) that user information might have been compromised, Cordaro added Wednesday.

Those who tried accessing the portal Thursday morning were greeted with a message in red lettering: “Alert: Due to technical difficulties with the website, some pages are temporarily unavailable. To file a complaint with OSHA or to ask a safety and health question, call 1-800-321-6742 (OSHA).”

Bloomberg BNA’s Ben Penn reported Wednesday that a DOL official didn’t identify the one company involved in the potential breach. While the portal will eventually be used to collect detailed employee records, experts told Penn that the information currently being collected isn’t sensitive. That being said, the snafu could betray a level of unpreparedness in the ITA rollout.

“This agency has a lot of experience with doing this—and doing it right,” said Deborah Berkowitz, a senior fellow with the National Employment Law Project who served as OSHA chief of staff under former President Barack Obama, according to Penn’s report. “This is a brand new application, and because of the new administration, it was never tested.”

Berkowitz added that OSHA should take the time offered by this suspension to “get it right” and protect the database.

Representatives with DOL and OSHA contacted via email and telephone were not immediately available Thursday to answer questions about the suspension and possible breach.

Update (8/25/17): The application was back online as of Friday, August 25, 2017. I have requested additional details on what led to the outage and will publish what I find.

Update (8/28/17): An OSHA spokesperson said in an email that the National Information Technology Center conducted a scan and confirmed that none of the ITA data had been compromised. “As part of this review, the entire OSHA website was scanned and improvements implemented,” the spokesperson said. Public access to the portal was restored Friday, as OSHA continues its regular security monitoring processes.

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