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Janine Romero – Page 6 – WorkCare

WorkCare

Author: Janine Romero

  • Having Naloxone Onsite to Reverse Overdoses Can Save Lives

    Having Naloxone Onsite to Reverse Overdoses Can Save Lives

    The U.S. Food and Drug Administration has approved Narcan 4 milligram (mg) naloxone hydrochloride nasal spray for over-the-counter (OTC) use, making it the first naloxone product to become available without a prescription.

    The manufacturer, Emergent BioSolutions, expects OTC NARCAN® Nasal Spray to become available in U.S. retail stores and online by late summer.  The manufacturer determines the timeline for availability and price per dose. While many insurers cover some or all of the cost of prescription Narcan, OTC medications typically are not covered by insurance.

    Saving Lives

    Naloxone can be given to any adult who shows signs of an opioid overdose. Prescription Narcan is administered with a nasal spray or injected into the muscle, under the skin or into the veins. Naloxone restores normal breathing to a person who has overdosed, but it has no effect on someone who does not have opioids in their system.

    Signs of overdose include:

    • Unconsciousness
    • Tiny pupils
    • Slow or shallow breathing
    • Vomiting
    • Inability to speak
    • Faint heartbeat
    • Limp arms and legs
    • Pale skin, purple lips and fingers

    Naloxone saves lives by rapidly reversing and blocking the effects of heroin, fentanyl and opioids in certain prescription medications. When it is administered by non-medical personnel, it is essential to immediately call emergency responders. Its effect wanes within 30 to 90 minutes.

    The FDA’s approval of OTC Narcan supports nationwide efforts to prevent overdose deaths. The opioid epidemic is an urgent public health concern. In the U.S., more than 101,750 fatal overdoses were reported in the 12-month period ending October 2022, with the majority of deaths linked to synthetic opioids such as illicit fentanyl. By comparison, about 50,000 people died from an opioid-involved overdoses in 2019.

    The number of lives saved is more difficult to quantify, partly because the social stigma associated with drug use makes people reluctant to report incidents. A National Institute on Drug Abuse policy brief refers to a statistical model that suggests high rates of naloxone distribution among first responders and in the general public could prevent 21 percent of opioid overdose deaths. The brief also cites studies that show overdose deaths decreased by 14 percent in states that have enacted naloxone access laws. In Tennessee, the state Department of Mental Health & Substance Abuse Services documented at least 60,000 lives saved after Regional Overdose Prevention Specialists distributed more than 450,000 units of naloxone from October 2017 to March 2023.

    Recommendations

    In its employer toolkit on overdose prevention, the National Safety Council advises employers to follow this checklist before making naloxone available onsite:

    • Assess workplace readiness for having naloxone in the workplace
    • Ensure all legal and liability concerns are addressed
    • Establish policies and procedures for responding to potential overdose scenarios
    • Provide training on how to respond to an opioid overdose with naloxone

    The Substance Abuse and Mental Health Administration’s (SAMHSA) Opioid Overdose Prevention Toolkit is also a helpful resource.

    WorkCare’s Response

    The workplace clinics staffed and operated by WorkCare stock naloxone (either nasal spray or pre-filled syringes/autoinjectors for intramuscular administration) in their emergency response kits. Standing orders support Narcan administration by trained onsite personnel within their scope of practice, explains Patrick O’Callahan, M.D., M.P.H., WorkCare’s vice president of onsite clinical operations.

    WorkCare’s consulting medical directors advise client companies that do not have onsite clinics to incorporate training for Narcan nasal spray administration into the CPR, AED and first aid training curriculum for both non-medical (lay people) and medical emergency responders. Narcan can be added to emergency response kits once responders are trained.

    Dr. O’Callahan doesn’t expect WorkCare’s recommendations for businesses to change significantly in response to the FDA’s approval of OTC Narcan. “Ideally, businesses should have a trained first response team whose members are certified in CPR, AED use and first aid measures, including Narcan administration,” he said. “There should be an appropriate number of first responders to cover all shifts. In situations where Narcan administration is indicated, it’s likely that ventilatory support and/or cardiopulmonary resuscitation will also be required. We will have best outcomes if lay responders have appropriate training and equipment.”

    All states have naloxone access laws, and most states have expanded Good Samaritan protections to cover lay people who administer naloxone when they respond to a suspected opioid overdose.

    Visit WorkCare’s Onsite Services & Clinics for more information.

  • Be Prepared to Respond to Bites and Stings

    Be Prepared to Respond to Bites and Stings

    It’s the first day of spring, ushering in the promise of renewal along with a period of increased insect activity as soil warms and thaws, larvae hatch and flowers bloom to attract pollinators.

    Insect bites and stings are a relatively common occurrence in many occupations. Reactions to bites and stings are usually mild and can be self-managed with first aid, but in some situations they can be serious or potentially deadly.

    This year America’s Poison Centers marks National Poison Prevention Week on March 19-23. The centers, a consortium of 55 organizations, operates a helpline (1-800-222-1222) for people who have questions about exposures including bites and stings, accidental medication overdoses, and drinking, inhaling or touching toxic substances.

     

    WorkCare Recommendations

    WorkCare’s Nursing Guidelines for 2023 include emergency response and first-aid instructions for bites and stings from bees, wasps, hornets, yellow jackets, spiders, scorpions, fire ants, mosquitoes, lice, ticks, fleas and other insects. According to the guidelines, reactions can range from mild local itchiness or pain to severe life-threatening systemic reactions.

    Patients with a known history of systemic reactions who are stung around the mouth or throat, or who have been stung multiple times, have a higher risk for severe reactions and should be carefully evaluated by a medical professional. Systemic reactions occur when inflammation caused by toxins, allergies or infection spread from a localized area, such as the skin, to other organs in the body.

    Anaphylaxis is an acute, potentially fatal reaction to an allergen. In addition to bites and stings, triggers for anaphylaxis may include certain foods (such as nuts or shellfish), medications or substances. Anaphylactic shock is a state of extremely low blood pressure (hypotension) and rapid heart rate (tachycardia) that requires an immediate emergency response.

    Signs and Symptoms

    Signs and symptoms of local bite or sting reactions include:

    • Itchiness
    • Redness
    • Pain
    • Swelling
    • Burning, numbness or tingling

    Systemic bite or sting reactions include

    • Hives
    • Abdominal pain, nausea, vomiting, diarrhea
    • Shortness of breath, wheezing or high-pitched whistling sound
    • Generalized swelling, or swelling of the face or throat
    • Chest pain, tachycardia, hypotension, low blood pressure
    • Dizziness, altered consciousness, fainting

    For emergency systemic reactions, after calling 911 or onsite emergency responders, a qualified person may administer CPR, an EpiPen® (or equivalent) and/or Benadryl® (diphenhydramine), as clinically indicated. In non-emergency situations, the following steps are recommended:

    1. Assess heart rate and blood
    2. Check airway and
    3. Inspect bite or sting
    4. Check for systemic reactions (e.g., hives, swelling, wheezing).
    5. Remove rings or constricting items because swelling may
    6. Scape to remove an embedded stinger; do not squeeze the stinger with an
    7. Cleanse the bite or sting area with soap and

    At WorkCare, we staff onsite clinics and have occupational nurses and physicians available 24/7 to provide telehealth triage. (Refer to our Onsite Services & Clinics and Incident Intervention service lines.) While remaining at work, employees whose employers are clients of our Incident Intervention program and those with WorkCare onsite clinical personnel can get advice on the use of ice and elevation of the affected area and over-the-counter topical antibiotic ointment or hydrocortisone cream, analgesics to reduce pain and inflammation and antihistamines for itchiness.

    It is recommended to re-evaluate all insect bites and stings after 24 hours.

    Prevention

    WorkCare clinicians advise employers to reinforce prevention strategies such as using insect repellant containing DEET; keeping exposed skin covered; not provoking insects whenever possible; avoiding wearing perfumes or brightly colored clothing; and not eating outdoors when insects are active. Individuals with known systemic insect allergies should be encouraged to carry an EpiPen, as prescribed by their primary care provider, and wear a Medic Alert-type bracelet or neck chain.

  • The Right Fit: The Importance of Proper Fitting in Women’s PPE

    The Right Fit: The Importance of Proper Fitting in Women’s PPE

    Today is International Women’s Day with the theme “Embrace Equity,” prompting us to observe that women’s personal protection needs are similar to but not exactly the same as they are for men in certain work environments.

    In the U.S., employers who are subject to Occupational Safety and Health Administration (OSHA) regulations are required to ensure all workers have properly fitted personal protective equipment (PPE) and that protective outer wear and clothing (PPC) is not damaged or worn out. While many vendors offer equipment and clothing designed to fit all body types, experience shows that female employees are still more likely than male employees to have improperly fitted PPE. This is of particular concern in hazardous occupations in which men tend to outnumber women in the workforce.

     

    Getting the Right Fit

    OSHA advises employees to test employer-provided PPE for proper fit and check PPE and PPC for wear. It’s a best practice for employers to offer employees a range of choices and access to suppliers who carry equipment, outer wear and other clothing to fit all body types.

    Optimally, PPE should be fitted based on anthropometric data, according to OSHA. Core elements of anthropometry are height, weight, head circumference, body mass index, body circumferences (waist, hip and limbs) and skinfold thickness. In adults, body measurements are typically used to help assess overall health, nutritional status and disease risk, and in some cases to diagnose obesity.

    According to the International Journal of Environmental Research, personal safety improves when anthropometric measurements are used in the production of clothing, gloves, footwear, and head, eye and face protection devices. These measurements also help ensure user comfort and consistency. In addition, anthropometric data may be used to inform the design of ergonomic workplaces, machines and tools while accounting for the use of PPE. Dimensional allowances for PPE may be further refined using 3D scanning methods.

     

    Reproductive Health

    In some workplaces, both men and women require personal protection due to exposure hazards that could affect their reproductive health. Additional layers of protection, or even a temporary job change, may be needed when a woman is planning to get pregnant or is pregnant.

    A pregnant woman who wears PPE and/or PPC may find it no longer fits correctly. Similarly, a woman’s shifting center of gravity may affect her balance and increase her risk of injury. Temporary adjustments may need to be made for pregnant women who do jobs that involve exposure to toxic substances, prolonged standing, excessive physical exertion or working in extreme temperatures.

    Pregnant employees can be encouraged to:

    • Consistently wear properly fitted PPE and PPC
    • Avoid bringing potentially contaminated PPE home
    • Review exposure risk information with their physician
    • Frequently wash their hands while working

    WorkCare’s occupational health clinicians provide guidance on ways to reduce exposure hazards and help employers protect and promote employee health in the workplace. Contact us for more information on how to safeguard the health and well-being of your employees in the workplace.

  • Pain Scale Tells Just Part of the Story

    Pain Scale Tells Just Part of the Story

    A pain scale is often used to help assess pain severity associated with an injury, disease or surgical procedure. You may wonder which scale is best to use when evaluating an employee’s response to a work-related injury, including non-specific muscle or joint pain.

    There are many types of pain scales. Commonly used scales include numerical, face, visual analog and verbal. There are also more comprehensive pain-scoring methods.

    At WorkCare, where our Incident Intervention clinicians evaluate thousands of non-emergency work-related injuries a year, we know that the way physical discomfort is evaluated and managed at onset can make a significant difference in the outcome. Each employee’s initial pain experience is shaped by a myriad of biomedical, psychosocial (e.g., belief system, expectations, mood) and behavioral factors.

    For example, two similar employees with the same job and similar injuries may have notably different perceptions of pain. In this scenario, assume each employee receives the same information from a WorkCare occupational clinician about the nature of their injury and expectations for recovery. These two employees may either choose clinician-guided self-care/first aid and remain at work or elect to be referred to an offsite clinic for follow-up. An employee who perceives pain as temporary and manageable is more likely to remain at work while recovering than an employee who reports intense pain and fears that working could make the injury and pain worse.

    When an injury does not quickly resolve and transitions from acute, to sub-acute, to chronic, related pain becomes particularly difficult to resolve. Chronic pain syndrome has been described as “a constellation of related symptoms and conditions that usually do not respond to the medical model of care,” and complex regional pain syndrome, which involves prolonged pain and inflammation following injury to an arm or leg, as a “biopsychosocial challenge.”

    Asking Questions

    Context is needed for an evaluating clinician to get a clear sense of an employee’s pain. In some cases, a clinician might ask an injured employee to remember the worst pain he or she has ever experienced in comparison with their current pain. The provider can then use that information to assess the effectiveness of interventions and pace of recovery.

    When a WorkCare occupational clinician asks an injured employee to rate their degree of pain on a scale of 0-10 during an Incident Intervention telehealth triage call, they may ask other questions, as well, because they know pain is a subjective experience. For instance:

    • Have you had pain other than everyday kind of pain during the past three days?
    • How does the pain you have now affect you physically and mentally?
    • Has the pain made you change your activity level?

    In addition, when an injured employee remains at work in a full or modified duty capacity during recovery, a WorkCare nurse will check in and see how they are feeling, whether their pain has decreased, stayed the same or gotten worse, and assess any other physical or psychological aspects of their pain that may be affecting their work.

    Types of Pain Scales

    Pain scales are often categorized as numerical, visual analog or categorical. A numerical rating scale is commonly used to assess physical pain on a continuum of 0-10, 11-item (counting 0) scale, with 0 no pain and 10 severe pain. Some scales, such as the widely used Wong-Baker FACES® Pain Rating Scale, features numbers as well as faces with expressions and descriptions so children and adults can choose the face that best illustrates their pain:

    A visual analog scale (VAS) is a horizontal or vertical line anchored by two verbal descriptors: “no pain” (score of 0) and “worst pain possible.” The VAS is used to measure a characteristic or attitude that is believed to range across a continuum of values that cannot easily be directly measured. A color analog scale uses a gradual transition from green to yellow to red to represent a continuous pain spectrum rather than a specific number or description.

    Another method, the Brief Pain Inventory (BPI), is a short form developed to measure pain intensity and the extent to which pain interferes with life activities. The BPI asks respondents to rate their current pain intensity, pain experienced in the last 24 hours and the degree to which pain interferes with seven domains of functioning: general activity, mood, walking ability, normal work (outside the home and housework), relations with other people, sleep and enjoyment of life (0 =does not interfere and 10 = interferes completely.)

    The McGill Pain Questionnaire uses another approach. It consists primarily of three major classes of word descriptors – sensory, affective and evaluative – that are used by respondents to specify subjective pain experience. It also contains an intensity scale and other items to determine the properties of pain experience. This questionnaire is designed to provide quantitative measures of clinical pain that can be treated statistically.

    Whatever type of scale is used, clinical interpretation is required. In situations in which a pain scale is used, a clinician trained in occupational medicine can provide useful insights at the onset of a work-related injury and through the recovery process.

  • More Employees Back in the Office Than You Think

    More Employees Back in the Office Than You Think

    It’s time to pay closer attention to the occupational health and safety needs of office employees who worked remotely during the COVID-19 pandemic. While remote and hybrid work schedules will continue to be popular alternatives, attitudes about returning to the office are shifting.

    Last week, Amazon’s CEO Andy Jassy announced the company will require office employees to be at work in person at least three days a week starting May 1 to make collaborating and learning from each other easier. The move by Amazon follows work-from-office announcements from other major tech employers, and it is expected to have strong ripple effects in other industries.

    In a blog post, Jassy said he’s “optimistic that this shift will provide a boost for the thousands of businesses located around our urban headquarter locations in the Puget Sound, Virginia, Nashville, and the dozens of cities around the world where our employees go to the office.”

    Kastle, a property technology and managed security company, monitors workplaces in more than 2,600 buildings in 138 U.S. cities. According to its Back-to-Work Barometer, post-pandemic office building occupancy is gradually increasing. It reached an average of 48.6 percent in 10 major U.S. cities during the week ending Feb. 8; Tuesday was the most heavily occupied day of the week and Friday, not surprisingly, was the lowest.

    In New York, the Partnership for New York City conducted a Return-to-Office survey of 140 major Manhattan office employers and found that:

    • 52 percent of Manhattan office workers are now at their workplace on an average weekday, up from 49 percent in September 2022
    • The share of fully remote workers dropped from 16 percent in September 2022 to 10 percent in January 2023
    • 82 percent of respondents said a hybrid office will be their predominant staffing model this year
    • 59 percent of full-time employees with hybrid schedules will work in the office at least three days a week

    In a Resume Builder survey of 1,000 business leaders, 90 percent of respondents said employees will be required to return to the office at least part of the week this year; a fifth said they will fire workers who do not return. In that survey, 66 percent of employers said employees are already required to be in the office.

    Meanwhile, researchers from Ladders, Inc., a career site for professionals, report that remote job opportunities represented about 15 percent of all $100,000-plus a year job listings in the third quarter of 2022, indicating that the majority of senior leaders are expected to be in the workplace at least part of the time.

     

    Understanding Vulnerabilities

    Other surveys have found that remote employees would be more willing to return to the office with the assurance that their health, safety and well-being will be protected. This is true in other types of workplaces, as well.

    In addition to health-related concerns, there are many other reasons why some office workers want to continue to work from home – flexibility, saving time and money by not having to commute, childcare or eldercare demands, and fewer distractions – to name a few. At the same time, many people crave human connection at a time when there is increasing dependence on technology for communication.

    In its spring 2022 survey of 20,000 people in 11 countries, Microsoft analyzed trillions of Microsoft 365 productivity signals, along with LinkedIn labor trends and Glint People Science findings to uncover workplace trends: 85 percent of responding employees said they would be more motivated to return to the office if they knew they would be socializing with co-workers and rebuilding team bonds.

    During the pandemic, managers had to re-evaluate ways to assess office worker productivity. The Microsoft survey contradicts an assumption made by some that remote employees are inclined to be less productive than those who come to the workplace. Microsoft found:

    • The number of meetings held per week has increased 153 percent for the average Microsoft Teams since 2020
    • Overlapping meetings increased by 46 percent per employee in 2022
    • Declines and tentative RSVPs has increased by 84 percent and 216 percent, respectively.
    • 42 percent of employees send emails or pings during online meetings

    In addition, 48 percent of employees and 53 percent of managers reported that they’re burned out. (Occupational burnout has been shown to be a contributing factor for productivity decline, exhaustion, depression, anxiety and other physical and mental health concerns.)

    Whether employees are in remote, hybrid or in-office settings, their employers face the challenge of preventing and managing work-related physical discomfort associated with prolonged sitting and screen time, as well as mental health disorders associated with stress, burnout, lack of human connection and “brain drain.”

    WorkCare has a solution. Our Industrial Athlete Program features onsite and virtual office consultations provided by industrial injury prevention specialists with training in ergonomics (people, workstations and tasks), sports medicine, wellness and safety. They coach office employees on best work practices and managers on ways to help employees be comfortable and productive.

    Contact us to learn more.

  • Honor Your Heart With Healthy Choices

    Honor Your Heart With Healthy Choices

    In recognition of Valentine’s Day and American Heart Month, we want to remind you about ways to protect your cardiovascular health, which directly impacts quality of life and the ability to work safely.

    Heart disease is the leading cause of death in the U.S., according to the Centers for Disease Control and Prevention. Many people at risk of a heart attack (myocardial infarction) do not manage their risk factors, and more than half of Americans who suffer a heart attack have no early-warning signs or symptoms.

    Some risk factors for heart disease, such as your race/ethnicity, age or genetic profile, cannot be controlled. However, people can make lifestyle changes to help prevent and manage medical conditions that increase their risk. Nearly half of U.S. adults have at least one of these three controllable risk factors: high blood pressure, high blood cholesterol and/or smoking. Other risk factors that can be managed for better health outcomes include diabetes, being overweight or obese, unhealthy diet, physical inactivity and excessive alcohol use.

     

    Controllable Risk Factors

    When the pressure of blood in your arteries and other blood vessels is too high, it can damage your heart, brain and other vital organs. High blood pressure, or hypertension, is referred to as a “silent killer” because it usually has no symptoms. You can monitor your blood pressure using a manual or automated device at home. (Refer to instructions from the American Heart Association.)

    Cholesterol is a waxy, fat-like substance made by the liver; it is also contained in certain foods. When you consume products containing cholesterol, it can build up in arterial walls, narrow arteries and decrease blood flow throughout your body. High levels of triglycerides, another type of fat in the blood, also contributes to increased risk for heart disease.

    Cigarette smoking raises your blood pressure and puts you at higher risk for both cardiovascular disease and cancer. Among thousands of chemicals contained in cigarette smoke, more than 70 are known carcinogens, the American Cancer Society reports. The lungs, mouth, throat and bladder are among parts of the body that are particularly susceptible.

    If you have diabetes, your body doesn’t make enough insulin, can’t use its own insulin as well as it should, or both. Your body needs glucose (sugar) for energy. Insulin is a hormone made in the pancreas that helps move glucose from the food you eat to your body’s cells for energy. Over time, high blood sugar can damage your blood vessels and heart.

    Obesity is excess body fat linked to higher “bad” cholesterol and triglyceride levels and to lower “good” cholesterol levels. Obesity is a common risk factor for hypertension, diabetes and heart disease. Obesity may be managed with diet, exercise, medication, and in some cases, surgical solutions. Medical guidance is recommended.

     

    Heart Disease Prevention

    Here are some things you can do to help reduce your chances of getting heart disease:

    1. Check your blood pressure at least once a year, and more often if you have hypertension. Get a medical checkup if your numbers are above the healthy range for your age, and make recommended lifestyle adjustments.
    2. Limit foods high in saturated fats, sodium and added sugars. Eat plenty of fresh fruit, vegetables and whole grains.
    3. Get regular exercise to strengthen your heart, improve circulation, stay flexible and feel more energetic.
    4. Limit alcohol. Too much alcohol can raise your blood pressure, and it adds extra calories to your diet. Men are advised to have no more than two alcoholic drinks per day; women no more than one per day.
    5. If you smoke, consider enrolling in a cessation program or seek advice from your personal provider on aids to help you quit.
    6. Manage stress in healthy ways such as exercising for fun, spending quality time with others, pursuing a hobby, exploring outdoors, doing deep breathing or meditation, or talking with a therapist.
    7. Many people don’t realize they have pre-diabetes or diabetes. Get tested for diabetes if you have risk factors. If you have diabetes, carefully monitor blood sugar, use insulin as prescribed, follow an exercise routine and adopt a diet focused on fresh, not processed, foods.
    8. Get enough sleep to reduce your risk for high blood pressure, obesity and diabetes. Most adults need seven-to-nine hours of sleep. If you have trouble sleeping or feel excessively sleepy during the day, see a medical professional.

    Refer to this edition of WorkCare’s Wellness Monthly and our heart health fact sheet to learn more.

  • The Important Investment of Fitness-for-Duty Exams

    The Important Investment of Fitness-for-Duty Exams

    Fitness-for-duty (FFD) examinations are a useful tool employers can invest in to reduce liability exposure and help ensure the health, safety and productivity of their workforce.

    The scope of an FFD medical exam focuses on whether an employee or job applicant has the physical, mental and emotional capacity to safely perform essential tasks.

    Findings from an objective FFD assessment may be relied on to clear an employee for full return to work. Alternatively, it may identify physical or mental health conditions that increase risk for a work-related injury or compromise the safety of others. Other potential risk factors such as advanced age, chronic conditions, fatigue, obesity or substance use may also be identified.

    Many employers consider FFD exams to be an essential contributor to their organization’s sustainability and risk management efforts. They often function as an extension of required medical surveillance exams that are performed to establish baselines and measure changes in health status over time. They are also associated with drug-free workplace policies, behavioral health and employee assistance programs, and regulatory compliance efforts.

    Exam Benefits

    An assessment may be performed:

    • As part of hiring and onboarding
    • To address safety-sensitive duties
    • Prior to a change in work assignment
    • At the request of the worker or employer
    • In response to observed behavior
    • Before return to work after an illness, injury or prolonged absence
    • When there is a reasonable concern about safety

    When an employee is returning to work after an injury or illnesses, a FFW evaluation provides reassurance and information to ensure successful reintegration back into the workplace on full duty, in a temporarily modified position or with other accommodations.

    Taking Action

    A multi-disciplinary approach that includes an occupational medicine physician to interpret clinical findings is recommended. WorkCare’s Medical Exams & Travel team facilitates access to FFD exam providers via our national provider network, while our occupational physicians provide clinical oversight. We also support clients where we have onsite clinics. Employers must provide functional job descriptions and a safe work environment for successful outcomes.

    It’s important to note that FFD exams are not a substitute for routine preventive care and medical treatment recommended by a personal provider. However, in the workplace, awareness of physical and mental functional capacity reveals the value of targeted preventive interventions (including cost avoidance) and a prompt response in the event of an injury or incident.

    To learn more about WorkCare’s Medical Exams & Travel capabilities, contact us.

  • Occupational Health Encounters Close Primary Care Gap

    Occupational Health Encounters Close Primary Care Gap

    WorkCare’s occupational health physicians are preventive medicine specialists. While they focus on work-related issues, they often discover underlying health conditions while providing injury care guidance or reviewing an employee’s medical surveillance exam results.

    Occupational clinicians typically refer employees with evidence of non-work-related conditions to their primary care provider for follow-up. These referrals are especially important when employees are made aware of “silent” conditions such as high blood pressure or diabetes, or when there is a clinical reason to assess symptoms an individual has dismissed as “nothing serious.”

    An encounter with an occupational health professional (e.g. physician, nurse, nurse practitioner, physician assistant or other qualified provider) may be the only one an employee has in a given year. Every encounter is an opportunity to educate an employee about healthy behaviors and encourage recommended check-ups for disease prevention and care for personal health concerns.

    Occupational health encounters also help ensure that employees are physically and mentally fit for work. When employers facilitate access to occupational clinicians, they reduce the likelihood of costly absenteeism and presenteeism linked to treatable acute and chronic complaints, and they demonstrate that they care about their employees’ health, safety and well-being.

    Primary Care Shortage

    There is a national shortage of primary care physicians. This raises a critical question: Who will provide the care workers need to stay safe, healthy and productive?

    Primary care physicians comprise about one-third of the overall physician workforce in the U.S. – short of the 40 percent recommended by the Council on Graduate Medical Education, according to Primary Care in the United States, A Chartbook of Facts and Statistics published in 2021. The Association of American Medical Colleges (AAMC) projects a shortage of 17,800 to 48,000 primary care physicians by 2034 in its report on The Complexities of Physician Supply and Demand.

    In 2018, a Kaiser Family Foundation survey found that 25 percent of U.S. adults did not have a primary care doctor; 50 percent of adults under 30 did not. Affordable Care Act provisions enacted in 2010 made free or low-cost preventive care more widely available, but many Americans still do not get recommended preventive care.

    Skipping care to save money for other life essentials is relatively common. While most U.S. companies offer health insurance benefits, in some cases, employees say they cannot afford to pay the deductible. Meanwhile, a significant percentage of Americans working part time or in low-paid, hourly positions often do not have any health insurance coverage. In addition, race and ethnicity, lack of insurance coverage and certain geographic locations decrease the likelihood of obtaining primary care, according to an analysis published in Characteristics of Americans With Primary Care and Changes Over Time, JAMA Internal Medicine.)

    While there is a well-established association between robust primary care delivery and better/more equitable health outcomes, the proportion of health care dollars going to primary care is shrinking, the Commonwealth Fund reports. If under-served populations experienced the same health care use patterns as populations with fewer barriers to access, the AAMC suggests the demand for primary care physicians would exponentially increase demand.

    Healthy Workers = Productive Workers

    The workplace is a well-established venue for injury prevention and onsite first aid. Medical surveillance exams in certain occupations are federally mandated, and work-related injury care beyond first aid is state-regulated. Workplace industrial athlete and wellness programs offer opportunities for ergonomic assessments, coaching and stretching, bio-metric screening, health risk assessments, immunizations, weight management, smoking cessation and other preventive interventions.

    Occupational medicine physicians have the ability to fill care delivery gaps because of their background and training. To practice occupational medicine and attain board-certification from the American Board of Preventive Medicine, they must demonstrate competency in clinical preventive medicine and chronic disease management, as well as toxicology, environmental medicine, epidemiology, biostatistics, health service and population health management, regulatory compliance, and behavioral and mental health. Before getting into occupational medicine, many providers have served in the military or practiced in family, emergency or internal medicine settings.

    Occupational health expertise is invaluable as employers and employees navigate the complex health care landscape. Whether occupational health practitioners are available onsite or virtually, they have a measurable positive impact on employees’ quality of life, health care costs and business results.

    To learn more about WorkCare’s occupational health physicians and safety services, visit our Contact Page or email us at info@workcare.com.

  • Benefits of Injury Prevention in Fast-Paced Workplaces

    Benefits of Injury Prevention in Fast-Paced Workplaces

    We’ve been doing some research on ways WorkCare’s injury prevention and management solutions can lower incident rates and help control costs in fast-paced industries.

    When employees have to move quickly to meet customer demands, their risk of injury increases. Compared to those in less physically demanding jobs, they are more likely to take safety shortcuts, overlook hazardous conditions or make mistakes due to time pressure or fatigue. Employees in the accommodations and food services industry, including restaurants, are among those with these types of exposure risks.

    Injury Trends

    Nationally, overall workers’ compensation claim frequency rates, including COVID-related claims, increased by nearly 3 percent in accident year 2021, according to the National Council on Compensation Insurance (NCCI). In a report on workers’ compensation frequency and severity, Carolyn Wise and Kevin Fernes with the NCCI say the COVID‐19 pandemic and its economic impacts have affected claim trends across all industries. Accommodations and food services, like other types of businesses, have been impacted by closures, staff shortages, workforce repositioning, and the availability of more remote work and short‐tenure opportunities nationwide.

    The U.S. Bureau of Labor Statistics reports there were 2.7 recordable work-related injuries or illnesses per 100 full-time workers in accommodations and food services (NAICS 72) in 2021, the most recent reporting year, with 1.3 cases per 100 involving days away from work, job restrictions or transfer.

    AmTrust Financial Services reports in its newly released 2022 Restaurant Risk Report that injury rates in restaurants declined overall in 2021, but certain types of work-related medical complaints increased significantly when compared to pre-pandemic numbers. Amtrust is a global specialty property and casualty insurer. The report features an analysis of nearly 170,000 claims over a 10-year period.

    Restaurants Operator Challenges

    AmTrust cites COVID-19 and “labor shortages, the great reshuffle and return to work” as underlying reasons for upticks in certain types of injuries in restaurants. “Restaurant workers can face high stress levels, especially with staffing shortages,” said Matt Zender, senior vice president, workers’ compensation strategy at AmTrust. “Restauranteurs should lean on their onboarding experience to ensure employee safety.”

    AmTrust found that the most common restaurant worker injuries in 2021 were cuts, punctures and scrapes; slips and falls; burns and scalds; and muscle strains and sprains. Cuts were 30 percent more common than falls and cost an average of $1,519 per claim, while slips and falls cost an average of $10,041 per claim, a 410 percent difference. Over the 10-year study period, transportation-related injuries cost the most, averaging nearly $20,000 paid out per claim, or 1,215 percent more than cuts.

    In addition, AmTrust reported the following percentage increases when comparing 2020 to 2021 restaurant-related workers’ compensation claim rates:

    • Crushing injuries increased 89 percent
    • Mental stress, 71 percent
    • Fainting, 61 percent
    • Inflammation, 35 percent
    • Strains, 23 percent
    • Dislocations, 11 percent

    AmTrust also reviewed seasonal trends and found that more restaurant injuries occur in late spring and summer than other times of the year. In general, staff hired for the season in accommodations and food services may not receive the same level of training as year-round personnel who also gain experience on the job. In other studies, teenagers – who often work at fast-food restaurants, summer camps and in other part-time jobs – and have been found to have higher-than-average injury rates compared to other populations.

    The AmTrust report includes injury prevention tips such as wearing protective gear (e.g., gloves, non-slip footwear, splatter shields and eyewear; removing trip hazards and promptly cleaning up spills; properly storing sharp objects and supplies; and reducing distractions. Training and safety reminders are encouraged.

    WorkCare’s Industrial Athlete Program features in-person and virtual consultations on ergonomics, stretching and proper lifting techniques to help reduce risk of musculoskeletal disorders associated with strenuous and repetitive tasks, and guidance to manage physical discomfort and safely using work tasks to promote healing. They also provide recommendations to help manage stress, fatigue and exposure to extreme temperatures.

    Our Incident Intervention Program offers telehealth triage to give supervisors and employees telephonic access to occupational nurses, physicians and industrial athlete specialists 24 hours-a-day in the event of a non-emergency, work-related injury. Our team provides self-care, first-aid guidance and referrals to offsite local providers for follow-up, as needed. Contact us to learn more.

  • 2023 Occupational Health Technology Trends

    2023 Occupational Health Technology Trends

    Health technology is a rapidly evolving field with the potential to revolutionize the way we approach occupational health care. Some recent advances in health technology have already had a significant impact on the way medical conditions affecting working populations are prevented, diagnosed and treated.

    Wearables

    Wearable sensors that track movement are now widely available. These devices can be comfortably worn to monitor and reduce an employee’s risk for overuse injury while doing routine tasks. Related technology, such as alert meters, smart watches and apps, support changes in personal health behaviors by tracking fatigue, heart rate, sleep patterns, daily step counts, calories burned and other health-related data.

    WorkCare partners with tech companies to offer our clients access to comfortable, wearable devices that produce data used to inform health and safety interventions for individual workers, by job category and across an enterprise. Our Industrial Injury Prevention Specialists, who have training in sports medicine, ergonomics and wellness, apply insights they gain from collected data when coaching employees on safe work practices.

    Telehealth and Telemedicine

    Telehealth and telemedicine applications allow employees to consult with occupational health practitioners and personal providers from any location with a secure internet connection. During the pandemic when access to in-person care was limited, it became commonplace to “see” a medical or behavioral health professional via a telephonic or video connection. This is particularly beneficial for individuals with mobility issues or who have limited access to care.

    WorkCare’s Incident Intervention team provides 24/7 telephonic first-aid guidance on work-related injuries and illness at onset. During the call, our providers can view photos of an injury while evaluating and making care recommendations. In some cases, an employee may be referred to a local provider for further evaluation. In certain markets, employees may be given the option to be referred to WorkCare TeleM.D.™ for diagnosis and potential treatment by one of our occupational physicians.

    3D Printing

    This revolutionary technology is used to create customized medical devices and prosthetics tailored to an individual’s specific needs. For example, 3D printing can make it possible for employees with hearing loss or a physical disability to be fitted with a device that allows them to work more safely and make them better qualified for more types of jobs.

    WorkCare recently introduced a Portable Hearing Conversation Program for onsite testing that does not require an audio booth. The program features use of a clinically validated, portable audiometer that complies with Occupational Safety and Health Administration (OSHA 29 CFR 1910.95) regulations and American National Standards Institute (ANSI 23.6), U.S. Food and Drug Administration and Health Canada standards. The device is optimized for use in a quiet room – outside of a traditional sound booth. Tablet audiometry and paperless data management make it easy to transport, set up and use. When hearing loss is detected, an employee may be referred to a specialist to be fitted for a custom-made, in-the-ear hearing aid created using 3D technology.

    Artificial Intelligence (AI)

    By analyzing large amounts of data, AI can help employers and medical providers identify patterns and trends that may not be immediately apparent to humans. These data are used to identify exposure risks before they become a serious threat to health and safety, and improve prevention, diagnosis and treatment plans.

    WorkCare’s dedicated information technology team focuses on the development of user-friendly platforms to simplify data collection and facilitate employee health management. For example, our Medical Exams & Travel platform facilitates medical surveillance exam monitoring and scheduling at provider locations in our national network, helps ensure regulatory compliance for organizations and securely stores medical records as required by law. Our WorkMatters’ client portal allows employers and employees to access COVID-19 prevention and management applications and medical exam functions. While protecting the privacy of employees, we use these systems to help our clients create heathier, safer workplaces.

    To learn more about WorkCare’s services and technology partners, contact us.