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General – WorkCare

WorkCare

Category: General

  • Celebrating Occupational Health Nurses: The Unsung Heroes of Workplace Wellness

    Celebrating Occupational Health Nurses: The Unsung Heroes of Workplace Wellness

    It’s Occupational Health Nurses Week, April 6-12, a time for us to recognize the nurses who work tirelessly to protect and promote the health, safety, and well-being of workers.  

    We particularly want to take this opportunity to honor the contributions of WorkCare’s 240+ nurses. You’ll find them on-site at client workplaces, providing care guidance to employees via our 24/7 telehealth program, and performing essential functions such as program administration, client account oversight, clinical quality assurance, case management, absence and leave management, and wellness education. 

    WorkCare employs occupational health nurses (OHNs), registered nurses (RNs), nurse specialists, licensed practical nurses, licensed vocational nurses, nurse case managers, and nurse practitioners.  

    “Our on-site nurses are the backbone of workplace wellness, providing immediate care, reducing injuries, ensuring regulatory compliance, and fostering a culture of health that enhances both employee well-being and business productivity,” said Allison Khosroshahin, senior vice president for WorkCare’s on-site operations. 

    “We rely on the expertise of our telehealth nurses to ensure that employees with work-related injuries or illnesses receive the best possible care at onset,” said Justin Gauser, senior vice president, occupational health solutions at WorkCare. “Their guidance helps relieve an employee’s anxiety about recovery and provides supervisors with the information they need to make sound job placement decisions.” 

    Educational Standards 

    According to the American Association of Occupational Health Nurses (AAOHN), OHN Week marks the founding of the American Association of Industrial Nurses on April 12, 1942, by 300 nurses from 16 states. That organization became the AAOHN, which helps nurses and allied professionals achieve their educational goals and supports them throughout their careers. 

    Nurses must pass an exam to obtain a license to practice in the state(s) where they work. An associate or bachelor’s degree in nursing is required to become an OHN. Nurse practitioners must have a bachelor’s degree in nursing, complete a focused graduate master’s or doctoral nursing program, and pass a national board-certification exam.  

    The American Board for Occupational Health Nurses is the only U.S. provider of exams to become a Certified Occupational Health Nurse (COHN), Certified Occupational Health Nurse – Specialist (COHN-S), or to receive a related case manager designation. To qualify to take the COHN exam, an applicant must have a current RN license or an international equivalent and proof of 3,000 hours of occupational health work experience earned during the past five years.   

    Nurses who practice in occupational health settings often have experience in emergency medicine, urgent care, public health, medical specialties such as orthopedics, or family practice. Nurses may obtain a master’s degree in nursing with a focus on occupational, public, or environmental health, or they may seek a doctoral degree to attain an academic, research, or senior leadership position.  

    The Nurse’s Role 

    Nurses and nurse practitioners who specialize in occupational health often work behind the scenes. Consequently, they may not be visible to the general public. They collaborate with physicians, physician assistants, and medical technicians, human resources directors, risk managers, insurers and claims administrators, and environment, health, and safety professionals.  

    They may be the only nurse at a manufacturing plant or part of an on-site clinic team. In some settings, such as hospitals and academic institutions, they are a go-to resource for internal employee health. Some OHNs are employed in occupational health programs or clinics, where they routinely encounter employees from all types of industries, or they respond to calls to telehealth or telemedicine contact centers.  

    At WorkCare, nursing responsibilities include but are not limited to: 

    • Evaluating work-related symptoms and providing guidance for first aid or medical treatment 
    • Managing workers’ compensation cases with the goal of functional recovery 
    • Monitoring requests for leave, managing absence, and facilitating return to work 
    • Coaching and educating employees on measures for optimal health and well-being 
    • Ensuring that all medical exam components are completed and adverse findings are addressed 
    • Advising employers on industry-specific legal and regulatory compliance issues 
    • Identifying workplace health hazards and recommending mitigation measures 
    • Implementing population health management strategies and tracking outcomes 
    • Participating in disaster planning and first response in the event of an emergency 

    Nurses make critical contributions on a daily basis to protect and promote employee health and contribute to a healthy bottom line for businesses.

    “It’s an honor to work beside such knowledgeable, compassionate, and talented professionals,” said Kathleen Wilhelmsen, RN, BSN, CCM, COHN-S, vice president of on-site clinic operations at WorkCare. “Their dedication and commitment to best practices and continuous improvement is impressive. They make a difference in the health and well-being of employees every day.”

    We are proud to have them on our team. Contact us to learn more about WorkCare or, if you’re interested in becoming part of the WorkCare team, check out the latest posting on our Careers site. 

  • WorkCare Applies Post-Pandemic Lessons

    WorkCare Applies Post-Pandemic Lessons

    Five years ago today, after more than 118,000 COVID-19 cases in 114 countries and 4,291 related deaths were reported, the World Health Organization declared a pandemic. According to a Centers for Disease Control and Prevention timeline, the first case of 2019 novel coronavirus in the U.S. was confirmed with a lab test less than two months earlier, on Jan. 20, 2020. 

    At that time, WorkCare’s occupational health professionals were poised for action. We put other initiatives on hold and redirected resources as part of our mission to protect and promote employee health. It was both a challenging and rewarding time for our team. 

    We rapidly deployed providers to check employees’ temperatures before entering the workplace and negotiated with global companies to obtain diagnostic tests when they became available. We obtained specimens from “essential workers” and created strategies to support on-site and remote operations and help sustain productivity.  

    When vaccines were developed, we created opportunities for employees to easily get their shots. For the duration of the pandemic, we sponsored weekly webinars featuring WorkCare occupational health physicians with updates on evolving developments, including the latest research on personal protection and industrial hygiene, viral variants, vaccine efficacy, and ways to manage the physical and mental health consequences of social isolation. 

    Fast Forward to Today 

    At the start of the pandemic, some members of the public were hesitant to use virtual care options. However, with the COVID-19 shutdown, people were discouraged from visiting a local hospital, clinic, or their doctor’s office unless it was clinically necessary. Online telehealth and telemedicine encounters soon became the best way to “see” a provider in a timely manner.  

    In a COVID-19 Telehealth Impact Study, the MITRE Corporation and Mayor Clinic reported on trends using a dataset of over 2 billion healthcare claims covering more than 50 percent of private insurance activity in the U.S. from January 2019 to December 2020. The study also included results from a July-August 2020 provider survey and a November 2020-February 2021 patient survey. The results confirmed rapid and widespread adoption of telehealth applications. Among the findings: 

    • Providers and patients expressed high levels of satisfaction with telehealth applications 
    • 75 percent of providers indicated that telehealth enabled them to provide quality care 
    • 84 percent of patients agreed that the quality of their telehealth visit was good 

    These and other findings validated what we already knew based on WorkCare’s years of experience providing Incident Intervention, our telehealth triage program for work-related injuries, illnesses, and physical discomfort at onset. With a simple phone call to our telehealth triage team, an employee receives an immediate evaluation of symptoms and care guidance from an occupational health nurse. In some cases, the employees may consult with a WorkCare occupational physician and/or an injury prevention specialist with training in sports medicine and ergonomics.  

    When care guidance beyond first aid is needed or an employee requests a visit with a local medical provider, we can offer a telemedicine visit with a WorkCare doctor as an alternative to an off-site clinic visit for further diagnosis and treatment in certain jurisdictions. Not surprisingly, employee receptivity to these options has become even greater after experiencing the convenience of telehealth options for personal and family care during the pandemic.  

    At WorkCare, we continue to leverage valuable post-pandemic lessons across our enterprise – from scheduling required respiratory protection exams for covered employees with qualified local providers, to providing on-site clinic staffing and health promotion programs, to conducting virtual ergonomic consultations with employees who work remotely to help reduce musculoskeletal injury risk. We’ve got it covered. 

  • WorkCare Results Affirm Pledge to Prevent Musculoskeletal Disorders

    WorkCare Results Affirm Pledge to Prevent Musculoskeletal Disorders

    The National Safety Council (NSC) and its MSD Solutions Lab recently released results from organizations that have pledged to reduce musculoskeletal disorders (MSDs). Work-related sprains, strains, and similar preventable disorders are a common cause of discomfort that can lead to lost work time and disability.

    WorkCare and more than 200 other organizations took the NSC’s initial pledge to reduce MSD exposure risk and injuries by 25 percent by 2025. A follow-up campaign (MSD Pledge 2.0) calls on organizations to continue their injury prevention efforts while building workplace cultures that value safety and engage in innovation and collaboration.

    Findings from 52 organizations were reported in the NSC’s 2022-2023 MSD Solutions Index. For the 2023-2024 index, 44 organizations completed a survey to report results. (Download both reports here.) According to key findings, organizations with favorable index scores track leading indicators and:

    • Incorporate environmental, organizational, individual, and other human factors in work processes
    • Consider ergonomics in purchasing decisions
    • Consistently provide appropriate ergonomic tools and equipment
    • Ask employees for suggestions about safe work practices and take steps to implement them

    WorkCare Gets Results

    WorkCare is dedicated to supporting its clients and their employees from hire to retire. We provide injury prevention and healthcare guidance in person at the workplace and virtually via our 24/7 telehealth triage program.

    In addition to taking the MSD prevention pledge, WorkCare’s injury prevention subject matter experts engage with the MSD Solutions Lab Advisory Council. One of our goals is to provide safety professionals with occupational health insights to create innovative and collaborative pathways for total employee health solutions.

    WorkCare’s Industrial Injury Prevention Specialists have training and experience in sports medicine, MSD prevention and management, ergonomics, first aid, and health education. In 2024, they provided more than 79,000 on-site occupational and non-occupational injury prevention and management encounters in group and individual settings at selected client locations.

    Among total encounters, 76 percent were preventive in nature. Services included ergonomic assessments, health and movement coaching, and wellness education to help employees build their physical and mental health resilience – on and off the job. Reactive services for physical discomfort included first aid and guidance on preventive maintenance.

    Our 2024 results show that the timely management of MSDs produces favorable health and business outcomes. Among more than 5,600 musculoskeletal discomfort cases, we found that:

    • There was an average of one prevention specialist visit per case
    • 95 percent of cases seen by a prevention specialist closed within 14 days
    • 84 percent of cases remained at the non-recordable, OSHA first-aid/self-care level
    • Nearly nine out of 10 employees remained at work during recovery

    Check out our website to learn about all the ways WorkCare deploys its medical expertise and best-in-class services in support of MSD pledge goals.

  • Wildfire Health Effects and Precautions

    Wildfire Health Effects and Precautions

    The January 2025 wildfires in the Los Angeles area have significant physical and mental health implications for residents, including respiratory complaints, potential exposure to toxins during cleanup, and long-term mental health concerns. These conditions underscore the importance of comprehensive occupational and public health responses during and after such disasters.

    The intense Los Angeles wildfires generated Air Quality Index (AQI) readings that surpassed 200 in affected areas, indicating “very unhealthy” conditions. In some regions, particulate matter (PM2.5) concentrations reached 184.1 µg/m³, approximately 36 times the World Health Organization’s recommended annual guideline.

    While much-needed rain in Southern California over the Jan. 25-26 weekend helped improve air quality and slow the spread of remaining fires, new problems emerged with reports of mudflows carrying toxic ash that closed roads and created hazardous conditions.

    Health Risks

    Wildfires produce smoke, ash, and other toxic matter. While anyone in a wildfire zone is at risk of exposure to toxins during and after a fire, particularly vulnerable populations include those with outdoor occupations, the elderly, children, and people with respiratory ailments such as asthma.

    Beyond the physical impact of wildfires, detrimental effects on mental health are also significant. Fire victims and first responders often experience symptoms of anxiety, depression, post-traumatic stress disorder, and other conditions that can remain unresolved without appropriate mental health interventions.

    Most wildfire-related injuries and deaths are caused by smoke inhalation, lack of oxygen, and exposure to toxic fumes from burning materials such as plastic and vinyl. Potentially lethal components include:

    • Particles that can lodge in the lungs, irritate eyes, and affect respiratory and digestive systems
    • Toxic liquids, gases, and vapors that can be inhaled or absorbed through the skin

    Chemical irritants found in smoke include ammonia, carbon monoxide, chlorine, hydrogen chloride, hydrogen cyanide, phosgene, and sulfur dioxide. Carbon monoxide, hydrogen cyanide, and hydrogen sulfide are examples of chemicals produced in fires that interfere with the body’s use of oxygen at the cellular level. Heat is also a respiratory hazard. Superheated gases burn the respiratory tract and can be fatal.

    Although the ash in Los Angeles is not classified as a hazardous waste, public health officials say it may contain traces of lead, cadmium, nickel, and arsenic; asbestos; perfluorochemicals (from degradation of non-stick cookware, for example); flame retardants; and caustic materials.

    Exposure Prevention

    During and after wildfires, public health officials advise people with exposure risk to wear an N95 mask with two elastic straps. A tightly fitted mask with an N95 rating (N=not oil resistant) filters out 95 percent of particles that are at least 0.3 microns in diameter. An N95 mask does not provide protection against toxic gases. (For firefighters, refer to National Fire Protection Association Standard 1970 on Protective Ensembles for Structural and Proximity Firefighting, Work Apparel, Open-Circuit Self-Contained Breathing Apparatus (SCBA) for Emergency Services, and Personal Alert Safety Systems.)

    To help reduce exposure to toxins in the air:

    • As feasible, work indoors or limit outdoor exposure
    • Avoid strenuous activity and outdoor exercise
    • Keep windows and doors closed and use the air recirculation option in vehicles
    • If using an air conditioner, keep the fresh-air intake closed and clean the filter
    • Do not burn candles or light a fire in a fireplace or wood-burning stove
    • Check local air quality reports or visit AirNow.gov to avoid polluted areas

    Refer to this California Environmental Protection Agency fact sheet on Protecting Public Health from Home and Building Fire Ash for toxic ash exposure risk reduction recommendations.

    Symptoms and Response

    In a medical emergency, it’s imperative to follow workplace first-response protocols or call 911. In non-emergency situations, WorkCare occupational health providers recommend moving to a location with clean air and seeking medical advice. Where there is toxic smoke exposure risk, watch for the following signs and symptoms:

    • Loss of consciousness (medical emergency)
    • Nausea/vomiting
    • Shortness of breath
    • Chest tightness
    • Coughing with or without mucus
    • Burning sensation in the throat and/or lungs
    • Voice changes/hoarseness
    • Tingling sensations (may be related to oxygen deficiency)
    • Headache, dizziness, lightheadedness
    • Confusion or irritability
    • Burning sensation to the eyes, blurry vision, watery eyes

    To help relieve discomfort:

    • Increase fluid intake to the extent personal health allows
    • Use over-the-counter natural tears or eye drops for burning or watery eyes
    • Use an inhaler, as directed, for respiratory distress

    Fire victims with mental health challenges are encouraged to seek professional counseling, join support groups, and get a medical evaluation, as needed, for symptoms such as trouble sleeping, loss of appetite, low energy, agitation, or irritability. It’s important to access available resources, which may include employee assistance programs, mental health care covered by insurance, and free or low-cost services provided by local community mental health agencies.

    Taking Precautions

    The risks and impacts of wildfires are escalating nationwide, with the Los Angeles area wildfires serving as a stark reminder of their destructive power. The U.S. Fire Administration estimates that more than 60,000 communities in U.S. wildland urban interface areas have elevated fire risk, and authorities say that number is climbing.

    Corelogic reports in its 2024 analysis of wildfire hazards that embers blown from burning vegetation into urban zones are responsible for an estimated 90 percent of home ignitions caused by wildfire. The U.S. Environmental Protection Agency tracks the frequency, extent, and severity of wildfires. It reports that wildfires are starting more easily and burning at higher temperatures than they have in the past, in some cases creating super-heated conditions that make them harder to fight, especially in remote areas.

    Preparation is key. This may include clearing dead and dry brush and trees located close to buildings, participating in neighborhood and business area watch groups and cleanup programs, identifying escape routes, having a family-friends-co-workers contact plan that doesn’t rely on cell phones, and knowing what you will take in the event of an evacuation.

    As the Los Angeles wildfires have so dramatically demonstrated, fire combined with high winds, hot temperatures, low humidity, and tinder-dry conditions can result in a conflagration that quickly overwhelms public safety and firefighting resources. Being prepared and leaving at-risk areas before an evaluation order is given helps save lives and structures.

    WorkCare’s telehealth triage team is available 24/7 to provide non-emergency care guidance to employees in the event of work-related exposures to wildfire smoke, ash, and other potentially toxic materials. Our Wellness Solutions team assists firefighters and other first responders with all aspects of their occupational and personal health.

  • Keep Employees’ Reproductive Health in Mind

    Keep Employees’ Reproductive Health in Mind

    The American College of Obstetricians and Gynecologists marks Maternal Health Awareness Day annually on January 23. Research shows that efforts to reduce the risk of exposure to certain workplace reproductive health hazards help improve outcomes for employees and their offspring.

    According to the Occupational Safety and Health Administration (OSHA), reproductive health risks may be chemical, physical, or biological in nature. Potential routes of exposure include inhalation, ingestion, and/or skin absorption. In some cases, exposure to certain substances or agents may impair fetal development or cause a miscarriage.

    Some exposure risks are more apparent than others. For example, in a study of 144 women working in industrial settings who were or had been pregnant, workload intensity, high temperatures, strong odors, and shift work were found to be contributing factors in pregnancy and menstrual cycle disorders. A study of 733 women in healthcare occupations found that:

    • Exposure to solvents was a risk factor for stillbirth
    • Prolonged work shifts were associated with spontaneous abortion and disrupted breastfeeding
    • Job rank and socioeconomic status affected fertility

    Pregnant women experience exposure risks differently from their non-pregnant co-workers because of the changes that are occurring in their bodies. In a paper on the effects of work during pregnancy, researchers reported:

    • Prolonged standing or repetitious lifting may reduce blood flow to an expectant mother’s placenta, which can affect fetal growth and cause preterm delivery.
    • Women whose jobs involve medical care, childcare, or teaching have a higher-than-average risk for miscarriage and preterm birth because they are more likely to get a contagious illness like the flu while pregnant.
    • Pregnant women are susceptible to injuries from slips and falls as their balance shifts and ligaments and tendons relax in preparation for childbirth.
    What Can You Do?

    Here are some suggestions for employers:

    1. Comply with applicable OSHA injury and illness prevention standards and provisions of the Pregnancy Discrimination Act, Pregnant Workers Fairness Act, Family and Medical Leave Act, and other federal laws that are intended to help protect employee health and support families.
    2. Provide well-fitted, personal protective equipment for all employees when reproductive health and other exposure hazards are or may be present. This includes making PPE adjustments during pregnancy.
    3. Facilitate the use of reasonable job accommodations (e.g., flexible work hours, more frequent breaks, less physically demanding tasks), as needed, for women during pregnancy and while breastfeeding.
    4. When supervising women, bear in mind that their healthcare needs differ from men for complex reasons. There is not a one-size-first-all approach to injury prevention and wellness.
    5. Employees often cite job-related stress as a health concern. Take steps to address stress-inducing conditions by keeping lines of communication open, supporting personal autonomy, and setting reasonable expectations.
    6. When evaluating employees’ performance, follow your employer’s human resources policies and procedures and look for opportunities to avoid gender bias.

    Questions? Consult with WorkCare’s occupational health subject matter experts on maternal health exposure risks in your workplace and ways to help mitigate them. We’re here to help.

  • Why WorkCare Monitors DOT Medical Exam Quality 

    Why WorkCare Monitors DOT Medical Exam Quality 

    A first-of-its kind study on the accuracy of medical information recorded on a form used to determine whether a driver can safely operate a commercial motor vehicle and qualify for a Department of Transportation (DOT) card reveals discrepancies that appear to warrant a second look. 

    The mandatory Federal Motor Carrier Safety Administration (FMCSA) Medical Examination Report form features questions designed to collect commercial drivers’ medical histories and document their physical examination results. Researchers found “significant inconsistencies” during a retrospective quality review of 1,603 forms completed in 2019. (The current version of the FMCSA 5875 form was updated in 2023.) 

    For the study, researchers abstracted data from one national employer. The examinations were performed by providers in a national network of medical examiners certified by the FMCSA to perform DOT exams.  

    More than half (55.5 percent) of completed forms contained errors. Medical examiners incorrectly or incompletely populated the form in 30 percent of examinations. Drivers inconsistently filled out their health history 38.7 percent of the time, including unanswered questions, inconsistent responses, or lack of necessary elaboration for positive responses.  

    The forms were reviewed by three FMCSA-registered medical examiners with board-certification in occupational medicine who were retained as corporate medical directors. The corporate physicians reviewed forms for completeness and documented their personal agreement or disagreement with findings based on The DOT Medical Examination: A Guide to Commercial Drivers’ Medical Certification, 6th Edition (2017). Strong disagreement could prompt a recommendation to restrict an employee’s operation of company vehicles.  

    What Does This Mean for Employers? 

    While the study was confined to the experience of a single national entity, the findings suggest that it’s advisable for any company that employs commercial motor vehicle operators to monitor the quality of medical exam findings. “This study precisely illustrates the reason why WorkCare provides oversight of DOT exams for our clients,” said Fred Kohanna, M.D., M.B.A., vice president of WorkCare’s medical screening business division. “When we see these errors on DOT exam forms, we get them corrected by the provider, or we fill in the missing information after speaking with the provider or the employee as part of our review process.” 

    A DOT card is typically valid for up to two years. Commercial drivers with certain medical conditions, such as high blood pressure or diabetes, may be issued a card with a shorter validity period and require more frequent monitoring. According to the study’s authors, medical exams require attention to detail on the part of both examiners and drivers. “Continued research, education, and regulation are needed to decrease inconsistencies and omissions in DOT certification documentation, and ultimately to understand and reduce the risks posed to drivers and society by virtue of these errors,” they concluded. 

    Medical monitoring helps save lives and reduce the risk of property damage, injuries, and related legal liability costs in the event of an accident. WorkCare facilitates timely scheduling of physical exams with qualified providers so drivers can promptly obtain or renew their DOT cards. WorkCare reviewers are on the lookout for findings that require follow-up to correct errors or omissions, or that warrant another medical opinion as part part of our mission to protect and promote employee health.

    Reference: Retrospective quality review of Department of Transportation (DOT) commercial drivers’ medical examination forms; M. Starchook-Moore, et. al; American Journal of Industrial Medicine, Vol. 67, Issue 12, September 2024; published by Wiley. 

  • Helping Employees Counteract Post-Holiday Blues 

    Helping Employees Counteract Post-Holiday Blues 

    While the start of a new year presents opportunities for a fresh start, it can also be a trigger for feelings of inadequacy. 

    Many employees feel blue after the holiday season draws to a close. Time constraints, financial pressures, and social demands that increased stress levels during the holiday season may linger. Meanwhile, in the winter months when it gets dark early and it’s cold outside, symptoms of stress-induced anxiety or depression can become more pronounced.  

    10 Tips

    Here are 10 tips to help employees manage post-holiday low moods:

    1. Get exposure to sunlight or a light therapy lamp. 
    2. Spend time outdoors or bring nature indoors. 
    3. Dress in layers and take precautions in extreme cold. 
    4. Remain socially connected without overcommitting. 
    5. Start or maintain a consistent exercise routine. 
    6. Eat a heathy diet to support your immune system. 
    7. Limit consumption of alcohol, a depressive substance.  
    8. Follow a consistent sleep schedule in a quiet place. 
    9. Occupy your mind with activities you enjoy. 
    10. Create a budget and stick to it to reduce stress. 
    Expectations 

    In daily life, expectations are often not clearly articulated. In the workplace, a lack of understanding about what an employee is expected to do within a specific timeframe and what the consequences will be if those expectations are not met can have a detrimental effect on productivity and morale. 

    Fear, negative self-talk, anger, social isolation, and eating disorders are examples of unhealthy responses to unrealistic expectations. It helps to clearly identify what can reasonably be accomplished and discuss ways to alleviate stress-inducing expectations with all stakeholders. Workplace supervisors who are receptive to employee suggestions on ways to improve processes and promote job satisfaction often see favorable results. 

    For people who tend to ruminate (obsessively dwell on problems without finding solutions), experts recommend deep breathing and other mindfulness techniques that encourage staying present in the moment rather than fretting about the past or worrying about the future. When a nagging issue is resolved, it can be crossed off the list. Even taking a small step toward solving a problem helps relieve stress.  

    Important Reminder 

    A mental health professional should be consulted for persistent symptoms of anxiety or depression such as rapid heart rate, irritability, fatigue, sleep loss, poor appetite, inability to concentrate, sadness, or suicidal thoughts. Referral to an employee assistance program or another behavioral health resource is a way for employers to support employees’ overall well-being. A qualified professional can evaluate symptoms and recommend solutions to help relieve them.  

    WorkCare’s Prevention + Wellness team has workplace resources for stress management across eight dimensions of wellness. Contact sales@workcare.com to learn more. 

     

  • Bird Flu-related Death Heightens Awareness

    Bird Flu-related Death Heightens Awareness

    The first severe human case of bird flu to occur during the nation’s current outbreak of avian influenza A (H5N1) has become the first human fatality, the Centers for Disease Control and Prevention reported on Jan. 6. The man who died was over 65 and had underlying medical conditions, according to the Louisiana Department of Health.

    Following the release of news about the infected Louisiana man who was hospitalized in December, California Gov. Gavin Newsom declared a state of emergency to help expedite the state’s response to the infections spreading in its dairy industry. 

    Since April, 66 human cases of bird flu have been confirmed in the United States. Avian influenza is a viral infection that primarily afflicts birds. It is a public health and economic concern because of its potential to mutate, spread among farm animals, and be passed from infected animals to people. 

    The CDC continues to rate the U.S. public’s overall exposure risk as low. Avian influenza viruses do not easily infect humans, and no cases of human-to-human transmission have been detected in the U.S.  

    Personal Protection  

    As a precaution, personal protection measures are recommended for workers with risk of exposure to animals and animal byproducts that are or may be infected. This includes poultry and livestock farmworkers, slaughterhouse employees, wildlife workers, veterinarians, and healthcare personnel. In response to the Louisiana case, which was caused by exposure to sick and dead wild birds, hunters, backyard flock owners, and other bird enthusiasts are now also being advised to take precautions.  

    “We anticipate increased occupational exposure risk to avian flu in some areas for our client employees, for example, for personnel in facilities, HVAC, building maintenance, construction, and pest control occupations who have potential contact with bird guano,” said Patrick O’Callahan, M.D., M.P.H., WorkCare’s vice president for on-site clinical operations. “If dairy farm outbreaks are associated with contaminated shared equipment and personnel, we may see sporadic cases involving transport workers and employees at product delivery sites.” If avian flu eventually spreads to commercial beef and pork industries, he added, there could be a major impact on employees at meat processing plants.

    Recommendations include:  
    • Avoiding unprotected, direct physical contact or close contact with sick or dead animals, carcasses, feces, or litter.  
    • Wearing personal protective equipment such as an N95 filtering facepiece respirator, eye protection, and gloves when contact cannot be avoided. 
    • Frequent and thorough handwashing when handling raw eggs, milk, or meat, and thoroughly cooking eggs and meat. 

    In healthcare settings, clinicians are advised to consider the possibility of H5N1 virus infection in patients with symptoms. Avian flu symptoms can range from fever, cough, sore throat, conjunctivitis (pink eye), and muscle aches to pneumonia, acute respiratory distress, and multiple-organ failure. Severe symptoms require emergency care and can be fatal. When treating those with confirmed infections, the CDC recommends using close contact and airborne precautions in combination with standard personal protection. 

    People with symptoms who suspect they have been exposed to an infected source animal are encouraged to contact their personal provider. 

    Surveillance

    The U.S. Department of Agriculture Animal and Plant Health Inspection Service is facilitating national milk supply surveillance and dairy herd status programs that involve several government agencies. It has reported 311 new infected cattle herds in California, and one each in Nevada and Texas in the last 30 days, bringing the total for the current outbreak to 865 cattle herds in 16 states.   

    The U.S. Food and Drug Administration (FDA) is investigating the potential for the H5N1 virus to infect bulk raw cow’s milk prior to pasteurization, a heating process that skills the virus. The FDA reports that about 99 percent of the nation’s commercial milk supply comes from farms that comply with controls that help ensure the safety of dairy products. 

    Testing and Treatment Challenges 

    Bird flu is caused by influenza type A viruses, which are classified into subtypes based on two proteins on the virus surface: hemagglutinin (H) and neuraminidase (N). The Center for Health Security at Johns Hopkins University notes that testing to confirm bird flu in humans is limited. Researchers believe the actual number of cases may be underreported because: 

    • Commercial testing for H5N1 is unavailable. 
    • When a flu test is positive for influenza A and cannot be subtyped, the CDC must retest it to confirm bird flu. 
    • Commercial farms with infected animals must be receptive to health department interventions. 
    • Workers may be reluctant to report symptoms to their employer. 

    Bird flu viruses can develop resistance to antiviral drugs (e.g., oseltamivir), which are often used to treat human influenza infections.  

    Conclusion 

    While the overall risk of work-related exposure to bird flu in the U.S. is low and symptoms are usually relatively mild, individuals in affected occupations are strongly advised to adopt strict safety measures when there is an outbreak. Ongoing surveillance and biosecurity practices have been shown to significantly reduce animal-to-human transmissions.  

    WorkCare’s occupational health physicians and other members of our medical monitoring team are well-prepared to assist employers in affected workplaces with the implementation of protective measures for employees with bird flu exposure risk. Visit our website to learn more about our capabilities. 

  • AI Revolutionizing Occupational Healthcare

    AI Revolutionizing Occupational Healthcare

    Posted by Peter P. Greaney, M.D.

    The use of artificial intelligence (AI) and related technologies in healthcare is poised to transform the delivery of occupational health services in the U.S.

    Healthcare is becoming a highly technical field, but that doesn’t diminish the importance of the human touch. Occupational health is both a science and an art. AI can serve as a valuable tool to enhance both dimensions.

    I agree with other thought leaders who see AI-related technology as a tool physicians should use to augment their medical practice, not as a replacement for doctors. Using AI, occupational health providers will have instantaneous access to diagnosis and treatment recommendations based on the best medical practices and data from millions of cases.

    The use of algorithms and machine learning will help make these recommendations even more robust, accurate, and individualized over time. AI-driven technology will also encourage employee adherence with care guidance and help streamline administrative functions for more efficient and cost-effective healthcare management.

    At WorkCare, our plans include the use of proprietary employee health information management platforms that put AI at the forefront of our business processes. For example, we will use AI to:

    • Build on our years of experience in the practice of occupational medicine
    • Simplify telehealth triage and medical management transactions
    • Streamline appointment scheduling with qualified providers
    • Auto-populate and securely store electronic medical records
    • Provide self-service access to certain functions and work-status reports
    • Help expedite hiring, job placement, and return-to-work decisions

    These efforts are driven by professionals at WorkCare who understand industry regulations, workplace environments, and the benefits of caring deeply about employee health and safety.

     FDA Guidance – A Related Development

    The U.S. Food and Drug Administration released guidance on Dec. 4, 2024, that is intended to streamline the market submission approval process for medical devices that use AI, including those that enable a machine or system to learn and improve its performance over time.

    In the guidance document, the FDA supports revisions to its approval process for the development and release of AI-enabled device software functions (AI-DSFs). It states that the process should be the “least burdensome for manufacturers” while providing reasonable assurance of device safety and effectiveness.

    Under the newly released guidelines, manufacturers can seek approval to change AI-enabled products without having to file a new submission. Applicants are expected to describe planned changes to a device, outline the testing needed to ensure the device remains safe and effective, and include a risk-mitigation strategy.

    The FDA recognizes that AI-related technology has the potential to improve methods of disease detection, diagnosis, therapeutics, and user experiences. The agency also notes that its guidance exemplifies its commitment to developing innovative approaches to the regulation of device software functions, in general.

    If you believe, as I do, that the practice of preventive medicine and population health management depends on astute pattern recognition, you will understand why the FDA is taking steps to support the iterative processes that are needed to drive technological advancements.

    Dr. Peter P. Greaney is WorkCare’s Founder, Chief Medical Officer, and Executive Chairman.

  • Preventing Ergonomic Injuries in Warehouse and Delivery Operations

    Preventing Ergonomic Injuries in Warehouse and Delivery Operations

    In anticipation of the holiday shopping season, the U.S. Government Accountability Office (GAO) has released a report that prods the Occupational Safety and Health Administration (OSHA) to do more to prevent ergonomic-related injuries in warehouses and short-distance delivery operations.

    Preventable work-related sprains, strains and other types of musculoskeletal disorders (MSDs) are common occurrences in these settings. Contributing factors may include overexertion, force, repetition and awkward or static postures. According to the Bureau of Labor Statistics, e-commerce warehouses and last-mile delivery operations had the highest serious-injury and illness rate among 19 transportation and warehousing sectors in 2022, with an estimated 3.8 cases per 100 workers.

    OSHA developed an ergonomics standard that was signed into law in 2000 during the Clinton administration. However, the law was rescinded in 2001 by the Bush administration in response to opposition from business groups, lawsuits, and enforcement-related complexities. In the absence of a specific standard, OSHA cites employers for ergonomic-related exposure hazards under the general duty clause of the 1970 Occupational Safety and Health Act.

    In its report on Why OSHA Should Take Steps to Better Identify and Address Ergonomic Hazards at Warehouses and Delivery Companies, the GAO notes that warehouse and last-mile delivery employers received more than 2,500 OSHA citations between fiscal years 2018 to 2023. Of those, only 11 identified specific ergonomic hazards. This suggests that validating connections between work-related ergonomic factors and the occurrence of MSDs in a workplace remains a challenge.

    National Emphasis Program

    OSHA launched a three-year National Emphasis Program on Warehousing and Distribution Center Operations in July 2023 to help address rising incident and injury rates in the rapidly expanding e-commerce marketplace. In addition to ergonomics, the program focuses on the operation of powered industrial vehicles, material handling and storage activities, walking-working surface and egress safety, fire protection, and work in hot environments. Employee exposures to ergonomic hazards must be assessed during:

    • Review of an employer’s injury and illness logs
    • Employee interviews
    • Workplace walkthroughs

    When ergonomic and/or heat exposures are identified, the scope of an OSHA inspection must be expanded to include potential employee health impacts.

    Recommendations

    In its report, the GAO says OSHA “can do more.” It makes five recommendations to the U.S. Department of Labor, which oversees OSHA:

    1. Ensure that OSHA compliance officers can easily obtain musculoskeletal disorder occurrence dates during inspections, potentially by adding a new column to recordkeeping forms.
    2. Make OSHA inspectors’ training on workplace ergonomic exposure hazards more robust.
    3. Direct the Assistant Secretary of Labor for Occupational Safety and Health to review and make needed changes to internal and publicly available guidance that compliance officers and employers use to identify, assess, and address ergonomic hazards. This may include clarifying and updating industry-specific guidance.
    4. Direct OSHA to conduct timely follow-ups with establishments that receive post-inspection ergonomic hazard-alert letters to evaluate the extent of corrective actions that have been taken.
    5. Direct OSHA to evaluate the effectiveness of its national emphasis program and document next steps to correct any deficiencies that may be identified.

    How WorkCare Can Help

    WorkCare employs specialists in injury prevention and customized ergonomic programs, and it has taken the National Safety Council’s MSD Solutions Lab pledge to help employers dramatically reduce work-related musculoskeletal disorders. Understanding the regulations and implementing injury prevention programs can seem like a daunting task. WorkCare is here to help. Connect with our team to learn about proven ways to create safer, healthier workplaces.