Fatal injuries caused by logs rolling off trucks: Kentucky 1994-1998

BACKGROUND

Logging is one of the most hazardous occupations and fatality rates are consistently among the highest of all industries. A review of fatalities caused by logs rolling off trucks is presented.

METHODS

The Kentucky Fatality Assessment and Control Evaluation Project is a statewide surveillance system for occupational fatalities. Investigations are conducted on selected injuries with an emphasis on prevention strategy development. Logging was an area of high priority for case investigation.

RESULTS

During 1994-1998, we identified seven incidents in which a worker was killed by a log rolling off a truck at a sawmill, accounting for 15% of the 45 deaths related to logging activities. These cases were reviewed to identify similar characteristics and risk factors.

CONCLUSIONS

Investigations led to recommendations for behavioral, administrative, and engineering controls. Potential interventions include limiting load height on trucks, installing unloading cages at sawmills and prohibiting overloaded trucks on public roadways.

Infection and exposure control in North American dental schools

The results of a survey sent to all U.S. and Canadian dental schools clearly indicate that several substantial changes have occurred in infection control and exposure control in the past fifteen to twenty years. Predominant among these are that the responsibility for instrument preparation and sterilization in most schools has passed from the student to trained staff, the routine practice of universal precautions has eliminated the need to treat patients known to carry bloodborne diseases in a special area, and pre-admission and enrollment vaccination and health screening requirements have changed significantly. Other important changes result from the fact that the majority of U.S. schools responding to the survey are now, to a great extent, in compliance with the OSHA Bloodborne Pathogens Standard or equivalent requirements.

New OSHA standards managers must know

For home care agencies, compliance encompasses far more than HCFA and the Joint Commission specifics. Other organizations also provide strict guidelines regarding daily operations and activities. This article describes the proposed OSHA ergonomics regulations and provides suggestions for managers on how to prepare for the changes.

Risk assessment for heart disease and workplace ETS exposure among nonsmokers

In 1994 the U.S. Occupational Health and Safety Administration (OSHA) published a study of risk assessment for heart disease and lung cancer resulting from workplace exposure to environmental tobacco smoke (ETS) among nonsmokers. This assessment is currently being revised. The present article considers different possible approaches to a risk assessment for heart disease among nonsmokers resulting from workplace ETS exposure, reviews the approach taken by OSHA in 1994, and suggests some modifications to that approach. Since 1994 the literature supporting an association between ETS exposure and heart disease among never smokers (sometimes including long-term former smokers) has been strengthened by new studies, including some studies that have specifically considered workplace exposure. A number of these studies are appropriate for inclusion in a meta-analysis, whereas a few may not be due to methodological problems or problems in exposure definition. A meta-analysis of eight relative risks (either rate ratios or odds ratios) for heart disease resulting from workplace ETS exposure, based on one reasonable selection of appropriate studies, yields a combined relative risk of 1.21 (95% confidence interval [CI], 1.04-1.41). This relative risk, which is similar to that used by OSHA in 1994, yields an excess risk of death from heart disease by age 70 of 7 per 1000 (95% CI 0.001-0.013) resulting from ETS exposure in the workplace. This excess risk exceeds OSHA's usual threshold for regulation of 1 per 1000. Approximately 1,710 excess ischemic heart disease deaths per year would be expected among nonsmoking U.S. workers 35-69 years of age exposed to workplace ETS.

Potential for Violence Toward Psychiatric Nursing Students: Risk Reduction Techniques

1. Nursing students could be vulnerable targets of violence in their psychiatric nursing clinical rotations by virtue of their predominant gender, and meek, insecure attitudes. 2. Nurses are taught to put the patients' needs first and students may blame themselves or minimize situations where they have been threatened or assaulted by a patient. Priority consideration must also be given to our own safety and that of our students, given the risk for occupational injury in the nursing workplace. 3. Affiliating agencies may restrict disabled students from patient care areas. Allowing a disabled student to participate in a clinical rotation on a psychiatric unit could put staff at unnecessary risk of violence if called on to protect the vulnerable student.

Current and historical American asbestos regulations

Asbestos, and asbestos-containing materials, are subject to regulation in the USA by both the federal government and each of the 50 state governments. This paper summarizes the federal government asbestos regulations which apply to the use of asbestos, asbestos-containing products, and asbestos fiber releases, in the workplace and in the ambient environment through the USA. Regulations by the 50 states apply only within the jurisdiction of each state and, to a large extent, mimic those of the federal government. The state regulations are not discussed in this paper. The principal American government agencies that deal with asbestos regulation are the Occupational Safety and Health Administration (OSHA) and the Environmental Protection Agency (EPA). Generally, OSHA regulations apply to regulate asbestos exposures, and potential asbestos exposures, in the occupational workplace while EPA regulations apply to asbestos exposures, and potential asbestos exposures, in the nonoccupational setting. Both agencies set regulatory levels for allowable asbestos exposure. Those levels have changed, in a decreasing progression, since their enactment in the early 1970s. This paper discusses those levels and traces their progression over time.

A survey of New Jersey industrial hygienists and safety engineers: health and safety conditions, practices, and priorities for OSHA reform

This study reports the results of an analysis of responses from more than 400 New Jersey industrial hygienists and safety engineers to a survey examining a wide range of health and safety conditions and practices. Findings are reported on a number of variables including the types and seriousness of safety and health hazards encountered at the respondents' work sites, perceived improvements in health and safety conditions, compliance with right-to-know requirements, the effectiveness of resources used in correcting hazards, and the barriers encountered in addressing hazardous conditions. The respondents were also asked to rank their priorities regarding 14 proposals for Occupational Safety and Health Administration (OSHA) reform. Opinion questions were scaled to reflect the respondent's sense of the importance of each variable. One finding of particular interest is that worker involvement in health and safety committees was perceived as an "effective" or "very effective" resource by more than one-half of the respondents. Changes in the Occupational Safety and Health Act that would strengthen requirements for worker participation were among the respondents' top priorities for OSHA reform.

Ergonomics and dentistry

Since 1992 the Occupational Safety and Health Administration (OSHA) has been preparing Federal legislation concerned with ergonomic hazards in at-risk workplaces. Although multifactorial in nature, there is sufficient evidence in the scientific literature to document an association between the practice of dentistry and a variety of musculoskeletal disorders. There are preventive strategies already known and available to us. Should dentistry be considered an at-risk profession and be required to comply with the forthcoming standard, or is self-monitoring sufficient?

Hazardous chemical exposure: guidelines for the optometric office

BACKGROUND

The Occupational Safety and Health Administration (OSHA) Hazard Communication Standard (HCS) applies to all types of employers, including optometrists. The purpose of the standard is to ensure that employees are aware of chemical hazards in the workplace and know how to protect themselves. Any optometric office that uses chemicals such as acetone, alcohol, lens-tinting dyes, or disinfection chemicals must comply with HCS.

METHODS

Optometrists must develop, implement, and maintain a written Hazard Communication Program for their practices. The program must describe how they plan to meet the requirements of HCS. It should include the development of a listing of all hazardous chemicals used in the office, the collection of appropriate Material Safety Data Sheets (MSDS) for each chemical, the labeling of hazardous chemical containers, and the provision of an effective employee-training program.

RESULTS

The implementation of an effective Hazard Communication Program will help ensure employee safety. A sample outline for a Hazard Communication Program for an optometric office is provided.

CONCLUSIONS

Optometrists with one or more employees have an obligation to ensure these employees are provided with a healthy and safe workplace. OSHA has established specific requirements relating to employees' potential exposure to chemicals. Failure to comply with OSHA regulations may result in significant fines.