Occupational disease:

Acute Occupational Pesticide-Related Illness and Injury -United States, 2007-2011

CDC's National Institute for Occupational Safety and Health (NIOSH) collects data on acute pesticide-related illness and injury reported by 12 states (California, Florida, Iowa, Louisiana, Michigan, Nebraska, North Carolina, New Mexico, New York, Oregon, Texas, and Washington). This report summarizes the data on illnesses and injuries arising from occupational exposure to conventional pesticides from 2007 through 2011. This report is a part of the Summary of Notifiable Noninfectious Conditions and Disease Outbreaks - United States, which encompasses various surveillance years but is being published in 2016 (1). The Summary of Notifiable Noninfectious Conditions and Disease Outbreaks appears in the same volume of MMWR as the annual Summary of Notifiable Infectious Diseases (2). In a separate report, data on illnesses and injuries from nonoccupational exposure to pesticides during 2007-2011 are summarized (3).

Dual loyalties and the ethical and human rights obligations of occupational health professionals

BACKGROUND

Underlying most ethical dilemmas in occupational health practice is the problem of Dual Loyalties where health professionals have simultaneous obligations, explicit or implicit, to a third party, usually a private employer.

METHODS

A literature review was undertaken of case studies of workplace occupational health conflicts, international human rights and ethical codes and strategies for managing dual loyalties, complemented by iterative discussions in an international working group convened to address the problem of Dual Loyalties.

RESULTS

Violations of the worker-patient's human rights may arise from: (1) the incompatibility of simultaneous obligations; (2) pressure on the professional from the third party; and (3) separation of the health professional's clinical role from that of a social agent. The practitioner's contractual relationship with the third party is often the underlying problem, being far more explicit than their moral obligation to patients, and encouraging a social identification at the expense of a practitioner's professional identity.

CONCLUSIONS

Because existing ethical guidelines lack specificity on managing Dual Loyalties in occupational health, guidelines that draw on human rights standards have been developed by the working group. These guidelines propose standards for individual professional conduct and complementary institutional mechanisms to address the problem.

Integration of workers' compensation and health insurance prescription drug programs: how does it work and do employees use it?

BACKGROUND

In 1998, New York State designed and developed an integrated workers' compensation (WC)/health plan prescription drug program, ONECARD Rx, in response to cost inefficiencies within the then current system and in an attempt to improve the quality of care provided to WC claimants. This paper describes the benefit's design and development process and factors related to its use.

METHODS

Users and non-users of the program were surveyed through a mailed questionnaire with appropriate telephone follow-up.

RESULTS

Eight steps were followed in the development of the benefit. Results obtained from the assessment of ONECARD Rx suggest that factors affecting use mainly relate to the knowledge of both, employees and pharmacists, of the program. The two main differences detected between users and non-users included the state agency the employee works for and the site of residence.

CONCLUSIONS

Innovative strategies that couple private and public agencies should aim at reducing the costs and eliminating inefficiencies while improving the quality of care, of which satisfaction is an important component.