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Hemorrhoids, History & the Western World

Hemorrhoids

Hemorrhoids are one of the most frequent problems people in westernized countries face. There are estimates of up to 75 to 90 percent occurrence rates of hemorrhoids in the U.S. population (1, 2, 3, 4, 5). An estimated 50 percent of those over the age of 50 years require some type of conservative or operative therapy (4).

The cost to the community, both financial and in lost work days, is great; and by any standards, this condition must be considered a major health hazard (7).

Seating & Hemorrhoids

Preventative measures to reduce risk factors for the development of hemorrhoids should be taken before it is too late. It is important to minimize external compression from poorly designed seating as much as possible. External compression from poorly designed seating concentrates forces on small areas of the body. This results in high localized pressure. The pressure can compress nerves, vessels, and other soft tissues, resulting in tissue-specific damage. These changes may themselves result in disease or predispose other tissues to damage.

U.S. History & Hemorrhoids

Hemorrhoids have plagued men and women for centuries, inflicting pain equally on individuals at all levels of society and of all occupations: Emperors (Napoleon); U.S. Presidents (Jimmy Carter); baseball sluggers (George Brett); judges; policemen; truck and cab drivers; and jockeys (6).

Ancient History & Hemorrhoids

It has been said that Napoleon’s hemorrhoids were troubling him during the battle of Waterloo (7).

Proctology flourished as a specialty in Ancient Egypt. The surgical treatment of hemorrhoids was practiced in Ancient Greece, and Hippocrates suggested that the cause could be attributed to bile and phlegm (8).

The Western World vs. The Third World & Hemorrhoids

Today, hemorrhoids are considered to be one of the most common ills of men and women, a judgment made by those with vision limited to the Western World (7).

The high rate of hemorrhoids in westernized societies contrasts sharply with Third World countries. Only about one in 25 to one in 30 individuals is thought to have hemorrhoids as compared to one in two individuals in Westernized societies. One doctor recounted in 30 years’ practice in Africa, one of the only two patients he saw with severe hemorrhoids was a prince taking a semi-European diet (5, 7).

1) Primary Care, Volume 26, Number 1, March, 1999, “Hemorrhoids,” by Joy N. Hussain, M.D., Cairns Base Hospital, Australia.
2) Family Medicine Principles & Practices, 1998, Fifth Edition: Chapter 91, “Diseases of the Rectum and Anus,” by Thomas J. Zuber.
3) MJA, Vol. 167, July, 1997, Clinical Practice, “Hemorrhoids: A Clinical Update,” written by Adrian L. Polglase, M.S., FRACS, Clinical associate Professor and Colorectal Surgeon, Australia.
4) American Family Physician, September 1, 1995, “Non-surgical Treatment Options for Internal Hemorrhoids, written by John Pfenninger, M.D., and James Surrel, M.D.
5) Surgical Clinics of North America, Vol. 65, No. 6, December, 1988, “Hemorrhoids, Non-operative Management,” written by A. R. Dennison, M.D.; D.C., Wherry, M.D.; and D.L. Morris, M.D., Ph.D.
6) Southern Medical Journal, Vol. 81, No. 5, May, 1988, “Alternatives in the Treatment of Hemorrhoidal Disease,” by Emmet F. Ferguson, Jr., M.D., University of Florida, School of Medicine, Jacksonville, F.L., U.S.A.
7) Postgraduate Medical Journal, September, 1975, 51, 631-636, “Hemorrhoids – Postulated Pathogenesis and Proposed Prevention,” written by D. P. Burkitt, C.M.G., M.D., F.R.C.S., F.R.S., and C.W. Graham-Stewart, MS, F.R.C.S.
8) The American Journal of Proctology, Vol. 21, No. 3, June 1970, “An Epidemiological Investigation of Hemorrhoids, written by John Philpot, Ph.D., Rutgers, The State University, New Jersey, U.S.A.

Forward Bending & Low Back Pain

Spine, Volume 21, Number 1, pp. 71-78, 1996, “Analysis of Lumbar Spine and Hip Motion During Forward Bending in Subjects With and Without a History of Low Back Pain,” written by Marcia A. Esola, M.S., P.T.; Philip W. McClure, M.S., P.T.; G. Kelley Fitzgerald, M.S., P.T.; and Sorin Siegler, Ph.D., U.S.A.:

In this study, a motion analysis system was used to measure the amount and velocity of lumbar spine and hip motion during forward bending.

The authors begin by citing the following previous findings:

EPIDEMIC OF LOW BACK PAIN

“Disorders of the low back have reached epidemic proportions, (DeRosa, C.P., 1992).”

BILLIONS OF $$$ ANNUALLY, LOST WORK TIME & WORKERS’ COMP CLAIMS

“Epidemiologic studies show that billions of dollars are spent annually on the problem of low back pain, which is one of the most commonly-cited problems for lost work time in industry and Workers’ Compensation claims, (Chase, J.A., 1992; Frymoyer, J.W., 1988; and Pope, M.H., et al., 1991).”

FREQUENT FORWARD BENDING & LOW BACK PAIN

“Researchers have shown an association between frequent forward bending and low back pain, (Berquist-Ullman, M., et al., 1977; Magora, A., 1973; Mellin, G., 1986; Punnett, L, et al., 1991; Svensson H.O., et al., 1989; Videman T., et al., 1989).”

SLOUCHING WHILE SEATED / BENDING AT THE WAIST WHILE STANDING

“Prolonged sitting with the lumbar spine in a flexed position (slouching) and flexed standing postures (bending at the waist) are also associated with an increased risk of low back pain, (Anderson, G.B.J., 1991; Berquist-Ullman, M., et al., 1977; Magora, A., 1972; Punnett, L., et al., 1991; Riihimaki, H., et al., 1989).”

OCCUPATIONS INVOLVING REPETITIVE FORWARD BENDING

“Saunders reports that people with herniated inter-vertebral discs often have a history of an activity or occupation involving repetitive forward bending.”

“Nachemson (1981) has shown that inter-vertebral disc pressure increases 20 percent over that measured in standing when forward bending 20 degrees, and increases 100 percent when bending up to 40 degrees.”

INADEQUATE HIP FLEXIBILITY & EXCESSIVE LUMBAR MOTION

“It has been suggested that inadequate hip flexibility coupled with excessive lumbar motion during forward bending results in low back pain, (Biering-Sorenson, F., 1984; Sahramann, S.A., 1993). . .Sahramann (1993) suggests that excessive lumbar mobility leads to tissue overloading, micro-trauma, and ultimately the development of degenerative joint and disc disease. A person may experience low back pain at any stage of this sequence of events.

FORWARD BENDING = RISK FACTOR FOR LOW BACK PAIN

“Forward bending has been clearly recognized as a risk factor for low back pain. Altered movement patterns of the lumbar spine and hips during forward bending may help explain why forward bending is a risk factor for the development of low back pain.”

HAMSTRING STRETCHING HELPFUL 

In the conclusions, the authors state: “The results provide quantitative data to guide clinical assessment of forward bending motion.  Results also suggest that although people with a history of low back pain have amounts of lumbar spine and hip motion during forward bending similar to those of healthy subjects, the pattern of motion is different.  It may be desirable to teach patients with a history of low back pain to use more hip motion during early forward bending, and hamstring stretching may be helpful for encouraging earlier hip motion.”

OSHA Revised Whistleblower Complaint

Trade Release

Department of Labor, United States of America

U.S. Department of Labor
Occupational Safety and Health Administration
Office of Communications
Washington, D.C.
www.osha.gov

For Immediate Release
July 28, 2017
Contact: Office of Communications
Phone: 202-693-1999

OSHA revises its online whistleblower complaint form

WASHINGTON – The Occupational Safety and Health Administration recently revised its online whistleblower complaint form to help users file a complaint with the appropriate agency. The form provides workers with another option for submitting retaliation complaints to the U.S. Department of Labor’s OSHA.

The updated form guides individuals as they file a complaint through the process, providing essential questions at the beginning so they can better understand and exercise their rights under relevant laws. One significant improvement to the system includes pop-up boxes with information about various agencies for individuals who indicate that they have engaged in protected activity that may be addressed by an agency other than OSHA. The new form is available in English and Spanish.

“Workers who report unsafe conditions and wrongdoing have a range of legal protections from retaliation,” said Deputy Assistant Secretary of Labor for Occupational Safety and Health Loren Sweatt. “The revised online complaint form works to ensure whistleblowers file their complaints with the appropriate federal agency for prompt action.”

In addition to the online form, workers can file complaints by fax, mail, or hand-delivery; contacting the agency at 800-321-6742; or calling an OSHA regional or area office.

OSHA enforces the whistleblower provisions of 22 statutes protecting employees who report violations of various securities laws, trucking, airline, nuclear power, pipeline, environmental, rail, public transportation, workplace safety and health, and consumer protection laws. Detailed information on employee whistleblower rights, including fact sheets, is available online at http://www.whistleblowers.gov/.

Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA’s role is to ensure these conditions for America’s working men and women by setting and enforcing standards, and providing training, education and assistance. For more information, visit www.osha.gov.

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OSHA Resources on Silica Final Rule

Information from OSHA

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U.S. Department of Labor

Occupational Safety and Health Administration

Office of Communications

202-693-1999

Department of Labor, United States of America

New and revised resources available from OSHA on silica final rule

OSHA has released two resources to help small business employers comply with the agency’s final silica rule. The Small Entity Compliance Guide for General Industry and Maritime outlines steps that employers are required to take including: assessing worker exposures; using engineering and work practice controls to keep exposures below a specified safety threshold; offering medical exams to certain highly exposed workers; and training workers. Enforcement of the final rule is scheduled to begin June 23, 2018.

Released earlier in the year, the Small Entity Compliance Guide for Construction describes requirements to protect employees including: using engineering controls specified in the standard or selecting other effective engineering controls to reduce exposures; offering medical exams to workers who will need to wear a respirator under the silica standard for 30 or more days a year; and training workers. The guide was updated to reflect the new enforcement date of Sept. 23, 2017.

You are receiving this email because you signed up for updates on the agency’s silica rule. To unsubscribe, see below.

OSHA Whistleblower Complaints Contact Office of Communications

Trade Release from OSHA

Having trouble viewing this email? View it as a Web page.

Trade Release

Department of Labor, United States of America

U.S. Department of Labor
Occupational Safety and Health Administration
Office of Communications
Washington, D.C.
www.osha.gov

For Immediate Release
July 28, 2017
Contact: Office of Communications
Phone: 202-693-1999

OSHA revises its online whistleblower complaint form

WASHINGTON – The Occupational Safety and Health Administration recently revised its online whistleblower complaint form to help users file a complaint with the appropriate agency. The form provides workers with another option for submitting retaliation complaints to the U.S. Department of Labor’s OSHA.

The updated form guides individuals as they file a complaint through the process, providing essential questions at the beginning so they can better understand and exercise their rights under relevant laws. One significant improvement to the system includes pop-up boxes with information about various agencies for individuals who indicate that they have engaged in protected activity that may be addressed by an agency other than OSHA. The new form is available in English and Spanish.

“Workers who report unsafe conditions and wrongdoing have a range of legal protections from retaliation,” said Deputy Assistant Secretary of Labor for Occupational Safety and Health Loren Sweatt. “The revised online complaint form works to ensure whistleblowers file their complaints with the appropriate federal agency for prompt action.”

In addition to the online form, workers can file complaints by fax, mail, or hand-delivery; contacting the agency at 800-321-6742; or calling an OSHA regional or area office.

OSHA enforces the whistleblower provisions of 22 statutes protecting employees who report violations of various securities laws, trucking, airline, nuclear power, pipeline, environmental, rail, public transportation, workplace safety and health, and consumer protection laws. Detailed information on employee whistleblower rights, including fact sheets, is available online at http://www.whistleblowers.gov/.

Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA’s role is to ensure these conditions for America’s working men and women by setting and enforcing standards, and providing training, education and assistance. For more information, visit www.osha.gov.

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MAINTENANCE OF LUMBAR LORDOSIS = DECREASED RISK OF LOW BACK PAIN,  ISCHIUM (BUTT BONE) PAIN, & COCCYX (TAIL BONE) PAIN

MAINTENANCE OF LUMBAR LORDOSIS = DECREASED RISK OF LOW BACK PAIN,  ISCHIUM (BUTT BONE) PAIN, & COCCYX (TAIL BONE) PAIN

Spine, Volume 22, Number 21, pp. 2571-2574, 1997, “Lumbar Lordosis, Effects of Sitting and Standing,” written by Michael J. Lord, M.D.; John M. Small, M.D.; Jocylane M. Dinsay, R.N., M.N.; and Robert G. Watkins, M.D., Kerlan-Jobe Orthopedic Clinic, California, U.S.A.:

The objective of the above-mentioned study was to document changes in segmental and total lumbar lordosis (inward curvature of the lumbar spine) between sitting and standing radiographs (x-rays).

“One hundred and nine patients with low back pain underwent radiography in the sitting and standing positions. The patients ranged in age from 21 years to 83 years (mean age, 47 years) and had had no prior lumbar spine fusion or clinical deformity. Seventy men and 39 women took part in the study.”

DECREASED LUMBAR LORDOSIS & LOW BACK PAIN

In their discussion, the authors state the following:

“Keegan (1953) in a study of the relationship between lordosis and sitting, found the most important factor in low back pain with prolonged sitting to be decreased trunk-thigh angle with consequent fattening of the lumbar curve.  Use of a lumbar roll that increases lordosis has been found to decrease low back pain, (Williams, A.M., et al., 1991).”

DECREASED LUMBAR LORDOSIS & BUTT PAIN / TAIL-BONE PAIN

“With decreased lordosis, sitting pressure increases over the ischium (butt bones) and coccyx (tail-bone) with resultant pain, (Drummond, D.S., et al., 1982 and 1985; Smith, R.M., et al., 1992.)

The following conclusions were made:

“Segmental and total lordosis were significantly different in the sitting and standing postures. Lordosis increased almost 50 percent when the patients moved from the sitting to the standing position. The clinical significance of this data may pertain to:

  1. The known correlation of increased intra-discal pressure with sitting, which may be caused by this decrease in lordosis;
  2. To the benefit of a sitting lumbar support that increases lordosis; and
  3. To the consideration of an appropriate degree of lordosis in fusion of the lumbar spine.”

 

 

 

Trade Release – OSHA – electronically submit injury and illness data on August 1, 2017 – Form 300

OSHA Electronic Filing August 1, 2017

Trade Release

Department of Labor, United States of America

U.S. Department of Labor
Occupational Safety and Health Administration
Office of Communications
Washington, D.C.
www.osha.gov
For Immediate Release
July 14, 2017
Contact: Office of Communications
Phone: 202-693-1999

OSHA launches application to electronically submit injury and illness data on August 1

WASHINGTON – The Occupational Safety and Health Administration will launch on Aug. 1, 2017, the Injury Tracking Application (ITA). The Web-based form allows employers to electronically submit required injury and illness data from their completed 2016 OSHA Form 300A. The application will be accessible from the ITA webpage.
Last month, OSHA published a notice of proposed rulemaking to extend the deadline for submitting 2016 Form 300A to Dec. 1, 2017, to allow affected entities sufficient time to familiarize themselves with the electronic reporting system, and to provide the new administration an opportunity to review the new electronic reporting requirements prior to their implementation.
The data submission process involves four steps: (1) Creating an establishment; (2) adding 300A summary data; (3) submitting data to OSHA; and (4) reviewing the confirmation email. The secure website offers three options for data submission. One option will enable users to manually enter data into a web form. Another option will give users the ability to upload a CSV file to process single or multiple establishments at the same time. A third option will allow users of automated recordkeeping systems to transmit data electronically via an application programming interface.
The ITA webpage also includes information on reporting requirements, a list of frequently asked questions and a link to request assistance with completing the form.
Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA’s role is to ensure these conditions for America’s working men and women by setting and enforcing standards, and providing training, education and assistance. For more information, visit www.osha.gov.
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