Beyond the costs of an injury — BWC Blog

A good read about prevention of injury and the need to address health disparities.

By Mark Leung, BWC Technical Medical Specialist, Recently promoted from the BWC Safety & Hygiene Fellowship program Occupational health and safety has been a public health focus for many years. Emphasizing worker protection and well-being advances the overall goal of reducing negative health outcomes in the future. The need to address health disparities within the […]

via Beyond the costs of an injury — BWC Blog

6 Hours Sitting May Cause Pressure Sore

SITTING & PRESSURE
By Darren Salinger, M.D., OB/GYN
& Melanie Loomos, Inventor

In modern society, sitting takes up an increasing amount of time, both at home and at work. It has been concluded there is a considerable shift to sedentary work in industrialized countries (3).

1881 Analysis of Contact Stresses

The original analysis of contact stresses which lead to pressure-related problems while sitting was published in 1881 by Heinrich Hertz (5).

6 Hours Sitting May Cause Pressure Sore

A healthy individual can develop a pressure sore in six to twelve hours if left undisturbed in the same position (7). A single pressure sore costs more than $8,000 to heal. The yearly costs of treating pressure sores and related problems have been estimated to be almost $1 billion (9).

One study found that 63 percent of patients who sat for an unlimited period of time developed pressure sores whereas only 7 percent of patients developed pressure sores who sat for maximum periods of two hours (1).

Limiting sitting time is only one starting point in preventing pressure sores. Other possibilities include appropriate posture and pressure-reducing seat cushions (1).

In a test of six pressure-relieving devices, the air doughnut was found to be the least effective in reducing inter-surface pressures. None of the devices tested eliminated the inter-surface pressures generated by sitting in one position (7).

To prevent tissue damage, people must be able to shift their weight or be assisted to alternate pressure points (7).

External Pressure = 1/2 Internal Pressure

Externally measured pressure under the butt bones is only one half of the internal pressure. Given the pressures that are prevalent, Staarink (1995) found it amazing that more people do not get pressure ulcers (1).

Risk Factors for Pressure Sores

Studies have implicated factors such as posture and posture changes, impact loading of tissue, elevated temperature and humidity, age, nutritional status, general health, activity level, body stature and shear stress in the development of pressure sores (4).

Shear Force & Pressure Sores

The interest in shear stems from the observation that shear increases the possibility of causing a pressure sore (6). In 1958, it was Reichel who started to focus attention on shear force, which is defined as a force parallel to a surface (2). It is important to reduce shear force as much as possible (6). Avoidance of shear force is as important as avoidance of direct pressure (8).

Snijders (1984) showed that the inclination and the position of a backrest as well as the angle of the seat surface influence the shear force on the seat (3). The proper combination of backrest and seat inclination can reduce shear forces on the seat and on the sitter.

In tests done on healthy young subjects, it was found that when little shear is accepted, a fixed inclination between seat and backrest should be chosen between 90 degrees and 95 degrees (3). When a person is sitting down, the weight of the body is distributed over the supporting surfaces. The distributed shear and pressure result in forces that act on four major body points:
▪ The Feet
▪ The Butt Bones
▪ The Top of the Hip Bones
▪ The Chest

Shear Stresses Reduced – 90N to 5N

In a study measuring shear stresses on wheelchairs, using healthy young subjects, different seat angles were tested. Previous measurements showed that a total shear force on the seat of a foldable wheelchair could become as high as 90N when the seat is horizontal (2). When the seat slant is 8 degrees forward, the shear force becomes smaller than 5N in healthy subjects (2). The assumption is made that if the unfavorable effect of shear stress can be measured in healthy, young subjects, the effect for the hospitalized geriatric and paraplegic population will be even worse (2).

Enveloping Cushion

The enveloping property of a seat cushion is a measure of its tendency to wrap around the object it supports. When the body adopts a sitting posture, the weight of the body is distributed over the supporting surfaces (3). A good enveloping cushion provides a large contact area and a uniform stress distribution (9).

Medium density foam results in the lowest shear stresses and compressive stresses tested. Soft foam results in the next lowest shear and compressive stresses because soft foam tends to “bottom out” and cause pressure from the surface below the foam.

Caution: Temperature Sensitive Foam

Researchers caution against materials in seat surfaces that react to body temperature because there is a risk of rising temperatures and increased humidity which can lead to pressure sores (1), as well as other pressure-related problems.

Researchers conclude that the use of armrests in the case of healthy persons has a very limited pressure-reducing effect but may help stabilize posture.

  1. Applied Nursing Research, Vol. 12, No. 3, August 1999, pp. 136-142, “Sitting Posture and Prevention of Pressure Ulcers,” written by Tom Defloor, MScN, N.N.; and Maria H.F. Grypdonck, Ph.D., RN, Nursing Sciences, University of Gent, Belgium.
  2.  Scandinavian Journal of Rehabilitation Medicine, 29: 131-136, 1997, “Shear Stress Measured on Beds and Wheelchairs,” written by R.H.M. Goossens, Ph.D.; C.J. Snijders, Ph.D., T.G. Holscher, Mac; W. Chr. Heerens, Ph.D.; and A. E. Holman, MSc.
  3.  Journal of Biomechanics, Vol. 28, No. 2, pp. 225-230, 1995, “Design Criteria for the Reduction of Shear Forces in Beds and Seats,” written by R.H.M. Goossens and C.J. Snijders, Erasmus University, Rotterdam, Faculty of Medicine, Department of Biomedical Physics and Technology, The Netherlands.
  4. Journal of Rehabilitation Research and Development, Vol. 29, No. 4, 1992, pp. 21 – 31, Department of Veterans Affairs, “Comparative Effects of Posture on Pressure and Shear at the Body-Seat Interface,” written by Douglas A. Hobson, Ph.D., School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, P.A. U.S.A.
  5.  Journal of Rehabilitation Research and Development, Vol. 27, No. 2, 1990, pp. 135 – 140, Department of Veterans Affairs, “Reduction of Sitting Pressures with Custom Contoured Cushions,” written by Stephen Sprigle, Ph.D.; Kao-Chi Chung, Ph.D.; Clifford E. Brubaker, Ph.D., University of Virginia, Rehabilitation Engineering Center, U.S.A.
  6.  Journal of Rehabilitation Research and Development, Vol. 27, No. 3, 1990, pp. 239 – 246, Department of Veterans Affairs, “Sitting Forces and Wheelchair Mechanics,” written by Paul Gilsdorf, B.S.; Robert Patterson, Ph.D.; Steven Fisher, M.D.; Nancy Appel, P.T., Department of Physical Medicine and Rehabilitation, University of Minnesota, U.S.A.
  7.  American Journal of Nursing, 1987, “Sitting Easy: How Six Pressure-Relieving Devices Stack up,” written by Robin Charges, RN, M.A., M.S.N.; and Bettie S. Jackson, RN, Ed.D., F.A.A.N., Montefiore Medical Center, N.Y., U.S.A.
  8.  Arch. Phys. Med. Rehabil., Vol. 60, July, 1979, “Shear vs. Pressure as Causative Factors in Skin Blood Flow Occlusion,” written by Leon Bennett, MAE; David Kavner, DEng; Bok K. Lee, M.D.; Frieda A. Trainor, Ph.D., Veterans Administration Prosthetic Center, N.Y., U.S.A.
  9.  J. Biomechanics, Vol. 15, No. 7, 1982, “Model Experiments to Study the Stress Distributions in a Seated Buttock,” Narender P. Reddy, Himanshu Patel, George Van B. Cochran, Biomechanics Research Unit, Helen Hayes Hospital; and John B. Brunski, Center for Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, N.Y., U.S.A.

OSHA watch — Premium Reduction Center Blog

Temporary enforcement policy on monorail hoists in construction Employers whose monorail hoists fail to comply with requirements in the Crane and Derricks in Construction Standard will not be issued citations as long as they adhere to other regulations, according to a recent memorandum. The temporary enforcement policy notes stakeholders identified gaps in the standard regarding […]

via OSHA watch — Premium Reduction Center Blog

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.

# # #

OSHA Whistleblower Complaints Contact Office of Communications

Trade Release from OSHA

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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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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.
# # #

What is Ergonomics?

After the 40 year fight for ergonomics programs, the passing of OSHA’s Ergonomics Standard in October 2000 and its repeal in March 2001, most people still don’t know what ergonomics is and how it affects us all at work and at home now that we are all on the computer so much.

merriam-webster.com/dictionary/ergonomics – Medical Definition of ergonomics. 1: an applied science concerned with designing and arranging things people use so that the people and things interact most efficiently and safely—called also human engineering, human factors engineering.

.techtarget.com – Ergonomics (from the Greek word ergon meaning work, and nomoi meaning natural laws), is the science of refining the design of products to optimize them for human use. … Ergonomics is sometimes known as human factors engineering.

http://www.osha.gov – Ergonomics: The Study of Work. U.S. Department of Labor. Occupational Safety and Health Administration. OSHA 3125. 2000 (Revised) …