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

Four Boring Foam Studies

Four Boring Foam Studies:

1)     Journal of Rehabilitation Research and Development, Vol. 27, No. 3, 1990, Pages, 229-238,“Load-bearing Characteristics of Polyethylene Foam:  An Examination of Structural and Compression Properties,” written by Eric J. Kuncir, MSBE;  Roy. W. Wirta, BSME;  Frank L. Golbranson, M.D.:   This work was supported by a grant entitled:  “Foot Interface Pressure Study,” from the Department of Veterans Affairs Rehabilitation Research and Development Service and was conducted at the DVA Medical Center, San Diego, California, U.S.A.”

“The use of cellular foams in the orthotics and prosthetics industries is widespread and ranges from applications as shoe insole material to prosthetic limb inserts.

“It is our impression that orthotic and prosthetic practitioners select interface materials, including cellular foams, in an arbitrary fashion based on availability and personal knowledge.

“Contributing to the arbitrariness of material selection is a lack of published information on detailed mechanical properties of cellular foams . . . We have studied the structural and compression properties of cellular foams.

“This discussion is relevant to orthotists and prosthetists because it addresses an overview of the properties of cellular foams, the knowledge of which may be useful in the determination of the function of a particular foam material in load-bearing applications.”

“Cellular polyethylene foams are best described as a mass of bubbles composed of a plastic and a gas phase.  The polymer is distributed in the walls of the bubbles and the lines where the buttles intersect (Blair, E.A., 1967).

“The bubbles are referred to as cells, the lines of intersection are called ribs or strands, and the walls are called windows . . . Depending on the configuration of this two phase gas/solid system and on the synthetic material used, cellular plastics exhibit a wide range of mechanical properties.”

OPEN CELL VS. CLOSED CELL FOAMS

“In general, two major descriptions are offered to characterize structural features of cellular materials.

“An open cell material is one which has open windows leaving many cells interconnected in such a manner that gas may pass from one cell to another.

“Alternatively, closed cell materials are made up of discrete cells through which gasses do not pass freely.”

“A physical test of the mechanical behavior of a material can be done by continuously measuring the force required to develop a degree of compression.  This information is useful because it aids in an evaluation of a foam’s response under load-bearing conditions.”

Compression data or polyethylene foam obtained by Skochdopole, 1965, in which compressive load versus percent compression for polyethylene foams of increasing open cell character was plotted.

The data show that compressive load of polyethylene foam increases as fraction of open cells decreases.

“When there is a small fraction of open cells, the compression force is distributed over a larger number of cell walls and ribs thereby increasing the compressive resistance.

“At larger degrees of compression, the data presented indicates that compressive load increases as the fraction of open cells decreases . . . This implies that foams of increased open cell character must provide less resistance to escape of gasses, which explains the reduction in compression resistance as open cell character increases.”

“It can be concluded that the influence of cell geometry on the mechanical properties of cellular foams is significant.  Specifically, increased compression strength is acquired as the cell diameter decreases.  In addition, decreasing the fraction of open cells increases the required force for a given degree of compression.”

“Closed cell polyethylene foam materials exhibit both time-related and non-time-related properties under load-bearing conditions.  The non-time-related properties happen under rapid cyclic loading conditions . . . The time-related properties happen when a load is sustained either a static load or an extended period of cyclic loading.”

2)     Journal of Rehabilitation Research and Development, Vol. 27, No. 2, 1990, “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.:
The authors state the following:
“Previous research indicated that matching a cushion to the shape of the buttocks results in less tissue distortion and lower interface pressures.”
“Material studies were determined by examining the load-deflection curves for flat foams of 1, 2, and 3 inch thickness.”
“It was found that sitting on contoured foam resulted in a lower pressure distribution than sitting on flat foam; and sitting on soft foam resulted in a lower pressure distribution than sitting on a stiffer foam.”
“Loaded contoured foam demonstrated increased enveloping of the buttocks, decreased foam compression, and a more uniform pressure distribution.  These attributes are typical of a safer sitting surface and may indicate less disuse distortion.”

The authors make the following statements:

TISSUE TRAUMA

“Wheelchair users often sit 12 to 16 hours a day while participating in daily activities . . . special seating support especially for spinal cord injured (SCI) persons and others with insensate skin.”
“Over the past three decades, many studies have focused on the biomechanical aspects of decubitus formation.  Tissue trauma is now recognized as a multidimensional process with externally applied pressure being identified as a primary contributing factor, (Bennett, L.; Kanner, D.; Lee, B. K.; and Trainor, F.A., 1979; Krouskop, T.A., 1983).”

TISSUE DISTORTION VS. TISSUE TRAUMA

“Recently, tissue distortion has also been identified as a potentially damaging condition, (Chung, K.C., 1987; Swart, M.E., 1985).”
“These two risk factors are related because distortion results from the external forces being exerted on soft tissue.”
“The original analysis of contact stresses was published in 1881 by Heinrich Hertz.”

 

3)     American Journal of Nursing, 1987,“Sitting Easy:  How Six Pressure-Relieving Devices Stack Up”:   written by Robin Chagares, R.N., M.A., M.S.N.; and Bettie S. Jackson, RN, Ed.D., F.A.A.N., Montefiore Medical Center, N.Y., U.S.A.:

The authors open with the following statements (1987 prices):

PREVENTING SKIN BREAKDOWN IS A PRIORITY

 “A single pressure sore costs more than $8,000 to heal.  Multiply that cost by more than a million hospital and nursing home patients who will develop pressure sores this year, and you see why preventing skin breakdown is a health care priority, (Hargast, T., 1979; Staggs, K., 1983).”

INTRINSIC FACTORS

The authors include the following findings:

“A number of intrinsic (within the body) factors such as:
·        immobility,
·        poor circulation,
·        malnutrition,
·        and elderly skin contribute to the development of pressure sores.

EXTRINSIC FACTOR(S)

“The only extrinsic (coming from outside the body) factor is pressure.”

“A healthy individual can develop pressure sores in six to twelve hours if left undisturbed in the same position, (Hargast, T., 1979; Staggs, K., 1983; Torrence, C., 1981).”

6 Pressure­-Relieving Devices Tested:

·        air doughnut pillow;
·        water donut  pillow;
·        Eggcrate cushion;
·        Spencegel pad;
·        Sheepskin;
·        Cotton-filled disposable pillow

RESULTS

“Of the six different pressure-relieving devices studied, the air donut was least effective in reducing inter surface pressures.  In addition, subjects reported it to be quite uncomfortable to sit on.

People Should Have More Than 1 Pressure-Relieving Device

All the other devices reduced inter-surface pressure about equally . . . having more than one pressure relieving device to choose from allows selection based on individual patient comfort.

“Pressure on capillaries (the smallest blood vessels) over time leads to tissue necrosis (degeneration.)  None of the devices tested minimized sitting surface pressures generated when sitting in one position.  To prevent tissue damage, people must be able to shift their weight or be assisted to alternate pressure points.”

4)     J.  Biomechanics.  Vol.  15, No. 7, 1982, “Model Experiments to Study the Stress Distributions on 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, Ny, U.S.A.:
Buttock Stress States During Sitting

    “Mechanical stress states that develop in the buttock during sitting may exceed tissue tolerance and lead to decubitus ulcer formation in susceptible patients, such as those with spinal cord injury.
“The danger of this complication can be reduced by using suitable cushions to minimize stress magnitudes and gradients within soft tissues.
“In this investigation, a two-dimensional physical model of the buttock-cushion system was developed to aid in cushion design.”

5 Materials Selected for Initial Tests

“Although many cushion materials are in current commercial use, the following five representative materials were selected for these initial tests:

1)    Gel;
2)    Medium density foam;
3)    Soft foam;
4)    Stiff foam;
5)    Viscoelastic ‘T-Foam.’”

“In order of increasing maximum compressive stress generated in the buttock model, the material samples of equal thickness can be ranked as follows:

1)    Medium density foam;
2)    Soft foam;
3)    Gel;
4)    Viscoelastic foam;
5)    Stiff foam.”

“The enveloping property of a seat cushion is a measure of its tendency to wrap around the object it supports, (i.e., in the present case, the buttock model).  A good enveloping cushion provides a large contact area and a uniform stress distribution, (Chow, 1974; Cochran and Palmieri, 1979).’

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

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

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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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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