Do Clinics in Meat and Poultry Plants Endanger Workers?

Most meatpacking workers are Black, Latinx, and immigrant workers earning low wages and at high risk for occupational injury. Most meat and poultry plants have on-site workplace clinics (OWCs) where workers are required to obtain care for work-related injuries or illnesses before seeking outside clinical assessment or intervention. Although OWCs can help plant managers identify and mitigate hazards, government and other investigations reveal that OWCs in meatpacking plants not only fail to advocate for safer work conditions, but also nurture conditions that exacerbate injury and illness.

A Quality Improvement Initiative: A Nurse Practitioner-Led Interdisciplinary Approach to Reducing Readmissions in the Subacute Population.

Background: To decrease the 30-day Subacute Readmissions in an outpatient facility by using an Advanced Practice Nurse (APN) Project Leader while applying evidence based transitional care processes.

Objective: Determine the effects of APN leadership within the Interdisciplinary Team in the subacute setting.

Methods: Immersion of an APN as Project Leader over a 12-week period.

Prevention of Occupational Heat-Related Illnesses.

High ambient temperatures and strenuous physical activity put workers at risk for a variety of heat-related illnesses and injuries. Through primary prevention, secondary prevention, and treatment, OEM health providers can protect workers from the adverse effects of heat. This statement by the American College of Occupational and Environmental Medicine provides guidance for OEM providers who serve workers and employers in industries where heat exposure occurs.

Assessment of Methylene Chloride-Related Fatalities in the United States, 1980-2018.

Importance: Methylene chloride is a halogenated organic solvent widely used in paint strippers, cleaners, adhesives, and sealants. Despite label warnings and occupational standards, methylene chloride-related fatalities continue to occur in the United States.

Objective: To identify and analyze methylene chloride-related fatalities in the US.

Bisphosphonate drug holidays: One size does not fit all.

Bisphosphonates have been safely used to treat osteoporosis, effectively reducing fracture risk after 3 to 5 years of treatment. Recent concerns about long-term safety coupled with posttreatment fracture risk reduction have increased support for drug holidays. The decision to start low-risk patients on drug holidays must be based on current fracture risk assessment.

Occupational Distribution of Campylobacteriosis and Salmonellosis Cases - Maryland, Ohio, and Virginia, 2014.

Campylobacter and Salmonella are leading causes of bacterial gastroenteritis in the United States and are estimated to cause >1 million episodes of domestically acquired illness annually (1). Campylobacter and Salmonella are primarily transmitted through contaminated food, but animal-to-human and human-to-human transmission can also occur (2,3). Although occupationally acquired infections have been reported, occupational risk factors have rarely been studied.

Under-recording of work-related injuries and illnesses: An OSHA priority.

Introduction: A 2009 Government Accounting Office (GAO) report, along with numerous published studies, documented that many workplace injuries are not recorded on employers' recordkeeping logs required by the Occupational Safety and Health Administration (OSHA) and consequently are under-reported to the Bureau of Labor Statistics (BLS), resulting in a substantial undercount of occupational injuries in the United States.

Methods: OSHA conducted a Recordkeeping National Emphasis Program (NEP) from 2009 to 2012 to identify the extent and causes of unrecorded and incorrectly recorded occupational injuries and illnesses.

Results: OSHA found recordkeeping violations in close to half of all facilities inspected.

Methemoglobinemia resulting from exposure in a confined space: Exothermic self-polymerization of 4,4'-methylene diphenyl diisocyanate (MDI) material.

A worker attempting to remove solidified material inside a confined space (storage tank) suffered severe methemoglobinemia and almost died. The tank contained liquid 4,4'-methylene diphenyl diisocyanate monomer that had solidified after an equipment power failure caused excessive heating. Wearing a full-face elastomeric air-purifying respirator and Tyvek® coveralls, the worker used pneumatic air hammers to break up the solid material.

Farmworker Housing in the United States and Its Impact on Health.

Farmworkers in the United States occupy a range of housing, including both on- and off-farm family and communal dwellings. As the farmworker population is becoming more settled, housing needs are changing. Existing regulations designed originally for grower-supplied migrant housing may need to be expanded.

Case cluster of pneumoconiosis at a coal slag processing facility.

Background: During an inspection by the Occupational Safety and Health Administration (OSHA) of a small coal slag processing plant with 12 current workers, four cases of pneumoconiosis were identified among former workers.

Methods: The OSHA investigation consisted of industrial hygiene sampling, a review of medical records, and case interviews.

Results: Some personal sampling measurements exceeded the OSHA Permissible Exposure Limit (PEL) for total dust exposures of 15 mg/m(3), and the measured respirable silica exposure of 0.

Cleaning and disinfecting environmental surfaces in health care: Toward an integrated framework for infection and occupational illness prevention.

Background: The Cleaning and Disinfecting in Healthcare Working Group of the National Institute for Occupational Safety and Health, National Occupational Research Agenda, is a collaboration of infection prevention and occupational health researchers and practitioners with the objective of providing a more integrated approach to effective environmental surface cleaning and disinfection (C&D) while protecting the respiratory health of health care personnel.

Methods: The Working Group, comprised of >40 members from 4 countries, reviewed current knowledge and identified knowledge gaps and future needs for research and practice.

Results: An integrated framework was developed to guide more comprehensive efforts to minimize harmful C&D exposures without reducing the effectiveness of infection prevention.

Paranitroanaline poisoning: a failure in basic prevention?

The Occupational Medicine Forum is prepared by the ACOEM Occupational and Environmental Medical Practice Committee and does not necessarily represent an official ACOEM position. The Forum is intended for health professionals and is not intended to provide medical or legal advice, including illness prevention, diagnosis or treatment, or regulatory compliance. Such advice should be obtained directly from a physician and/or attorney.

Smoking-cessation counseling practices of college/university health-care providers--a theory-based approach.

Objective: The author's purpose in this study was to examine the relation between smoking cessation counseling self-efficacy, knowledge of smoking cessation counseling, motivation to counsel smokers, and barriers to performing smoking cessation counseling, relative to the smoking cessation counseling stage of change.

Participants And Methods: Members of The American College Health Association, who are health-care providers (N=296), completed a survey measuring the predictor variables of knowledge, motivation, self-efficacy and perceived barriers, and the members' readiness for conducting smoking-cessation counseling with students.

Results: The majority reported that they were knowledgeable about smoking-cessation counseling practices, they were motivated to conduct counseling, and they had the confidence (self-efficacy) to perform smoking-cessation counseling effectively.