Interstitial pulmonary disease and aluminum trihydrate exposure: A single case report and detailed workplace analysis.

Exposure to aluminum compounds is clearly associated with pulmonary function decrements, and several animal models document possible mechanisms of aluminum- compound-induced pulmonary toxicity. Nevertheless, disagreements remain about the precise mechanism by which exposures lead to damage. We present a strong case for attributing a case of interstitial pulmonary disease to occupational exposure to aluminum trihydrate.

OSHA Workplace Violence Enforcement.

Objective: To examine violence inspections at the Occupational Safety and Health Administration (OSHA).

Methods: The authors examined all inspections that involved violence against workers begun by January 1, 2019. They conducted semi-structured interviews with compliance officers who had conducted inspections on a sample of facilities that received General Duty Clause (GDC) citations (n = 22) or Hazard Alert Letters (HALs) (n = 22).

Hospitalised heat-related acute kidney injury in indoor and outdoor workers in the USA.

Objectives: To characterise heat-related acute kidney injury (HR-AKI) among US workers in a range of industries.

Methods: Two data sources were analysed: archived case files of the Occupational Safety and Health Administration's (OSHA) Office of Occupational Medicine and Nursing from 2010 through 2020; and a Severe Injury Reports (SIR) database of work-related hospitalisations that employers reported to federal OSHA from 2015 to 2020. Confirmed, probable and possible cases of HR-AKI were ascertained by serum creatinine measurements and narrative incident descriptions.

A cluster of hypersensitivity pneumonitis associated with exposure to metalworking fluids.

Background: Workers exposed to metalworking fluids (MWF) can develop respiratory illnesses including hypersensitivity pneumonitis (HP). These respiratory manifestations are likely due to microbial contamination of aerosolized MWF. This paper reports a cluster of HP and respiratory symptoms at a manufacturing plant where MWF and workplace air were contaminated with bacterial endotoxin despite frequent negative bacterial cultures of MWF.

Actual and simulated weather data to evaluate wet bulb globe temperature and heat index as alerts for occupational heat-related illness.

Heat stress occupational exposure limits (OELs) were developed in the 1970s to prevent heat-related illnesses (HRIs). The OELs define the maximum safe wet bulb globe temperature (WBGT) for a given physical activity level. This study's objectives were to compute the sensitivity of heat stress OELs and determine if Heat Index could be a surrogate for WBGT.

Evaluation of Occupational Exposure Limits for Heat Stress in Outdoor Workers - United States, 2011-2016.

Heat stress, an environmental and occupational hazard, is associated with a spectrum of heat-related illnesses, including heat stroke, which can lead to death. CDC's National Institute for Occupational Safety and Health (NIOSH) publishes recommended occupational exposure limits for heat stress (1). These limits, which are consistent with those of the American Conference of Governmental Industrial Hygienists (ACGIH) (2), specify the maximum combination of environmental heat (measured as wet bulb globe temperature [WBGT]) and metabolic heat (i.

Risk Factors for Heat-Related Illness in U.S. Workers: An OSHA Case Series.

Objective: The aim of this study was to describe risk factors for heat-related illness (HRI) in U.S. workers.

Development and Validation of the Work-Related Well-Being Index: Analysis of the Federal Employee Viewpoint Survey.

Objective: To describe development and validation of the work-related well-being (WRWB) index.

Methods: Principal components analysis was performed using Federal Employee Viewpoint Survey (FEVS) data (N = 392,752) to extract variables representing worker well-being constructs. Confirmatory factor analysis was performed to verify factor structure.

Occupational chemical exposures: a collaboration between the Georgia Poison Center and the Occupational Safety and Health Administration.

Context: In the United States, regional poison centers frequently receive calls about toxic workplace exposures. Most poison centers do not share call details routinely with governmental regulatory agencies. Worker health and safety could be enhanced if regulators such as the Occupational Safety and Health Administration (OSHA) had the ability to investigate these events and prevent similar incidents.

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.

Does Employee Safety Matter for Patients Too? Employee Safety Climate and Patient Safety Culture in Health Care.

Objective: We examined relationships between employee safety climate and patient safety culture. Because employee safety may be a precondition for the development of patient safety, we hypothesized that employee safety culture would be strongly and positively related to patient safety culture.

Methods: An employee safety climate survey was administered in 2010 and assessed employees' views and experiences of safety for employees.

A brief summary of workers' compensation performance improvement projects 2008 to 2012 in the Veterans Health Administration.

Background: The Veterans Health Administration undertook a series of performance improvement projects (PIP) using local initiatives identified through a national committee of regional workers' compensation representatives.

Methods: A steering committee identified five types of risks and interventions that were considered worthwhile. They defined performance metrics as outcome measures and distinguished short-term from long-term disability management success.

Quality management and federal workers' compensation: the Veterans Health Administration workers' compensation program model.

Objective: The federal workers' compensation program includes under a single employer five commonly encountered roles and responsibilities-injured patient, clinical provider, third-party administrator, adjudicator, and insurer. Data within the Veterans Health Administration (VHA) provide a unique opportunity to apply a simple model of health care quality improvement, exploring interactions between structures, processes, and outcomes.

Methods: A facility survey identified reporting structures, levels of education and training, policies and processes, tool availability and use, and perceptions of role adherence.

Impact of clinical quality on employee choice of providers for workers' compensation-related medical care.

Objective: The study examined the relationship between onsite occupational health practice characteristics, provider choice, and workers' compensation outcome metrics.

Methods: Cross-sectional survey of 140 medical center occupational health clinics within the Department of Veterans Affairs. Multivariate regression models examined how specific clinical quality factors influenced provider choice and workers' compensation measures.

Federal workers' compensation programs: Department of Defense and Veterans Health Administration experiences.

Objective: The objective of this article is to introduce the reader to this special supplement to the Journal of Occupational and Environmental Medicine regarding Federal Workers' Compensation Programs.

Methods: The short history of both the VHA and DoD Federal Workers' Compensation Programs are provided and a short synopsis of each author's article is provided.

Results: The lessons learned from the articles in the supplement are summarized in this article and 6 key findings are highlighted.

Implementation of a novel occupational and environmental medicine specialty teleconsultation service: the VHA experience.

Objective: Occupational and environmental medicine (OEM) physician specialty practices continue to grow in scope and intensity across the Veterans Health Administration. This study characterizes the implementation of a novel, nationwide telemedicine program that provides OEM specialty consultation to providers across the Veterans Health Administration.

Methods: We examined provider requests and specialist responses for a 6-month pilot from May to October 2013.

Patient handling in the veterans health administration: facilitating change in the health care industry.

Objective: To describe a 15-year process creating an industry standard of practice without regulatory support through organizational leadership.

Methods: Description of the development and rollout of a safe patient-handling program, including the initial scientific development, a cultural history, and agency data.

Results: Patient-handling injuries represent more than 20% of injuries to nurses.

Comprehensive survey of hand hygiene measurement and improvement practices in the Veterans Health Administration.

Background: Veterans Health Administration (VHA) is a national health care system with variation in hand hygiene (HH) measurement and improvement practices across its facilities. The objective of this national survey was to characterize this variability and identify opportunities for standardization.

Methods: Survey covered 3 major areas of HH: (1) methods of measuring HH compliance, (2) interventions to improve HH compliance, and (3) site-specific targets for HH compliance.

Sitting on stability balls: biomechanics evaluation in a workplace setting.

Use of a stability ball alone and stability ball chair were evaluated in the Veterans Health Administration as possible alternatives to incorporate with regular office chair use. The evaluation of stability ball use was conducted under the auspices of a work site health promotion program as a cross-over trial with participants rotating through use of the stability ball, stability ball chair, and regular office chair on a monthly basis for a total duration of 3 months. Rotations on regular office chairs served as the control.